Gastroenterologie Clinique Et Biologique最新文献

{"title":"Multinodular fatty sparing","authors":"M. Garetier , C. Delluc , J. Rousset , S. Chinellato , C. Sandillon-Garetier , J.-A. Bronstein","doi":"10.1016/j.gcb.2010.07.019","DOIUrl":"10.1016/j.gcb.2010.07.019","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 651-652"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.07.019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29281744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterotopic pancreas: An unusual cause of epigastric pain","authors":"S. Reggoug , I. Errabih , L. Ouazzani , N. Benzzoubeir , H. Krami , M. Raiss , A. Hrora , M. Ahallat , H. Ouazzani","doi":"10.1016/j.gcb.2010.09.005","DOIUrl":"10.1016/j.gcb.2010.09.005","url":null,"abstract":"","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 726-727"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29375731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stem cells and colon cancer: The questionable cancer stem cell hypothesis","authors":"C. Gespach","doi":"10.1016/j.gcb.2010.08.014","DOIUrl":"10.1016/j.gcb.2010.08.014","url":null,"abstract":"<div><p>The fine-tuning between cell proliferation and differentiation of self-renewing stem cells and pluripotent progenitors in gastric glands and colon epithelial crypts is coordinated by the mechanisms that regulate colon epithelial cell migration and guidance along the crypt axis. This leads to the acquisition of specialized cellular functions and the exfoliation of desquamated senescent and apoptotic epithelial cells at the apical mucosa interface with the gut lumen. Self-renewing stem cells and pluripotent progenitors are involved in the clonal and polyclonal growth of digestive tumors. Several lines of evidence support the existence of a subpopulation of cancer cells with stem cell-like (SCL) phenotypes in solid tumors of breast and digestive system. Consistently, epithelial cancer cell lines in long-term culture are phenotypically and functionally heterogeneous. It is suggested that only a small proportion of transformed cells are clonogenic in vivo and ex vivo to form colonies and to initiate tumor growth in immunodeficient mice. A discrete subpopulation of tumor -initiating SCL cancer cells are highly competent to survive, propagate and spread through the invasive and metastatic cascade. A better understanding of the mechanisms driving the plasticity and pluripotency of stem cells, their derived progenitors and SCL colon cancer initiating cells during tumor progression will open new avenues for the early detection and treatment of local and distant tumors of the digestive tract.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 653-661"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.08.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29447089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating free tumor DNA and colorectal cancer","authors":"T. Lecomte ,&nbsp;N. Ceze ,&nbsp;É. Dorval ,&nbsp;P. Laurent-Puig","doi":"10.1016/j.gcb.2009.04.015","DOIUrl":"10.1016/j.gcb.2009.04.015","url":null,"abstract":"<div><p>Cancer is characterized by multiple somatic genetic and epigenetic alterations that could be useful as molecular markers for detecting tumor DNA in different bodily fluids. In patients with various diseases as well as in healthy subjects, circulating plasma and serum carry small amounts of non-cell-bound DNA. In this free circulating DNA, tumor-associated molecular alterations can be detected in patients who have cancer. In many instances, the alterations identified are the same as those found in the primary tumor tissue, thereby suggesting tumor origin from a fraction of the circulating free DNA. In fact, various types of DNA alterations described in colorectal cancer have been detected in the circulating free DNA of patients with colorectal cancer. These alterations include <em>KRAS2</em>, <em>APC</em> and <em>TP53</em> mutations, DNA hypermethylation, microsatellite instability (MSI) and loss of heterozygosity (LOH). Also, advances in polymerase chain reaction (PCR)-based technology now allow the detection and quantification of extremely small amounts of tumor-derived circulating free DNA in colorectal cancer patients. The present report summarizes the literature available so far on the mechanisms of circulating free DNA, and on the studies aimed at assessing the clinical and biological significance of tumor-derived circulating free DNA in colorectal cancer patients. Thus, tumor-derived circulating free DNA could serve as a marker for the diagnosis, prognosis and early detection of recurrence, thereby significantly improving the monitoring of colorectal cancer patients.</p></div><div><p>Les altérations génétiques ou épigénétiques somatiques des cellules tumorales constituent un moyen d’identification moléculaire de la présence d’ADN tumoral dans un prélèvement biologique. De l’ADN libre est présent dans le sang et, chez les patients atteints de cancer, une fraction de cet ADN est d’origine tumorale. Chez des patients atteints de cancer, l’origine tumorale d’une fraction de l’ADN libre circulant a été démontrée au moyen de la détection d’altérations génétiques de l’ADN libre circulant plasmatique et/ou sérique identiques à celles mises en évidence au niveau de l’ADN extrait de la tumeur. Les altérations génétiques et épigénétiques les plus communes décrites dans le cancer colorectal ont été détectées au niveau de l’ADN libre circulant plasmatique et/ou sérique de patients atteints de cancer colorectal. Il s’agit principalement de mutations de l’oncogène <em>KRAS2</em>, de mutations des gènes suppresseurs de tumeurs <em>APC</em> et <em>TP53</em>, d’altérations de marqueurs microsatellites et d’anomalies de la méthylation de l’ADN tumoral. Grâce aux développements technologiques considérables réalisés dans le domaine de l’analyse de l’ADN, la recherche de nouveaux biomarqueurs du cancer colorectal basée sur la détection de l’ADN libre d’origine tumorale sérique ou plasmatique ou extrait d’autres prélèvements biologiques ouvre de nouvelles","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 662-681"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2009.04.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40061374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of granulocytapheresis in Crohn's disease: A prospective cohort study","authors":"G. Bresci ,&nbsp;A. Romano ,&nbsp;A. Mazzoni ,&nbsp;F. Scatena ,&nbsp;E. Altomare ,&nbsp;A. Capria ,&nbsp;R. Sacco","doi":"10.1016/j.gcb.2010.09.009","DOIUrl":"10.1016/j.gcb.2010.09.009","url":null,"abstract":"<div><h3>Background and objective</h3><p>This study evaluated the feasibility and safety of granulocytapheresis (GCAP) in inducing and maintaining remission in refractory Crohn's disease. The relationship between the clinical outcomes and the location (ileal or ileocolonic) of disease was also assessed.</p></div><div><h3>Patients</h3><p>We evaluated 16 patients with ileal location (group A), 14 with ileocolonic location (group B). The patients underwent five sessions (1 session/wk) of GCAP (Adacolumn^TM). CDAI was measured at the end of the GCAP, at 6, 9 and 12 months.</p></div><div><h3>Results and conclusions</h3><p>No major complications were observed. At the end of GCAP, 19 (63.3%) patients showed a clinical remission: 10 (62.5%) in group A versus 9 (64.2%) in group B. At 6 months, 16 (53.3%) of the cases had maintained remission: 9 (56.2%) in group A versus 7 (50.0%) in group B. At 9 months, 13 (43.3%) patients had maintained remission: 7 (43.7%) in group A versus 6 (42.8%) in group B. At 12 months, 12 (40%) patients were still in clinical remission: 7 (43.7%) in group A versus 5 (35.7%) in group B. Risk of relapse was not related to disease location. The procedure was well tolerated and feasible in an important percentage of Crohn's disease patients.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 682-686"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.09.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29467951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter local thrombolysis in patients with extensive TIPS thrombosis","authors":"J. Dumortier ,&nbsp;T. Walter ,&nbsp;O. Guillaud ,&nbsp;F. Pietu ,&nbsp;M. Vallin ,&nbsp;L. Henry ,&nbsp;F. Pilleul","doi":"10.1016/j.gcb.2010.07.011","DOIUrl":"10.1016/j.gcb.2010.07.011","url":null,"abstract":"<div><h3>Background</h3><p>Transcatheter local thrombolytic therapy in patients with portosplanchnic venous thrombosis has been used in few cases.</p></div><div><h3>Case reports</h3><p>Here, we present our single-center experience with transcatheter thrombolytic therapy in three patients with extensive refractory portal and transjugular intrahepatic portosystemic shunt (TIPS) thrombosis. Thrombolytic therapy was successful for all three patients. Two patients developed minor procedure-related bleeding.</p></div><div><h3>Conclusion</h3><p>Local thrombolysis could be proposed in case of TIPS thrombosis for patients in whom the venous flow cannot be restored by using conventional anticoagulant therapy and stent mechanical revision.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 721-725"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.07.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29342046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple intestinal perforation in a patient with Wegener's granulomatosis: A case report and review of the literature","authors":"A.C. Yildirim ,&nbsp;E. Koçak ,&nbsp;P. Yildiz ,&nbsp;M. Yildiz ,&nbsp;A.Ş. Karakayalı ,&nbsp;B. Kaptanoglu ,&nbsp;S. Köklü","doi":"10.1016/j.gcb.2010.08.009","DOIUrl":"10.1016/j.gcb.2010.08.009","url":null,"abstract":"<div><p>Wegener's granulomatosis is a necrotizing vasculitis of unknown etiology characterized mainly by inflammation of the small- and medium-sized arteries and veins that affect any viscera. It may rarely involve the gastrointestinal tract. Only a few cases of multiple focus ileal perforation due to ulcers associated with Wegener's granulomatosis have been reported. Herein we report a case of a 32-year-old man with extensive intestinal small bowel ischaemic perforation due to Wegener's granulomatosis.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 712-715"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.08.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29314760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonoscopy practices, and colorectal cancer and polyp screening, as assessed in the French district of Isère from May to July in 2004","authors":"C. Exbrayat ,&nbsp;F. Poncet ,&nbsp;A. Billette de Villemeur ,&nbsp;A. Garnier ,&nbsp;P. Bureau du Colombier","doi":"10.1016/j.gcb.2009.09.008","DOIUrl":"10.1016/j.gcb.2009.09.008","url":null,"abstract":"<div><h3>Background</h3><p>A pilot program of organized screening for colorectal cancers was conducted in Isère, an administrative district in France. A fecal occult blood test (Hemoccult II^®) was proposed for all individuals aged greater than 50<!--> <!-->years (women since 1991 and men since 2002), followed by colonoscopy for those testing positive. A prospective study was carried out from May to July in 2004 and compared with a similar study conducted in 1996. The goal was to investigate colonoscopy practices, especially the role of screening.</p></div><div><h3>Methods</h3><p>Gastroenterologists practising in Isère (<em>n</em> <!-->=<!--> <!-->39/42 practitioners) completed a questionnaire including their patients’ age and gender, indications, methods and results for all colonoscopies performed in those aged greater than 20<!--> <!-->years. Any tissue samples taken were sent away for histological evaluation.</p></div><div><h3>Results</h3><p>The study involved 2558 colonoscopies (54% female, 73% patients aged greater or equal to 50<!--> <!-->years), an increase of 35% from 1996 to 2004. Of the patients referred, 50.0% were symptomatic (pain; bowel problems: 28.7%; rectal bleeding: 21.3%), 23.5% had colonic disease and 22.5% came from screening (3.1% had positive stool tests, 17.8% had a family history). Recommendations related to family history (update of the 1998 consensus conference: screening indicated for patients with a first-degree relative diagnosed with cancer or advanced polyps aged less than 60<!--> <!-->years) were well applied in terms of relatedness (81%) but, in 52% of cases, the age was greater than 60<!--> <!-->years. Colonoscopy was carried out in almost all cases (0.1% failure), with complications in 0.4% of the examinations. Of the 2558 colonoscopies performed, 10% revealed advanced polyps or cancer: 30% were following a positive test compared with 8% for symptoms and 6% with a family history. Multivariate analyses showed that polyps greater or equal to 10<!--> <!-->mm or malignant tumors are 1.5 times more common in men than in women, and six times more frequently seen in patients having colonoscopy following a positive test for blood in stools than in those with a family history of colorectal cancer. The number of pathologies found increased significantly in those aged greater than 50<!--> <!-->years.</p></div><div><h3>Conclusion</h3><p>This cross-sectional survey of colonoscopy practices in Isère shows an increase in the number of colonoscopies performed between 1996 and 2004. This increase is not explained by expansion of the screening program, which was the reason for only 3% of colonoscopies. However, the best diagnostic yield for advanced polyps or cancers was obtained in screened patients (30%).</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 702-711"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2009.09.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29374759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and endoscopic features of responders and non-responders to adsorptive leucocytapheresis: A report based on 120 patients with active ulcerative colitis","authors":"Tomotaka Tanaka ,&nbsp;Hideharu Okanobu ,&nbsp;Yoshio Kuga ,&nbsp;Yoshikazu Yoshifuku ,&nbsp;Hatsue Fujino ,&nbsp;Tomohiro Miwata ,&nbsp;Takashi Moriya ,&nbsp;Toshihiro Nishida ,&nbsp;Toshihide Oya","doi":"10.1016/j.gcb.2010.08.007","DOIUrl":"10.1016/j.gcb.2010.08.007","url":null,"abstract":"<div><h3>Background and Objective</h3><p>Elevated/activated myeloid leucocytes, like the CD14(+)CD16(+) monocytes are sources of TNF-α, and therefore, selective depletion of these cells by granulocyte/monocyte (GM) adsorption (GMA) should promote remission or enhance drug efficacy. However, studies in ulcerative colitis (UC) reported contrasting efficacy, from an 85% to statistically insignificant level. We investigated patients’ demography in responders and non-responders.</p></div><div><h3>Methods</h3><p>In 120 UC patients, 61 steroid naive and 59 steroid dependent, we looked for entry clinical or endoscopic features to identify responders (or non-responders) to GMA. Patients received up to an 11 Adacolumn GMA sessions over 12 weeks. Patients were clinically and endoscopically evaluated, allowing each patient to serve as her/his own control. Immunohistochemistry on colonic biopsies was to reveal the impact of GMA on leucocyte infiltration of the mucosa.</p></div><div><h3>Results</h3><p>Entry average clinical activity index (CAI) was 12.6, 10–16. An 80 of 120 patients responded (CAI<!--> <!-->≤<!--> <!-->4); 45 steroid naïve (73.8%) and 35 steroid dependent (59.3%). Over 900 biopsies were processed. Infiltrating leucocytes were overwhelmingly polymorphonuclear and macrophages around and within crypt abscesses. There was a marked reduction of infiltrating leucocytes in responders. Most non-responders had extensive colonic lesions with virtually no mucosal tissue left at the lesions.</p></div><div><h3>Conclusions</h3><p>Steroid naïve patients with short duration of UC were the best responders, while patients with deep colonic lesions and extensive loss of the mucosal tissue were non-responders.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 687-695"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29344635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A not so solitary fibrous tumor of the liver","authors":"C. Brochard ,&nbsp;S. Michalak ,&nbsp;C. Aubé ,&nbsp;C. Singeorzan ,&nbsp;H.-D. Fournier ,&nbsp;L. Laccourreye ,&nbsp;P. Calès ,&nbsp;J. Boursier","doi":"10.1016/j.gcb.2010.08.004","DOIUrl":"10.1016/j.gcb.2010.08.004","url":null,"abstract":"<div><p>Solitary fibrous tumor (SFT) is a rare neoplasm. Liver parenchyma is a rare location of SFT and, in this case, it usually follows a benign course. We report here the case of a 54-year-old man who presented a large SFT tumor of the right hepatic lobe. The tumor was surgically resected. Local recurrence occurred 6 years later as a 15 cm diameter liver tumor. Histological examination of the resected lesion showed features of an aggressive form of SFT. Two years later, the patient presented with complaints of neck pain and ensuing examinations revealed a tumor of the cranial base. A new surgical resection was performed and histological examination confirmed a metastasis of the SFT. Few weeks later, the patient presented an irreducible psoitis due to an iliac bone metastasis. He died within 1 month.</p></div><div><p>La tumeur fibreuse solitaire est une néoplasie rare. Sa localisation hépatique est peu fréquente et, dans ce cas, est le plus souvent bénigne. Nous rapportons le cas d’un homme de 54 ans ayant présenté une volumineuse tumeur fibreuse solitaire du foie droit. Après un traitement chirurgical initial la tumeur récidivait six ans plus tard sous forme d’une lésion de 15 cm. L’analyse histologique montrait des caractéristiques en faveur d’une forme agressive. Deux ans plus tard, le patient a consulté pour des cervicalgies. Les examens réalisés ont révélé une tumeur de la base du crâne. Une nouvelle résection chirurgicale a été réalisée et l’histologie était en faveur d’une métastase de la tumeur fibreuse solitaire du foie. Quelques semaines plus tard, le patient a présenté un psoïtis irréductible en lien avec une métastase osseuse iliaque. Il est décédé un mois plus tard.</p></div>","PeriodicalId":12508,"journal":{"name":"Gastroenterologie Clinique Et Biologique","volume":"34 12","pages":"Pages 716-720"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gcb.2010.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29298296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}