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Biomedical subjects

P Leman

Publications and source records attributed to P Leman.

At least 37 records · Page 2Linked to original sources
PubMed1996

Toxicity following accidental ingestion of Aconitum containing Chinese remedy.

Various species of Aconitum are commonly used in traditional Chinese medicine. These plants are known to contain highly potent cardiotoxins. A 22 year old Chinese male accidentally ingested a herbal liniment prepared from Aconitum with near fatal results. His ventricular tachyarrhythmias responded to standard treatment including the use of i.v. magnesium.

Aconitine↗
PubMed1985

[Cerebral lesions in a case of Degos' disease].

The central nervous system may be involved in Degos disease, but neuropathologic observations are still few. We report a typical case with cerebral involvement. The diagnosis was suggested by the characteristic skin lesions and vascular damage. In the central nervous system, occlusive changes of small arteries were responsible for areas of ischaemic necrosis. These foci of infarction were of varying size, age and distribution. Intestinal lesions were discrete and death was due to several cerebral infarcts.

Adult↗
PubMed1985

[Spontaneous subarachnoid hemorrhage. Plea for a standard evaluation system].

There is no univocal grading of subarachnoid hemorrhage by ruptured intra-cranial aneurysms. Three systems are commonly used: Botterell's, Hunt's and Hess's, Nischioka's. Besides, many surgical teams use modified or derived systems. It is this very difficult to compare series of patients whose grading has not been made, using the same criteria. The authors propose to make a unique system of grading with new criteria of clinical evaluation.

Humans↗
PubMed1983

[Supratentorial malignant glioma in adults. Adjustment of the treatment of 3 groups according to a clinical classification].

Therapeutic goals cannot be the same for every patient with malignant glioma, as suggested by the study of 106 cases seen from 1975 to 1982. Seventy patients were uniformly treated by surgery, chemotherapy and radiotherapy. Two clinical parameters, i.e. age and postoperative neurological status (NS), were used to divide patients into three groups with a significantly different prognosis. Median survival was 59.5 months for group 1 (age 50 or less, good NS) and 11.5 months for group 2 (age 51 to 65 and good NS, or younger than 51 but poor NS). For group 3 (age 51 to 65 and poor NS, or older than 65), survival was six months. From 1978, two trials were carried out, with therapy being adjusted to each group. Whatever the group, surgical excision was done whenever it was consistent with preservation of the neurological status and followed by combination chemotherapy (Vincristine-VM 26-CCNU). For group 1, radiotherapy was not modified: 60 grays were delivered to the tumor and surrounding safety margin in 30 fractions over 6 weeks. Patients in group 2 received 69 grays in two daily fractions over 6 weeks (1.15 Gy each morning and evening five days a week). With this modified treatment, median survival was brought up to 20.5 months. Patients in group 3 were treated initially by surgery and chemotherapy; radiotherapy was restricted to recurrences. This policy significantly improved patients' comfort by enabling their prompt return to home. The median survival for 14 patients was 10.5 months. Our experience suggests that different therapeutic goals should be set for each group. In group 1, therapy should be aimed at obtaining prolonged survival. In group 3, survival remains short and the main concern is to improve patients' comfort. As patients in group 2 have an intermediate prognosis, they are the best candidates for therapeutic trials designed to improve the response to radiotherapy and chemotherapy.

Adolescent↗
PubMed1981

[Response factors in the treatment of malignant gliomas in the adult (author's transl)].

A statistical study was used to determine the significant prognostic factors in a protocol containing surgery, radiotherapy and polychemotherapy applied to 121 consecutive unselected patients suffering from malignant gliomas. The histological grade of the malignant tumor, the age of the patient and the neurological state if it could be evaluated after surgery appeared to be significant. It is therefore possible to suggest a clinical classification into three groups. Group 1 consists of patients aged 50 or less and a postoperative neurological state of 1 or 2 according to Order's classification; group 2 consists of patients with one pejorative factor, i.e. aged over 50 or a postoperative neurological state of 3 or 4; group 3 is those patients with two pejorative factors (aged over 50 and postoperative neurological state of 3 or 4) or aged 65 or over. Methods of application of treatment are also involved in the therapeutic response: Excision surgery appears to be essential. It improves the duration and quality of survival and influences the efficacy of combined radio-chemotherapy. By contrast, the effects of cobalt and chemotherapy must be envisaged in an efficacy/tolerance ratio which is difficult to evaluate, but for which the suggested clinical classification as a certain indicative value. Finally, the various factors lead to an approach to the concept of therapeutic responses and to determine within the total population of malignant gliomas various categories of patients in whom the profile is defined both by clinical characteristics and the tolerance of treatment and in whom different treatment techniques must be envisaged.

Adolescent↗