Discrepancy between 3H-thymidine uptake and cell cycle studies in stimulated lymphocyte cultures treated with methotrexate.

The mode of action of methotrexate (MTX) in rheumatoid arthritis (RA) is unknown. The hypothesis that its cytostatic effect may be involved has been questioned based on the evidence of several negative results, the most intriguing being its lack of effect on the Lymphoblastic Transformation Test (LTT) and other lymphoproliferations in cultures from patients' samples. Our study demonstrates that LTT evaluation by 3H-thymidine uptake, a standard method, is misleading when applied to MTX-treated cells. At in-vitro concentrations similar to those present in the red blood cells of RA patients, MTX produced an early block in the cell cycle without reducing the cellular uptake of 3H-thymidine. While the explanation of this discrepancy is still open to discussion, it is clear that future studies on the immunological status of RA patients on MTX should not use thymidine uptake for the measurement of the lymphocyte response to mitogens and various stimuli, but must rely on other methods for evaluating DNA synthesis.

Anatomical basis of the role of vastus medialis muscle in femoro-patellar degenerative arthropathy.

In order to evaluate the femoro-patellar syndrome, more especially to better define the vastus medialis/vastus lateralis imbalance, we performed 44 anterior thigh region examinations in dissecting room subjects. Vastus medialis morphological aspect was always found regular without definite separation. One the other hand we found two innervation possibilities: either only one nerve pedicle from femoral nerve, associated with cartilage degeneration (arthrosis) located on the patella lateral facet, or two pedicles from femoral nerve, associated with either no arthrosis, or diffuse cartilage degeneration. The innervation mode seems to be determinant to explain the two functions of vastus medialis (knee extension and patellar alignment).

[Anatomic bases of groin strain]. / Bases anatomiques des pubalgies.

It was attempted to identify the anatomical bases of the syndrome frequently encountered in sportsmen and women and commonly known under the all-encompassing term of "groin strain". The continuity of fasciae and the intersection of the insertion tendinous fibers of the abdominal and thigh muscles in the pre-pubic region binds the muscle elements firmly together and helps to understand why the disorder occurs and how to treat it. In contrast, the articular portion made up of the symphysis pubis, which is greatly exerted both during movement and at rest, has early signs of ageing making articular strain much more difficult to treat.

[Behcet's syndrome and ankylosing spondylarthritis]. / Syndrome de Behçet et spondylarthrite ankylosante.

Signs of ankylosing spondylitis were sought in 11 patients suffering from Behcet's syndrome and followed up in different departments of the Clermont-Ferrand teaching hospital group. Three patients, described in detail, had definite ankylosing spondylitis and 2 had phenotype B27. This prevalence would be greater than that predicted on the basis of data in the literature. This combination is rare but it is felt to be legitimate to seek the other disease when one of these two conditions is diagnosed.

[Fabry's disease. Rare etiology of a long-term inflammatory syndrome. Apropos of a case]. / La maladie de Fabry. Etiologie rare de syndrome inflammatoire au long cours. A propos d'une observation.

A man aged 54 years presented multiple symptoms (acroparesthesia, familial deafness, cardiomyopathy, diarrhea, adenopathy with infiltration of frothy macrophages, pancytopenia with a dense marrow, chronic meningitis, renal failure) associated with intermittent fever, with feverish attacks and a temperature of 40 degrees C, and with a severe biologic febrile syndrome. Fabry's disease was diagnosed only after 3 years of fruitless explorations. The reasons for this delay are analysed and it is suggested than Fabry's disease be added to the list of conditions responsible for fever or for a persistent inflammatory syndrome.

[Methods of measuring the mechanical stresses on the human lumbar spine and their results]. / Les méthodes de mesure des contraintes mécaniques s'exercant sur le rachis humain lombaire et leurs résultats.

The authors in a review of the literature and their personal studies, report the various measurements methods of the stresses exerted on the lumbar spine, with their results. This study comprises three chapters: study of an isolated spinal segment, static study of the lumbar spine and dynamic study of the lumbar spine.