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Reich-Schupke S, Alm J, Altmeyer P, Bachter D, Bayerl C, Beissert S, Bieber T, Böhmer J, Dill D, Dippel E, Dücker P, Effendy I, El Gammal S, Elsner P, Enk A, Feldmann-Böddeker I, Frank H, Gehring W, Gieler U, Goebeler M, Görge T, Gollnick H, Grabbe S, Gross G, Gudat W, Happ A, Herbst R, Hermes B, Hoff NP, John SM, Jungelhülsing M, Jünger M, Kaatz M, Kapp A, Kaufmann R, Klode J, Knaber K, König A, Krieg T, Kohl P, Kowalzick L, Lehmann P, Löffler H, Maschke J, Marsch W, Mechtel D, Mohr P, Moll I, Müller M, Nashan D, Ockenfels HM, Peter RU, Pillekamp H, Rompel R, Ruzicka T, Salfeld K, Sander C, Schaller J, Scharffetter-Kochanek K, Schuler G, Schulze HJ, Schwarz T, Splieth B, Stege H, Stolz W, Strölin A, Tran H, Tronnier M, Ulrich J, Vogt T, Wagner G, Welzel J, Willgeroth T, Wollina U, Zillikens D, Zouboulis CC, Zuberbier T, Zutt M, Stücker M. [Phlebology in German departments of dermatology. An analysis on behalf of the German Society of Phlebology]. Hautarzt 2013; 64:685-94. [PMID: 24022632 DOI: 10.1007/s00105-013-2623-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP). METHODS To investigate the reasons for this development, we--on behalf of the DGP--sent a questionnaire to 120 German Departments of Dermatology in autumn 2012. RESULTS In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments. CONCLUSIONS Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available.
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Gawel, E, Purkus, A, Korte, K, Lehmann P. Förderung der Markt- und Systemintegration erneuerbarer Energien – Perspektiven einer instrumentellen Weiterentwicklung. ACTA ACUST UNITED AC 2013. [DOI: 10.3790/vjh.82.3.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
Rosacea is a frequent chronic dermatological disorder mainly affecting the face. Since it affects the appearance, it can be very distressing for the patient leading to psychosocial disturbances. Rosacea occurs in adults, peaking between 40 and 50 years of age. The course of rosacea is quite variable and the disease may stop at any stage. Generally, three main stages are differentiated: erythemato-teleangiectatic rosacea (rosacea stage I), papulopustular rosacea (rosacea stage II), hyperglandular-hypertrophic rosacea (rosacea stage III). Besides these main manifestations numerous special forms exist, which often lead to difficulties in the differential diagnoses and require specific therapeutic strategies. These include rosacea conglobata, rosacea fulminans, granulomatous rosacea, persisting edema, (Morbihan disease), gram negative rosacea, ocular rosacea, and steroid rosacea. Recently increasing numbers of patients have been observed, whose rosacea was were induced by inhibitors of epidermal growth factors (cetuximab, geftinib) used as chemotherapy in patients with different malignancies. These side effects have been described as acneiform eruptions but at least some of the described patients have a rosacea-like appearance; therefore, this form can be classified as a subset of drug induced rosacea.
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Kuerten S, Schickel A, Kerkloh C, Recks M, Addicks K, Ruddle N, Lehmann P. The development of tertiary lymphoid organs in the central nervous system facilitates determinant spreading of the MP4-specific T cell response (P4164). THE JOURNAL OF IMMUNOLOGY 2013. [DOI: 10.4049/jimmunol.190.supp.172.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Accumulating evidence indicates that B cells aggregate into tertiary lymphoid organs (TLOs) in the central nervous system (CNS) in the human autoimmune disease multiple sclerosis (MS). In patients with secondary-progressive MS the presence of ectopic B cell aggregates has been linked to more severe clinical disease and cortical pathology. Here we demonstrate the formation of TLOs in myelin basic protein (MBP)-proteolipid protein (PLP) fusion protein MP4-induced experimental autoimmune encephalomyelitis (EAE) of C57BL/6 mice. TLOs were a characteristic feature of the chronic disease stage and most prevalent in the cerebellum, while also being present in the spinal cord and cerebrum, but absent in the brain stem. TLOs were characterized by B and T cell compartmentalization, the presence of high endothelial venules and germinal center formation. An association with TH17, but not TH1 cells was evident. In addition, results obtained from ELISPOT analysis of the antigen-specific T cell response suggest that TLOs facilitate determinant spreading of the MP4-specific T cell response to myelin oligodendrocyte glycoprotein (MOG). Our data add novel insights into the contribution of TLOs to disease progression in the context of CNS autoimmunity. We suggest that the blockade of TLO development is a therapeutic strategy that needs to be carefully considered in future studies.
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Fahlbusch M, Wesselmann U, Lehmann P. Herpes zoster nach Varicella-Zoster-Virus-Impfung. Hautarzt 2013; 64:107-9. [DOI: 10.1007/s00105-012-2477-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lehmann P, Vélez MDP, Saumet J, Lapensée L, Bissonnette F, Kadoch J. Anti-müllerian hormone (AMH): a reliable biomarker of oocytes quality in stimulated in vitro fertilization (IVF). Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.07.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Saumet J, Dzineku F, Velez MDP, Jamal W, Lehmann P, Kadoch IJ. Evaluation of the ovarian reserve: is there still a place for ultrasound? Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.07.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Appleton T, Bryan P, Contos D, Henry TR, Lehmann P, Ohorodnik S, Reed D, Robichaud C, Schetter J, South N, Weissmann J, Whitmire ML. Nonclinical dose formulation: out of specification investigations. AAPS J 2012; 14:523-9. [PMID: 22566150 DOI: 10.1208/s12248-012-9347-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 03/05/2012] [Indexed: 11/30/2022] Open
Abstract
Nonclinical safety studies are required to follow applicable Good Laboratory Practice (GLP) regulations. Nonclinical dose formulations are required to be analyzed to confirm the analyte concentration, homogeneity, and stability. Analytical samples that fall outside of the acceptance criteria are considered out of specification (OOS), and an investigation should be conducted. The US FDA has issued a guidance document for GMP studies on conducting OOS investigations. However, no regulatory guidance has been issued regarding nonclinical safety study (GLP) OOS investigations, which often vary in regard to content, assessment, and impact statements. There is opportunity to improve the quality of OOS investigations by defining expectations and providing guidance in several areas including root cause assessment, impact statements, and acceptable paths forward. This paper will provide recommendations of best practices for nonclinical dose formulation OOS investigations.
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Dirschka T, Radny P, Dominicus R, Mensing H, Brüning H, Jenne L, Karl L, Sebastian M, Oster-Schmidt C, Klövekorn W, Reinhold U, Tanner M, Gröne D, Deichmann M, Simon M, Hübinger F, Hofbauer G, Krähn-Senftleben G, Borrosch F, Reich K, Berking C, Wolf P, Lehmann P, Moers-Carpi M, Hönigsmann H, Wernicke-Panten K, Helwig C, Foguet M, Schmitz B, Lübbert H, Szeimies RM. Photodynamic therapy with BF-200 ALA for the treatment of actinic keratosis: results of a multicentre, randomized, observer-blind phase III study in comparison with a registered methyl-5-aminolaevulinate cream and placebo. Br J Dermatol 2011; 166:137-46. [PMID: 21910711 DOI: 10.1111/j.1365-2133.2011.10613.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) or its methylester [methyl-5-aminolaevulinate (MAL) or 5-amino-4-oxopentanoate] was recently ranked as first-line therapy for the treatment of actinic keratosis (AK) and is an accepted therapeutic option for the treatment of neoplastic skin diseases. BF-200 ALA (Biofrontera Bioscience GmbH, Leverkusen, Germany) is a gel formulation of ALA with nanoemulsion for the treatment of AK which overcomes previous problems of ALA instability and improves skin penetration. OBJECTIVES To evaluate the efficacy and safety of PDT of AKs with BF-200 ALA in comparison with a registered MAL cream and with placebo. METHODS The study was performed as a randomized, multicentre, observer-blind, placebo-controlled, interindividual trial with BF-200 ALA, a registered MAL cream and placebo in a ratio of 3:3:1. Six hundred patients, each with four to eight mild to moderate AK lesions on the face and/or the bald scalp, were enrolled in 26 study centres in Germany, Austria and Switzerland. Patients received one PDT. If residual lesions remained at 3months after treatment, PDT was repeated. RESULTS PDT with BF-200 ALA was superior to placebo PDT with respect to patient complete clearance rate (78·2% vs. 17·1%; P<0·0001) and lesion complete clearance rate (90·4% vs. 37·1%) at 3months after the last PDT. Moreover, superiority was demonstrated over the MAL cream regarding the primary endpoint patient complete clearance (78·2% vs. 64·2%; P<0·05). Significant differences in the patient and lesion complete clearance rates and severity of treatment-related adverse events were observed for the narrow- and broad-spectrum light sources. CONCLUSIONS BF-200 ALA is a very effective, well-tolerated new formulation for AK treatment with PDT and is superior to a registered MAL medication. Efficacies and adverse events vary greatly with the different light sources used.
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Lehmann P, Nöthen J, von Braun SS, Bohnsack MT, Mirus O, Schleiff E. Transitions of gene expression induced by short-term blue light. PLANT BIOLOGY (STUTTGART, GERMANY) 2011; 13:349-61. [PMID: 21309982 DOI: 10.1111/j.1438-8677.2010.00377.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Blue light modulates many processes in plants and plant cells. It influences global and long-term responses, such as seedling development and phototropism, and induces short-term adaptations like stomatal opening and chloroplast movement. Three genes were identified as important for the latter process, namely PHOT1, PHOT2 and CHUP1. The former two phototropin blue light receptors act in perception of the blue light signal. The protein CHUP1 is localised to the outer envelope membrane of chloroplasts and is involved in chloroplast movement. To explore whether short-term reactions required for chloroplast movement are under transcriptional control, we analysed the transcriptome in wild-type Arabidopsis thaliana, phot1, phot2 and chup1 with different blue light treatments for 5 or 30 min. Blue light-induced changes in transcription depended on illumination time and intensity. Illumination with 100 μmol·m(-2) · s(-1) blue light induced down-regulation of several genes and might point to cascades that could be important for sensing low levels of blue light. Analysis of the transcriptome of the mutants in response to the different light regimes suggests that the transcriptional response to blue light in the wild-type can be attributed to phot1 rather than phot2, suggesting that blue light-induced alteration of expression is a function of phot1. In contrast, the blue light response at the transcriptional level of chup1 plants was unique, and confirmed the higher light sensitivity of this mutant.
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Donnet A, Valade D, Lanteri-Minet M, Demarquay G, Guegan-Massardier E, Geraud G, Levrier O, Lehmann P. Céphalées liées à l’effort, l’activité sexuelle et la toux : étude prospective et multicentrique versus témoins. Rev Neurol (Paris) 2011. [DOI: 10.1016/s0035-3787(11)70010-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gillet JL, Donnet A, Lausecker M, Guedes JM, Guex JJ, Lehmann P. Pathophysiology of visual disturbances occurring after foam sclerotherapy. Phlebology 2010; 25:261-6. [DOI: 10.1258/phleb.2009.009068] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Visual disturbances (VDs) are reported with an average rate of 1.4% after foam sclerotherapy (FS). Some clinical clues indicate that they could correspond to migraine with aura (MA). Aims To validate the hypothesis that VDs occurring after FS correspond to MA and are not transient ischaemic cerebro-vascular events. Method A prospective multicentre study was carried out by the French Society of Phlebology in collaboration with the Neurology Department of the Marseille University Hospital (France). We included prospectively and consecutively all patients who experienced VDs after FS using air to make the foam. The patients were assessed (1) clinically with a specific form describing procedures of FS and recording neurological symptoms, later analysed by a neurologist specialized in migraine; and (2) by a brain diffusion-weighted magnetic resonance imaging (MRI) (T1, T2, T2*, diffusion) carried out within two weeks and analysed by a neuroradiologist. Results Twenty patients, 16 women and four men, were included in 11 phlebology clinics. All kinds of veins were treated. VDs occurred in average seven minutes after FS. Clinical assessment showed that VDs presented characteristics of MA in all patients, with headache in 10 and without in 10. Paresthesia was observed in five patients and dysphasic speech disturbance in one. Fifteen patients (75%) had a personal history of migraine. Fifteen MRIs were performed within two weeks (mean: 8 days) and three were late (26 days). All of them were normal. MRI was not performed in two patients. Conclusion These results show that VDs occurring after FS correspond to MA and are not transient ischaemic cerebro-vascular events. We suggest a pathophysiological hypothesis resting on the release of endothelin that would reach the cerebral cortex through a paten foramen ovale.
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Festag R, Hessel V, Lehmann P, Ringsdorf H, Wendorff J. Micellar and lyotropic behavior of three isomeric bola-amphiphiles with pyridinium groups. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19941130410] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Whitmire ML, Bryan P, Henry TR, Holbrook J, Lehmann P, Mollitor T, Ohorodnik S, Reed D, Wietgrefe HD. Nonclinical dose formulation analysis method validation and sample analysis. AAPS JOURNAL 2010; 12:628-34. [PMID: 20711763 PMCID: PMC2976985 DOI: 10.1208/s12248-010-9226-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 07/06/2010] [Indexed: 11/30/2022]
Abstract
Nonclinical dose formulation analysis methods are used to confirm test article concentration and homogeneity in formulations and determine formulation stability in support of regulated nonclinical studies. There is currently no regulatory guidance for nonclinical dose formulation analysis method validation or sample analysis. Regulatory guidance for the validation of analytical procedures has been developed for drug product/formulation testing; however, verification of the formulation concentrations falls under the framework of GLP regulations (not GMP). The only current related regulatory guidance is the bioanalytical guidance for method validation. The fundamental parameters for bioanalysis and formulation analysis validations that overlap include: recovery, accuracy, precision, specificity, selectivity, carryover, sensitivity, and stability. Divergence in bioanalytical and drug product validations typically center around the acceptance criteria used. As the dose formulation samples are not true “unknowns”, the concept of quality control samples that cover the entire range of the standard curve serving as the indication for the confidence in the data generated from the “unknown” study samples may not always be necessary. Also, the standard bioanalytical acceptance criteria may not be directly applicable, especially when the determined concentration does not match the target concentration. This paper attempts to reconcile the different practices being performed in the community and to provide recommendations of best practices and proposed acceptance criteria for nonclinical dose formulation method validation and sample analysis.
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Sobottka A, Lehmann P. [Rosacea 2009 : new advances in pathophysiology, clinical staging and therapeutic strategies]. Hautarzt 2010; 60:999-1009. [PMID: 19957073 DOI: 10.1007/s00105-009-1825-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Rosacea is one of the most common dermatoses of adults. In recent years many studies have contributed to a better understanding of the pathophysiology of rosacea. They suggest that an altered innate immune response is involved in the vascular and inflammatory manifestations seen in rosacea. A good understanding of the disease and its special features is necessary for the differential diagnosis of the many clinical subtypes and for a stage- and phase-specific treatment approach. Topical treatments that are widely accepted are metronidazole and azelaic acid; agents under investigation that show promise include permethrin, calcineurin inhibitors and sulfur compounds. For systemic therapy antibiotics (tetracyclines, macrolides) and recently doxycycline in anti-inflammatory rather than anti-microbial dosages are used, as well as isotretinoin in severe cases. Findings such as rhinophyma and telangiectases can be treated using different laser systems or dermabrasion. This article gives an overview regarding rosacea, a challenging condition with multiple therapeutic options.
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Shokri N, Lehmann P, Or D. Liquid-phase continuity and solute concentration dynamics during evaporation from porous media: pore-scale processes near vaporization surface. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2010; 81:046308. [PMID: 20481828 DOI: 10.1103/physreve.81.046308] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Indexed: 05/29/2023]
Abstract
Evaporation from porous media involves complex pore scale transport processes affecting liquid phase distribution and fluxes. Often, the initial evaporation rate is nearly constant and supplied by capillary flow from wetted zones below to the surface. Sustaining constant flow against gravity hinges on an upward capillary gradient and on liquid phase continuity with hydraulic conductivity sufficient for supplying evaporative flux. The pore scale liquid phase adjustments during evaporative displacement necessary for maintaining a constant flux have been postulated but rarely measured. In this study we employed detailed imaging using x-ray synchrotron radiation to study liquid phase distribution and dynamics at the most sensitive domain just below the surface of evaporating sand columns. Three-dimensional images at a resolution of 7 microns were obtained from sand column (mean particle size 0.6 mm) initially saturated with calcium iodide solution (4% by mass) to enhance image contrast. Detailed imaging of near-surface liquid phase distribution during evaporation confirmed phase continuity at micrometric scale and provided quantitative estimates of liquid conductance in agreement with values required to supply evaporative flux. Temporal variations in bulk salt concentrations determined from x-ray attenuation were proportional to evaporative water mass loss. Highly resolved salt concentration images revealed existence of evaporating chimneys that supply the bulk of evaporative demand. Delineated mass loss dynamics and salt distribution measured by the x-ray attenuation were in reasonable agreement with a simplified analytical convection-diffusion model for salt dynamics during evaporation from porous media.
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Franc J, Lehmann P, Saliou G, Monet P, Kocheida EM, Daguet E, Laurent A, Legars D, Deramond H. [Vertebroplasty: 10 years clinical and radiological follow-up]. J Neuroradiol 2010; 37:211-9. [PMID: 20304496 DOI: 10.1016/j.neurad.2009.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 10/22/2009] [Accepted: 10/27/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Ten years follow-up of the first patients treated with percutaneous vertebroplasty. PATIENT AND METHODS Eighteen patients were retrospectively reviewed having undergone vertebroplasty in our centre between 1989 and 1998. Eight were treated for angioma, eight for osteoporotic compression and two followed for myeloma. They all underwent clinical and radiological evaluation in 2007 (standard X-rays, CT scan and MRI). These examinations were compared to prior baseline pre- and post-therapeutic images. RESULTS Radiological characteristic of cement remained unchanged in the long term and there was no modification of anatomical structures in contact with it. Even if the distribution of cement was asymmetrical there was no fracture of the treated vertebras at distance. Degenerative changes of discs facing the vertebroplasty were not more pronounced than for distant discs. We found no significant signal or density anomaly of disc in contact direct with cement. 38.8 % of the patients presented new fractures (n=30). Seventy percent of the fractures were multiple and contiguous. In the long term, all patients reported improvement of pain after the procedure. CONCLUSION In our series, we found a good stability of treatment over time. This study shows the long-term safety of percutaneous acrylic vertebroplasty, in particular harmlessness of cement for bone and discs in contact.
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Korting H, Lehmann P. Acne vulgaris. Hautarzt 2010; 61:97-8. [DOI: 10.1007/s00105-010-1918-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lehmann P, Monet P, de Marco G, Saliou G, Perrin M, Stoquart-Elsankari S, Bruniau A, Vallée J. A Comparative Study of Perfusion Measurement in Brain Tumours at 3 Tesla MR: Arterial Spin Labeling versus Dynamic Susceptibility Contrast-Enhanced MRI. Eur Neurol 2010; 64:21-6. [DOI: 10.1159/000311520] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2010] [Accepted: 03/31/2010] [Indexed: 11/19/2022]
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Brochart C, Vanrenterghem A, Blanpain S, Demuynck F, Lehmann P. [Answer to November e-quid. Ultrasound diagnosis of an omphalomesenteric fistula in an infant]. JOURNAL DE RADIOLOGIE 2009; 90:1871-1873. [PMID: 20032833 DOI: 10.1016/s0221-0363(09)73596-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Monet P, Franc J, Brasseur A, Desblache J, Saliou G, Deramond H, Lehmann P. [Arterial spin labeling: state of the art]. ACTA ACUST UNITED AC 2009; 90:1031-7. [PMID: 19752806 DOI: 10.1016/s0221-0363(09)73242-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
UNLABELLED Arterial spin labeling (ASL) perfusion MR imaging is a technique by which water from circulating arterial blood is magnetically labeled and acts as a diffusible tracer allowing non-invasive measurement of cerebral blood flow. In this paper, the technique and current applications in neuroimaging will be reviewed. CURRENT STATUS First, the technical principles of ASL will be reviewed and both available techniques (continuous and pulsed ASL) explained. A review of the literature will demonstrate advances with the techniques of ASL and its clinical impact. Clinical research involves normal volunteers and patients with ischemic and tumoral pathologies. CONCLUSION Recent technical advances have improved the sensitivity of ASL perfusion MR imaging. The routine clinical use of ASL at 3.0 Tesla should increase over the next few years.
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Saliou G, Rutgers DR, Kocheida EM, Langman G, Meurin A, Deramond H, Lehmann P. Balloon-related complications and technical failures in kyphoplasty for vertebral fractures. AJNR Am J Neuroradiol 2009; 31:175-9. [PMID: 19749220 DOI: 10.3174/ajnr.a1783] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to describe the immediate or early complications and technical failures occurring during balloon kyphoplasty (BKP) procedures and attributable to balloon inflation. MATERIALS AND METHODS We performed a retrospective review of all consecutive kyphoplasty procedures performed in our institution from May 2005 to October 2006. Fifty-one patients were treated by BKP at 75 spinal levels, and 137 vertebroplasties were performed as well. RESULTS Several recurrent complications or procedural failures were observed during BKP: cortical or endplate fracture by balloon expansion (4 vertebrae), partial vertebral re-collapse after deflation (4 vertebrae), balloon rupture during inflation (5 vertebrae), and transient hyperalgia after the procedure (11 patients, 27.5%). CONCLUSIONS Several symptomatic or asymptomatic complications and technical failures can occur during BKP. Some modifications of the usual kyphoplasty technique may decrease the frequency of these complications.
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Best D, Gossop M, Lehmann P, Harris J, Strang J. The relationship between overdose and alcohol consumption among methadone maintenance patients. JOURNAL OF SUBSTANCE USE 2009. [DOI: 10.3109/14659899909052894] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Blanpain S, Brochart C, Demuynck F, Lefranc M, Morvan J, Brasseur A, Page C, Peltier J, Lehmann P, Le Gars D, Vallée JN. [Imaging management of osteo-dural defects: report of a rare case of spontaneous ethmoidal breach]. JOURNAL DE RADIOLOGIE 2009; 90:739-741. [PMID: 19623128 DOI: 10.1016/s0221-0363(09)74730-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Lehmann P, Bouaziz R, Page C, Warin M, Saliou G, Deschepper B, Strunski V, Deramond H. [Sinonasal cavities: CT imaging features of anatomical variants and surgical risk]. ACTA ACUST UNITED AC 2009; 90:21-9. [PMID: 19182710 DOI: 10.1016/s0221-0363(09)70074-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Anatomical variants of the sinonasal cavities are common. About 15 major variants are described (nasal septal deviation is present in up to 62% of the population). Because the may lead to complications at the time of endovascular procedures or endoscopic sinonasal surgery (vascular, nervous, or osseous injury), there detection has medicolegal implications. Knowledge of anatomical variants by radiologists and ENT surgeons is thus required. We will describe these variants, their imaging features, frequency, implications and associated risk of potential complication.
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Lehmann P. [Cutis verticis gyrata-like acne inversa. Combined medical and surgical management]. Hautarzt 2009; 60:328-30. [PMID: 19280163 DOI: 10.1007/s00105-009-1731-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 22-year-old soldier developed during his assignment in Afghanistan purulent draining nodules and fistulas on the scalp. The clinical picture resembled an inflammatory variant of cutis verticis gyrata, and taken together with the histology the diagnosis of acne inversa of the scalp was established. Therapy was started with corticosteroids and isotretinoin, which stopped the secretion of pus: thereafter all there nodules and draining sinuses were excised. After surgery, medication was continued with low dose isotretinoin and dapsone. A complete healing was achieved with this combined regimen.
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Lehmann P, Saliou G, Brochart C, Page C, Deschepper B, Vallée JN, Deramond H. 3T MR imaging of postoperative recurrent middle ear cholesteatomas: value of periodically rotated overlapping parallel lines with enhanced reconstruction diffusion-weighted MR imaging. AJNR Am J Neuroradiol 2009; 30:423-7. [PMID: 18945795 DOI: 10.3174/ajnr.a1352] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE MR diagnostic of postoperative recurrent cholesteatomas is difficult. Our purpose was to compare multishot fast spin-echo periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) diffusion-weighted MR imaging (DWI) with array spatial sensitivity encoding technique (ASSET) single-shot echo-planar DWI and late postgadolinium T1-weighted MR imaging for the detection of postoperative recurrent middle ear cholesteatomas with a 3T imaging unit. MATERIALS AND METHODS Thirty-five patients with suggested postoperative recurrent middle ear cholesteatoma underwent 3T MR imaging with PROPELLER DWI, ASSET echo-planar DWI, and late postgadolinium T1-weighted MR imaging. Three radiologists (2 seniors, 1 fellow) analyzed unlabeled images for visualization of recurrence. Interobserver and intraobserver agreement was assessed by using the Cohen kappa statistic test. Sensitivity, specificity, and predictive value were assessed for the 3 observers. RESULTS Nineteen recurrent cholesteatomas were diagnosed. PROPELLER interobserver agreement was very good (1, 0.89, 0.89) among the 3 observers. Intraobserver agreement between PROPELLER and T1-weighted imaging was very good to moderate (0.88, 0.57, 0.58). PROPELLER DWI provided less interobserver variability than other sequences, and the best sensitivity, specificity, and predictive value. CONCLUSIONS On a 3T imaging unit, multishot fast spin-echo PROPELLER DWI allows an easier detection of postoperative recurrent middle ear cholesteatoma than T1-weighted imaging by reducing artifacts and by its better contrast. DWI with PROPELLER is diagnostically robust and accurate.
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Stoquart-El Sankari S, Lehmann P, Gondry-Jouet C, Fichten A, Godefroy O, Meyer ME, Baledent O. Phase-contrast MR imaging support for the diagnosis of aqueductal stenosis. AJNR Am J Neuroradiol 2008; 30:209-14. [PMID: 18832663 DOI: 10.3174/ajnr.a1308] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Patients with aqueductal stenosis (AS) present with various clinical and radiologic features. Conventional MR imaging provides useful information in AS but depends on a subjective evaluation by the neuroradiologist. The purpose of this study was to evaluate the support of the phase-contrast MR imaging (PC-MR imaging) technique (sensitive to CSF flows) for the diagnosis of AS. MATERIALS AND METHODS We retrospectively considered 17 patients who underwent PC-MR imaging to explore hydrocephalus, with the absence of CSF flow at the aqueductal level. We analyzed their clinical and morphologic MR imaging data. RESULTS None of the usually reported direct or indirect signs of aqueductal obstruction were seen in 7 patients in whom the clinical suggestion of AS was confirmed by PC-MR imaging results. Seven patients in this population had a third ventriculostomy, and 5 of them were among those in whom conventional MR imaging failed to reveal signs of aqueductal obstruction. All of these 7 patients had a positive postsurgical outcomes. The analysis of CSF and vascular dynamic data in this population was compared with an aged-matched population, and these data were found similar except for the fourth ventricular CSF flush flow latency. CONCLUSIONS PC-MR imaging supports the diagnosis of CSF flow blockage at the aqueductal level in a reliable, reproducible, and rapid way, which aids in the diagnosis of AS in patients with clinical and/or radiologic suggestion of obstructive hydrocephalus. We, therefore, suggest using this technique in the current evaluation of hydrocephalus.
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Saliou G, Balédent O, Lehmann P, Paradot G, Gondry-Jouet C, Bouzerar R, Devisme G, Theaudin M, Deramond H, Le Gars D, Meyer ME, Vallée JN. [Acute CSF changes in the mesencephalon aqueduct after subarachnoid hemorrhage as measured by PC-MRI]. J Neuroradiol 2008; 36:41-7. [PMID: 18701163 DOI: 10.1016/j.neurad.2008.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Determining acute intracranial hydrodynamic changes after subarachnoid hemorrhage through an analysis of the CSF stroke volume (SV) as measured by phase-contrast MRI (PC-MRI) in the mesencephalon aqueduct. METHOD A prospective study was performed in 33 patients with subarachnoid hemorrhage. A PC-MRI imaging study was performed n the acute phase (< 48 hours). CSF flow was measured in the aqueduct. The appearance of acute hydrocephalus (HCA) was then compared with data on CSF flow, and the location of the intraventricular and perimesencephalic bleeding. RESULTS CSF analysis was performed on 27 patients, 11 of whom presented with an acute HCA. All 11 patients had an abnormal SV in the aqueduct: patients with a communicating HCA had an increased SV (n=8); and patients with a noncommunicating HCA had a nil SV (n=3). Patients with a normal SV in the aqueduct did not develop an acute HCA. Intraventricular bleeding significantly led to HCA (P=0.02), which was of the communicating type in 70% of cases. CONCLUSION Subarachnoid hemorrhage leads to intracranial CSF hydrodynamic modifications in the aqueduct in the majority of patients. CSF flow can help us to understand the mechanism of the appearance of acute HCA. Indeed, hydrocephalus occurred - of the communicating type in most cases - even in the presence of intraventricular bleeding.
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Stoquart-ElSankari S, Lehmann P, Périn B, Gondry-Jouet C, Godefroy O. MRI and diffusion-weighted imaging followup of a stroke-like event in a patient with MELAS. J Neurol 2008; 255:1593-5. [DOI: 10.1007/s00415-008-0968-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Revised: 04/03/2008] [Accepted: 04/11/2008] [Indexed: 10/21/2022]
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85
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Lehmann P, Ruzicka T. Die Krankheit mit dem Schmetterling. Hautarzt 2008; 59:591-3. [DOI: 10.1007/s00105-008-1589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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86
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Ruf BR, Sandow P, Lehmann P, Del Piero L, Skopnik H. [Significance of the neuraminidase inhibitor oseltamivir for the management of seasonal influenza]. Dtsch Med Wochenschr 2008; 133:1259-64. [PMID: 18509804 DOI: 10.1055/s-2008-1077250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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87
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Hunzelmann N, Genth E, Krieg T, Lehmacher W, Melchers I, Meurer M, Moinzadeh P, Müller-Ladner U, Pfeiffer C, Riemekasten G, Schulze-Lohoff E, Sunderkoetter C, Weber M, Worm M, Klaus P, Rubbert A, Steinbrink K, Grundt B, Hein R, Scharffetter-Kochanek K, Hinrichs R, Walker K, Szeimies RM, Karrer S, Müller A, Seitz C, Schmidt E, Lehmann P, Foeldvári I, Reichenberger F, Gross WL, Kuhn A, Haust M, Reich K, Böhm M, Saar P, Fierlbeck G, Kötter I, Lorenz HM, Blank N, Gräfenstein K, Juche A, Aberer E, Bali G, Fiehn C, Stadler R, Bartels V. The registry of the German Network for Systemic Scleroderma: frequency of disease subsets and patterns of organ involvement. Rheumatology (Oxford) 2008; 47:1185-92. [PMID: 18515867 PMCID: PMC2468885 DOI: 10.1093/rheumatology/ken179] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective. Systemic sclerosis (SSc) is a rare, heterogeneous disease, which affects different organs and therefore requires interdisciplinary diagnostic and therapeutic management. To improve the detection and follow-up of patients presenting with different disease manifestations, an interdisciplinary registry was founded with contributions from different subspecialties involved in the care of patients with SSc. Methods. A questionnaire was developed to collect a core set of clinical data to determine the current disease status. Patients were grouped into five descriptive disease subsets, i.e. lcSSc, dcSSc, SSc sine scleroderma, overlap-syndrome and UCTD with scleroderma features. Results. Of the 1483 patients, 45.5% of patients had lcSSc and 32.7% dcSSc. Overlap syndrome was diagnosed in 10.9% of patients, while 8.8% had an undifferentiated form. SSc sine scleroderma was present in 1.5% of patients. Organ involvement was markedly different between subsets; pulmonary fibrosis for instance was significantly more frequent in dcSSc (56.1%) than in overlap syndrome (30.6%) or lcSSc (20.8%). Pulmonary hypertension was more common in dcSSc (18.5%) compared with lcSSc (14.9%), overlap syndrome (8.2%) and undifferentiated disease (4.1%). Musculoskeletal involvement was typical for overlap syndromes (67.6%). A family history of rheumatic disease was reported in 17.2% of patients and was associated with early disease onset (P < 0.005). Conclusion. In this nationwide register, a descriptive classification of patients with disease manifestations characteristic of SSc in five groups allows to include a broader spectrum of patients with features of SSc.
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Lehmann P, Brasseur A, Saliou G, Canaple S, Deramond H. Do TIAs require investigation by thin-slice high-resolution diffusion MRI with a 3T MR unit? Eur J Neurol 2008; 15:e62-3. [DOI: 10.1111/j.1468-1331.2008.02156.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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89
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Brochart C, Blanpain S, Page C, Saliou G, Deramond H, Lehmann P. An uncommon imaging aspect of recurrent cholesteatoma: the donut. Clin Otolaryngol 2008; 33:194-6. [PMID: 18429920 DOI: 10.1111/j.1749-4486.2008.01652.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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90
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de Marco G, Menuel C, Guillevin R, Vallée JN, Lehmann P, Fall S, Quaglino V, Bourdin B, Devauchelle B, Chiras J. [Clinical interest of fMRI and functional exploration methods of brain activity and interactivity: physical and neurophysiological considerations]. J Neuroradiol 2008; 35:131-43. [PMID: 18206238 DOI: 10.1016/j.neurad.2007.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
After having provided a brief reminder of the principle of the blood oxygen level-dependent (BOLD) contrast effect, the physiological bases of brain activity and the concepts of functional integration and effective connectivity, we describe the most recent approaches, which permit to explore brain activity and putative networks of interconnected active areas in order to examine the normal brain physiology and its dysfunctions. We present various methods and studies of brain activity analysis clinically applicable, and we detail the concepts of functional and effective connectivity, which allow to study the cerebral plasticity which occurs at the child's during the maturation (e.g., dyslexia), at the adult during the ageing (e.g., Alzheimer disease), or still in schizophrenia or Parkinson disease. The study of specific circuits in networks has to allow defining in a more realistic way the dynamic of the central nervous system, which underlies various cerebral functions, both in physiological and pathological conditions. This connectivity approach should improve the diagnostic and facilitate the development of new therapeutic strategies.
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Abstract
Photodynamic therapy (PDT) is gaining increasing significance in the treatment of skin cancers and precancerous lesions. Most of the studies dealing with this procedure focus on efficacy. Whereas treatment results are a decisive parameter, before any therapy is accepted the evaluation should also consider side effects in daily practice. We treated 2031 patients with PDT between 2001 and 2006, and evaluated the side effects during and after treatment with a specially designed protocol. The most prominent side effect was pain, which occurred in 92% of patients, followed by erythema/edema (89%) and scaling in conjunction with itching (80%). Less common unwanted effects included crusting (9%), pustules (6%), large erosions (1.2%), pigmentary changes (1%) and infections (0.4%). Especially widespread erosions and pustules caused significant anxiety for the patients. Patients should be informed in detail about the side effects of PDT prior to treatment, since most of the unwanted effects are easily managed, heal without scarring and do not influence the therapeutic response.
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Brochart C, Blanpain S, Lehmann P, Smail A, Demuynck F, Hassani H, Testelin S, Lacour MC, Ducroix JP, Salle V, Saliou G. [CT-scan findings in "silent sinus syndrome"]. J Neuroradiol 2007; 34:347-8. [PMID: 18031814 DOI: 10.1016/j.neurad.2007.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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93
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Saliou G, Théaudin M, Grados F, Clavel G, Lehmann P, Rutgers DR, Vallée JN. Cervico-brachial neuralgia caused by spontaneous resorption of ligamentum flavum calcification. Rheumatology (Oxford) 2007; 47:106-7. [PMID: 18033798 DOI: 10.1093/rheumatology/kem225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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94
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Fall S, Lehmann P, Ambaiki K, Vallée JN, Meyer ME, de Marco G. [Contribution of the spectral analysis to the brain connectivity study by fMRI]. Neurophysiol Clin 2007; 37:239-47. [PMID: 17996812 DOI: 10.1016/j.neucli.2007.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 05/28/2007] [Accepted: 05/28/2007] [Indexed: 10/23/2022] Open
Abstract
AIM To validate, through functional magnetic resonance imaging (fMRI) from spectral analysis of time series during a visuomotor task, a model of functional connectivity mainly constituted by the pre-supplementary motor area (pre-SMA), the supplementary motor area proper (SMA-proper) and the primary motor cortex (M1). MATERIALS AND METHODS The paradigm that was tried out in young subjects (n=5) consisted of a preparation task of motor movement. We firstly proceeded with an estimate in the frequency domain of coherency coefficients and values of phase shift between these three areas. Secondly, the estimated coherency coefficients were integrated to a model of functional connectivity. Two interaction coefficients were calculated, one for the related M1 and pre-SMA regions, the other one for the related M1 and SMA-proper regions. RESULTS AND CONCLUSION Our results demonstrate hemodynamic activity that definitely occurred earlier in the pre-SMA area during the preparatory period of the task. In the same way, a more important interaction was found between M1 and pre-SMA areas, which corroborates the assumption of the prevalent role played by these two areas in the case of a preparation task of a motor movement. Thus, this study has allowed highlighting a functional dissociation between the two portions of the SMA.
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Delotte J, Schumacker-Blay C, Bafghi A, Lehmann P, Bongain A. Information médicale et choix des patientes. Influences sur la pratique de l'accouchement du siège à terme par voie basse. ACTA ACUST UNITED AC 2007; 35:747-50. [PMID: 17698388 DOI: 10.1016/j.gyobfe.2007.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Accepted: 05/18/2007] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The mode of delivery of term singleton breech presentation has been argued for decades. Many elements are responsible for the current increase in the rate of elective cesarean delivery. Among these elements, the influence of medical information and patients' choices are unknown. PATIENTS AND METHODS We studied retrospectively, between January 1996 and December 2005, the mode of term breech delivery in a French maternity. RESULTS Medical information relates primarily to the complications of vaginal birth. Patient's request for an elective Cesarean has been in constant increase since 1996. DISCUSSION AND CONCLUSION Medical information and patients' choices strongly influence the practice of breech delivery.
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Carminati A, Kaestner A, Flühler H, Lehmann P, Or D, Lehmann E, Stampanoni M. Hydraulic contacts controlling water flow across porous grains. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2007; 76:026311. [PMID: 17930146 DOI: 10.1103/physreve.76.026311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Revised: 06/22/2007] [Indexed: 05/25/2023]
Abstract
Water flow between porous grains varies widely depending on the water distribution in contacts between grains. The hydraulic behavior of contacts varies from highly conductive when water fills the contacts to a bottleneck to flow as water pressure drops and contact asperities rapidly drain. Such changes greatly impact the hydraulic conductivity of porous grain packs such as aggregated soil. The dominant driving force of water flow across contacts is capillarity, often quantified relative to gravity and viscous forces using the capillary and Bond numbers. For fast water infiltration, viscous forces dominate. For simplicity we modeled the water distribution between spherical porous grains whose surfaces are covered by spherical bumps of much smaller radii. We provide experimental evidence obtained by neutron radiography and synchrotron-based x-ray tomographic microscopy documenting transitions in the flow behavior across contacts.
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Vanden Abeele B, Saliou G, Lehmann P, Théaudin M, Kocheida EM, Bonnaire B, Vallée JN. Recanalization of cerebral venous thrombosis within 24 hours: a case report. Neurology 2007; 69:221. [PMID: 17620559 DOI: 10.1212/01.wnl.0000268500.32178.8d] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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98
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Lehmann P. Methyl aminolaevulinate?photodynamic therapy: a review of clinical trials in the treatment of actinic keratoses and nonmelanoma skin cancer. Br J Dermatol 2007; 156:793-801. [PMID: 17419691 DOI: 10.1111/j.1365-2133.2007.07833.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Methyl aminolaevulinate-photodynamic therapy (MAL-PDT) has advanced the management of nonmelanoma skin cancer (NMSC), providing a treatment option for actinic keratosis (AK), basal cell carcinoma [both superficial (sBCC) and nodular (nBCC)] and Bowen's disease, with good clinical outcomes, low recurrence rates and enhanced cosmetic acceptability. Excellent results have been reported, with complete responses (CRs) in AK ranging from 69% to 93% at 3 months; CRs in Bowen's disease are 93% at 3 months and 68% at 24 months. In sBCC, CRs range from 85% to 93% at 3 months and are comparable with cryosurgery up to 60 months (75% vs. 74%). In nBCC, CRs range from 75-82% at 3 months to 77% at 60 months. MAL-PDT specifically targets diseased cells, leaving healthy tissue unharmed. This noninvasive treatment option is associated with minimal risk of scarring. Moreover, systemic uptake of MAL is negligible and the local phototoxic reactions that often occur during treatment rapidly heal to produce excellent cosmetic results. The side-effects of therapy, which are predominantly local phototoxic effects (burning, stinging and prickling sensations), are of mild-to-moderate intensity, of short duration and easily managed. Overall, the efficacy and low risk of side-effects afforded by this therapy have resulted in high patient preference in clinical trials. The current evidence base for MAL-PDT in the treatment of AK and NMSC is reviewed in this article.
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Saliou G, Kocheida M, Vernois J, Bonnaire B, Lehmann P, Vanden Abeel B, Boulu G, Le Blanche AF, Vallée JN. [Ankle and foot sprains: conventional radiography aspects]. ACTA ACUST UNITED AC 2007; 88:541-7. [PMID: 17464252 DOI: 10.1016/s0221-0363(07)89853-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Emergency departments frequently encounter pathology resulting from injury to the foot and ankle, with approximately 6000 case per day in France. In an ankle sprain, 85% of the lesions involve the lateral collateral ligament. Many other, much rarer, types of lesion with different therapeutic consequences can present, however. Interpretation of the initial conventional radiographs is vital to establishing the type lesion and to proposing adapted and rapid treatment. The objective of this article is to review the various osteoarticular and ligament injuries encountered in the foot and the ankle.
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Carminati A, Kaestner A, Ippisch O, Koliji A, Lehmann P, Hassanein R, Vontobel P, Lehmann E, Laloui L, Vulliet L, Flühler H. Water flow between soil aggregates. Transp Porous Media 2006. [DOI: 10.1007/s11242-006-9041-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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