value of adjuvant 5-fluorouracil [FU] and leucovorin [LV] protracted venous infusion and radiotherapy in the postoperative management of carcinoma of the rectum and the rectosigmoid

Following potentially curative resection, the locoregional failure and the distant relapse, remain high. Consequently, adjuvant chemo and /or radiotherapy programs have been initiated. In the present study, 72 patients with stages II and III adenocarcinoma of the rectum and rectosigmoid were treated by radical surgery, and were divided at random into three equal groups: group I: treated by adjuvant radiotherapy alone, group II: treated by adjuvant chemotherapy alone for six cycles, and group III: treated by adjuvant three cycles of chemotherapy, then radiotherapy, and thereafter three more cycles of the same chemotherapy. Radiotherapy was given to the potential areas of soft tissue extensions, 45 to 50 Gy/4.5 to 5 weeks, five weekly fractions. Chemotherapy agent used was 5-fluorouracil [5-FU], 500 mg/day x 5 days, given by intravenous drip infusion and preceded by 20 mg/m[2] calcium leucovorin [LV]. Statistically significant lower local and distal failures were obtained in the combined modality group. Failures were significantly higher in patients with higher performance status, poor pathological differentiation, and in patients where the surgical resection margins were positive. The one year disease free survival [DPS] was significantly higher in group III as compared to groups I and II:. 83%, 50% and 58% respectively. The overall survival [OS] was nearly the same in the three groups of the study without statistically significant differences

Transit time, bacterial growth and electron microscope study of the small intestine in schistosomal hepatic fibrosis with portal pressure chances

Transit time, bacterial growth together with both light and electron microscopy of small intestine were studied in relation to different portal pressure levels in 23 patients with schistosomal hepatic fibrosis Schistosomal patients were divided into two groups: the first included those without ascites or elevated portal pressure [100-150 mm H[2]0] while the second group comprised patients with ascites and a portal pressure varying between 180 and 400 mm H[2]0. Although all findings were within normal in the first group patients, yet those of the second group showed delayed intestinal transit time[80%], small bowel bacterial overgrowth whether aerobic or anaerobic [80%] along with mild, moderate or marked light and electron microscopic pathological changes which seemed to depend on the extent of rise of the portal pressure. In spite of the fact that all studied parameters seem to be of importance, yet further attempts should be made in order to clarify the role and sequence of event, each of these factors play, in induction of altered intestinal functions in hepatic schistosomiasis patients