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Biomedical subjects

J L Kuntz

Publications and source records attributed to J L Kuntz.

At least 19 recordsLinked to original sources
PubMed1996

Detection of Borrelia burgdorferi by DNA amplification in synovial tissue samples from patients with Lyme arthritis.

OBJECTIVE: To compare the detection rates of chromosomal flagellin gene from Borrelia burgdorferi in synovial tissue (ST) and synovial fluid (SF) using polymerase chain reaction (PCR) techniques. METHODS: B burgdorferi DNA was sought in SF and ST from 12 consecutive patients with Lyme arthritis and from 29 patients with noninfectious diseases (controls). RESULTS: No DNA amplification was observed in samples obtained from the 29 control patients, whereas B burgdorferi DNA was detected in all ST and/or SF samples from the 12 patients with Lyme arthritis. Results from 1 ST sample were not interpretable because of PCR inhibitors. Among the 11 remaining patients, 10 had positive ST samples, whereas only 4 had positive SF samples (P < 0.05). CONCLUSION: These data suggest that detection of chromosomal B burgdorferi DNA may be more efficient in ST than SF.

Adolescent↗
PubMed1996

Sulphasalazine in psoriatic arthritis: a randomized, multicentre, placebo-controlled study.

A prospective double-blind, placebo-controlled, randomized study of 24 weeks duration was carried out comparing the efficacy and tolerability of sulphasalazine (SSZ) versus placebo in patients with psoriatic arthritis. A total of 120 patients were included in nine centres. All patients had active disease and fulfilled the criteria of definite psoriatic arthritis of at least 3 months duration. They received either SSZ (2.0 g/day) or placebo. Efficacy variables included pain, patient's overall assessment of joint and skin improvement, morning stiffness, Ritchie articular index, ESR and CRP. An intention-to-treat (ITT) analysis was performed for the 117 patients who qualified (three patients did not qualify due to missing data after baseline). A per-protocol analysis was performed for the 81 patients who completed the 6 months study period (SSZ = 38, placebo = 43). Major reasons for withdrawal were inadequate response (SSZ = 4, placebo = 7) and adverse events (SSZ = 8, placebo = 12). Pain was the only statistically significantly different primary outcome variable at end point in favour of SSZ in the ITT analysis. No significant differences were present in other clinical or biological variables, although there was a trend in favour of SSZ for some variables. SSZ, at a dose of 2.0 g/day, appeared to be a safe treatment in patients with psoriatic arthritis. At this dosage, its efficacy was only demonstrated for the pain variable.

Adult↗
PubMed1995

Recurrent psoriatic onychoperiostitis induced by hydroxychloroquine.

Synthetic antimalarial agents can cause exacerbation of latent or patent psoriatic skin lesions. A case of psoriatic onychoperiostitis precipitated by hydroxychloroquine therapy is reported. The patient had primary Sjögren's syndrome, raising questions about the incidence and causation of the ungual abnormalities associated with this condition.

Female↗
PubMed1994

[Scaphoid fissure in algodystrophy: diagnostic value of MRI].

Stress fractures are exceptional in patients with reflex sympathetic dystrophy syndrome, even when bone loss is severe. We report a case of stress fracture of the navicular bone documented by magnetic resonance imaging. Recurrence of localized pain in patients with reflex sympathetic dystrophy syndrome suggests either a relapse of the syndrome or a bony fissure. Magnetic resonance imaging can provide early differentiation of these two conditions.

Fractures, Stress↗
PubMed1993

[Macrophage activation syndrome in lupus].

A patient with systemic lupus erythematosus developed unexplained fever, nonregenerative anemia, leukopenia, and elevations in serum triglyceride and ferritin levels. Bone marrow studies established the diagnosis of macrophage activation syndrome with active hemophagocytosis. No infectious cause was found but pulmonary nocardiosis developed during the course of the disease. Intravenous gammaglobulin therapy was followed by a transient remission. Cyclophosphamide was given subsequently. In lupus patients, macrophage activation syndrome is exceedingly rare and has the same clinical, laboratory, and histologic features as those seen in patients with hemopathies, infections, or immune deficiencies. Investigations for an underlying infection are often negative, suggesting that the macrophage activation syndrome is due to lupus-related immune changes. Treatment is not standardized and relapses are common. This diagnosis should be considered in lupus patients with febrile pancytopenia.

Adult↗
PubMed1993

[Infectious osteoarthritis of the pubis in sportmen. Apropos of 2 cases].

In athletes, osteoarthritis of the symphysis pubis is an uncommon condition that should be promptly differentiated from pubic pain due to microtrauma. The symphysis pubis is infected via the bloodstream, usually by a staphylococcus. Pubic pain with fever and severe disability suggests the diagnosis. Increased uptake of bone-seeking radionuclides is an early finding. Microbiological and histological studies of specimens obtained under radiological guidance confirm the diagnosis. Two new cases of pubic osteoarthritis in young athletes are reported. In one case the causative organism was a Peptostreptococcus, a gram-positive commensal organism normally found on the skin and mucous membranes.

Adolescent↗
PubMed1992

[Sciatic radiculalgia with muscular hypertrophy].

A 52-year-old male developed hypertrophy of the right calf after several bouts of right lumbar pain with sciatica. Electromyography disclosed evidence of demyelination in the territories of the right S1 and S2 roots. Microscopic studies showed both atrophic muscle fibers scattered among fibers of normal caliber and a large number of hypertrophic fibers. Post-sciatica hypertrophy of the calf is a true muscle hypertrophy with muscle weakness. Electromyography may show unusual tracings with repeated complex bursts or continuous activity of motor units. Muscle enzyme levels may be elevated. The size of hypertrophied fibers varies across cases. The cause of the muscle fiber hypertrophy may be either stretching due to the action of antagonists or unusual electrical activity.

Electromyography↗
PubMed1991

The majority of peripheral blood monoclonal IgM secreting cells are CD5 negative in three patients with mixed cryoglobulinemia.

The mixed cryoglobulinemia is considered to be a nonmalignant human B-cell proliferation that frequently produces a monoclonal IgM with anti-IgG activity (rheumatoid factor). Using murine monoclonal anti-idiotypic antibodies specific for private or minor idiotopes on monoclonal IgM from three patients suffering from nonmalignant mixed cryoglobulinemia, we investigated the presence of the CD5 antigen on the monoclonal IgM producing cells in these patients. It is shown by two-color cytofluorometric analysis that the majority of the peripheral blood monoclonal IgM rheumatoid factor secreting cells is CD5 negative in these three patients. One of the monoclonal rheumatoid factor K variable regions was sequenced at the protein level and belongs to the human VK III group, as a high proportion of monoclonal rheumatoid factors and some B-cell chronic lymphocytic leukemia (CLL) membrane bound Igs. Thus, despite the preferential use of similar VK genes and the absence of somatic mutation affecting these variable regions in both malignant B-cell CLL and nonmalignant mixed cryoglobulinemia, these proliferating B cells differ in the CD5 membrane expression.

Amino Acid Sequence↗
PubMed1991

Molecular analysis of V kappa III variable regions of polyclonal rheumatoid factors during rheumatoid arthritis.

We report the first molecular characterization of V kappa regions of the main human autoantibodies occurring during rheumatoid arthritis, the polyclonal rheumatoid factors. Using two sets of polymerase chain reactions in order to amplify the cDNA derived from both peripheral blood and synovial fluid rheumatoid factor-secreting cells, nucleotide analysis of the V kappa III family usage shows the following: (a) at least three different V kappa III genes are used to encode polyclonal rheumatoid factors in a single patient, (b) each one of these genes seems more or less somatically mutated (from 1 to 14 mutations), (c) the mutation process preferentially affects the complementarity determining regions suggesting a selective pressure of antigen and (d) there is no clear difference between the mutation rates affecting the synovial fluid and peripheral blood rheumatoid factor-secreting cells. These results are able to explain some of the known idiotypic differences between monoclonal and polyclonal rheumatoid factors in humans. They also provide evidence that polyclonal autoantibodies arising during an autoimmune disease can be the products of multiple somatically mutated genes and suggest that this process is antigen driven, whether this antigen is the Fc piece of IgG or another unknown antigen.

Amino Acid Sequence↗