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3. Lung infiltrate in a male with a bronchopleural fistula

Author

Michel Aubier, M.C. Dombret, Grossin M, Bruno Crestani, M Piperaud, and Raynaud C

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Fistula, Bronchopleural fistula, Pleural disease, medicine, Humans, Mineral Oil, Emollients, medicine.diagnostic_test, business.industry, Pleural empyema, Pneumonia, Middle Aged, Pleural Diseases, Pleural cavity, medicine.disease, Thoracostomy, Surgery, medicine.anatomical_structure, Bronchial Fistula, Tomography, X-Ray Computed, Chest radiograph, business, Aspergilloma
Abstract

A 49-yr-old male was admitted to the Pulmonology Unit of Bichat Hospital (Paris, France) in February 2001 due to minor haemoptysis. He had a history of right upper lobe tuberculosis in 1970, complicated with secondary aspergilloma in 1999 and treated with itraconazole between April and October 1999. In November 1999, he presented with right pleural empyema (local samples yielded Pseudomonas aeruginosa and Streptococcus sanguis ) due to a bronchopleural fistula (fig. 1a⇓). Right open thoracostomy was performed in December 1999 and daily local care provided for 14 months until admission. On questioning, he denied experiencing fever, weight loss and shortness of breath. Fig. 1.— Chest radiographs on a) diagnosis of empyema and before thoracostomy (November 1999) and b) admission (January 2001). Physical examination results were normal. The pleural cavity was clean and sterile and the bronchopleural fistula still open. Laboratory results, including white blood cell count and erythrocyte sedimentation rate, were normal. The chest radiograph is shown in figure 1b⇑. Computed tomography was also performed (fig. 2⇓). Fig. 2.— Computed …

Published
2003
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4. Assessment of the European classification criteria for Sjögren's syndrome in a series of clinically defined cases: results of a prospective multicentre study. The European Study Group on Diagnostic Criteria for Sjögren's Syndrome

Author

Vitali, C., Bombardieri, S., Moutsopoulos H, M., Coll, J., Gerli, R., Hatron P, Y., Kater, L., Konttinen Y, T., Manthorpe, R., Meyer, O., Mosca, M., Ostuni, Pierantonio, Pellerito R, A., Pennec, Y., Porter S, R., Richards, A., Sauvezie, B., Schiødt, M., Sciuto, M., Shoenfeld, Y., Skopouli F, N., Smolen J, S., Soromenho, F., Tishler, M., Tomsic, M., Vandemerwe, Jpv, Yeoman, Cm, Wattiaux, Mj, Hitzelhammer, J., Petera, P., Hietanen, J., Malmstrom, M., Youniou, P., Grossin, M., Kahn, Mf, Ehrenfeld, M., Ianniello, A., PAOLO SFRISO, Ercolani, R., Muscat, C., Degiovanni, R., Rizzi, L., Vandenhoogen, Fhj, Hoodkaas, H., Kruize, Aa, Alves, J., Presetnik, M., Rozman, B., Axell, T., Larsson, A., Tabety, H., Maddison, Pj, Mutlu, S., Scully, C., Franklin, Cd, and Nelson, M.

Subjects
Adult, Male, medicine.medical_specialty, Systemic disease, Eye disease, Immunology, Validity, Keratoconjunctivitis Sicca, Test validity, Sensitivity and Specificity, Xerostomia, General Biochemistry, Genetics and Molecular Biology, Salivary Glands, Sialadenitis, Rheumatology, Immunopathology, Internal medicine, Xerophthalmia, Immunology and Allergy, Medicine, KERATOCONJUNCTIVITIS SICCA, Humans, Prospective Studies, Prospective cohort study, Aged, Autoantibodies, business.industry, Middle Aged, medicine.disease, Surgery, Sjogren's Syndrome, Female, business, Research Article
Abstract

OBJECTIVE: To assess the recently proposed preliminary criteria for the classification of Sjogren9s syndrome (SS) in a multicentre European study of a new series of clinically defined cases. METHODS: The criteria included six items: I = ocular symptoms; II = oral symptoms; III = evidence of keratoconjunctivitis sicca; IV = focal sialoadenitis by minor salivary gland biopsy; V = instrumental evidence of salivary gland involvement; VI = presence of autoantibodies. Each centre was asked to provide five patients with primary SS, five with secondary SS, five with connective tissue diseases (CTD) but without SS, and five controls (patients with ocular or oral features that may simulate SS). The preliminary six item classification criteria set was applied to both the SS patients and the non-SS controls, and the performance of the criteria in terms of sensitivity and specificity was tested. RESULTS: The criteria set was tested on a total of 278 cases (157 SS patients and 121 non-SS controls) collected from 16 centres in 10 countries. At least four of the six items in the criteria set (limiting item VI to the presence of Ro(SS-A) or La(SS-B) antibodies) were present in 79 of 81 patients initially classified as having primary SS (sensitivity 97.5%), but in only seven of 121 non-SS controls (specificity 94.2%). When the presence of item I or II plus any two of items III-V of the criteria set was considered as indicative of secondary SS, 97.3% (71 of 73) of the patients initially defined as having this disorder and 91.8% (45 of 49) of the control patients with CTD without SS were correctly classified. CONCLUSION: This prospective study confirmed the high validity and reliability of the classification criteria for SS recently proposed by the European Community Study Group.

Published
1996

5. Assessment of the European classification criteria for Sjogren's syndrome in a series of clinically defined cases: Results of a prospective multicentre study

Author

Vitali, C Bombardieri, S Moutsopoulos, HM Coll, J Gerli, R Hatron, PY Kater, L Konttinen, YT Manthorpe, R and Meyer, O Mosca, M Ostuni, P Pellerito, RA Pennec, Y and Porter, SR Richards, A Sauvezie, B Schiodt, M Sciuto, M and Shoenfeld, Y Skopouli, FN Smolen, JS Soromenho, F and Tishler, M Tomsic, M vandeMerwe, JPV Yeoman, CM and Wattiaux, MJ Hitzelhammer, J Petera, P Hietanen, J and Malmstrom, M Youniou, P Grossin, M Kahn, MF Ehrenfeld, M and Ianniello, A Sfriso, P Ercolani, R Muscat, C and DeGiovanni, R Rizzi, L vandenHoogen, FHJ Hoodkaas, H and Kruize, AA Alves, J Presetnik, M Rozman, B Axell, T and Larsson, A Tabety, H Maddison, PJ Mutlu, S Scully, C and Franklin, CD Nelson, M

Abstract

Objective-To assess the recently proposed preliminary criteria for the classification of Sjogren’s syndrome (SS) in a multicentre European study of a new series of clinically defined cases. Methods-The criteria included six items: I = ocular symptoms; II = oral symptoms; III = evidence of keratoconjunctivitis sicca; IV = focal sialoadenitis by minor salivary gland biopsy; V = instrumental evidence of salivary gland involvement; VI = presence of autoantibodies. Each centre was asked to provide five patients with primary SS, dive with secondary SS, five with connective tissue diseases (CTD) but without SS, and five controls (patients with ocular or oral features that may simulate SS). The preliminary six item classification criteria set was applied to both the SS patients and the non-SS controls, and the performance of the criteria in terms of sensitivity and specificity was tested. Results-The criteria set was tested on a total of 278 cases (157 SS patients and 121 non-SS controls) collected from 16 centres in 10 countries. At least four of the six items in the criteria set (Limiting item VI to the presence of Ro(SS-A) or La(SS-B) antibodies) were present in 79 of 81 patients initially classified as having primary SS (sensitivity 97.5%), but in only seven of 121 non-SS controls (specificity 94.2%). When the presence of item I or II plus any two of items III-V of the criteria set was considered as indicative of secondary SS, 97.3% (71 of 73) of the patients initially defined as having this disorder and 91.8% (45 of 49) of the control patients with CTD without SS were correctly classified. Conclusion-This prospective study confirmed the high validity and reliability of the classification criteria for SS recently proposed by the European Community Study Group.

Published
1996

9. Targeted skin overexpression of the mineralocorticoid receptor in mice causes epidermal atrophy, premature skin barrier formation, eye abnormalities, and alopecia.

Author

Sainte Marie Y, Toulon A, Paus R, Maubec E, Cherfa A, Grossin M, Descamps V, Clemessy M, Gasc JM, Peuchmaur M, Glick A, Farman N, and Jaisser F

Subjects
Alopecia pathology, Animals, Apoptosis, Cell Proliferation, Embryo, Mammalian anatomy & histology, Embryo, Mammalian pathology, Embryo, Mammalian physiology, Eye Abnormalities genetics, Hair Follicle cytology, Humans, Keratin-15, Keratin-5 genetics, Keratin-5 metabolism, Keratinocytes cytology, Keratinocytes metabolism, Mice, Mice, Transgenic, Mineralocorticoid Receptor Antagonists, Phenotype, Receptors, Calcitriol genetics, Receptors, Calcitriol metabolism, Receptors, Glucocorticoid genetics, Receptors, Glucocorticoid metabolism, Receptors, Mineralocorticoid genetics, Skin anatomy & histology, Alopecia metabolism, Eye Abnormalities pathology, Gene Expression Regulation, Receptors, Mineralocorticoid metabolism, Skin metabolism, Skin pathology
Abstract

The mineralocorticoid receptor (MR) is a transcription factor of the nuclear receptor family, activation of which by aldosterone enhances salt reabsorption in the kidney. The MR is also expressed in nonclassical aldosterone target cells (brain, heart, and skin), in which its functions are incompletely understood. To explore the functional importance of MR in mammalian skin, we have generated a conditional doxycycline-inducible model of MR overexpression, resulting in double-transgenic (DT) mice [keratin 5-tTa/tetO-human MR (hMR)], targeting the human MR specifically to keratinocytes of the epidermis and hair follicle (HF). Expression of hMR throughout gestation resulted in early postnatal death that could be prevented by antagonizing MR signaling. DT mice exhibited premature epidermal barrier formation at embryonic day 16.5, reduced HF density and epidermal atrophy, increased keratinocyte apoptosis at embryonic day 18.5, and premature eye opening. When hMR expression was initiated after birth to overcome mortality, DT mice developed progressive alopecia and HF cysts, starting 4 months after hMR induction, preceded by dystrophy and cycling abnormalities of pelage HF. In contrast, interfollicular epidermis, vibrissae, and footpad sweat glands in DT mice were normal. This new mouse model reveals novel biological roles of MR signaling and offers an instructive tool for dissecting nonclassical functions of MR signaling in epidermal, hair follicle, and ocular physiology.

Published
2007
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11. Vitamin E uncouples joint destruction and clinical inflammation in a transgenic mouse model of rheumatoid arthritis.

Author

De Bandt M, Grossin M, Driss F, Pincemail J, Babin-Chevaye C, and Pasquier C

Subjects
Animals, Antioxidants metabolism, Arthritis, Rheumatoid immunology, Body Weight, Disease Models, Animal, Glutathione blood, Hydrogen Peroxide blood, Interleukin-1 blood, Isoprostanes urine, Joints immunology, Leukocytes drug effects, Leukocytes immunology, Luminescent Measurements, Mice, Mice, Inbred NOD, Mice, Transgenic, Oxidation-Reduction, Tumor Necrosis Factor-alpha metabolism, Vitamin E blood, Zymosan pharmacology, Antioxidants pharmacology, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid pathology, Joints pathology, Vitamin E pharmacology
Abstract

Objective: Reactive oxygen species are thought to play a role in rheumatoid arthritis (RA) in humans. We postulated that antioxidant treatment could have a beneficial effect in this disease. We therefore investigated the effects of vitamin E in the transgenic KRN/NOD mouse model of RA., Methods: Mice were treated by gavage with oral vitamin E (alpha-tocopherol). Clinical, histologic, and biochemical parameters were assessed for 6 weeks., Results: Vitamin E treatment did not modify the clinical features of the disease (date of onset or disease intensity, as measured by the articular index), but it did prevent joint destruction, as measured by qualitative and semiquantitative analyses. Redox status did not differ between treated and control mice. White blood cell chemiluminescence was higher in transgenic KRN/NOD mice than in controls, but vitamin E treatment attenuated this difference. Vitamin E treatment of the transgenic animals led to a significant decrease in the levels of interleukin-(IL-1beta) but not tumor necrosis factor alpha., Conclusion: Vitamin E seems to uncouple joint inflammation and joint destruction in this model of RA, with a beneficial effect on joint destruction. Since many investigations are currently in progress to evaluate the benefit of interventions targeted toward anti-IL-1beta, our findings suggest opportunities of therapeutic interest in human RA.

Published
2002
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12. Suppression of arthritis and protection from bone destruction by treatment with TNP-470/AGM-1470 in a transgenic mouse model of rheumatoid arthritis.

Author

de Bandt M, Grossin M, Weber AJ, Chopin M, Elbim C, Pla M, Gougerot-Pocidalo MA, and Gaudry M

Subjects
Animals, Arthritis, Rheumatoid pathology, Arthritis, Rheumatoid prevention & control, Cyclohexanes, Disease Models, Animal, Endothelial Growth Factors blood, Lymphokines blood, Male, Mice, Mice, Inbred NOD, Mice, Transgenic, O-(Chloroacetylcarbamoyl)fumagillol, Vascular Endothelial Growth Factor A, Vascular Endothelial Growth Factors, Angiogenesis Inhibitors therapeutic use, Arthritis, Rheumatoid drug therapy, Bone Resorption prevention & control, Sesquiterpenes therapeutic use
Abstract

Objective: We assessed the clinical and histologic features of angiogenesis inhibition in a transgenic mouse model of arthritis that closely resembles rheumatoid arthritis (RA) in humans., Methods: KRN/NOD mice, which spontaneously develop arthritis, were treated with TNP-470, an angiogenesis inhibitor. Disease was monitored by use of clinical indices and histologic examinations; circulating blood levels of vascular endothelial growth factor were determined by enzyme-linked immunosorbent assay., Results: In the preventive protocol, with TNP-470 administration at a dosage of 60 mg/kg of body weight, the onset of arthritis was delayed and its clinical intensity was rather mild; 100% of placebo-treated transgenic mice developed arthritis that led to severe articular destruction. At a dosage of 90 mg/kg of TNP-470, the appearance of clinical signs was delayed for a longer period of time and disease was almost abolished. The therapeutic regimen alleviated clinical signs only when given during the very early stage of disease. Reductions in cartilage and bone destruction by TNP-470 treatment were observed histologically, a feature that was still evident at 30 and 80 days after injections were withdrawn., Conclusion: Our demonstration that in vivo administration of an angiogenesis inhibitor suppresses arthritis and protects from bone destruction provides new insight into the pathogenesis of the disease and opens new possibilities in the treatment of RA in humans.

Published
2000
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