Chimio-embolisation trans-artérielle des carcinomes hépatocellulaires par billes chargées à la doxorubicine. Transarterial chemoembolization of hepatocellular carcinoma with doxorubicin eluting beads.

OBJECTIVES: The goal of our study was to describe the chemoembolization technique of transarterial catheterization using microspheres loaded with doxorubicin and to evaluate its tolerance and short-term efficacy on a small number of patients. MATERIALS AND METHODS: Our retrospective study was conducted over 8 months (December 2007-July 2008). It was done at the Brest University Medical Centre (France), in the radiology and hepato-gastroenterology departments of the Hôpital de la Cavale Blanche. We performed a transarterial chemoembolization using microspheres loaded with doxorubicin to 9 patients who had hepatocellular carcinoma in relation to alcoholic cirrhosis. RESULTS: Eight of 9 patients have benefited from a complete procedure (88.9% technical success) and in 100% of these cases, there were no clinical complications or biologic modifications immediately after embolization. After 4 weeks, there were seven cases of regression of more than 30% of the size of the tumor nodules, six cases of total tumor necrosis, and two cases of contrast uptake inside the nodules (partial tumor necrosis). In three cases (37.5%), there was an emergence of new tumor nodules. CONCLUSION: Chemoembolization accomplished by transarterial catheterization using microspheres loaded with doxoribicin is a probable technique for the future of palliative treatment of hepatocellular carcinomas. The technique is simple to perform and seems to be well tolerated by patients in terms of clinical and biological aspects.

[Incidence of inflammatory bowel disease in children in Brittany (1994-1997). Breton association of study and research on digestive system diseases (Abermad)]. / Incidence des maladies inflammatoires du tube digestif chez l'enfant en Bretagne (1994-1997). Association bretonne d'étude et de recherche sur les maladies de l'appareil digestif (Abermad).

BACKGROUND: The aim of this work was to determine in Brittany the incidence and main clinical pattern of inflammatory bowel disease (IBD) occurring during childhood. These data are compared to the previous epidemiologic data available from the Northern France registry or around the world. METHODS: Private and public Brittany gastroenterologists (2,836,418 inhabitants including 618,049 children under 17 years of age) referred all patients consulting for inflammatory bowel disease from January 1994 to December 1997. An interviewer-practitioner completed at the gastroenterologist's office a standard questionnaire for each patient. Each case was independently reviewed by four experts in a blind manner and made a final diagnosis of Crohn's disease (CD), ulcerative colitis (UC), or ulcerative proctitis and acute colitis (onset of symptoms < 6 weeks) or unclassified chronic colitis. RESULTS: Among 1,309 cases recorded, 88 were under 17 years of age (6.7%): 43 (49%) had CD (including three possible cases), 14 (16%) had UC (including three proctitis), 24 (27%) acute colitis and 7 (8%) unclassified chronic colitis. The crude mean annual incidence (per 100,000 children) based on definite and probable cases only was 2.5 for IBD, 1.6 for CD and 0.57 for UC, without variation between 1994 and 1997. The male/female ratio was 2.3 for CD and 1.3 for UC. The mean time between onset of disease and diagnosis was equal to 7.2 and 8.6 months for CD and UC respectively (median: 3 and 5 months). A familial history of IBD was present in 5 cases (8%). In CD, the small and large bowel were involved in 58% of patients, whereas an isolated involvement of small or large bowel occurred in 15% and 23% of cases. Among the 14 UC, there were three proctitis and four pancolitis. Among 43 CD, a granuloma was present in 48% of cases. CONCLUSIONS: In Brittany the incidence of CD and UC in childhood was similar to the published data from Northern France. Clinical presentation and symptoms were not different. However, the rate of acute colitis was higher and the accurate incidence of IBD could be underestimated, requiring a follow-up to classify these cases.

Absence of human papillomavirus DNA detected by polymerase chain reaction in French patients with esophageal carcinoma.

BACKGROUND & AIMS: Recent studies have suggested that esophageal human papillomavirus infection could be a risk factor for esophageal squamous cell carcinoma. The aim of this study was to evaluate the prevalence of human papillomavirus DNA sequences in the esophagus of French patients with esophageal squamous cell carcinoma. METHODS: Multiplex polymerase chain reactions with consensus primers directed to the L1 gene or specific primers for human papillomavirus types 6, 11, 16, 18, 31, and 33 directed to E6 gene (40 cycles followed by restriction mapping of the amplified products) were used to determine the presence of human papillomavirus DNA sequences in esophageal squamous cell carcinoma (n = 75), normal adjacent mucosa (n = 49), and metastatic lymphadenopathies (n = 5). As an internal control, a target located in the embryonic myosin heavy-chain gene was used in each reaction. RESULTS: Human papillomavirus DNA sequences could not be detected in any of the tumoral samples, the normal adjacent mucosa, or the metastatic lymphadenopathies. CONCLUSIONS: Human papillomavirus seems not to be implicated in esophageal carcinogenesis, at least in French patients, because the viral genomes are not associated with esophageal squamous cell carcinomas.

[Treatment of and survival after epidermoid cancer of the esophagus in the department of Finistère between 1984 and 1988 (716 cases)]. / Traitement et survie du cancer épidermoïde de l'oesophage dans le département du Finistère entre 1984 et 1988 (716 cas).

The incidence of esophageal cancer in the French county of Finistère is among the highest in France (26.7/10(5) for males). The authors analyzed the survival rates for squamous cell carcinomas from data of the Finistère tumor registry in order to describe different prognostic groups of patients using the multivariate Cox model. From 1984 to 1988, 716 patients with esophageal squamous cell carcinomas were registered in an overall population of 828,000 residents: 675 males and 41 females. Survival was calculated using the actuarial method. Six hundred and seventy five patients died before the point date (31 Dec 1989). Only one patient was lost to follow-up. The actuarial survival rates of all patients were 89 +/- 1% at 3 months, 68 +/- 2% at 6 months, 37 +/- 2% at one year, 12 +/- 1% at 3 years and 6 +/- 1% at 5 years; median survival was 9.1 +/- 0.4 months. Survival was significantly related to cancer size, tumor extension and surgical contraindications. In the Cox model, age, cancer size, surgical contraindications, year of diagnosis were independent prognostic predictors. There was a significant increase in survival rates after 1986: median survival was 8.1 +/- 0.4 months between 1984 and 1986 and 10.1 +/- 0.5 months between 1987 and 1988. Patients treated by curative resection had higher actuarial survival rates (median survival 22.5 +/- 4.1 months) than patients who underwent palliative resection (median survival 11.3 +/- 1.2 months). In patients with cancer managed surgically, the prognostic predictors were tumor size, curative vs palliative surgical resection and association with chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

[Saturnine colic and hemolytic anemia due to ingestion of solid lead. Apropos of a case]. / Colique saturnine et anémie hémolytique par ingestion de plomb solide. A propos d'une observation.

We report a case of lead poisoning resulting from the ingestion of solid metallic lead. A 24 year old patient was admitted for abdominal pain and microcytic anemia. Review of the literature suggests that clinical manifestations of chronic poisoning by solid lead in adults are extremely rare. Their misreading can lead to erroneous diagnose.