Nonuraemic calciphylaxis: response to treatment with pamidronate and negative pressure therapy.

Calciphylaxis is a rare cause of skin ulcerations and necrosis in patients with both normal renal and parathyroid function. Although calciphylaxis appears to be on the increase, treatments are mainly empirical, especially for wound care. The lesions in calciphylaxis are typically very painful and carry a high risk of infection, with sepsis being the leading cause of death in this serious disease. We report two cases of nonuraemic calciphylaxis, which responded to treatment with pamidronate and wound management by negative pressure system.

[Theoretical and experimental vibrational spectroscopy study of K3Ln(PO4)2 phosphates]. / Etude théorique et expérimentale des spectres de vibration des phosphates K3Ln(PO4)2.

The monoclinic phosphates with K3Ln(PO4)2 (Ln=rare earth) formula were synthesized. Their infrared and Raman spectra have been reported and analysed. The results of a force field calculation for K3Nd(PO4)2 are presented.

[Vibrational spectra of monoclinic diphosphates of formula AMP2O7]. / Spectres de vibration des diphosphates monocliniques de formule AMP2O7.

The monoclinic pyrophosphates with AMP2O7 formula were synthesized. Their infrared and Raman spectra have been reported and analysed. The results of a force field calculation for CaCuP2O7 are presented.

[Gynecological and breast cancer in the department of Somme]. / Cancers gynécologiques et mammaires dans le département de la Somme.

BACKGROUND: Breast and gynecological tumors are the most common cancers in women. The aim of this study was to show the epidemiologic features of gynecological and breast cancers in the French administrative district of La Somme. METHODS: This study focused on the 1982-1999 period. Incidence, mortality and survival rates were calculated. RESULTS: In 1997-1999, the world standardized breast incidence and mortality rates were 81.6 and 20.2 per 100,000 females per year. Breast and genital tract cancers accounted for 47% of all cancers in women. The incidence and mortality of uterine cervix cancers showed a clear decline over the past 10 years, whereas the trend of breast cancers was dominated by continuing increase. However, mortality was stable for breast cancers. Five year relative survival rates were respectively 80% for breast cancers, and 68%, 76%, 38%, for uterine cervix, uterine body and ovary cancers respectively. Incidence and mortality rates in Somme were in the middle risk range of other cancer French registries. CONCLUSION: The results of this study indicate that genital tract and breast cancers constitute a serious public health problem pointing out the importance of screening activities in the Somme area.

[Descriptive epidemiology of upper aerodigestive tract cancers in the department of Somme]. / Epidémiologie descriptive des cancers des voies aérodigestives supérieures dans le département de la Somme.

The aim of this study is to show the epidemiologic features of upper aerodigestive tract cancers in the department of Somme. This study focused on the 1984-1995 period. For men, the upper aerodigestive tract cancers are the most frequent cancers in the Somme area. The incidence rate of pharynx cancers has shown slightly a decline over the past 10 years. The mortality rate of larynx cancers for males fell from 18.2 in 1984-1987 to 13.8 in 1992-1995 per 100,000. 5-year survival rates are between 20 and 39% for men, and from 23 to 42% for women. France has the highest incidence of these cancers in Europe. Within the country, the Somme area has a high risk for incidences and mortality as well. The results of this study indicate that upper aerodigestive tract cancers represent a serious problem for public health. Further areas need to be researched before such factors can be causally implicated in the aetiology of the disease in order to make up the prevention.

[Epidemiology of breast cancers in the Somme department (1990-1993)]. / Epidémiologie des cancers du sein dans la Somme (période 1990-1993).

Breast cancer is the commonest female cancer in the Somme region and represents the leading cause of cancer mortality in women. It therefore constitutes an important public health problem. From 1990 to 1993, 1,106 new cases of breast cancer were recorded by the Somme Cancer Registry. The incidence continued to increase over this period in the Somme region. The mortality rate for this period was 35.1/100,000 women, while the standardized mortality rate for the world population was 20.9/100,000 women. The most frequent histological types were invasive ductal carcinoma (64.3%) and invasive lobular carcinoma (5%). Carcinoma in situ represented 2.9% cases; 4% of patients presented metastases at the time of diagnosis. For the period 1990-1993, 44.3% cases were classified as T1, 37.9% as T2 and 11.5% as T3-T4. The lymph node extension rate was less than 15% for tumours less than 10 mm (on the resection specimen). The 5-year survival rate was 73%. It is important to increase the rate of early diagnosis in order to improve the overall survival of this disease.

[Incidence of esophageal cancer synchronous with upper aerodigestive tract cancers (100 cases): value of vital staining with lugol and toluidine blue]. / Fréquence du cancer de l'oesophage synchrone des cancers des voies aéro-digestives supérieures (100 cas): intérêt des colorations vitales au lugol et au bleu de toluidine.

A number of studies have demonstrated a high incidence of synchronous or metachronous esophageal carcinoma in association with carcinoma of head and neck. Carcinoma of the esophagus must be systematically looked for before the treatment of head-neck carcinomas and during follow-up. The aim of this study was to determine the incidence of synchronous esophageal carcinoma in patients with head and neck carcinoma and to evaluate the advantages of lugol and toluidine blue vital staining in fiberoptic endoscopy. One hundred patients (97 males and 3 females, mean age 54.9 years) were studied. A fiberoptic esophagoscopy was performed in all patients. Vital staining was realized with 5 p. 100 lugol in 40 cases and with 1 p. 100 toluidine blue e in 20 cases. Squamous cell carcinoma of the esophagus was observed in 12 patients, typical grossly in 5 cases and occult in 7 cases. In these latter cases, lugol (2 cases) or toluidine blue (5 cases) stain facilitated the forceps biopsies. Histological examination was positive in all cases. The incidence of esophageal carcinoma synchronous to carcinoma of the mouth was high (35.3 p. 100). Lugol vital staining seems to be sensitive, non-specific and easy to realize. Toluidine blue staining calls for a more difficult and prolonged technique. Although it can reveal occult carcinoma, false positive or negative results may be observed.

[Upper esophageal varices. Study of 6 cases and review of the literature]. / Varices oesophagiennes supérieures. Etude de 6 cas et revue de la littérature.

Distal esophageal varices are most frequently associated with portal hypertension, while varices of the upper esophagus are occasionally observed in patients with vena caval obstruction. One hundred and nineteen cases of upper esophageal varices (downhill varices) have been reported in the literature. We report 6 cases (4 men and 2 women), with vena caval obstruction. Upper gastrointestinal hemorrhage occurred in one patient. Endoscopy showed varices in the proximal third of the esophagus in 5 patients and in the proximal half of the esophagus in the other patient. Superior vena cavogram demonstrated total or partial occlusion of the vena cava in 6 cases, with opacification of the right azygos vein in 4 cases and thrombosis of this vein in one case. Superior vena caval obstruction was secondary to malignant lymphoma in 2 cases, to malignant thymoma in 2 cases, to malignant thyroid tumor in one case and to anaplastic bronchogenic carcinoma in one case. Clinical symptoms of vena caval obstruction are present in 91.4 p. 100 of the cases in the literature. Upper gastrointestinal hemorrhage are observed in 7.6 p. 100 of cases. It is generally agreed that the predominant factors involved in the determination of the downward extension of varices along the esophagus are the level of superior vena caval obstruction and its duration. Because of the risk of digestive hemorrhage and of the topographic meaning of the degree of extension, upper esophageal varices should be routinely searched in patients with vena caval hypertension.

Liver abscess complicating Yersinia pseudotuberculosis ileitis.

The occurrence of solitary liver abscess is described in a young farmer with subacute terminal ileitis mimicking Crohn's disease. Serologic tests showed high titers of antibodies for Yersinia pseudotuberculosis. Treatment with troleandomycin was successful. This case report suggests that: (a) Yersinia infection must be systematically searched for in all forms of subacute ileitis; (b) a classically benign Yersinia ileitis may be complicated by liver abscess; (c) antibiotic therapy must be undertaken in Yersinia pseudotuberculosis subacute ileitis to avoid severe infectious complications.

Evidence for an association between cholelithiasis and diverticular disease of the colon: a case-controlled study.

A prospective case-control study was carried out to determine if there was a true association between diverticular disease of the colon and cholelithiasis. The prevalence of gallstones was higher in 102 patients with diverticular disease of the colon (45%) than in 102 control subjects, matched for age, sex, body weight, and number of pregnancies (22%) (P less than 0.001). The difference was only significant in women. Although these results obtained in hospitalized patients cannot be generalized to the population at large, this study suggests an association between diverticular disease of the colon and gallstone disease. The possibilities of referral bias, detection bias, and chance are considered, and the mechanism of this association is discussed, with particular reference to the role of a fiber-depleted diet.

Pyloric bilirubin outputs: a new method for evaluation of duodenogastric reflux.

Duodenogastric reflux of bile and pancreatic secretions is known to induce acute chronic alterations of gastric and oesophageal mucosa. Several complex methods have been reported to demonstrate duodenogastric reflux (DGR) in man. The aim of this work was to describe a simple test for evaluation of DGR. The studied groups included: 1) 30 patients with DGR demonstrated by the radiological test of Capper and by endoscopic examination (group I); 2) 18 subjects without demonstrable DGR (group II). Bilirubin concentrations were measured in gastric juice collected for 10 min periods during one hour before and one hour after gallbladder stimulation by cholecystokinin-pancreozymin (CCK-PZ) (35 Ivy-dog Units). Bilirubin output was determined in the basal state (basal bilirubin output); maximal bilirubin peak (MBP) was determined by the highest of the collected samples following CCK-PZ administration. There was no significant difference between the two groups for basal bilirubin output. Analysis of the MBP showed that the two groups were significantly different (p less than 0.05). A duodenogastric reflux is present and can be quantitated when the MBP is above 200 microgram. Our results suggest that this method is available to evaluate the role of duodenogastric influx in gastric and/or oesophageal diseases.