Concurrent diagnosis of oropharynx cancer and bone sarcoidosis mimicking metastasis.

Bone location is uncommon in both sarcoidosis and in neck cancer (HNC). Diagnosis of a bone lesion is therefore challenging to distinguish its nature in a patient suffering from both diseases. We report the case of a 69-years-old woman referred for P16 positive HPV-HNC. Magnetic Resonance Imaging (MRI) showed T2 hypo-signal on iliac crest and spine. 18FDG-PET demonstrated radiotracer uptake on these locations suggesting bone metastasis. However, bone biopsy showed epithelioid granuloma without malignant cells compatible with sarcoidosis location. The diagnosis of both localized advanced HPV-HNC and systemic sarcoidosis (bone, central nervous system) were retained. The patient received corticosteroid regimen at 0.5mg/kg/day and Methotrexate for sarcoidosis and radiation and chemotherapy with platins for carcinoma. As granulomatous bone marrow infiltration may have an uptake on 18FDG-PET, bone sarcoidosis can mimic metastatic disease. In addition, MRI often fails to distinguish sarcoidosis lesions from metastatic lesion in bones. As no reliable imaging test can decipher both diseases, the description of our case reinforces the necessity to perform bone biopsy in a patient suffering from both conditions to expertise the nature of bone lesions.

Agriculture increases the bioavailability of silicon, a beneficial element for crop, in temperate soils.

Crops may take benefits from silicon (Si) uptake in soil. Plant available Si (PAS) can be affected by natural weathering processes or by anthropogenic forces such as agriculture. The soil parameters that control the pool of PAS are still poorly documented, particularly in temperate climates. In this study, we documented PAS in France, based on statistical analysis of Si extracted by CaCl2 (SiCaCl2) and topsoil characteristics from an extensive dataset. We showed that cultivation increased SiCaCl2 for soils developed on sediments, that cover 73% of France. This increase is due to liming for non-carbonated soils on sediments that are slightly acidic to acidic when non-cultivated. The analysis performed on non-cultivated soils confirmed that SiCaCl2 increased with the < 2 µm fraction and pH but only for soils with a < 2 µm fraction ranging from 50 to 325 g kg-1. This increase may be explained by the < 2 µm fraction mineralogy, i.e. nature of the clay minerals and iron oxide content. Finally, we suggest that 4% of French soils used for wheat cultivation could be deficient in SiCaCl2.

Adjuvant Chemotherapy in Rectal Cancer after Chemoradiotherapy.

The aim of this overview was to investigate whether adjuvant chemotherapy has a favourable effect on the outcome of patients with rectal cancer who had preoperative (chemo)radiotherapy. A review of randomised clinical trials that allocated patients between fluorouracil-based and observation or between fluorouracil-based and oxaliplatin-based adjuvant chemotherapy after preoperative (chemo)radiotherapy was carried out, including their corresponding meta-analyses. None of the five randomised trials has shown a significant benefit of fluorouracil-based adjuvant chemotherapy for overall survival or disease-free survival. Also, the three corresponding meta-analyses failed to show a benefit of adjuvant treatment. Of three randomised trials - two phase III and one phase II with a 3-year disease-free survival end point - two showed a small benefit of adding oxaliplatin to fluorouracil, one failed. The corresponding meta-analyses showed that the pooled difference was not significant. In conclusion, the use of postoperative 5-fluorouracil-based chemotherapy with or without oxaliplatin in patients with rectal cancer after preoperative (chemo)radiotherapy is not scientifically proven.

[13C]aminopyrine and [13C]caffeine breath test: influence of gender, cigarette smoking and oral contraceptives intake.

The [13C]aminopyrine breath test ([13C]ABT) measures the global activity of cytochrome P450 in vivo and is a sensitive indicator of liver metabolic dysfunction. The present study aims to determine whether gender and cigarette smoking influence the results of [13C]ABT as well as to confirm the effect of oral contraceptive steroids (OCS) intake on this metabolic test. Hundred and ten healthy subjects, including men and women, smoker and non-smoker, women taking OCS or not, were phenotyped for CYP1A2 using the [13C]caffeine breath test and underwent a [13C]ABT. Both tests showed large inter-individual variations in accordance with that of CYP450 liver content. [13C]ABT was sensitive enough to point out a significant induction or inhibition related to cigarette smoking habits or OCS. The combined effect of smoking and OCS resulted in an overall unchanged metabolic activity. Consequently, the impact of the studied conditions on the [13C]ABT parameters must be considered by clinicians or clinical investigators.

[Orthotopic liver graft with aortic clamping. Experimental study in dogs (author's transl)]. / La greffe orthotopique du foie sous clampage aortique. Etude expérimentale chez le chien.

Orthotopic liver transplants were conducted in 15 dogs, with aortic clamping during the anhepatic time of the operation and without venous shunting. Aortic clamping lasted for between 30 and 42 minutes. Immunosuppressant treatment was not given. Eight dogs died within 2 hours after the operation, 5 from haemorrhage and 3 accidentally. Seven animals survived for between 6 hours and 11 days: 3 died within 24 hours from haemorrhage, 2 from hepatic failure between the 2nd and 3rd day. One animal died on the 7th day from an acute intestinal invagination, the dog surviving for the longest period eventually dying after rejection of the transplant. These results demonstrate, as in other reported series, that the most frequent cause of death is the haemorrhagic diathesis, probably as a result of poor graft conservation. Dogs tolerate the supracoeliac aorta clamp both from the renal and intestinal points of view ; spinal cord tolerance to the ischaemia is less evident as paraplegia of the hindquarters was noted in one animal in the group. Aortic clamping considerably reduces operative time, as it avoids the need to construct a mesentericocaval anastomosis and a femorojugular shunt. It also avoids splanchnic blood sequestration and the risk of reducing cardia filling during clamping of the inferior vena cava.