AIMS: The aim of this study was to determine long term prognostic factors of gastric cancer in a population-based series. METHODS: Out of 1 462 gastric cancers diagnosed in the Côte-d'Or area (494 000 residents) over a 20-year period (1976-1995), 649 (44.4 %) were resected for cure. Prognostic factors were determined using the actuarial method and relative survival and a multidimensional relative survival model. RESULTS: The 10-year crude survival rate was 8.7 % and the corresponding relative survival rate was 14.9 %. Age, stage and period of diagnosis were independent prognostic factors. After surgery for cure, operative mortality decreased from 18.3 % (1976-1979) to 6.6 % (1988-1991) and 10-year relative survival increased from 30.8 % to 37.2 % (NS). After resection for cure (postoperative mortality excluded), the 10-year survival rate remained stable over time. Stage at diagnosis was the main prognostic factor: the relative risk of death was more than 10 times higher at stages IIIB and IV than at stage I. Age, site and macroscopic type of growth were prognostic factors independently of stage. Prognosis did not improve over time after resection for cure. CONCLUSION: Although improving, the overall prognosis of gastric cancer remains poor. Improvement in prognosis was mainly due to decrease in operative mortality. Earlier diagnosis and effective adjuvant treatment represent two ways to improve prognosis.

Aged↗

PubMedDate not supplied

[Lymphocytic colitis due to Modopar].

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Benserazide↗

PubMedDate not supplied

[Lymphocytic colitis in a women with Biermer's disease treated with Cirkan].

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Aged↗

PubMedDate not supplied

[Disposable versus reusable biopsy forceps. A prospective cost analysis in the gastrointestinal endoscopy unit of the Dijon University Hospital].

AIMS: The goal of this study was to compare the cost of a biopsy session performed with a disposable and a reusable endoscopic biopsy forceps. MATERIAL AND METHODS: Over a 10-month period, 15 new reusable forceps (10 gastric and 5 colonic) were prospectively tracked. A biopsy session performed with a reusable forceps included its current purchase price, the sterilization cost and the number of uses. A biopsy session performed with a disposable forceps was calculated with its current purchase price and its incineration cost. RESULTS: At the end of the study, only one reusable forceps had broken and the number of uses was 65. The cost of a biopsy session performed with a gastric reusable forceps was euro 7.52 (including euro 1.92 of sterilization cost) and euro 8.67 for a reusable colonic forceps (with the same sterilization cost). The cost of a biopsy session performed with a gastric or a colonic disposable forceps was euro 11.98. From 44 uses for a colonic forceps and 37 uses for a gastric one, a biopsy session performed with a reusable forceps was already cheaper. CONCLUSION: In this study, a biopsy session performed with a reusable forceps was less expensive than with a disposable one. However, the extra cost generated by the disposable forceps may be offset by an easier inventory control and the reduction of the cross contamination risk.

Biopsy↗

PubMedDate not supplied

[Spontaneous rhinorrhea due to (congenital?) evagination of arachnoidea in the paranasal sinuses].

Report on two cases of spontaneous, intermittent and long lasting spinal fluid rhinorrhea. The lesion responsible of the spinal fluid fistula is a glio-arachnoid expansion of the convexity of the frontal pole, contained into a fibrous pedicle ; it crosses the dura mater and penetrates, through a well individualized bone orifice, into the posterior wall of the frontal sinus or into an ethmoid-frontal cell. This arachnoid diverticle is not associated with an hydrocephalon. In the absence of any traumatic past history, its congenital nature may be admitted. No para-clinical investigation makes possible to detect such a minor abnormity ; the isotopic transit of the spinal fluid may remain silent, when performed at a moment of drying up of the nasal flow. Surgical exploratory study of the anterior level has to be complete, while numerous independent diverticles may coexist.

Adult↗

PubMedDate not supplied

[Radicular sciatica due to an intrarachidian mucoid cyst in a child].

In a 15 years old boy, a sciatica appears, at surgery, to be related with the compression of one SI root, and into the epidural space, by a pseudo-cyst, limited by a connective wall and containing a mucoid substance. Authors note the similarity of this lesion with the para-synovial cysts of extremities and with the colloid degeneration of the tunica adventitia of some vessels or of the connective sheath of the peripheric nerves. To their knowledge, such formations with mucoid content, at the spinal level, have only been reported on in the adult subject; they insist therefore on their patient's young age.

Adolescent↗

PubMedDate not supplied

[General practitioners' experience in a mass screening campaign of colorectal cancers].

In a mass screening campaign of colorectal cancer, general practitioners play an essential role for obtaining a high rate of participation from people. It is important to analyze the reasons for the participation and their actual experiences in the campaign. Out of 71 GPs participating in the campaign, 67 have been interviewed by a sociologist and 51 GPs (76%) considered themselves "motivated" for participating after an instruction course in small groups. Sixteen GPs were sceptical about the outcome or not highly motivated. However thirteen of them participated by moral obligation vis à vis their patients or for not being different from their colleagues. All GPs appreciated being actively involved in the organization of the screening campaign and considered that the public had been well informed. Such information covered the information leaflet, the press campaign at the beginning of the campaign and the recall letter for those who had not been consulted during the time when the test was distributed by GPs. The main constraint was the time spent to convince the patients to do the screening test and explain its importance. The additional time, 5 to 10 minutes per consultation was important to the GPs. They thought it was fair to be paid for their active participation. These data suggest that it is possible to motivate GPs for a mass screening campaign, on the condition that they are actively involved and participate in an instruction course for small groups.

Aged↗

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[Epidemiology and prevention of colorectal cancer].

Colorectal carcinoma is very common in western countries. It is in the front line of malignant pathology in France. The estimated number of new cases is almost 26,000 per year. The role played by diet in the onset of colorectal carcinomas is well established. The majority of studies indicate the protective role played by green vegetables. The role of other factors remains controversial: protective role of fibres, calcium and vitamins and favorizing role of fats, proteins, red meat, alcohol and calorie intake. The role of bile salts in increasing the size of adenomas and their malignant change is accepted. A number of therapeutic trials have involved modifications in bile salt concentrations. These should enable the proposal of a primary prevention strategy. The early detection of carcinomas and the secondary prevention of colorectal carcinoma (by detection of the adenomas which precede a high proportion of carcinomas) are areas of great interest. Detection of occult blood in stools as a mass screening test is currently being evaluated. Methods used to obtain a high participation rate among the population vary from one country to another, but are now well-defined. It will be necessary to wait for 2 years before being able to determine the effect on mortality and an even longer period to evaluate the effect on the incidence of colorectal carcinoma.

Adenoma↗

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[Posterior fossa syndrome terminating the course of histiocytosis X. Study of lesions of the central nervous system. Association with polyvinylpyrrolidone thesaurismosis].

The authors report the pathological and clinical findings in a case of histiocytosis X in a child. A rapidly progressive neurological syndrome of brain stem damage, occurred 5 years after the onset. Blockage of the 3rd ventricle led to surgical exploration of the posterior fossa. Lesions of the brain stem and cerebellum, in addition to the granuloma of the hypothalamus, are described. The neurological symptoms in histiocytosis X often suggest a space-occupying lesion but usually occur in the later prolonged forms in the adult. Association of thesaurismosis due to P.V.P., of therapeutic origin, produced numerous clinical skin and joint signs.

Brain Stem↗

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[Markers of the hepatitis B virus and chronic alcoholism. Prevalence and risk factors].

In this retrospective study, the prevalence of hepatitis B virus markers was studied in groups of heavy drinkers and primary hepatocellular carcinoma patients (202 patients), hospitalized for the first time in a medical department of gastroenterology in France. HBs Ag, anti-HBs and anti-HBc were respectively detected in 1.1, 25.8 and 20.9 p. cent of alcoholic patients without hepatocellular carcinoma. The overall prevalence of hepatitis B virus infection was 26.9 p. cent. The presence of hepatitis B virus markers did not depend on excess alcohol consumption, sex, age, alcoholic liver disease intensity, or previous gastrointestinal bleeding or hospitalization, but was related to racial group and residence in countries with a high prevalence of HBs Ag. HBs Ag, anti-HBs and anti-HBc were observed in 0, 36.4 and 36.4 p. cent of the alcoholic cirrhotic patients with hepatocellular carcinoma and the prevalence of hepatitis B virus markers was 45.5 p. cent. The findings reported in this study suggest that hepatitis B virus infection has no major role in determining the rate of progression of alcoholic liver disease and plays a far lesser causal role in hepatocellular carcinoma in France than in high incidence regions.

Alcohol Drinking↗

PubMedDate not supplied

[Rectocolonic cancers in young patients. A population study (Côte-d'Or: 1976-1983].

Between 1976 and 1983, 1,783 colorectal cancers were diagnosed among the Cote-d'Or residents; of these 44 (2.5 p. 100) were under age 45. Cancer developed more often on familial polyposis (11.4 p. 100), ulcerative colitis (2.3 p. 100) or in the Lynch cancer family syndrome (4.6 p. 100) before 45 than in older patients: 0.2 p. 100 (p less than 0.01), 0.2 p. 100 (NS) and 0 p. 100 (p less than 0.01) respectively. There was no significant difference between young and older patients concerning the site, the histologic type or the stage of diagnosis. Curative resection rates were similar before age 45 (68.2 p. 100) as after that age (61.8 p. 100). Operative mortality was lower in younger (3.3 p. 100) than in older patients (12.6 p. 100; NS). After surgery for cure (operative mortality excluded) the 5-year corrected survival rates were similar in the two age groups: 69.4 +/- 8.8 p. 100 and 64.0 +/- 1.8 p. 100 respectively (NS). These data suggest that with the exception of predisposing diseases there is no important difference between young and older patients with regard to the anatomoclinical and evolutive aspects of colorectal cancers.

Adolescent↗