Levels of Intestinal Inflammation and Fibrosis in Resection Specimens after Preoperative Anti-Tumor Necrosis Factor Alpha Treatment in Patients with Crohn's Disease: A Comparative Pilot Study.

BACKGROUND: Strictures are a common complication in Crohn's disease (CD), found in more than 50% of patients. They are characterized by the excessive deposition of extracellular proteins in the tissue as a result of the chronic inflammatory process. The effect of anti-tumor necrosis factor alpha (TNF-α) therapy on the development of fibrosis is not yet fully understood. AIM: To investigate whether the degree of intestinal inflammation and fibrosis is correlated with preoperative anti-TNF-α) therapy on the development of fibrosis is not yet fully understood. METHODS: This unblinded, prospective, single tertiary center, pilot cohort study included all adult patients with CD who underwent elective, laparoscopic, or open intestinal resection. Preoperative investigations included measurement of blood TNF-α) therapy on the development of fibrosis is not yet fully understood. RESULTS: Histopathological specimens from 10 patients with CD who underwent ileocecal or ileocolic resections were retrieved. Four of those patients were on anti-TNF-α) therapy on the development of fibrosis is not yet fully understood. α) therapy on the development of fibrosis is not yet fully understood. α) therapy on the development of fibrosis is not yet fully understood. p=0.01). Anti-TNF-α) therapy on the development of fibrosis is not yet fully understood. α) therapy on the development of fibrosis is not yet fully understood. α) therapy on the development of fibrosis is not yet fully understood. CONCLUSIONS: Patients who underwent preoperative anti-TNF-α treatment had a higher fibrosis score than controls.α) therapy on the development of fibrosis is not yet fully understood.

RAS testing for colorectal cancer patients is reliable in European laboratories that pass external quality assessment.

Wild-type status of KRAS and the NRAS gene (exon 2, 3, and 4) in the tumor should be determined before treatment of metastatic colorectal cancer (mCRC) patients with EGFR-targeting agents. There is a large variation in test methods to determine RAS status, and more sensitive detection methods were recently introduced. Data from quality assessment programs indicate substantial error rates. This study assessed the completeness and correctness of RAS testing in European laboratories that successfully passed external quality assessment (EQA). Participants were requested to send material of their most recent ten patients with mCRC who had been tested for RAS status. Isolated DNA, a hematoxylin and eosin stained tissue slide with a marked area for macrodissection and accompanying patient reports were requested. Samples were reevaluated in a reference laboratory by using a next-generation sequencing approach. In total, 31 laboratories sent in the requested material (n = 309). Despite regulations for anti-EGFR therapy, one institute did not perform full RAS testing. Reanalysis was possible for 274 samples with sufficient DNA available. In the hotspot codons of KRAS and NRAS, seven discordant results were obtained in total, five of them leading to a different prediction of anti-EGFR therapy efficacy (2%; n = 274). Results show that oncologists can rely on the quality of laboratories with good performance in EQA. Oncologists need to be aware that the testing laboratory participates successfully in EQA programs. Some EQA providers list the good performing laboratories on their website.

Immunoprophylactic evaluation of a 37-kDa Brugia malayi recombinant antigen in lymphatic filariasis.

The Brugia malayi filarial antigens recognised preferentially by sera from an endemic normal population are considered to be potential vaccine candidates. By immunoscreening the cDNA library of the infective L3 stage of B. malayi with pooled endemic normal sera, a cDNA clone Bm-SL3 was identified. Analysis of sera from different patient groups with the rBm-SL3 protein showed it to be highly reactive with endemic normal sera compared to its reactivity with microfilaraemic and non-endemic normal sera. The immunoprotective efficacy of the rBm-SL3 antigen against B. malayi filarial infection was evaluated in susceptible host jirds (gerbils) (Meriones unguiculatus). Jirds immunised with the rBm-SL3 antigen showed 68% cytotoxicity against microfilariae and 67-69% cytotoxicity against infective larvae in in-vitro antibody-dependent cellular cytotoxicity assays and in-situ micropore chamber methods. Analysis of IgG subclasses against Bm-SL3 revealed a significant increase in IgG1 and IgG2 antibodies in endemic normal sera compared with other groups. Lymphocyte proliferation to Bm-SL3 was significantly higher in the endemic normal group compared with that in clinical and microfilarial carriers (p < 0.001). Significantly enhanced levels of IFN-gamma in the culture supernatant of peripheral blood mononuclear cells of endemic normal sera after stimulation with Bm-SL3 suggest that the cellular response in this group may have a Th1 bias.

[Urinary peritonitis caused by perforation following trans-intestinal ureterostomy. Apropos of 3 cases]. / Péritonite urinaire par perforation après urétérostomie transintestinale. A propos de trois cas.

The authors report three cases of peritonitis due to perforation of an ileal loop diversion. Two cases occurred 21 and 26 days after surgery with a persistent lesion at the base of the graft. The third case, much more unusual, occurred 8 months after the operation due to a stress ulcer in the ileal loop. The three patients were successfully treated surgically but the ileal loop diversion could only be preserved in one case: the other patients underwent cutaneous ureterostomy. The authors distinguish between fistulae of intermediate and late onset after the operation. The first type of fistulae can be prevented by improvement of the surgical technique and drainage. The second type of fistulae may develop whenever an associated arterial pathology is present.

[Compression of the large vessels by a giant diverticulum of the bladder]. / Compression des gros vaisseaux par un diverticule géant de la vessie.

The authors report the case of a giant diverticulum of the bladder compressing the iliac vessels. They go on to make an anatomicopathological, clinical and therapeutical study of these giant diverticula.

[Action of dydrogesterone in postpubertal menstruation disorders]. / Action de la dydrogestérone dans les troubles des règles post-pubertaires.

Seventy-four post-pubertal young women with menstrual disturbances of a functional nature were treated with 20 mg of dydrogesterone per day from the 16th to the 25th day of the cycle for three cycles. Overall efficacy was considered satisfactory, results being significantly more positive with regard to disturbances in the duration of the cycle rather than excessively heavy periods. The authors draw attention to the possibility of the restoration of luteal function in a patient treated with dydrogesterone and the validity of temperature curve and plasma progesterone levels in this context.

[Ovarian pregnancy: its status in 1982. Apropos of 6 cases operated, review of the literature]. / Grossesses ovariennes: le point en 1982. A propos de 6 cas opérés, revue de la littérature.

The authors compare six personal cases of ovarian pregnancy with those in the literature. They point out that there is no specific clinical sign which makes it possible to tell whether one is dealing with an ovarian or a tubal pregnancy. They show the value of laparoscopy and especially of laparotomy and the histo-pathology of the specimen. Finally they show that although ectopic pregnancy rarely occurs in this site it is easy to treat and nearly always can be treated conservatively.

[Iliac vein thrombosis with a "floating clot" at the 37th week of pregnancy. Caesarean section and the application of a clip on the inferior vena cava. A case history (author's transl)]. / Thrombose veineuse iliaque avec caillot "flottant à 37 semaines de grossesse: Césarienne et clip de veine cave. A propos d'un cas.

The authors describe a case of high venous thrombosis with floating clots at the 37th week of pregnancy. The problem of diagnosis was solved by urgent Doppler examination and by phlebograms of the legs. It is necessary to have a team of many disciplines that can be brought together at any time. These consist of: -an anaesthesist who can resuscitate with heparin and give obstetrical anaesthesia, -an obstetrician who can carry out caesarean sections, -a vascular surgeon who can carry out a partial block of the inferior vena cava. This would appear only to be possible in a special centre.