Adenovirus-mediated gene therapy of experimental hepaarterial blood supply, 67% of the total liver blood supply. tocarcinoma is hindered by low transduction efficacy in Compared with intraportal administration, arterial injection vivo. We evaluated the extent of gene expression following improved gene transfer into tumors whereas that to the various routes of administration of recombinant adenovirus non-tumor areas was diminished. In addition, this route of AdCMVlacZ in diethylnitrosamine-induced rat hepatocarciinjection allowed the efficient transduction of dysplastic noma. We first characterized the vascularization of dinodules. Diethylnitrosamine-induced hepatocarcinoma in ethylnitrosamine-induced hepatocarcinomas using a comrats is a relevant model for the study of human hepatocarputerized tomography scanner approach. The efficacy of cinoma due to its vascularization. Arterial infusion gene transfer was then evaluated by three routes of adminimproved the ratio of transduced tumorous to nontumorous istration: intraportal, selective injection through the hepatic cells and allowed targeting of gene transfer to dysplastic artery and direct injection into the tumor. Diethylnitronodules. This will be useful in the design of gene therapy samine-induced hepatocarcinomas had predominantly an for hepatocarcinoma.
Introduction Enteroscopy resection of small bowel polyps in Peutz-Jeghers syndrome has only been described in small case series. Herein, we aimed to assess the efficacy of enteroscopy resection of small bowel polyps within a specialised tertiary care centre and the impact on intraoperative enteroscopy. Methods This was an observational single-centre study. All adult Peutz-Jeghers syndrome patients followed in the Predisposition Digestive Ile-de-France network who underwent an endoscopic resection of at least one small bowel polyp ≥ 1 cm by enteroscopy between 2002–2015 were included. Small bowel polyps were detected under a dedicated screening programme by previous capsule endoscopy and/or magnetic resonance enterography, performed every 2–3 years. Complete treatment was defined as the absence of polyps ≥ 1 cm after conventional endoscopic resection. Intraoperative enteroscopy or surgical resection were indicated in incomplete treatments. The overall complete treatment rate including conventional enteroscopy and intraoperative enteroscopy was also considered. Results Endoscopic resection of 216 small bowel polyps (median: 8.6 per patient, size: 6–60 mm) was performed by 50 enteroscopies in 25 patients (mean age: 36 years, range: 18–71, 56% male) with small bowel polyp ≥ 1 cm. Twenty-three patients (92%) underwent 42 screening capsule endoscopies and 14 (57%) had 23 magnetic resonance enterographies during a median follow-up of 60 months. Complete treatment was achieved in 76%. Intraoperative enteroscopy and surgical resection were performed in four (16%) and two (8%) patients. Intraoperative enteroscopy improved by 16% the complete treatment rate and the overall rate was 92%. The complication rate was 6%. Conclusion This long-term study confirmed the efficacy and safety of endoscopic resection of small bowel polyps in Peutz-Jeghers syndrome. Intraoperative enteroscopy can be a complementary approach in selected cases.
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