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Biomedical subjects

Y Pawlotsky

Publications and source records attributed to Y Pawlotsky.

At least 19 recordsLinked to original sources

DPB1 polymorphism in rheumatoid arthritis: evidence of an association with allele DPB1 0401.

HLA-DP polymorphism was examined in 71 rheumatoid arthritis patients and 148 controls, using dot-blot analysis with 14 synthetic oligonucleotide probes specific for the variable region of the DPB1 second exon. The DPB1 0401 allele was found to be significantly more frequent in RA patients than in controls (77.46% vs 55.40%, p less than 0.002, pc less than 0.03, relative risk value: 2.74). An association between DPB1 0401 and seropositivity for rhumatoid factors was also observed: 44 of the 55 seropositive RA patients were DPB1 0401 (p less than 0.001). Analyzing the HLA DPB1 alleles frequencies in 57 HLA-DR-typed RA patients did not show any linkage between the DPB1 0401 and the DR4 specificities. Furthermore, the DPB1 0401 homozygous frequency was increased in DR4-negative RA patients. Our findings suggest an independent role of the DPB1 0401 allele in the genetic susceptibility to RA.

Adult

[Real effects of sport on the bone mass in women].

What is the role of physical training in the prevention of osteoporosis? The authors tried to answer the question, comparing the positive and negative effects of exercise on women bone mass before and after the menopause and proposed a way of management of bone loss in amenorrheic women athletes.

Amenorrhea

Recurrent postoperative sciatica: evaluation with MR imaging and enhanced CT.

Magnetic resonance (MR) imaging and computed tomography enhanced with intravenous iodine injection (ECT) were prospectively compared in 80 patients in the diagnosis of recurrent postoperative sciatica. Diagnostic accuracy was determined with surgical verification. Isolated fibrosis was considered a contraindication to surgery. A decision to operate was made in 56 of the 80 patients on the basis of MR imaging findings; in 21 of the 56, the decision was also made on the basis of ECT findings. Of the 80 patients, 45 underwent surgery, In all but one of these patients, the diagnosis made on the basis of MR imaging findings was confirmed with surgical analysis. The only surgical finding that did not agree with MR imaging findings was a calcification of the common posterior ligament. The 21 diagnoses of disk herniation based on ECT findings were confirmed surgically, but among the 24 diagnoses of fibrosis made with the help of ECT, there were actually 19 recurrent herniations, four herniations with fibrosis, and one herniation at the level above the previously resected disk. MR imaging seems to be the investigation of choice in diagnosing the cause of recurrent postoperative sciatica.

Adult

[Value of scintigraphy using labelled polynuclears in the diagnosis of infection of a joint prosthesis].

Fifty-three patients with suspected infection of prosthetic joints had Indium-111 granulocyte scintigraphy. Twenty-nine of them had associated technetium-99m phosphate scans. Labelled granulocyte sensitivity was 82% and specificity 100% for the group of 47 patients with suspected late infection. Technetium phosphate sensitivity was 92% and specificity 25%. The main quality of labelled granulocyte scintigraphy is its high specificity: there were no false positives in our series. Its main limitation seems to be that sensitivity is sometimes only moderate: we had 4 false negatives. The probable explanation is the histological characteristics of bone infection: vascular thromboses occur frequently and at an early stage, the inflammatory infiltrate is not very abundant and often has a low granulocyte content. The method is therefore reliable and can be used in situations where diagnosis of periprosthetic infection is difficult with conventional techniques.

Evaluation Studies as Topic

[Comparison of MRI and scanning coupled with myelography in the diagnosis of cervicobrachial neuralgia].

A prospective study was undertaken to compare the accuracy of surface coil magnetic resonance imaging (MRI) and computed tomography with myelography (CTM) in the determination of cervical radiculopathy with or without myelopathy. Twenty five patients underwent both imaging studies. The separately imaging diagnosis and the surgical findings were the basis of this study. The based-MRI and based-CTM predictions were not significant. MRI predicted two disc herniations that CTM did not predict. CTM predicted a combination of disk herniation and stenosis and one more lateral stenosis that MRI did not predict. Among the fourteen patients who underwent surgery, one underwent surgery only on based-MRI prediction, it was a disc herniation; one patient was operated on only on based-CTM prediction, it was a stenosis. In these operated patients, the predictive value of the both imaging modalities was not significant. In this report the diagnostic assessment of MRI and CTM was overall the same. The major advantages of MRI were its ability to display all the cervical spine, to study the disk pathology and to delineate a signal alteration within cord substance but the disadvantage was the difficulty to characterize the osteophytes made of cortical bone which did not give signal.

Adult

[Value of magnetic resonance imaging in the diagnosis of recurrent postoperative lumbosciatica].

Twelve patients who had a subsequent lumbar sciatica after surgery were evaluated with computerized tomography (C.T.) and magnetic resonance imaging (M.R.I.). The M.R.I. was performed with a 0.35 T whole body superconducting unit using spin echo technique. Two pulse sequences were realized varying the repetition time (TR) from 500 to 2,000 ms and the echo time (TE) from 28 to 60 ms. For the longer pulse, the twice echo were interpreted. The slide obtained with a surface-coil were performed in sagittal plane for the twice pulse sequences and in transaxial plane for the shorter pulse sequence. In seven cases, the results obtained with C.T. and M.R.I. were correlated. In two cases, the C.T. showed a scar formation, the M.R.I. showed a recurrent disk herniation. In three times, C.T. was unable to differentiate clearly between recurrent disk herniation and scar formation, the M.R.I. showed unequivocally on one case a scar formation and on two cases a recurrent disk herniation.

Adult

[B27-negative spondylarthritis. Results of 3 familial surveys, with monozygotic twins in one].

With the typing of the major histocompatibility complex (HLA, A, C, B, Bf, C4, DR, GLO), the authors study three (3) family investigations of patients suffering from primary ankylosing spondylarthritis, B27 negative, including one concerning a discordant pair of monozygotic female twins. The possible links between the patient's haplotypes and the phenotypic expression of their ankylosing spondylarthritis, B27 negative, is discussed: a complotype (C4 A4 B2) and 2 antigens (B18 and Bw62) from the group B35 CREG over-represented in ankylosing spondylarthritis (Family n degree 1): presence of antigen B40 of B7 CREG in the patient of Family n degree 2, contrasting with the presence of antigen B27 in 2 first-degree parents, apparently healthy; presence of antigen B7 from the B7 CREG and the possible role of an environmental factor in the discordant monozygotic female twins (Family n degree 3). The results are compared to the studies of families with ankylosing spondylarthritis, B27 negative, of monozygotic twins and discordant ankylosing spondylarthritis-antigen B27 reported in the literature. Pathogenetic implications are discussed (linked gene hypothesis, direct role and/or heterogeneity of B27).

Adult

[Ankylosing panarthritis].

The authors report 4 cases of "Sheathing Panarthritis" (S.P.): two female patients with a positive rheumatoid serology, presented a complete ankylosis of the articular system, including the temporo-mandibular joint and the spine; two male patients presented a complete articular ankylosis of the lower extremities and a more or less total spine ankylosis, by only a slight involvement of the upper extremities. The study of the HLA system, carried out in ten cases--3 in this series--showed the presence of B27 in six cases, and the presence of A2 in five cases out of eight. A single study of locus DR revealed the presence of DR 1. On the nosological point of view, this radio-clinical picture, individualized by Forestier, was successively considered as an autonomous affection, a rheumatoid polyarthritis (P.R.), an ankylosing spondylarthritis (AS). The author's opinion is dual since, from the analysis of the cases, they do not feel that it is possible to classify all cases either with P.R. or with A.S. After studying the various radio-clinical aspects of P.R., they believe that, in patients with S.P., it exists an ankylosing "factor X" which exacerbates the ability of P.R. and A.S. to manufacture sclerosis, transforming these diseases into S.P.

Adult

[A new diagnostic method of spondylodiscitis. Magnetic resonance imaging].

Twenty four patients who were hospitalized for a suspicion of spondylodiscitis were prospectively evaluated with magnetic resonance imaging (MRI), radiology and radionuclide studies. Fifteen patients had an infectious spondylodiscitis, four had a vertebral degenerative disease, four had a rheumaticus spondylodiscitis, one had a chemical spondylodiscitis. The microbiological examinations and the clinical development bore the diagnosis out. Seven patients underwent Indium 111 scanning. The results of this scanning were correlated with MRI results. The MRI was performed with a 0.35 T whole body superconducting unit using spin echo technique. All patients were studied in the sagittal plane with two pulse sequences and more often with a surface-coil: TR 500 msec./TE 28 msec. and TR 2,000 msec./TE 60 msec. In all cases of true infectious spondylodiscitis the MRI results finding were characteristics. On the image obtained with the TR 500 msec./TE 28 msec., there was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space. On the image obtained with TR 2,000 msec./TE 60 msec. there was an increased signal intensity from the vertebral bodies and the intervertebral disk space. The other spondylodiscitis have given a different MRI imaging, it was a confluent decreased signal intensity from the vertebral bodies and the intervertebral disk space on the twice pulse sequences. different images were obtained during the evolution of the infectious: first we observed a modification of the vertebral signal then the typical image that we described then a normal signal of the vertebral bodies with a pathological signal from the intervertebral disk space at last a degenerative intervertebral disk.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

[Morning changes in the sigma ESR, erythrocyte sedimentation rate (Westergren) and C-reactive protein].

A comparative study of the morning variation of the Sigma and Westergren sedimentation rates, and C-reactive protein was undertaken in 90 patients with osteoarticular disease (measurements at 07:00, 09:00, 10:00, and 12:00). The mean values of all three tests were elevated at 07:00 in patients with inflammatory disease, and no significant variation was observed in the Westergren sedimentation rate or C-reactive protein throughout the morning, irregardless of whether an anti-inflammatory agent was used. On the other hand, there was a very significant increase in the Sigma sedimentation rate at 09:00 in untreated patients (p less than 0.0001, n = 24). This morning increase of the Sigma sedimentation rate was not related to food intake, identical value being obtained in fasting or postprandial samples from the same patients. The Sigma sedimentation rate at 09:00 was significantly reduced however, in patients treated with an effective level of an anti-inflammatory agent (p less than 0.001, n = 32). This decrease varied in size and duration depending on the anti-inflammatory agent used. The existence of a circadian rhythm of the Sigma sedimentation rate which can be reversed with anti-inflammatory drug usage is helpful in understanding the chronobiologic aspects of the inflammatory process. Numerous therapeutic applications can be foreseen.

Adult