Adjuvant gemcitabine and concurrent radiation for patients with resected pancreatic cancer: a phase II study.

The safety and efficacy of gemcitabine and concurrent radiation to the upper abdomen followed by weekly gemcitabine in patients with resected pancreatic cancer was determined. Patients with resected adenocarcinoma of the pancreas were treated with intravenous gemcitabine administered twice-weekly (40 mg m(-2)) for 5 weeks concurrent with upper abdominal radiation (50.4 Gy in 5(1/2) weeks).

Management for severe Crohn's disease: a lifetime cost-utility analysis.

Objectives: Infliximab is a costly therapy for active Crohn's disease resistant to corticosteroids and immunosuppressive medication. The purpose of this study was to examine whether a treatment including infliximab (episodic re-infusions for relapse or maintenance therapy every 8 weeks) was relevant compared with conventional management (surgery and medical treatment without infliximab) for nonfistulizing resistant Crohn's disease.

Methods: We performed a life-time cost-utility analysis with an analytic Markov decision model from the perspective of the third-party payer system.

[Chronic active ulcerative colitis. Efficacy of intravenous followed by oral cyclosporine combined with azathioprine].

Objective: To know whether the therapeutic protocol applied in the case of severe acute ulcerative colitis (UC) associating ciclosporine and azathioprine was also effective in the case of moderate chronic active ulcerative colitis (UC).

Subjects And Methods: in this retrospective study 10 patients (31-65 years, 6 distal colitis, 1 left colitis, 3 pancolitis) moderately active and corticosteroid-resistant or dependent were included. Patients received ciclosporine intraveinously (4 mg/kg/d) and were evaluated 10 days later.

Is scintigraphic double-track appearance a sign of severe acute episodes of ulcerative colitis?

Aim: In comparison to endoscopy, clinical and biological criteria are less predictive of severity in attacks of ulcerative colitis (UC). Our aim was to assess the value of the double-track scintigraphic appearance in the assessment of the severity of acute UC by comparing it to endoscopic criteria.

Patients And Methods: We reviewed medical records of 52 patients hospitalized for an acute attack of UC, who had undergone within 48 hours of presentation both a technetium 99m hexamethyl propylene amine oxime (99mTc-HMPAO) granulocyte scintigraphy and endoscopic examination (colonoscopy: n=20; rectosigmoidoscopy: n=32).

Small bowel length in Crohn's disease.

Background And Aims: This prospective study compared jejunoileal length in patients with Crohn's disease (CD) and the general population to determine whether this parameter can be related to outcome and management of CD complications.

Patients And Methods: Small bowel (SB) length was measured during abdominal surgery prior to bowel resection in 93 patients with CD and 92 patients without inflammatory or small bowel disease.

Results: SB length was shown to be shorter in patients with CD (462 vs.

Exogenous oestrogen as an alternative to food allergy in the aetiology of angioneurotic oedema.

Although frequently reported as an aetiology for chronic angioneurotic oedema or urticaria, food allergy is often a diagnosis proposed in the absence of more convincing evidence, as illustrated by the disappointing results of eviction regimens. We report a series of women with an initial diagnosis of food allergy, but in whom the role of oral contraceptives was subsequently demonstrated. Detailed medical history was obtained from 26 young women presenting with chronic angioneurotic oedema or urticaria initially attributed to food allergy, but in whom C1-esterase inhibitor (C1 INH) deficiency was demonstrated.

Therapeutic advances in the management of metastatic colorectal cancer.

Metastatic colorectal cancer has long been considered as a short-term, poor prognosis, chemoresistant disease. Until the early 1990s, the impact of systemic chemotherapy on patient outcome was debated. Recently, the emergence of new therapeutic modalities (5-FU modulations and associations with oxaliplatin and irinotecan) has led to a significant improvement in tumor response rates and patient survival.

Lhermitte sign and urinary retention: atypical presentation of oxaliplatin neurotoxicity in four patients.

Background: Regimens combining oxaliplatin with fluorouracil and folinic acid are standard therapeutic options for patients with metastatic colorectal carcinoma. Oxaliplatin has a good safety profile, although it is responsible for dose-limiting neurotoxicity typically consisting of two distinct clusters of symptoms. Cold-induced distal paresthesiae occur during or shortly after infusion in most patients and are usually transient and mild.

Butyrate strongly inhibits in vitro stimulated release of cytokines in blood.

We studied the in vitro effects of butyrate on the stimulated release of proinflammatory cytokines and cytokines involved in the Th-1/Th-2 balance using the whole-blood model in nine healthy humans. Cytokines were measured without (control) and after stimulation by bacterial lipopolysaccharides (LPS) and phytohemagglutinin (PHA) alone or with addition of butyrate at six different concentrations (0.0625, 0.

[Granulomatous arteritis through sarcoidosis].

Introduction: Digestive localisation of sarcoidosis is rare.

Observation: A 35 year-old man presented with sarcoidosis revealed by a mediastinal hilum lymphadenopathy 13 years earlier. Epigastric pain led to oeso-gastroduodenal fibroscopy and biopsies, showing inflammatory mucosa and numerous giant-cell epithelioid granulomas, without concomitant necrosis or fibrosis.

Effective use of argon plasma coagulation in the treatment of severe radiation proctitis.

Purpose: Chronic radiation proctitis, a well described complication of pelvic radiation therapy, can result in severe bleeding that is refractory to conventional treatment. Argon plasma coagulation is an effective treatment for hemorrhagic lesions of the gastrointestinal tract. The aim of this study was to assess the efficacy and safety of argon plasma coagulation in the management of severe radiation proctitis resistant to medical treatment.

Prevalence of germline mutations of hMLH1, hMSH2, hPMS1, hPMS2, and hMSH6 genes in 75 French kindreds with nonpolyposis colorectal cancer.

Hereditary nonpolyposis colorectal cancer (HNPCC) is a syndrome characterized by familial predisposition to colorectal carcinoma and extracolonic cancers of the gastrointestinal, urological, and female reproductive tracts. This dominant disorder is caused by germline defects in one of at least five DNA mismatch repair (MMR) genes: hMLH1, hMSH2, hPMS1, hPMS2, and hMSH6 (GTBP). Germline mutations of hMSH2 and hMLH1 are also frequently identified in families not fulfilling all the Amsterdam criteria, thereby demonstrating that the involvement of these genes is not confined to typical HNPCC.

[A 1993-1995 epidemiological survey of home parenteral nutrition in approved centers for adults in France].

Objectives: A 1993-1995 three year epidemiological survey of home parenteral nutrition was performed through in France in approved centers for adults.

Methods: Data were retrospectively collected each year on a standardized questionnaire focussing on indications and short term outcome.

Results: All centers (n = 14) participated in the study and 524 new adult patients were recruited.

[Adjuvant treatment of colonic cancers].

In the last decade, adjuvant chemotherapy has led to significant improvement in survival for large bowel cancer patients. The association of 5-FU plus levamisole was the first described and demonstrated its efficacy in stage Dukes C (T1,2,3,4 N1 M0) completely-resected adenocarcinoma. Recently, chemotherapy with 5-FU and folinic acid was recommended on the basis of randomized trials.

[Type I hypersensitivity reactions and etiopathogenesis of hemorrhagic rectocolitis].

There is a body of clinical, epidemiological, biologic, histological and therapeutic data suggesting that type I hypersensitivity plays a role in the pathogenesis and maintenance of ulcerative colitis. Contradictory evidence from different studies on the pathogenic mechanisms may simply mean that there is not one but several types of ulcerative colitis. Chronic inflammation of the intestine would cover a heterogeneous group of conditions.

[Maintenance treatment of Crohn's disease using orally administered mesalazine (Pentasa). A controlled multicenter study. The Study Groups on the Treatment of Inflammatory Digestive Disorders].

Background: Mesalamine provides a new therapeutic approach in treating Crohn's disease.

Methods: To assess the efficacy and safety of slow-release mesalamine (Pentasa) in maintaining remission in Crohn's disease, 161 patients with inactive disease were randomized to receive either Pentasa (2 g/day) or placebo in a 2-year double-blind, multicenter trial. Two strata were defined according to the duration of their remission: < 3 months (n = 64) or 3-24 months (n = 97), presumed to be high and low relapse risk strata, respectively.

Outcome of perianal fistulae in Crohn's disease--value of Hughes' pathogenic classification.

Applying the Hughes' pathogenic classification of ano-perineal lesions of Crohn's disease, this study was conducted to find out its possible prognostic value in perianal fistulas. Thirty-eight patients with ano-perianal fistulas were included; primary specific lesions (condyloma, cavitating ulcer, fissure) were found in 22 patients (group 1) and were absent in the other 16 patients (group 2). Patients of group 1 underwent more abdominal surgical interventions (G 1: 68%; G 2: 31% - P = 0.

Oral mesalamine (Pentasa) as maintenance treatment in Crohn's disease: a multicenter placebo-controlled study. The Groupe d'Etudes Thérapeutiques des Affections Inflammatoires Digestives (GETAID).

Background: Mesalamine provides a new therapeutic approach in treating Crohn's disease.

Methods: To assess the efficacy and safety of slow-release mesalamine (Pentasa; Ferring AS, Vanløse, Denmark) in maintaining remission in Crohn's disease, 161 patients with inactive disease were randomized to receive either Pentasa (2 g/day) or placebo in a 2-year double-blind, multicenter trial. Two strata were defined according to the duration of their remission: < 3 months (n = 64) or 3-24 months (n = 97), presumed to be high and a low relapse risk strata, respectively.