Treatment of advanced pancreatic cancer with 5-fluorouracil, folinic acid and interferon alpha-2A: results of a phase II trial.

Interferon alpha-2a (IFN-alpha) and folinic acid (FA) have been shown to modulate the cytotoxic effects of 5-fluorouracil (5-FU) in the treatment of cancer. A phase II study was initiated to evaluate the effect of a combination of 5-FU/FA/IFN-alpha in patients with advanced pancreatic cancer. Sixty previously untreated patients with advanced adenocarcinoma of the pancreas were treated with 500 mg m-2 FU via an intravenous bolus 1 h after the initiation of a 2 h infusion of 500 mg m-2 FA. Before starting the FA infusion, 6 million units (MU) of IFN-alpha was administered subcutaneously. The treatment was repeated once a week. Of 57 evaluable patients, eight (14%) had a partial response (PR),…

Maternally inherited diabetes and deafness (MIDD): unusual occult exocrine pancreatic manifestation in an affected German family

The mitochondrial (mt) 3243 DNA mutation is an underlying cause of maternally inherited diabetes and deafness (MIDD) syndrome and the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). We report an affected German MIDD pedigree with maternal lineage over three generations. The index patient, her mother, her maternal aunt and her maternal grandmother all suffered from diabetes and premature hearing loss and were positive on testing for the mt 3243 DNA mutation. The 27-year-old index patient had a history of grand mal seizures. As sequela of abdominal ultrasound and confirmed by magnetic resonance cholangio-pancreaticography, she was diagnose…

Endoscopie et IRM: une collaboration nécessaire

Depuis la decouverte des rayons X il y a 100 ans, l’imagerie par resonance magnetique (IRM) est appelee a jouer un des roles les plus importants du diagnostic medical. L’efficacite de l’IRM a ete demontree dans une grande variete de troubles gastro-intestinaux. L’attention du gastro-enterologue est couramment centree sur les maladies des voies bilio-pancreatiques et intestinales. La cholangiopancreatographie par resonance magnetique (CPRM) est devenue une technique d’imagerie competitive et assue meme le remplacement du diagnostic par CPRE dans un grand nombre de pathologies hepato-biliaires et pancreatiques. L’enteroscopie en IRM s’impose comme la methode de choix dans l’evaluation de la t…

Long-Segment Early Squamous Cell Carcinoma of the Proximal Esophagus: Curative Treatment and Long-Term Follow-Up after 5-Aminolevulinic Acid (5-ALA)-Photodynamic Therapy

Photodynamic therapy (PDT) is an established treatment for the ablation of dysplastic Barrett's epithelium and early esophageal carcinoma, but no data have been published on curative 5-aminolevulinic acid (5-ALA)-PDT for long-segment early esophageal cancer with infiltration of the upper sphincter. We describe successful curative treatment of an unusual early long-segment squamous cell carcinoma (uT1a,N0) of the proximal esophagus (18 - 28 cm aborally), with three sessions of 5-ALA-PDT. Endoscopic and endosonographic follow-up macroscopically showed a complete remission of the tumor, proven by biopsy showing total histological ablation. After a follow-up period of 23 months, there has been …

Schmerz im rechten Oberbauch

Stellenwert der Rektoskopie und Koloskopie f�r den Internisten

The endoscopic examination of the large intestine can be considered today a routine examination in internal medicine. Since the introduction of flexible videoendoscopy, evaluating diseases in the distal colon using rectoscopy has become less important. Anoproctoscopy is an obligatory component for a complete colon diagnostic after a flexible ileo-colonoscopy has been performed. Colonoscopy has improved significantly the diagnosis and therapy of diseases in the large intestine since it has been introduced more than 30 years ago. By introducing modern videocolonoscopy in addition to other instruments, there is today a broad spectrum of diagnostic and therapeutic indications available. Specifi…

Coloscopie virtuelle — par tomodensitométrie (CTDM) et résonance magnétique (CRM) — dans la détection des polypes coliques et des lésions néoplasiques

Tant chez l’homme que chez la femme, le cancer colorectal (CCR) constitue la deuxieme cause de deces dans les pays occidentaux. Par consequent, le depistage du cancer colorectal et de ses precurseurs est un important probleme de sante publique. L’utilisation de la coloscopie par tomodensitometrie computee (CTDM) et par resonance magnetique (CRM), mieux connue sous l’appellation coloscopie virtuelle, rencontre un succes populaire croissant. Le present article a pour but de passer en revue les donnees de la litterature, d’etablir l’etat actuel de la coloscopie virtuelle, et de predire son impact potentiel sur la pratique actuelle et future en gastro-enterologie.