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  • 1
    Electronic Resource
    Electronic Resource
    Fractal Analysis of Bone Texture on Os Calcis Radiographs Compared with Trabecular Microarchitecture Analyzed by Histomorphometry (1998)
    Springer
    Calcified tissue international 63 (1998), S. 121-125 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Fractal analysis—Os calcis—Radiographs—Histomorphometry—Microarchitecture.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. Microarchitecture of trabecular bone is an important determinant of bone fragility; to date, its evaluation requires bone biopsy with histomorphometry analysis. Methods of noninvasive characterization of trabecular bone microarchitecture are in development and we have developed and validated a bone texture analysis applied to bone radiographs and based on fractal geometry. The aim of our study was to compare this fractal analysis of trabecular bone texture on radiographs to the trabecular microarchitecture analyzed by bone histomorphometry on os calcis biopsies. Thirty eight ossa calcis from 19 human cadavers were studied. Fractal analysis of the trabecular bone of os calcis radiographs was performed by the maximum likelihood estimator following the fractional brownian motion model. The ossa calcis were dissected, then transcortical biopsy cores focused on the fractal analysis region of interest were obtained. Structural and connectivity parameters were measured with both automatic and semiautomatic analyzers. We have found a significant relationship between the fractal Hmean parameter and structural histomorphometric indices; the best correlation was found with trabecular separation (r =−0.55; P= 0.0004). Based on a stepwise regression analysis, trabecular spacing and trabeculae number together would explain 38% of the variance of the fractal parameter. Although the relationship with connectivity indices was poor, our fractal analysis of os calcis trabecular bone texture on radiographs seemed to partially reflect the trabecular bone microarchitecture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900501
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  • 2
    Electronic Resource
    Electronic Resource
    Large-scale open trials with etodolac (Lodine®) in France: An assessment of safety (1990)
    Springer
    Rheumatology international 10 (1990), S. 29-34 
    Details
    ISSN: 1437-160X
    Keywords: Etodolac ; Arthritis ; NSAID ; Safety ; Adverse reactions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two large-scale open-label studies were performed in France to confirm the efficacy and safety of etodolac (Lodine®), a new non-steroidal anti-inflammatory drug (NSAID). Study I, a 6-week study performed by 974 rheumatologists, involved 4947 patients who had rheumatoid arthritis (RA), ankylosing spondylitis (AS), or osteoarthritis (OA). Both efficacy and safety were assessed. Study II, a postmarketing safety study performed by approximately 9000 general practitioners, involved 51 355 patients who had rheumatic conditions requiring therapy with NSAIDs. The daily dose of etodolac ranged from 200 to 600 mg/day in these studies, depending on the protocol and patient response. By the end of study I (visit 3), spontaneous pain improved by 33% for patients with RA, by 42% for patients with AS, and by 50% for OA patients. A total of 1276 adverse reactions (AR) were reported during the study, and fewer than half of these were related to study treatment. Only 6 severe reactions were reported; three of these were considered unrelated to study treatment, including 2 deaths. In study II, 10.1% of patients reported 6236 ARs and 9.0% of patients dropped out because of AR. Twenty-two of the ARs reported in study II were judged severe, and all of these patients recovered completely. The overall opinion of safety was assessed as very good or good by 89% of patients. In both studies (〉55 000 patients), 11% of patients reported an AR, and severe reactions were rare. These results confirmed the very acceptable risk/benefit ratio of etodolac and rank this drug high for efficacy and safety among the NSAIDs recently introduced in France.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02274753
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  • 3
    Electronic Resource
    Electronic Resource
    Thoracic and lower cervical spine involvement in a case of rheumatoid arthritis (1989)
    Springer
    Rheumatology international 9 (1989), S. 39-41 
    Details
    ISSN: 1437-160X
    Keywords: Costovertebral joint ; Cervical spine ; Rheumatoid arthritis ; Cervical cord compression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report a case of spine involvement in a severe case of rheumatoid arthritis treated with corticosteroids. First, the patient developed acute back pain, related to costovertebral joints arthritis at levels T9–T10. Then, neck pain and cord involvement yielded to diagnosis of cervical interapophyseal joints arthritis; there was a C5–C6 subluxation which necessitated surgical treatment. The conjunction of these two rheumatoid localizations is an uncommon feature. Study by the CT scan is valuable when rheumatoid arthritis of the spine is suspected. Lower cervical spine subluxation, even severe, may be well tolerated. Surgery is necessary when there is medullary involvement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00270288
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  • 4
    Electronic Resource
    Electronic Resource
    Fractal Analysis of Trabecular Bone Texture on Radiographs: Discriminant Value in Postmenopausal Osteoporosis (1998)
    Springer
    Osteoporosis international 8 (1998), S. 618-626 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Calcaneus radiographs – Fractal analysis – Osteoporosis – Trabecular microarchitecture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Trabecular bone microarchitecture cannot be routinely evaluated. We have developed and validated a fractal analysis of trabecular bone texture on calcaneus radiographs. The aim of this work was to evaluate the ability of the fractal analysis to discriminate a group of 39 postmenopausal women with osteoporotic (OP) vertebral crush fractures (68.0 + 10.8 years) from an age-matched control group of 39 women (68.0 + 10.7 years). The value of the fractal analysis was compared with the value of the femoral neck bone mineral density (FNBMD) and trochanteric bone mineral density (TRBMD). The result is expressed by the parameter Hme an (Hme an= 2 7 fractal dimension). Hme an value was 0.691 + 0.050 in the OP group versus 0.739 + 0.024 in the controls, while FNBMD was 0.598 + 0.113 g/cm2 versus 0.645 + 0.109 g/cm2 and TRBMD was 0.512 + 0.108 g/cm2 versus 0.594 + 0.106 g/cm2 respectively. The statistical significance of the Hme an test (p50.0001) was higher than for FNBMD (p50.05) and for TRBMD (p= 0.0004). We used a receiver operating characteristic (ROC) curve to check this superiority. The area under the ROC curve was 0.824 for Hme an, 0.633 for FNBMD and 0.727 for TRBMD. This superiority of the Hme an ROC curve was statistically significant versus FNBMD, but not versus TRBMD. In a second analysis, we studied the subgroups of OP patients and controls with overlapping FNBMD or TRBMD values to check whether the fractal dimension test could be discriminant in these subgroups. Significant statistical differences were found for Hme an between OP patients and controls in the overlapping subgroup for FNBMD or TRBMD (respectively p= 0.006 and p50.02). These data confirm that the fractal analysis of texture on calcaneus radiographs is able to discriminate OP patients with vertebral crush fracture from controls. This discrimination was stronger than that obtained by FNBMD or TRBMD alone. It was also present when we compared subgroups with overlapping values of FNBMD or TRBMD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050108
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  • 5
    Electronic Resource
    Electronic Resource
    Calciotropic hormones in elderly people with and without hip fracture (1995)
    Springer
    Osteoporosis international 5 (1995), S. 103-107 
    Details
    ISSN: 1433-2965
    Keywords: Bone aging ; 1,25-Dihydroxycholecalciferol ; Hip fracture ; lα-Hydroxylase ; Hyperparathyroidism ; Osteocalcin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of age on calciotropic hormones are not completely understood. The presence of secondary hyperparathyroidism has previously been demonstrated, particularly in patients with hip fracture. The role of a disturbance of vitamin D metabolism, especially a defect in lα-hydroxylation, is debated. The aim of this study was to compare serum parathyroid hormone (PTH), osteocalcin and vitamin D metabolites (25(OH)D and 1,25(OH)2D) in osteoporotic elderly patients with hip fracture (HF) and in elderly controls. We studied 57 HF patients aged 83.9±5.9 years (mean±SD) and 68 controls aged 82.5±5 years recruited during two periods: 1 January and 30 April 1988 and 1989. Patients with chronic renal failure (serum creatinine above 150, µmol/l), cancer, or other metabolic bone disease were excluded. Thirty healthy young adults were studied in 1989 only for measurement of 1,25(OH)2D. (1,25(OH)2D was measured by different laboratories in 1988 and 1989 for technical reasons.) We also measured serum PTH, osteocalcin, total calcium and ionized calcium. 1,25(OH)2D levels were not statistically different between HF patients and controls for the two years, nor between HF patients and young healthy adults in 1989. 25(OH)D was decreased in HF patients (p〈0.003), as was ionized calcium. Serum PTH levels were higher in HF patients than in controls (p〈0.01). A positive correlation has been found between PTH and age in HF patients (r=0.29;p〈0.03) and in the whole group of HF patients and controls. There was a significant decrease in osteocalcin in HF patients versus elderly controls (p〈0.04). Our results confirm the high levels of intact PTH in elderly HF patients, this elevation of PTH being known to increase bone resporption. Low serum osteocalcin in HF patients seems to reflect decreased bone formation. Thus, this association contributes to the accelerated bone loss in hip fracture. This study also suggests that 1,25(OH)2D is not significantly lowered in case of hip fracture, and lα-hydroxylase is not deficient, in spite of a lack of the substrate of this enzyme (25(OH)D). Therefore, a defect of 1,25(OH)2D does not appear to be a pathogenetic factor in bone aging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623311
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  • 6
    Electronic Resource
    Electronic Resource
    Hyperparathyroidism in proximal femur fractures biological and histomorphometric study in 21 patients over 75 years old (1991)
    Springer
    Clinical rheumatology 10 (1991), S. 144-150 
    Details
    ISSN: 1434-9949
    Keywords: Secondary Hyperparathyroidism ; Bone Ageing ; Hip Fracture ; Proximal Femur Fractures ; Histomorphometry ; Intact PTH ; Vitamin D ; Osteocalcin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Proximal femur fractures in elderly people are more and more frequent. Falls and senile bone disorders are the risk factors of this fracture. In order to understand the mechanisms of these bone disorders, we studied 21 consecutive patients with this fracture using bone histomorphometry. Measurements of serum intact parathormone (PTH), 25-(OH)-vitamin D, 1,25-(OH) 2-vitamin D and osteocalcin have been performed in these 21 patients, included in a larger series. We excluded patients with renal failure (serum creatinine greater than 140 μmols/l), cancer, or previous metabolic bone disease. There were 19 female and 2 male patients, ranging from 75 to 96 years, (means 84.9). We found a low frequency of cortical (2/21) and trabecular (3/21) osteoporosis. There was no case of clearcut osteomalacia. Following histomorphometric bone study, two patients showed a typical pattern of hyperparathyroidism, and in a third one, this condition seemed very likely. In these three patients who were among the oldest, and who had high levels of serum PTH, chronic renal failure and primary hyperparathyroidism could be excluded. High bone remodeling was frequent in our patients, as reflected by the enhancement of eroded surfaces (13 cases) and of osteoid thickness (7 cases). Intact PTH level was elevated in our series compared to normal values in adults (in accordance to the PTH elevation in the case control study in a larger series). These findings suggest a major role of a secondary hyperparathyroidism in senile bone disorders favoring proximal femur fractures. This hyperparathyroidism is probably secondary to mild calcium and vitamin D deficiency. It may lead to architectural bone changes favoring this fracture. These conclusions suggest that prevention by calcium, vitamin D derivatives, or both, may be useful.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02207653
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  • 7
    Electronic Resource
    Electronic Resource
    Costo-vertebral arthropathy. Diagnostic and therapeutic value of arthrography (1988)
    Springer
    Clinical rheumatology 7 (1988), S. 220-223 
    Details
    ISSN: 1434-9949
    Keywords: Costo-Vertebral Arthropathy ; Arthrography ; Arthro-Tomodensitometry ; Abdominal Pain ; Loin Pain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report five cases of costo-vertebral (CV) joint arthropathies, without osteo-arthritis. The patients had referred pain, with misleading irradiations to the loin or to the abdomen, so that the diagnosis was difficult. The authors have performed in these five cases an arthrography of T11 and T12CV joints. In every case, the arthrography triggered pain at one of these levels. The arthrography was followed by intra-articular injection of corticosteroid derivative in the symptomatic joint. In these cases, this procedure was a valuable diagnostic and therapeutic method. CV joint arthropathies are frequent, but often lead to incorrect diagnosis. These preliminary results encourage further use of this procedure in CV arthropathies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02204458
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