PubMed Health⌕ Search

Biomedical subjects

M Poisson

Publications and source records attributed to M Poisson.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of malignant gliomas with surgery, intraarterial chemotherapy with ACNU and radiation therapy.

Forty patients with malignant supratentorial gliomas received iterative intraarterial (IA) infusions of ACNU, 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea at a dose of 150 mg repeated every 6 weeks. Group A consisted of eighteen patients previously treated with surgery, radiation therapy (RT) and sometimes chemotherapy, who received IA ACNU at tumor recurrence. Group B consisted of twenty two patients who received IA ACNU in the postoperative pre-RT period. In group A, 8/18 patients (44%) had an objective response, including 6/12 anaplastic astrocytomas (AA) and 2/6 glioblastoma multiforme (GBM), while 10/18 patients (56%) did not respond. Median survival time was 6 months for GBM and 12 months for AA. In group B, 6/22 patients (27%) had an objective response (4/18 GBM and 2/4 AA) and 16/22 patients (73%) did not respond. Nine patients had such an extensive tumor after one or two courses of IA ACNU that RT was cancelled. Median survival time was 8 months for GBM and 8 months for AA. Three patients (8%) had ophthalmologic toxicity on the infused side. There was no case of leukoencephalopathy.

Adult↗
PubMed1992

[Primary non-Hodgkin's malignant lymphoma of the central nervous system].

The incidence of primary central nervous system lymphoma (PCNSL) is increasing, not only in immunodeficiency states, but also in apparently normal individuals. The most common presentation of PCNSL is that of an intracranial mass lesion. Ocular involvement is associated in 20% of patients. CT/MR scan typically shows one or several periventricular tumors with indistinct margins that diffusely and densely enhance following contrast infusion. The diagnosis relies on lumbar puncture, vitreous biopsy, or stereotactic biopsy of a brain lesion demonstrating lymphomatous cells. If possible, corticosteroids should be used only after definite diagnosis. Corticosteroids have a cytotoxic effect responsible for transient remission in 40% of patients. Whole brain radiation therapy induces a complete or partial response in 80% of patients but recurrence always occurs and the median survival does not exceed 14-18 months. The addition of systemic and intrathecal chemotherapy seems to substantially improve the prognosis with median survival exceeding 3 years in some studies. PCNSL associated with AIDS generally occurs at a late stage of the disease and is the fourth cause of death in AIDS patients. Radiation therapy is useful but the median survival does not exceed 5.5 months because patients most often die of opportunistic infections.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Orbital myositis, recurrence of Whipple's disease].

Whipple's disease, a chronic systemic and multi-organ disease can be associated with ophthalmological manifestations with or without CNS involvement. Myositis rarely occurs during Whipple's disease. Antibiotic treatment prevents CNS recurrence. We report here the association of an orbital pseudotumor with Whipple's disease. This myositis was discovered on a follow-up CT examination. It appeared only one year after the end of a long course of antibiotic treatment, but it resolved within a few weeks when treatment was reintroduced. Relations between these two diseases are discussed.

Eye Diseases↗
PubMed1992

[Chorea disclosing polycythemia and renal adenocarcinoma].

A 79-year-old woman had chorea complicating polycythaemia. The polycythaemia and the chorea disappeared after surgical removal of a renal carcinoma. The literature on polycythaemic chorea is reviewed and its pathophysiology discussed.

Adenocarcinoma↗
PubMed1992

[Chromosome abnormalities and adenine metabolism in human glial tumors].

Most chromosome aberrations in gliomas are numerical, resulting in either gains or deficiencies of whole chromosomes. In tumors of low malignancy, the karyotype is frequently normal or exhibits a loss of sex chromosome and a gain of chromosome 7. These two anomalies may not be directly related to malignancy. In the highly malignant cases, the two most frequent aberrations are the gain of chromosome 7 and the loss of chromosome 10, other anomalies such as losses or deletions of chromosomes, 9, 22, 6, 13 and 14 being detected at various frequencies. Several of these chromosomes carry important genes of adenine metabolism: AK1 and AK3 (adenylate kinase) and MTAP (methylthioadenosine phosphorylase) for chromosome 9; ADK (adenosine kinase) and mitochondrial ATPase for chromosome 10; ADSL (adenylosuccinate lyase) for chromosome 22, NP (nucleoside phosphorylase) for chromosome 14. We performed the corresponding assays of enzyme activity on both fresh tumors and tumors grafted on nude mice, which showed that these enzymes had a relatively low activity although the tumors were proliferating. However, chromosome losses do not seem to directly cause the metabolic alterations by gene dosage effect. Interestingly, chromosome 10, frequently deficient, also carries genes of importance for glycolysis (hexokinase) and glutamate metabolism (glutamate dehydrogenase and glutamate oxaloacetate transaminase). The deficiency for these genes could be taken into account for a better type of chemotherapy by antimetabolics.

Adenine↗
PubMed1992

[Treatment of supratentorial glioma in adults by intra-arterial HECNU. Experience of the Pitié-Salpétrière group].

Between 1984 and 1988, patients suffering from malignant gliomas received intraarterial chemotherapy with HECNU (IAC). Three groups were identified. Group 1 consisted of 56 patients previously treated with surgery and radiation therapy (RT), who received IAC at recurrence. Group 2 consisted of 46 patients with unresectable tumors, and group 3 of 40 patients who had their tumor surgically removed. In groups 2 and 3, three courses of IAC were administered prior to conventional RT (50-54 Gy). Immediate tolerance was good but delayed ocular and cerebral toxicity occurred in 14% and 11% of cases, respectively. A better therapeutic response was observed with anaplastic gliomas than with glioblastomas (GBM). For anaplastic gliomas, median survivals (MS) were 18 months (group 1), 24 months (group 2) and 30 months (group 3). For GBM, MS were 4.5, 7.5 and 10.5 months in groups 1, 2 and 3, respectively. IAC does not seem to improve the prognosis of GBM.

Glioma↗
PubMed1991

Treatment of recurrent malignant supratentorial gliomas with carboplatin (CBDCA).

Twenty patients with malignant supratentorial gliomas progressing after radiation therapy and chemotherapy with nitrosoureas received intravenous carboplatin, 450 mg/m2. Courses of therapy were repeated every four weeks. Therapeutic evaluation was performed monthly using neurologic examination and CT scan of the brain. Of 19 patients evaluable for response, 2 (10%) responded to therapy and 6 (30%) had stable disease. The estimated median time to tumor progression for responding and stable patients was 6 months. Median duration of survival was 6 months for all patients. Of 20 patients evaluable for toxicity, none had renal or auditory toxicity. Side effects consisted of hematologic toxicity in 4 patients (20%): one patient had grade 4 toxicity requiring discontinuation of carboplatin and 3 patients had grade 2-3 toxicity.

Adult↗
PubMed1991

[Autoimmunity and paraneoplastic neurologic syndromes].

Paraneoplastic syndromes affecting the nervous system are rare and their diagnosis is often difficult when the original cancer is unknown. Recently, high levels of antineuronal antibodies (AB) have been found in serum and CSF of some patients with paraneoplastic syndromes. The anti-Yo AB recognizes 2 proteins of 34 and 62 kd in the cytoplasm of Purkinje cells and in malignant cells of patients suffering from paraneoplastic cerebellar degeneration associated with ovarian and breast cancer. The anti-Hu AB recognizes a 37-40 kd protein in nuclei of neurons and in tumor cells of patients suffering from subacute sensory neuronopathy and encephalomyelitis associated with small cell lung cancer. Other antineuronal AB have been more rarely identified. The presence of high titer of one of these AB in a patient with suspected paraneoplastic syndrome is of great practical interest since it confirms the neurological diagnosis and strongly suggests the location of the primary tumor when the malignancy is unknown. The pathogenetic role of the antineuronal AB is unknown but it is likely that some paraneoplastic syndromes affecting the nervous system are due to an immune reaction against antigens shared by the tumor and the nervous system. To date, no efficient treatment has been found.

Autoantibodies↗
PubMed1990

Treatment of malignant recurrent glioma by intra-arterial, infra-ophthalmic infusion of HECNU 1-(2-chloroethyl)-1-nitroso-3-(2-hydroxyethyl) urea. A phase II study.

53 patients suffering from malignant recurrent glioma were treated with iterative arterial infusions of HECNU. The intra-carotid injections were performed below the ophthalmic artery. The response rate was 49% and the median survival was 8.5 months. The results differ substantially according to the histological subtype. The response rate was 33% for glioblastomas, 50% for anaplastic astrocytomas and 92% for malignant recurrences of low grade astrocytomas. The median survival was 4.5 months for glioblastomas and 18 months for anaplastic astrocytomas and malignant recurrences of low grade astrocytomas. Serious complications were a monocular blindness in 3 cases and a leucoencephalopathy in 6 cases.

Adult↗
PubMed1990

Treatment of malignant gliomas with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy: a phase II study.

Forty patients with malignant supratentorial gliomas were treated with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy. The median duration of survival was 12 months; it differed according to the histological subtype (over 30 months for patients with anaplastic astrocytomas or anaplastic oligodendroglioma and 10.5 months for glioblastoma; P = 0.0025). Serious complications of monocular blindness and leukoencephalopathy were observed in four patients (10%).

Adolescent↗
PubMed1990

[Metastasis to the pituitary stalk in a case of breast cancer].

A 64-year old woman with breast cancer developed diabetes insipidus. CT scan showed thickening and contrast enhancement of the pituitary stalk highly suggestive of metastasis. The patient was successfully treated with desmopressin followed by external radiation therapy.

Breast Neoplasms↗
PubMed1989

Clindamycin with primaquine for Pneumocystis carinii pneumonia.

Combined therapy with clindamycin and primaquine was used in twenty-eight episodes of Pneumocystis carinii pneumonia in 25 patients, of whom 17 had been unresponsive or intolerant to conventional treatment and 8 were being treated for the first time. The treatment was effective in all but two episodes, the main adverse reaction being a generalised maculopapular rash.

Administration, Oral↗