A cooperative study on the detection of colorectal cancer and polyps in France.

Systematic investigations testing for the presence of polyps and cancers of the large bowel were conducted in a population of 1,369 inpatients and outpatients, aged 45-70 years, in eight university departments of gastroenterology or abdominal surgery (Toulouse, Dijon, Paris, Marseille, and Strasbourg). Double-contrast barium enema and proctosigmoidoscopy examinations were carried out in all cases, whereas total coloscopy was performed only in the case of detected tumors. A questionnaire including 233 parameters (age, sex, family, and personal history and symptoms) was completed for each patient. A total of 414 lesions were detected in 252 patients, including 245 adenomatous or villous polyps, 8 transformed polyps, and 30 carcinomas; 3 of 4 lesions were located in the rectum or sigmoid. Cancer or adenomatous or villous polyps were found in 13% of the patients. The prevalence of these lesions in the population studied was increased in patients with rectorrhagia (19%) or with a personal history of surgery for colorectal cancer or polyp (23%). In the patients without rectorrhagia or a history of intestinal tumor, the incidence was 9.7%. It was significantly increased in males and patients more than 50 year old. The efficacy of proctosigmoidoscopy and double-contrast barium enema was compared in 909 patients. Sensitivity and specificity were, respectively, 35% and 99% for endoscopy, 96% and 94% for radiology.

[Water and electrolytes intestinal secretion (author's transl)]. / Sécrétion intestinale hydro-électrolytique.

This paper reviews methods used for studying intestinal secretion in man and animals, fasting and post prandial intestinal secretion, as well as that induced by bacterial enterotoxins, hormonal stimuli, some endocrine tumours and various intraluminary agents; finally the possible mechanisms and sites of intestinal secretion are discussed. That the intestine secretes fluid under physiological conditions is not proven but seems very likely. Several mechanisms seem to be involved in the production of fluid by the intestine. The adenylate-cyclase-cyclic adenosine monophosphate (AMPc) system is currently thought to play a major role in endotoxins and some hormone-induced secretions. The site of intestinal secretion remains a matter of discussion: both crypts and villi seem to participate in the secretory process.