Biomedical subjects
Publications and source records attributed to R Juvin.
In a 39-year-old patient with tibial productive osteitis, Propionibacterium acnes was identified in a surgical specimen of the bone lesion. Similar cases have been reported by others. The possibility that P. acnes may play in a pathogenic role in the SAPHO syndrome by causing inflammatory or infectious changes is discussed.
Initial signs of malignant lymphoma are rarely due to bone lesions. We reviewed 6 cases with early skeletal involvement, recently observed in the rheumatology and hematology departments. In 3 patients, magnetic resonance imaging (MRI) was added to traditional investigations, including radiography, radionuclide bone scan and computerized tomography. We stress the possibility of bone involvement in the clinical onset of malignant lymphoma and the usefulness of early bone assessment using MRI.
Arthropathy affecting the small joints of the hand are one of the osteo-articular complications of chronic renal failure treated by hemodialysis. Amongst the 44 patients studied, there were 9 cases of arthropathy of the fingers. The clinical characteristics (age, duration of hemodialysis) and paraclinical characteristics (oxygenated free radical activity indicators, serum levels of aluminium and beta-2-microglobulins) appear to be specific to this population and may help us to understand the pathogenesis of the joint lesions.
To perform a fast and reproducible analysis in bone histomorphometry, we developed an automatic method for calculating static and dynamic parameters. A color automatic image analyzer (SAMBA 200) was used to obtain the usual parameters of bone histomorphometry: bone volume (Cn-BV%TV), osteoid volume (Cn-OV%BV), and osteoid surface (Cn-OS%BS). A specialized algorithm was designed for calculation of the mineral apposition rate (MAR). Eroded surface (Cn-ES%BS) was read in a semiautomatic mode using a cursor. To validate this program, we input 30 samples from patients with bone disease (20 osteoporosis, 6 renal osteodystrophy, 2 osteomalacia, and 2 hyperparathyroidism) using manual and automatic modes. The results obtained showed a highly significant correlation with the usual manual method for all parameters: OS/BS, r = 0.93; OV/BV, r = 0.98; MAR, r = 0.90. With the automatic method, larger values were found for osteoid parameters and MAR and lower values for BV/TV. There were no statistical differences for OV/BV and MAR when compared to the reference manual method. This study establishes that automatic measurements of osteoid parameters and MAR can be performed by a fast analyzer with as good reproducibility and accuracy as the manual method.
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Two further cases of aseptic osteonecrosis of femoral head during pregnancy are reported, and the literature reviewed of this rare etiology of debatable etiopathogenicity. The value of MR imaging is demonstrated both for early positive diagnosis and for the differential diagnosis from decalcifying algodystrophy.
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This study involved the screening for dermal microcirculatory abnormalities using periungueal capillaroscopy in a group of 80 cases of rheumatoid arthritis, so-defined in terms of ARA criteria. Excessive erythrocyte aggregation and/or pericapillary edema were detected in 74% of cases and were statistically correlated with ESR, reflecting an inflammatory syndrome. Capillary neogenesis, probably in reaction to subclinical cutaneous vascularity, was detected in 59% of cases (86% of subjects presenting extra-articular rheumatism). In 28% of cases this was accompanied by spontaneous hemorrhage, suggesting a progressive condition. Stigmata of cutaneous atrophy were present in 54% of subjects. These findings demonstrate the frequency of subclinical cutaneous damage in rheumatoid disease and suggest the possibility of the clinical usefulness of capillaroscopy, a non-invasive technic, in the follow-up of this disease.
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