[Results of autopsy examination of the knee cartilage of 120 patients dying in the hospital. II. The femoro-tibial joint]. / Résultats de l'examen autopsique des cartilages des genoux chez 120 subjets décédés en milieu hospitalier. II. Articulation fémoro-tibiale.

The authors have studied the autopsy results of both tibio-femoral joints in 120 patients: 57 women and 63 men, 112 of whom were over the age of 50. The condylar and tibial cartilages were classified into 5 categories: no lesion (0); slight fissure (I); severe fissure (II); slight deep ulceration (III); large ulceration (in more than 25 p. cent of the cartilage surface) exposing the sub-chondral bone (IV). In 120 patients, the 4 condyles in 58 patients (43.8 p. cent) and both tibio-femoral joints in 51 patients (42.5 p. cent) did not present any degenerative lesions beyond stage I. Stage III and IV cartilaginous lesions are rare before the age of 50. Their frequency suddenly increases after the ages of 70 in women and 80 in men. 44 p. cent of women and 31 p. cent of men presented tibio-femoral cartilaginous lesions of stages II or IV in at least one knee; 15.8 p. cent of women and 4.7 p. cent of men presented tibio-femoral lesions, stage IV, in at least one knee. In 58 p. cent of stage III and IV knee lesions, the menisci were abnormal: atrophic or torn. A menisco-chondrocalcinosis was found in 50 knees (20.8 p. cent of knees) of 28 patients (23.3 p. cent of patients). After the age of 60, the cartilaginous lesions were more severe and more extended in knees with menisco-chondrocalcinosis).

[Results of autopsy examination of knee cartilage in 120 patients dying in the hospital. I. Femoro-patellar joint]. / Résultats de l'examen autopsique des cartilages des genoux chez 120 sujets décédés en milieu hospitalier. I. Articulation fémoro-patellaire.

The authors have performed the pathological examination of the knees of 57 women and 63 men or 112 patients over the age of 50, who died in the hospital. The lesions of the patellar and trochlear cartilages were studied and classified according to four categories: stage I: non extended fissures; stage II: fissures extending over 25 p. cent of the articular surface; stage III: fissures associated with small deep ulcerations of the cartilage; stage IV: deeps and extended ulcerations of the articular cartilage exposing the sub-chondral bone. Cartilage alterations were found in 93.3 p. cent of the patellas; 26.2 p. cent of stage I; 22.5 p. cent of stage II, 27.1 p. cent of stage III; 17.5 p. cent of stage IV. These alterations are bilateral and symmetrical, most of the time. Their frequency and severity increase with age. Thus, deep and extended ulcerations (stage IV) of the patellar cartilage have a frequency of 1.9 p. cent before the age of 60.8 p. cent between 60 and 70 years, 13.6 p. cent between 70 and 80 years and 38.9 p. cent after 80 years. Alterations of the patellar cartilage are more frequent and more severe in women than in men. In 85.7 of the patellas they occupy both facets, overriding the patellar crest; more seldom, they are exclusively localized to the medial patellar facet (11.6 p. cent) or lateral facet (3.1 p. cent). Alterations of the trochlear cartilage, although more common are less frequent than that of the patellar cartilages. Patellar osteophytosis is very frequent.(ABSTRACT TRUNCATED AT 250 WORDS)

[Antiphospholipid antibodies, thrombosis and lupus disease. Value of the assay of anticardiolipin antibodies by the ELISA technic]. / Anticorps anti-phospholipides, thromboses et maladie lupique. Intérêt du dosage des anticorps anti-cardiolipine par la méthode ELISA.

The authors have developed a sensitive immunoenzymatic method for assaying anti-cardiolipin antibodies in the serum of patients with lupus (SLE). These antibodies were present in the serum of 43/108 SLE patients, particularly in those patients with either false syphilis serology (p less than 0.02) or circulating anticoagulant (p less than 0.05). The mean titre of anti-cardiolipin antibodies was higher in the group with positive VDRL (less than 0.03). The anti-cardiolipin antibody titre was independent of the anti-native DNA antibody titre, but there was a correlation with the anti-denatured DNA antibody titre (p less than 0.02). This correlation can be partially explained by the antigenic similarity (phosphodiester bridge) between the two molecules. The preliminary clinical studies have not shown any correlation between the presence of anti-cardiolipin antibodies and the presence of signs such as thrombocytopenia, haemolysis, cerebral vascular accident, venous thrombosis, recurrent abortion. A longitudinal study of certain patients suggests that the anti-cardiolipin antibodies may disappear at the time of thrombotic accidents, which induces fixation of these antibodies to a platelet or vascular target and as a result of corticosteroid therapy.

[Determination of anti-native DNA antibodies by immunofluorescence on Crithidia luciliae. Correlation between renal involvement and the presence of high-avidity anti-native DNA antibodies in lupic disease]. / Dosage des anticorps anti-ADN natif par immunofluorescence sur Crithidia luciliae. Corrélation entre atteinte rénale et présence d'anticorps anti-ADN natif de haute avidité au cours de la maladie lupique.

Low avidity native DNA - anti-native DNA complexes dissociate at alkaline pH and in high molarity solutions. This property was used to modify the indirect immunofluorescence reaction on Crithidia luciliae in order to assay high avidity anti-native DNA antibodies resistant to alkaline and strongly saline solutions. Assays were performed in the sera of 36 patients (31 women and 5 men) with systemic lupus erythematosus (SLE). Seventeen of these patients had histologically significant lupus nephritis (WHO types III, IV and V) and 19 had no renal, urinary or biochemical abnormalities. The mean titer of total anti-native DNA antibodies was similar in both groups, but the titer of high avidity anti-native DNA antibodies was significantly higher in patients with lupus nephritis. The percentage of patients with high avidity antibodies was 87% in the group with renal involvement and 28% in the group with no kidneys involvement. Thus, lupus nephritis should be feared when anti-native DNA antibodies with high dissociation constant are found in the sera of SLE patients.

[Levels of anti-nDNA using immunofluorescence on Crithidia luciliae. II. Prognostic value of complement-fixing anti-nDNA. Longitudinal study of 16 lupus disorders]. / Dosage des anticorps anti-ADNn par immunofluorescence sur Crithidia luciliae. II--Valeur pronostique des anti-ADNn fixant le complément. Etude longitudinale de 16 maladies lupiques.

Measurements of the hemolytic complement level and titrations of anti dS DNA antibodies by immunofluorescence using Crithidia luciliae and by the Farr binding assay were performed in 13 females and 3 males suffering from systemic lupus erythematosus (SLE). In each patient, 2 to 5 serum samples were analyzed during a mean follow up time of 16.6 months. The complement fixing ability of the anti dS DNA antibodies was also investigated. In this longitudinal study the titers of the dS DNA antibodies detected by immunofluorescence correlated with the Farr binding assay results. Mean anti dS DNA antibody titers were significantly higher and CH 50 levels were lower when SLE was active. Among sera with anti dS DNA antibodies, only sera with high titers (greater than or equal to 1/80), fixed complement. Study of individual cases disclosed that an increase in complement fixing anti dS DNA antibodies could occur in the absence of disease activity. Sera from patients with severe organ involvement, in particular with nephritis had low titers of anti dS DNA antibodies with no complement fixation activity. There was no relationship between falls in serum complement level and the complement fixation ability of anti dS DNA antibodies. Thus, complement fixation capacity of anti dS DNA antibodies correlates better with antibody titer than with SLE severity or activity.

[Determination of anti dsDNA antibodies by immunofluorescence using Crithidia luciliae. I--Diagnostic and prognostic value in systemic lupus erythematosus. Comparison with the Farr radioimmunoassay]. / Dosage des anticorps anti-ADNn par immunofluorescence sur Crithidia luciliae. I--Valeur diagnostique et pronostique au cours de la maladie lupique. Comparaison avec le dosage radio-immunologique de Farr.

Antibodies to double stranded (ds) DNA were sought by the indirect immunofluorescence method using Crithidia luciliae in 196 sera from patients suffering from hepatic, thyroid or inflammatory rheumatic disorders. Anti ds DNA antibodies were demonstrated in 29 out of 45 systemic lupus erythematosus (SLE) sera. Lower titers were found in 3 out of 7 sera from drug-induced SLE, 2 out of 6 from mixed connective tissue diseases, 1 out of 60 from scleroderma, 2 from unclassified arthritis, 8 out of 40 from rheumatoid arthritis with antinuclear factors, and in 4 out of 15 sera from chronic hepatitis. For SLE diagnosis the sensitivity of the method was 73 percent, its specificity was 87 percent. 84 percent of these results were in agreement with those obtained with the Farr method, but titers did not correlate well. The sensitivity of the Farr method was 64.5 percent, its specificity was 85 percent. In this study, high titers of anti ds DNA antibodies demonstrated on Crithidia Luciliae did not correlate with disease severity. Low titers of anti14C labelled DNA antibodies demonstrated by the Farr assay correlated with inactive SLE without nephritis. The immunofluorescence assay using Crithidia luciliae is a valid method to detect anti ds DNA antibodies but does not allow prognostic conclusions in SLE.

[Significance of reduced complement level in the articular fluid. 81 cases]. / Signification de la diminution du taux du complément dans le liquide articulaire. A propos de 81 cas.

Based on their own experience, the authors report that a fall in the complement level of joint fluid, which is particularly common in rhumatoid arthritis, is also seen in cases of systemic lupus eryrthematosis and a variety of arthritis: infectious arthritis, gout, articular chondrocalcinosis and psoriatic rheumatism. This should be taken into account when evaluating the diagnostic value of this test in rheumatoid arthritis.

[Anatomic incidence of meniscochondrocalcinosis of the knee]. / Fréquence anatomique de la ménisco-chondrocalcinose du genou.

The authors have studied the incidence of menisco-calcinosis (MC) and that of menisco-chondrocalcinosis (MCC) of knee joints of 108 non selected cadavera. The mean age of the subjects was 71.8 +/- 13.8 years. The study was performed by radiographic examination of the menisci and cartilagineous fragments of femoral condyles using high contrast films. The incidence of MC or MCC was found to be 18.5 per cent. It was slightly higher in females (21.5 p. cent) than in males (15.8 p. cent) subjects but this difference failed to reach the level of statistical significance. No positive case was detected before the age of 60 years. For the age groups of: 60-69, 70-79, 80-89 and over 90 years, its incidence was: 11.7; 26.9; 21.2 and 50 (4 subjects out of 8) per cent respectively. Approximately 40 per cent of all positive cases had meniscocalcinosis without associated chondrocalcinosis. No single case of chondrocalcinosis without meniscocalcinosis was observed. Six out of 8 cases with MC calcinosis and 2 out of 12 cases with MCC were unilateral. The external menisci were more frequently and more heavily affected than internal ones. Eighty per cent of the knees affected by either MC or MCC were at the same time associated to an osteoarthrotic lesion compared to 35 p. cent of the knees without MC or MCC matched for age: a result which appeared to be highly significant difference.