[Recent advances in the treatment of adrenocortical carcinomas]. / Avancées recentes dans le traitement des carcinomes corticosurrénaliens.

Adrenocortical carcinomas are rare and aggressive malignant tumors, with an incidence of 1 to 2 cases per million inhabitants. Their diagnosis is made in three clinical situations: during the work up of a syndrome of hormonal hypersecretion, during the work up of locoregional symptoms, or incidentally during an unrelated radiological procedure. Surgery is usually indicated except in situations of advanced metastatic disease. Adjuvant chemotherapy with mitotane is associated with a significant increase in disease-free survival when the drug is administered at adequate therapeutic dosage. Novel anti-mitotic therapies have recently been described for treating recurrent adrenocortical carcinoma under mitotane treatment, but their overall efficacy remains unsatisfactory.

Liver function in physically trained subjects: galactose elimination capacity, plasma disappearance of indocyanine green, and aminopyrine metabolism in long-distance runners.

Physical exercise and physical training are known to affect several aspects of hepatic metabolism. To assess whether adaptation to long-lasting exercise modifies microsomal drug metabolism, 8 long-distance runners were compared with a group of medical students having significantly lower maximal rates of oxygen consumption. At rest the hepatic galactose elimination capacity and the indocyanine green plasma disappearance rate used as reference methods were the same in both groups. The plasma clearance of ([14C]dimethylamine) aminopyrine and the kinetics of 14CO2 in breath did not differ either. It is concluded that adaptation to long-lasting exercise can occur without evidence for changes in hepatic galactokinase activity, liver blood flow, or microsomal metabolism of aminopyrine.