The biological carbon pump in CMIP6 models: 21st century trends and uncertainties.

The biological carbon pump (BCP) stores ∼1,700 Pg C from the atmosphere in the ocean interior, but the magnitude and direction of future changes in carbon sequestration by the BCP are uncertain. We quantify global trends in export production, sinking organic carbon fluxes, and sequestered carbon in the latest Coupled Model Intercomparison Project Phase 6 (CMIP6) future projections, finding a consistent 19 to 48 Pg C increase in carbon sequestration over the 21st century for the SSP3-7.0 scenario, equivalent to 5 to 17% of the total increase of carbon in the ocean by 2100.

Randomized trial of 5-fluorouracil, leucovorin and cisplatin in advanced pancreatic cancer.

Background/aims: Phase II trials of combined 5 fluorouracil, leucovorin and cisplatin have demonstrated an 18-28% response rate in advanced pancreatic carcinomas. We investigated the effect of this chemotherapy regime on patients' survival.

Methodology: Patients included gave informed consent.

Bile duct cysts in adults: a multi-institutional retrospective study. French Associations for Surgical Research.

Objective: To review the features of adult patients undergoing surgery for bile duct cysts, focusing on the anatomy of the biliary tree as well as the long-term outcome.

Summary Background Data: Bile duct cysts (BDCs) are uncommon in Western countries, and the majority of reported cases originate from Asia. Japanese authors have emphasized the frequent association of extra- and intrahepatic bile duct dilatations, but grading of patients based on Todani's classification is often hindered by the absence of an accurate definition of types IC and IVA cysts.

Assessment of biliary excretion of piperacillin-tazobactam in humans.

Piperacillin-tazobactam concentrations in serum and bile were measured intraoperatively in 10 patients undergoing cholecystectomy (group 1) and 5 cholecystectomized patients provided with external bile duct drainage (group 2). Each patient received a single intravenous dose of piperacillin at 4 g plus tazobactam at 0.5 g over 30 min.

[Cystic dystrophy on an aberrant duodenal pancreas. Apropos of a case].

Cystic dystrophy of the aberrant pancreas is a rare poorly understood condition which is difficult to diagnose and treat. The primary clinical signs are epigastralgia associated with poor general health and complications due to stenosis of the duodenum. Endoscopy gives the most information on tissue lesions and cystic formations in the duodenal mucosa.

[Predictive factors of recurrence in surgically treated rectal villous tumors. Therapeutic approach based on 184 cases].

The aim of this retrospective study on 184 operated cases was to propose a therapeutic management scheme for villous tumours of the rectum. Among the 184 operated patients, 167 (90,7%), mean age 65 years, were seen after a follow-up of 2 to 20 years. The tumour was most often localized in the rectal ampoula (141 cases) and was benign in 65 p.

Role of intrahepatic protein binding in the hepatobiliary extraction profile of cefixime in humans.

The hepatobiliary extraction profile of cefixime, a dianionic cephalosporin antibiotic, was studied in 10 patients, each of whom was provided with T-tube drainage of his or her common bile duct after cholecystectomy. After a single 200 mg oral dose, cefixime biliary clearance proved to be nonlinear, mostly in its initial phase, which is consistent with a concentrative uptake and intracellular protein binding for the drug. The latter process appears to be saturable and to operate at a rate that correlates with the total amount of cefixime recovered in the 24-hour bile drainage.

Pancreatic localization of a Castleman's tumour.

Castleman's tumour is a rare anatomo-clinical entity. Most cases of Castleman's tumour occur in the mediastinum. The histopathology demonstrates benign angiofollicular lymph node hyperplasia.

[Local recurrence after surgery for cancer of the rectum].

Local tumor recurrence rates after curative rectal cancer surgery are reportedly high and herald a poor diagnosis. Extramural recurrence is most common and is due to the failure to remove all of the tumor during the initial operation. In the rarer anastomotic recurrence, the implantation of exfoliated malignant cells is possible, but histochemical changes in the mucosa surrounding a tumor may be considered as an alternative cause of local recurrence.

[Colorectal cancer in patients over the age of 80 years].

Between January 1, 1973 and December 31, 1986, 1.734 patients underwent colorectal resections for carcinoma. The patients were divided into two groups: group I included 163 patients > 80 years on first presentation; group II comprised 1.

[Proctocolectomy with ileo-anal anastomosis performed with mechanical suture without mucosectomy and without protective ileostomy].

Abdominal proctocolectomy with formation of an ileal reservoir anastomosed onto the anal canal using a stapler device is described. This technique avoids also stripping the mucosa from the anal canal which is time consuming and often difficult and incomplete. The avoidance of a temporary ileostomy did not lead to an increase in post operative complications.

Regulatory role of enteric kappa opioid receptors in human colonic motility.

The effects of different kappa opioid agonists and antagonists on spontaneous mechanical activities and responses to electrical transmural nerve stimulation of both longitudinal and circular muscle strips from the human sigmoid colon were studied. A superfusion apparatus was used to record isometric contractions. Exogenously added kappa agonists did not modify spontaneous contractile activities on either type of strip.

[Surgical widening of strictures in the small intestine in Crohn disease].

Twenty-two stricture plasties were performed in five patients with multiple stenosis of the small intestine due to Crohn's disease. Immediate post-operative results were satisfactory but progressive degradation followed. These findings are similar to those reported in the literature on this technique which does not give better results than other methods since none have an effect on the clinical course of the disease.

[Pancreatojejunostomy or pancreatogastrostomy after cephalic pancreatoduodenectomy].

The propensity for leakage at the site of pancreatojejunostomy continues to be a major reason for morbidity and death after pancreaticoduodenectomy. Pancreatogastrostomy has been introduced as a possible alternative to pancreatojejunostomy and although this procedure was developed experimentally more than 50 years ago its use has not gained widespread clinical use. The purpose of this study was to evaluate the role of pancreatogastrostomy.

Colorectal cancer in patients over 80 years of age.

Between January 1, 1973, and December 31, 1986, 1,734 patients underwent colorectal resections for carcinoma. Patients were divided into two groups: Group I included 163 patients aged greater than or equal to 80 years on first presentation; Group II comprised 1,571 patients aged less than 80 years. The total perioperative mortality rates for the elderly and young group were 15.

Morphine stimulates HIV replication in primary cultures of human Kupffer cells.

Intravenous drug abusers represent a high risk group for HIV infection in Europe and North America. Although the use of blood-contaminated needles undoubtedly constitutes the main factor of transmission of the virus, an effect of the drug itself either on the immune system or on virus replication, thus favouring the initiation of the infection, may not be excluded. We have formerly established that primary cultures of human Kupffer cells (KC) are permissive for HIV1.

[Role of pancreaticojejunostomy in the treatment of chronic pancreatitis. A study of 105 operated patients].

105 patients with intractable pain due to chronic pancreatitis were selected for treatment by lateral pancreatico-jejunostomy (according to the procedure of Partington Rochelle) after pre operative endoscopy had revealed a dilatation of the main pancreatic duct (mean : 6 mm). Pancreatico-jejunostomy was the unique procedure in 59 patients; it was associated with a biliary or duodenal diversion in 46 others patients. 2 patients died post-operatively and 12 required a second operation some years subsequent to the pancreatic drainage, for biliary stenosis due to the progress of the sclerosis.

[Colonic cancers. A retrospective study of 1122 surgically-treated patients].

A retrospective study of 1122 cancers of the colon operated by the same surgical team from 1973 to 1989 makes a number of statements possible: In spite of the improved diagnostic means, 66 (5.8%) only of the cancers were of Dukes' type A. 116 patients had complications, ie.

[Coloproctectomy with ileo-anal pouch. A simplified technique].

Coloproctectomy with pelvic ileal pouch allows normal transit while preserving and sphincter function. Using stapplers facilitates the construction of the ileal reservoir. Avoiding distal mucosectomy makes the anastomosis with the rectal stump easier and eliminates the need for a protective ileostomy as well as the morbidity associated with its closure.

Progress in the assessment of lymphatic spread in rectal cancer. Rectal endoscopic lymphoscintigraphy.

Rectal endoscopic lymphoscintigraphy was performed in 10 control subjects and in a series of 85 patients with adenocarcinoma of the rectum as a prospective study to evaluate lymphatic drainage of the rectum and lymphatic spread in rectal cancer. Complete cranial drainage was demonstrated in all control subjects, and internal iliac nodes were also visible in 50 percent of cases. Results were correlated with histologic node examination in all patients operated upon for rectal cancer.

[Progress in the evaluation of lymphatic involvement in cancer of the rectum: endoscopic rectal lymphoscintigraphy].

The preoperative evaluation of lymphatic spread in rectal cancer constitutes a considerable problem. A prospective study including 45 patients operated for rectal cancer, was carried out in order to assess the diagnostic value of a new technique: endoscopic rectal lymphoscintigraphy. The results of the preoperative assessment were compared with histological data according to Dukes' classification (Dukes A/B: 22 cases, Dukes C: 23 cases).