[Determination of synovial fibronectin by laser nephelometry. Its diagnostic value in rheumatology]. / Dosage de la fibronectine synoviale par néphélométrie laser. Son intérêt diagnostique en rhumatologie.

The object of the present study was to define the optimal conditions for the quantitative determination of fibronectin in synovial fluid by laser nephelometry and to determine the diagnostic importance of this analysis in rheumatology. The results show that this technique is sensitive (threshold sensitivity is 70 mg/l if the sample is diluted 1/30 and 5 mg/l for a sample diluted to 1/2), accurate, reproducible (coefficient of variation less than 10%), specific, simple and rapid. The response is linear for dilutions from 1/30 to 1/240. Fibronectin P and fibronectin S were determined in 104 subjects who had contracted an arthropathy; 26 cases of rheumatoid polyarthritis, 43 mechanical arthropathies and 35 cases of non-rheumatoid arthritis. the plasma fibronectin does not vary significantly from one group of arthropathies to another but the mean value for the total population of arthropathies is significantly lower than that for a control group. In the synovial fluid the mean value for fibronectin in the patients with rheumatoid arthritis (583 + 76 mg/l) is very considerably higher than that in non-rheumatoid (379 + 58 mg/l) or mechanical (367 + 32 mg/l) arthritis patients. Thus, the determination of synovial fibronectin may provide useful information for the etiological diagnosis of inflammatory arthropathies.

[Lesions of the rotator cuff and acromioclavicular joint. Data of arthrography. Apropos of 2 cases]. / Lésions de la coiffe des rotateurs et articulation acromio-claviculaire. Données de l'arthrographie. A propos de 2 cas.

Arthrography using an opaque medium to explore the shoulder in two cases demonstrated rupture of the rotator muscles sheath associated with a communication into the acromioclavicular joint. Rupture of the sheath allows direct contact between the humeral head and the capsule of the acromioclavicular joint which becomes eroded progressively. Recent studies have produced data indicating participation of the acromioclavicular joint in the natural history of deteriation of the sheath of the rotator muscles.

[[Calciuria and phosphaturia during fasting. Effect of calcitonin alone or with a thyroid hormonotherapy combination]. / Calciurie et phosphaturie au cours du jeûne. Action de la calcitonine seule ou associée à une hormonothérapie thyroïdienne.

The author compares 4 groups of obese individuals subjected to fasting for 7 days: Some took no medication, the others received either triiodothyronine (100 to 150 microgram per day), or calcitonin (1 unit MRC per day) or both triiodothyronine and calcitonin. An increase in calciuria and phosphaturia was observed with either triiodothyronine or calcitonin. Triiodothyronine in association with calcitonin did not increase further the calciuria caused by calcitonin but increased phosphaturia. The author offers an explanation for these various observations.

[The action of somatotropic hormone on bone and on phospho-calcic metabolism]. / Action de l'hormone somatotrope sur l'os et le métabolisme phospho-calcique

The author reviews present knowledge concerning the action of somatotropic hormone on the kidney, the intestine, and on developmental changes in bone. He reviews, in particular, the controversial question of acromegalic osteoporosis and in this connexion considers the possibility of associated hyperparathyroidism.

[Mechanism of fasting hyperuricemia]. / Recherche sur le mécanisme de l'hyperuricémie du jeûne.

The authors followed up 73 obese patients submitted to fasting for 7 days; 46 of them took nos drugs (control subjects); the others took daily 100 to 200 mg of benzbromarone. The average serum uric acid of the controls rose from 49.37 mg to 90.52 mg per litre. Their uric acid clearance during the week of fasting fell to 4.67 ml per minute. The uric acid turnover was multiplied by two and the mixable pool by 3.5. These results that the hyperuricemia of fasting is due both to a fall in uric acid clearance and increased catabolism of cellular nucleic acid.

[Urinary calcium and phosphate during fasting. Effect of various hormonal factors (author's transl)]. / Calciurie et phosphaturie au cours du jeûne. Action des divers facteurs hormonaux.

Obese patients who fasted during seven days were divided into four groups according to whether they received triiodothyronine (100 to 150 microgram per day), calcitonin (1 MRC unit per day), both T3 and calcitonin, or neither of these two hormones. Urinary calcium and phosphate were increased in patients receiving T3 or calcitonin. T3 given with calcitonin did not increase the calcitonin-induced calciuria but did increase the phosphaturia. The authors suggest a possible explanation for these findings. No changes in serum parathormone were recorded during fasting acidosis.

[Ossification after transplantation of model cartilage in the rat patella]. / Recherches sur l'ossification après transplantation d'ébauches cartilagineuses de rotule chez le rat.

The cartilage model of the rat's patella constitutes a formation susceptible of inducing ossification, following its transplantation in a variety of sites (muscle, thyroïd, testis, ovary, anterior chamber of the eye, etc.), including those considered inappropriate in other experiments of induced ossification (liver, kidney). So we have an experimental model allowing the influence on the osteogenesis of various factors, local or general, natural or experimental, to be studied. Ossification occurs in this model only in cases of histocompatibility between donor and recipient. It is constant after autotransplantation or isotransplantation. It is never seen after heterotransplantation. In cases of homotransplantation its frequency varies: this is not influenced by the technical conditions of implantation but by tissue compatibility and the age of the animals giving and receiving. A private perichondrium cartilage retains its osteogenic potency. A cartilage killed by alcohol or cold no longer demonstrates its osteoformative capacities, even when put into contact with a living cartilage. Our findings are difficult to reconcile with the hypotheses invoking the osteogenic potency of the periosteum, or the intervention of substances either inducing osteoformation or inhibiting vascular invasion, for the explanation of endochondral ossification. However, they lead one to the opinion that chondrocytes play an active role in its release.

[Experimental studies on the factors of osteogenesis by transplantation of patellar cartilage framework in rats]. / Recherches expérimentales sur les facteurs de l'ostéogenèse par transplantation d'ébauches cartilagineuses de rotule chez le rat.

The cartilage framework of the patella in rats is capable of inducing ossification after homotransplantation in many various sites: muscle, thyroid, testicle, ovary, kidney, anterior chamber of the eye, etc. The frequency of ossification does not depend on the technical conditions of the transplant, but on the age of the donors and receivers; it approximates 84 p. cent when the two rats are three weeks old. It is close to 100 p. cent in case of autotransplant. It is non-existent in case of heterotransplantation. A cartilage that is killed by alcohol or cold, has no longer osteogenetic abilities, even if it is placed in contact with live cartilage. The transplant of patellar cartilaginous framework represents a model which may be used to study the factors responsible for physiological ossification as well as the effect of various experimental conditions on osteogenesis.

[Erythrocyte uric acid in the non-gouty subject]. / L'acide urique érythrocytaire chez le sujet non-goutteux.

The red cell uric acid concentration (E) is lower than its plasma concentration (P). In normal subjects the ration E/P is close to 0.7. Under experimental or pathological conditions (uricosuric treatment, fluid'diet, hemodialysis) causing changes in serum uric acid, the latter rises or falls proportionately less in red cells than in the plasma. There results a significant variation in the distribution of blood uric acid between the plasma and red cell compartments.

[Clinical study of benorilate. Co-ordinated multi-centre test (author's transl)]. / Etude clinique du bénorilate. Essai multi-centre coordonné.

During a co-ordinated test realized by four centres of rheumatology, 91 patients had been treated by benorilate,giving so the possibility to appreciate its efficiency and its tolerance as well in the articulary fits of degeneration as in the inflammatory rheumatisms. The observations had been collected during ambulatory treatments and consequently in the conditions of daily practice. The efficiency of benorilate has been estimated by the two big disadvantages of the rheumatic person: importance of pains and capacity to do principal movements of daily life. The almost totality of patients having been preliminarily treated by another anti-inflammatory and/or antalgesic, the judgement aimed at the amelioration given by the benorilate : 41% of patients affected by arthropathy of degeneration feeled better or much better after taking benorilate. The amelioration reaches 61% for cases of rheumatoid polyarthritis. About the four criterions which could have been numerically quoted, the amelioration that had been observed is statistically significant. No anomaly had been pointed out as for the biological tolerance. The suspension form is well accepted by the rheumatic persons.

[Polyarthritis in leprosy (author's transl)]. / Polyarthrites au cours de la lèpre.

Inflammatory rhumatisms simulating rheumatoid arthritis belong to the manifestations of the reactions of leprosy. Pathology of these arthritis variate with the type of reaction. In the present observations, it must probably be the transition from a tuberculoid leprosy to a lepromatosis form in which the immunological state looks like the lupus one.

[Circulating immune complexes in rheumatoid arthritis. Results of a personal research (author's transl)]. / Les immuns-complexes circulants au cours de la polyarthrite rhumatoïde. Résultats d'une recherche personnelle.

Using the technic of Pillot and Grangeot (précipitation by PEG 6,000 at 2.5%, followed radial immuno-diffusion), the authors have detected circulating immune complexes (CIC) 38 times in a group of 55 RA. The presence of CIC is significantly more frequent in sero-positive RA, but without correlation between the concentration of CIC and the positivity rate of Waaler-Rose reaction. There is no correlation between the evolutive state of RA and the presence or the concentration of CIC. The sedimentation rate is, in mean, significantly higher in RA with CIC; but, among these, there is no correlation between sedimentation rate and the concentration of CIC. In the group studied, the CIC are present in all cases of RA with vasculitis or visceral symptoms.

[Plasma and synovial beta-2-microglobulin. Results of a personal study]. / La bêta-2-microglobuline plasmatique et synoviale. Résultats d'une recherche personnelle.

Beta-2-microglobulin was assayed in the plasma and the synovial fluid in 41 subjects with mechanical joint disorders, 27 patients with rheumatoid arthritis and 32 patients with non-rheumatoid arthritis. The plasma beta-2-microglobulin may be raised in all forms of joint disease, especially in the course of rheumatoid arthritis, but its ability to discriminate between rheumatoid arthritis and other forms of inflammatory joint disease is poor. In contrast, for the beta-2-microglobulin level in the synovial fluid, the differences in the means are highly significant between rheumatoid arthritis and non-rheumatoid arthritis. Concentrations of beta-2-microglobulin in the synovial fluid greater than 5.2 micrograms/ml, in this study which excluded patients with renal failure, were 100 per cent specific for rheumatoid arthritis and were found in 52 per cent of cases. However, this result has to be interpreted in the light of the fact that any extra-articular cause for an increased plasma beta-2-microglobulin, particularly renal failure, also causes a rise in the synovial concentration, invalidating the test. For this reason, the authors propose using the value of the beta-2-microglobulin in the synovial fluid minus the plasma beta-2-microglobulin, as a more specific index.

[Open clinical trial of a new oral galenic form of ketoprofen]. / Expérimentation clinique en essai ouvert d'une nouvelle forme galénique orale du kétoprofène.

Thirty-two patients with rheumatoid arthritis and several other rheumatic diseases were entered into a randomized study to investigate the correlation between the pharmacokinetics and clinical effectiveness of Bi-Profenid 150 mg. Each patient was given, in a variable order, one 150 mg Bi-Profenid tablet twice daily for 2 days, and two 50 mg Profenid capsules each morning and noon with one 100 mg suppository each evening for 2 days. Dosage convenience, effectiveness on pain during the second part of the night and resolution of morning stiffness were considered better with Bi-Profenid by 23 patients and with conventional forms by four, while five reported no preference. In 15 patients treated for one month, only 5 reported mild side-effects which did not require withdrawal from the study. The patients' preference appears to be a result of the bioavailability of Bi-Profenid.