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Introduction: Stage III NSCLC comprises a heterogeneous population. Different treatment strategies are available, including surgery, radiotherapy, and chemotherapy. The PACIFIC trial results represented a significant change and improvement in the therapeutic strategy for these patients. We aimed to compare the different treatment strategies employed in Stage III NSCLC patients within our institution. Methods: All Stage III NSCLC patients discussed during the weekly thoracic oncology multidisciplinary team meetings at the University hospital Grenoble Alpes (France) between January 2010 and January 2017 were included. Patients’ overall survival (OS) according to treatment strategies along with their respective changes were compared. Results: Overall, 476 patients were identified. Among patients initially scheduled to receive neoadjuvant chemotherapy followed by surgery (n = 60), only 37 (62%) actually underwent surgery. Median OS of the cohort was 21.3 months [IQR 25%–75%: 9.6–48.3]. Patients who received neoadjuvant chemotherapy followed by surgery displayed better survival than those treated by CT-RT: 53.2 months [IQR 25%–75%: 16.1–87.3] versus 23.9 [IQR 25%–75%, 13.3–48.1]. Survival was slightly superior for patients treated by upfront CT-RT than for those planned for neoadjuvant chemotherapy followed by surgery who eventually converted to CT-RT (concurrent or sequential): 23.9 months [IQR 25%–75%: 13.3–48.1] versus 20.4 [IQR 25%–75%:10.8–36], respectively. Conclusion: While patients who underwent neoadjuvant chemotherapy followed by surgery displayed a better survival than those treated using CT-RT, switch from surgery to CT-RT actually shortened survival. These results stress the relevance of the tumor board in deciding which is the best therapeutic strategy for Stage III disease patients.

Abstract The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified as foreign body ingestion, caustic ingestion, esophageal perforation, and esophageal trauma. These lesions can be life-threatening either by digestive contamination of surrounding structures in case of esophageal wall breach or concomitant damage of surrounding organs. Early diagnosis and timely therapeutic intervention are the keys of successful management.

Objectives Home-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge.Design A prospective observational study.Intervention All patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week).Outcomes The H-RP was defined as ‘completed’ if the four components were performed before surgery.Results Out of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%–75%; 60–74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex.Conclusion Facing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP.Trial registration number NCT03530059.

Bronchiolitis obliterans syndrome (BOS), the main manifestation of chronic lung allograft dysfunction, leads to poor long-term survival after lung transplantation. Identifying predictors of BOS is essential to prevent the progression of dysfunction before irreversible damage occurs. By using a large set of 107 samples from lung recipients, we performed microarray gene expression profiling of whole blood to identify early biomarkers of BOS, including samples from 49 patients with stable function for at least 3 years, 32 samples collected at least 6 months before BOS diagnosis (prediction group), and 26 samples at or after BOS diagnosis (diagnosis group). An independent set from 25 lung recipients was used for validation by quantitative PCR (13 stables, 11 in the prediction group, and 8 in the diagnosis group). We identified 50 transcripts differentially expressed between stable and BOS recipients. Three genes, namely POU class 2 associating factor 1 (POU2AF1), T-cell leukemia/lymphoma protein 1A (TCL1A), and B cell lymphocyte kinase, were validated as predictive biomarkers of BOS more than 6 months before diagnosis, with areas under the curve of 0.83, 0.77, and 0.78 respectively. These genes allow stratification based on BOS risk (log-rank test p

Solid-phase extraction (SPE) methods are easy, rapid, and reliable. Their growing popularity is in part due to their operational simplicity and cost reduction in solvents, and partly because they are easier to automate. Sphingolipids are implicated in various cellular events such as growth, differentiation, and apoptosis. However, their separation by small SPE cartridges has attracted limited attention. Here we describe an SPE procedure on aminopropyl cartridges that by sequential elution allows the separation of a lipid mixture into free ceramides, neutral glycosphingolipids, neutral phospholipids (sphingomyelin), and a fraction containing the acidic phospholipids and phosphorylated sphingoid bases, phosphoceramides and sulfatides. Individual components are obtained in high yield and purity. We applied the procedure to obtain data on separation of [3H]myristic acid-labeled sphingolipids from fish gills, and from human melanoma tumor tissue. Individual lipids in the SPE fractions were identified by chromatography on several high-performance thin-layer chromatography (HPTLC) systems. The chromatographic behavior of free sphingoid bases is also reported. —Bodennec, J., O. Koul, I. Aguado, G. Brichon, G. Zwingelstein, and J. Portoukalian. A procedure for fractionation of sphingolipid classes by solid-phase extraction on aminopropyl cartridges. J. Lipid Res. 2000. 41: 1524–1531.

We have developed a novel, simple, and rapid, two-dimensional thin-layer chromatography method to separate 1,2-, 1,3-diacylglycerols and ceramides containing alpha-hydroxy and normal fatty acids from other neutral lipids on one 10 x 10 cm precoated silica gel plate. The three solvent systems used in succession leave the phospholipids at the origin and separate neutral lipids of interest into component species. We have applied this method to incorporation of 9,10-[3H]myristic acid into lipids of gills from sea bass and obtained results that are similar and comparable to those obtained by described methods.

Ultrathin layered films in new transistors architectures (FinFET and fully depleted SOI) require damage-free plasma etching techniques with unprecedented selectivity between materials. To assist the development of advanced processes, molecular dynamics simulations are performed to quantify modifications (plasma-induced damage, etch rate) of Si films after exposition to various Cl2 plasma conditions, simulated by bombarding the substrate with both ion (Cl+, Cl2+) and neutral (Cl, Cl2) species. All simulations show the formation of a stable SiClx reactive layer and a constant etch yield at steady state. The key plasma parameter to control the etching of ultrathin Si layers is the ion energy (Ei), which lowers significantly both the damaged layer thickness (from 1.8 nm at 100 eV to 0.8 nm at 5 eV when Γ=100) and the etch yield when it is decreased. The neutral-to-ion flux ratio (Γ) is the second key parameter: its increase reduces the damaged layer thickness (from 1.8 nm for Γ=100 to 1.1 nm for Γ=1000 at 100 eV) while the etch rate grows. While maintaining Γ constant, the neutral dissociation rate and the ion composition do not influence significantly the etching process. Quantitatively, simulations suggest that plasmas with low ion energies (<15 eV) and high Γ ratios (>1000) should induce sub-nm thick reactive layers, confirming an interest in low-Te or pulsed plasmas (operating at low duty cycle) to achieve nanometric precision etching. [ABSTRACT FROM AUTHOR]

We describe a patient with polytrauma that included anterior chest flail caused by a fall while climbing. As the situation was similar to a pectus excavatum, we attempted to stabilize the depressed chest wall by using a vacuum bell. Deep breath, peak flow, and pectus index were increased when the patient used the vacuum bell. Conservative treatment with a vacuum bell during the day and continuous positive airway pressure during the night was undertaken for 6 weeks. This report documents stabilization of an anterior flail chest using a vacuum bell. [ABSTRACT FROM AUTHOR]