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During every cell cycle, both the genome and the associated chromatin must be accurately replicated. Chromatin Assembly Factor-1 (CAF-1) is a key regulator of chromatin replication, but how CAF-1 functions in relation to the DNA replication machinery is unknown. Here, we reveal that this crosstalk differs between the leading and lagging strand at replication forks. Using biochemical reconstitutions, we show that DNA and histones promote CAF-1 recruitment to its binding partner PCNA and reveal that two CAF-1 complexes are required for efficient nucleosome assembly under these conditions. Remarkably, in the context of the replisome, CAF-1 competes with the leading strand DNA polymerase epsilon (Polϵ) for PCNA binding. However, CAF-1 does not affect the activity of the lagging strand DNA polymerase Delta (Polδ). Yet, in cells, CAF-1 deposits newly synthesized histones equally on both daughter strands. Thus, on the leading strand, chromatin assembly by CAF-1 cannot occur simultaneously to DNA synthesis, while on the lagging strand these processes may be coupled. We propose that these differences may facilitate distinct parental histone recycling mechanisms and accommodate the inherent asymmetry of DNA replication.

Introduction Patients with interstitial lung diseases (ILD) can be suspected to be at risk of experiencing a rapid flare-up due to COVID-19. However, no specific data are currently available for these patients. Methods We retrospectively analyzed a cohort of 401 patients with ILD and determined the proportion of patients hospitalized for proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and specific symptoms of COVID-19. Results We found that 1% of patients (n = 4) were hospitalized (1 in ICU) for COVID-19. In total, 310 of the 401 patients answered the phone call. Only 33 patients (0.08%) experienced specific symptoms of SARS-CoV-2 infection. Conclusion Our study did not demonstrate any increased occurrence of severe COVID-19 in ILD patients compared to the global population. Based on our findings, we could not make any conclusion on the incidence rate of SARS-CoV-2 infection in patients with ILDs, or on the overall outcome of immunocompromised patients affected by COVID-19.

Summary Introduction Common bile duct lithiasis after Roux-en-Y gastric bypass (RYGB) or upper gastrointestinal stenosis has become a challenging problem nowadays, especially as obesity surgery is increasing. In this study, we assess the feasibility and performance of laparoscopy-assisted transgastric endoscopic retrograde cholangiopancreatography (LAERCP) and describe its technique. Methods A retrospective review of a prospectively collected database of consecutive patients undergoing a LAERCP between February 2014 and May 2015 was performed at a single institution. Indications were common bile duct lithiasis associated with acute or past episodes of cholangitis and pancreatitis. Endoscopic access to the gastric remnant was obtained laparoscopically. Results In total 5 cases were identified. Four of them had undergone a RYGB and one of them presented a benign esophageal peptic stenosis, not allowing peroral gastric access. Biliary cannulation using LAERCP associated with sphincterotomy and stone extraction was successfully achieved in all patients. Mean duration of the entire procedure was 134 minutes (range: 66–200 min). No early major complications were observed and the mean postoperative hospital stay was 4 days (range: 2–5 days). Conclusions LAERCP is a safe and successful procedure for the treatment of common bile duct lithiasis when conventional biliary access is not feasible, notably after RYGB. Larger trials still need to be performed to evaluate efficacy, technical success, and complications related to this technique.

Because of the devastating health effect of chronic burned tobacco inhalation, smoking cessation is a public health priority. After a short review of the validated pharmacological tools for smoking cessation we have analysed the clinical data obtained with the increasingly popular e-cigarette as an aid to help current smokers to quit. Although e-cigarette has not proved its effectiveness in smoking cessation yet, the public health authorities have usually adopted a pragmatic position. They recommend trying e-cigarette when validated pharmacological tools have failed in making patients abstinent, on the basis that e-cigarette is strongly assumed to be less toxic and may still help reducing the amount of smoked cigarettes.Compte tenu des effets dévastateurs du tabagisme chronique sur la santé, le sevrage tabagique est un objectif prioritaire de santé publique. Après un bref rappel sur les méthodes validées d’aide au sevrage, nous abordons les données cliniques obtenues avec la cigarette électronique, dont l’utilisation chez nous devient de plus en plus populaire. Au vu de la littérature actuelle, il semble bien que si la cigarette électronique n’a pas encore démontré de façon univoque son efficacité dans l’aide au sevrage complet, néanmoins, les autorités officielles de santé ont généralement adopté une position compréhensive et pragmatique à son égard, au vu de son potentiel à réduire la consommation de cigarette classique chez les patients ayant échoué avec les aides au sevrage validées.

Endoscopic submucosal dissection (ESD) was developed in Japan but has now also become permanently established in various centers in Europe. ESD is an endoscopic en bloc mucosal resection technique for the treatment of early cancers with a diameter >1 cm and also superficial precancerous lesions, which could only be removed unsatisfactorily in several fragments or with uncertain lateral safety margins using previous loop excision procedures. Using ESD a lesion is excised after circular marking and generous submucosal injection with a safety margin of approximately 5 mm and subsequently resected at the level of the submucosa with a 1-3 mm short diathermic knife. ESD requires high technical skills in interventional endoscopy and is more time-consuming than snare resection techniques. However, numerous studies have shown a clear superiority for ESD with respect to the R0 resection rate and the local recurrence rate. The present article gives a current review of the use of ESD in the upper and lower gastrointestinal tract and demonstrates perspectives of the procedure.

PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and workup of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.

PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and work-up of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.

This review reports the highlights of the first International Conference on Capsule and Double-Balloon Endoscopy, held in Paris (27 - 28 August 2010), under the chairmanship of Professor G. Gay (Nancy, France). The conference was devoted to the technical issues and clinical experience related to capsule endoscopy and double-balloon endoscopy (DBE), techniques that have been developed over the past decade for the endoscopic investigation of intestinal diseases. The conference focused on the technical advances of new-generation endoscopes and capsules and the clinical experience gained with capsule endoscopy and DBE. Important advances in the knowledge of obscure gastrointestinal bleeding, inflammatory bowel diseases, and celiac disease were also discussed. The second part of the conference was mainly devoted to the investigation of the colon and discussed the technical issues and results of initial controlled studies of the colonic capsule vs. conventional colonoscopy. In addition, the clinical usefulness of double colonoscopy was demonstrated in patients with previously failed colonoscopy. Finally, the role of DBE was discussed with respect to the investigation and treatment of patients with surgically modified anatomy. The conference was attended by 750 delegates and presented a unique opportunity for an in-depth review of the current knowledge in the field and to ascertain/determine the main lines for the future developments of capsule endoscopy and DBE.

Les progres recents ont considerablement etendu les possibilites d’examen morphologique de l’intestin grele, tant par des examens radiologiques (enteroscanner ou entero-IRM) qu’endoscopiques (capsule endoscopique, endoscopie double ballon).

Until recently, large parts of the small bowel were not accessible with nonsurgical endoscopic techniques. In this scenario, the advent of video capsule endoscopy and balloon-assisted enteroscopy represented a major breakthrough. Although capsule endoscopy is a safe method that may provide imaging of the entire small bowel, major drawbacks are that biopsy sampling and endoscopic treatment cannot be performed; moreover, in many cases interpretation of nonspecific findings remains a concern. In contrast to capsule endoscopy, flexible enteroscopy with push enteroscopy or balloon-assisted enteroscopy is labour-intensive and more invasive but allows real-time-controlled observation with the option for tissue sampling and endoscopic treatment. Push enteroscopy was established during the 1980 s but due to excessive loop formation it allows only limited visualization of the small intestine. This limitation has been overcome by the invention of balloonassisted enteroscopy, which may permit imaging of the entire small bowel by threading it onto the overtube, thereby minimizing looping and maximizing insertion. Initially, a double balloon enteroscopy (DBE) system was developed by Yamamoto and colleagues in 2001 [1]. This system has rapidly gained an established role in small-bowel investigation and therapy and is widely applied in clinical practice. Importantly, besides small-bowel endoscopy the DBE technique can be applied for additional indications, for example difficult colonoscopies, for gaining access to the pancreatic and biliary tract in patients with a surgically modified gastrointestinal tract, and access to the stomach in patients after bariatric surgery. Very recently, another balloon-assisted enteroscopy device with only one balloon at the tip of the overtube was introduced as the single balloon enteroscopy (SBE) system.

Background and study aims The study aim was to compare the diagnostic yield of capsule endoscopy and esophagogastroduodenoscopy (EGD) in patients with suspected esophageal disease. Secondary aims were to assess interobserver variability of capsule endoscopy readings and safety. Patients and methods In total, 98 patients (53 men, 53 +/- 13 years) with an indication for EGD were included. The patient population was artificially enriched to include two thirds of patients with abnormal esophageal findings at EGD, which was followed by capsule endoscopy. Capsule recordings were blindly read by three endoscopists, one from the center that recruited the patient and two from the other center. Study outcomes were the findings described on EGD and capsule endoscopy, agreement between EGD and capsule endoscopy for findings, quality of the capsule recording, and interobserver agreement for capsule endoscopy quality and findings. Results EGD was normal in 34 patients and showed esophageal findings in 62 (esophagitis 28, hiatus hernia 21, varices 21, Barrett's esophagus 11, others 7). Average esophageal transit time of the capsule was 361 +/- 393 seconds. Capsule endoscopy was normal in 36 patients but detected esophagitis in 23, hiatus hernia in 0, varices in 23, Barrett's esophagus in 18, and others in 4. The positive predictive value of capsule endoscopy was 80.0 % and the negative predictive value was 61.1 %. Overall agreement per patient was moderate between EGD and capsule endoscopy for the per-patient (kappa = 0.42) and per-findings (kappa = 0.40) analyses. Interobserver agreement between capsule endoscopy readings was moderate for findings (kappa = 0.39) and quality assessment (kappa = 0.24). No adverse event was observed after either EGD or capsule endoscopy. Conclusion In this study, despite artificial prevalence enrichment, capsule endoscopy showed a moderate sensitivity and specificity in the detection of esophageal diseases.

Background and study aims The endoscopes that were developed for double-balloon enteroscopy have been successfully used in cases of failed colonoscopy. This study was a pilot series in which a new colonoscope was tested that utilized this double-balloon principle. Patients and methods A total of 29 patients (5 men, 24 women; mean age 54 years) in whom conventional colonoscopy had failed were included in this study. Both the failed colonoscopy and the double-balloon colonoscopy procedures were performed under general anesthesia, the usual practice in France. A prototype instrument (working length 152 cm, diameter 9.4 mm) designed to incorporate the principles of double-balloon enteroscopy was used. The completeness of colonoscopy was assessed according to conventional criteria by the achievement of a stable position in the cecum. The indicatons for the procedure, the time to reach the cecum, the need for fluoroscopic control, and adverse events were recorded. Results The previous colonoscopy failed due adhesions (n = 16), or to long or fixed loops (n = 13). Complete colonoscopy using the balloon method was achieved in 28/29 patients, taking an average time of 18 +/- 14 minutes; a long sigmoid loop limited the examination to the left flexure in one patient. Balloon colonoscopy using double-balloon methodology was used in 24 patients and the instrument was used without an overtube (i. e. using a single-balloon technique) in five patients. Fluoroscopy was used in 16 patients to monitor endoscope progression. No complications were reported. Conclusions Double-balloon colonoscopy enables full colonic examination in almost all patients with a previous incomplete colonoscopy. The overtube should be used in most cases. The use of fluoroscopic assessment of scope progression could be reduced further with increasing experience.

Introduction: L’examen endoscopique du colon est complet jusqu’a la valvule ileo-caecale dans pres de 90% des cas. Les examens incomplets sont favorises par des dispositions anatomiques particulieres: colon trop long, ou secondaires a des antecedents chirurgicaux responsables d’angle ou de segment colique fixe en raison d’adherences. Dans ce contexte, il a ete propose d’appliquer le principe de l’enteroscopie double ballon developpe pour l’intestin grele au niveau du colon en cas de coloscopie difficile en associant coloscope avec un ballonnet et surtube avec egalement un ballonnet.

Le developpement recent des methodes d’exploration morphologique de l’intestin grele a profondement modifie l’approche diagnostique des maladies intestinales. Les lesions intestinales sont aujourd’hui accessibles a l’exploration endoscopique sur l’ensemble de l’intestin grele et donc au traitement. La combinaison de ces methodes permet un diagnostic plus precoce des lesions et modifie favorablement l’evolution des patients.

Visceral sensitivity has been recognized over the last decade as a frequent pathophysiological component of functional bowel disorders. Studies in animals and humans have identified numerous neurotransmitters involved in the processing of sensations from the gut to the brain. However, up to now none of them has actually been proven to have a marked clinical efficacy and the benefit comes rather from their action of bowel disturbances. Reproducible tests are lacking to detect visceral hypersensitivity in humans and distension tests are difficult to undertake in a clinical setting. Therefore, abnormal visceral sensitivity may not be regarded as a tool to select IBS patients as candidates for a given treatment.

Background and study aim The main complication of video capsule endoscopy (VCE) is the blocking of the capsule by a gastrointestinal stenosis. The "patency capsule" is a self-dissolving capsule that is the same size as the video capsule. It contains a radiofrequency identification (RFID) tag that allows it to be detected by a scanning device placed on the abdominal wall. When its passage is blocked by a stenosis, the patency capsule dissolves in 40-80 hours after ingestion. The aim of this study was to evaluate the usefulness of this system in patients with suspected intestinal stenosis but also requiring VCE. Patients and methods 22 patients (16 men; 46 +/- 18 years; 15 with diagnosed or suspected Crohn's disease, two with suspected intestinal tumor, and two on nonsteroidal anti-inflammatory drugs) were first investigated with an abdominal CT plus enteroclysis (entero-CT, n = 15) or a small-bowel follow-through (SBFT, n = 7). The patency capsule was then administered at around 09.00 to fasting patients. The presence of the patency capsule in the digestive tract was assessed 30 hours later using the hand-held scanner. When the patency capsule was detected, a plain abdominal film was obtained, and this was repeated every 24 hours until capsule expulsion. Results At 30 hours after ingestion, the patency capsule was detected in 17 patients (72.3 %): in the area of the small intestine (n = 6) and in the colon (n = 11). In all the patients in whom the capsule was blocked in the small intestine, the stenosis had been suspected on CT or SBFT. In three patients, the delay in progression of the patency capsule led to cancellation of the VCE procedure. In three patients, the patency capsule induced a symptomatic intestinal occlusion, which resolved spontaneously in one and required emergency surgery in two. Although these two patients would have been obliged to undergo operation for their primary disease in any case, the procedure had to be brought forward. In one patient, the capsule passed through the stenosis without symptoms. All patients in whom the progression of the patency capsule was delayed had an established or suspected diagnosis of Crohn's disease. Conclusions The current technical development of the patency capsule limits its use in clinical practice, as it did not detect stenoses undiagnosed by CT or SBFT. The start of dissolution at 40 hours after ingestion is too slow to prevent episodes of intestinal occlusion. Patients with Crohn's disease are most likely to be at risk of blockage of progression of the capsule and should benefit from a CT investigation before VCE. However, a careful interview eliciting the patient's medical history and symptoms remains the most useful indicator with regard to suspicion of an intestinal stenosis.

Cancer is characterized by cell cycle deregulation, progressive loss of cell differentiation and uncontrolled growth. Since cancer cells are particulary sensitive to oxidative stress, we took advantage of this poor antioxidant status to develop an experimental approach to selectively expose cancer cells to an oxidant insult induced by the association of vitamins C and K3 (CK3). The results we obtained reinforce the major role of oxidative stress as the main mechanism involved in cell killing by CK3, either under in vivo or in vitro conditions. such an antitumor activity has been attributed to redox cycling of the vitamins and the possible generation of peroxides and other reactive oxygen species. We report herein, on the ability of the association of ascorbate with several quinone derivatives (having differentredox potentials) to cause cell death. Finally, we determined that cell death by CK3 is not related to the activation of MAP kinases pathways.

La prise en charge du syndrome de l’intestin irritable doit tenir compte de sa physiopathologie multifactorielle et de l’expression clinique tres variable de l’affection dans le temps chez chaque patient ainsi que de l’existence de sous-groupes de patients, principalement caracterises par la nature des troubles du transit qu’ils presentent.

La capsule video-endoscopique permet l’exploration de la totalite de l’intestin grele, mais il manque la possibilite de realiser des biopsies et des actes therapeutiques. L’enteroscopie double ballon qui est maintenant mise a notre disposition est une methode qui se propose de resoudre ces deux problemes. Les principes qui permettent son utilisation sont passes en revue de meme que la methode d’introduction et de progression de l’endoscope au niveau de l’intestin grele. Les premiers resultats de notre experience sont rapportes et discutes a la lumiere des experiences japonaise et allemande deja publiees.

BACKGROUND AND STUDY AIMS The long-term outcome for patients with obscure bleeding after capsule endoscopy (CE) is still unclear. In this study, the clinical outcome was used as the gold standard to determine the sensitivity and specificity of CE and push enteroscopy (PE) in the diagnosis of small-bowel lesions in patients with obscure bleeding. PATIENTS AND METHODS Fifty-eight patients from a previous prospective study (comparing PE and CE) were included; the patients were contacted after 1 year. The final diagnosis, bleeding status, new gastrointestinal examinations, and treatments performed were recorded. On the basis of these data, each case was classified into true/false positive or true/false negative findings at PE and CE. The results were compared with the initial classification of lesions observed at CE: highly relevant (P2) and less relevant (P0, P1) lesions. RESULTS Follow-up data were available for 56 patients. According to the defined true/false positive and negative cases, the sensitivity and specificity values for CE and PE were 92 % and 48 %, and 80 % and 69 %, respectively ( P < 0.01 for the difference between CE and PE). Highly relevant (P2) lesions observed at CE were more frequently classified into true-positive cases (15 of 18 versus seven of 22; P < 0.01) and led more frequently to therapeutic decisions (11 of 18 versus five of 22; P = 0.02) in comparison with less relevant lesions (P0, P1). CONCLUSIONS CE is a highly sensitive examination for the detection of small-bowel lesions in patients with obscure gastrointestinal bleeding, with a specificity lower than that of PE when the clinical outcome is used as the gold standard.

A 26-year-old woman was admitted for the investigation of abdominal symptoms related to ileal Crohn's disease. The patient had been diagnosed 3 years previously with systemic sclerosis, and had been experiencing digestive complaints for 6 months. A first computed tomography (CT) scan showed ileal intestinal mucosal alterations, associated with a sclerolipomatosis and suspicion of ileal stenosis. An ileocolonoscopy was then performed and showed ulcers in the terminal ileum with nonspecific inflammatory changes found on biopsies, both suggesting the diagnosis of Crohn's disease. The patient was admitted for M2A capsule endoscopy, in order to clarify the respective roles of systemic sclerosis and Crohn's disease with regard to the symptoms and secondarily to determine the anatomical extent of the Crohn's lesions. A patency capsule was administered, for detection of intestinal stenosis before capsule endoscopy was done. At 30 hours after capsule ingestion, the patient complained of abdominal pain and nausea and experienced intestinal obstruction due to the blockage of the patency capsule in the ileal stenosis. The capsule dissolved after 76 hours and the patient then improved. After a few days, the patient underwent ileocecal resection. Pathological examination of the surgical specimen confirmed the presence of an ileal stenosis 17 cm in length. In some circumstances a patency capsule may dissolve slowly, leading to transitory intestinal obstruction requiring medical intervention. It should thus be used cautiously under clinical surveillance in patients with Crohn's disease.

Background and study aims In patients with obscure digestive bleeding, the bleeding source is frequently located in the small bowel. Capsule endoscopy (CE) is an effective method of investigating the whole small bowel in such patients. In the present study, a diagnostic approach was tested in patients with obscure digestive bleeding in which CE was included as the initial examination of the small bowel when the esophagogastroduodenoscopy (EGD) and colonoscopy findings were normal. Patients and methods Patients admitted between October 2000 and February 2002 for obscure digestive bleeding underwent CE as the initial intestinal investigation, and the further management was decided on the basis of the results. After 12 months, follow-up data were obtained from all patients and referring physicians. The positive predictive value was calculated as the percentage of patients in whom CE detected a relevant lesion, and the negative predictive value as the percentage of patients with normal CE in whom no intestinal lesion was detected during the follow-up period. Results Forty-four patients (21 men, 23 women, aged 63 +/- 17 y) were included in the study. Twenty-two had overt bleeding and 22 had occult bleeding. CE detected an intestinal lesion in 18 patients (41.9 %)-- nine with angiomas, five with ulcers, one with a tumor, two with portal hypertension, and one with ischemic ileitis. The findings were normal in 17 patients (39.5 %). CE detected upper gastrointestinal lesions missed at EGD in four patients and blood in the stomach in two patients or in the proximal colon in three, leading to new endoscopies. Intestinal lesions detected at CE were treated as follows: push enteroscopy with treatment in eight patients, surgery in four, and medical treatment in six. In eight patients who underwent push enteroscopy, the procedure did not reveal lesions missed by CE. After 1 year, 15 of the 18 patients treated for intestinal lesions had no further bleeding and no anemia; one died after surgery (for resection of an ischemic intestinal loop), one relapsed, and one was diagnosed with a different intestinal condition. In all patients with extraintestinal lesions or blood detected at CE, further endoscopies led to diagnosis and therapy, with a favorable outcome. In patients with normal CE, no intestinal lesion was detected, but an extraintestinal source of bleeding was diagnosed and treated in nine patients (in the upper gastrointestinal tract in five cases and in the colon in four). Three patients had anemia of hematological origin and four had inadequate iron intake. The positive predictive value of CE was 94.4 % in patients with intestinal lesions, and the negative predictive value was 100 % in patients with normal CE findings. Conclusions In patients with obscure digestive bleeding, CE positively predicted the intestinal diagnosis or normal status in 95.5 % of cases. A diagnostic approach to obscure digestive bleeding that includes CE after the initial endoscopic work-up thus appears to be a valid strategy for small-bowel examinations.

Resume Le systeme d'imagerie diagnostique par videocapsule est une technique d'exploration du tractus digestif, en particulier de l'intestin grele. Cette videocapsule endoscopique (VCE) n'est pas dirigeable, elle ne permet pas actuellement de prelevement biopsique. D'ores et deja on peut considerer qu'elle est validee dans le diagnostic etiologique des saignements digestifs chroniques obscurs. Elle doit etre mise en œuvre avant la realisation de la videoenteroscopie poussee. Elle est utile egalement dans la surveillance des polyposes familiales et dans la recherche de lesions creees par la prise d'anti-inflammatoires. Son evaluation est en cours dans les maladies chroniques inflammatoires, en particulier la maladie de Crohn, les syndromes de malabsorption, et plus particulierement le suivi des patients porteurs de maladie cœliaque. Il s'agit donc d'un procede qui pour la premiere fois permet l'exploration complete de l'intestin grele. On peut esperer dans le futur des developpements qui permettent de controler sa progression. Dans l'etat actuel, il ne s'agit pas d'un materiel capable d'explorer le colon et l'estomac.

Video capsule endoscopy represents a significant advance in the investigation of intestinal diseases. The performance of the procedure and indications are reviewed here in order to establish guidelines for its use, in accordance with current knowledge from the published literature. Capsule endoscopy is performed in patients who have fasted for 12 h, but who are allowed to drink 2 h after and to eat 4 h after ingesting the capsule. Software features highlighting suspected blood and allowing simultaneous viewing of two images reduce the time required to review the findings, as well as improving the diagnostic yield. Pacemakers and other electrical medical devices are no longer a contraindication to the procedure. Indications that have been validated include obscure digestive bleeding, intestinal lesions related to nonsteroidal anti-inflammatory drugs, and familial polyposis. Capsule endoscopy frequently detects intestinal lesions in patients with Crohn's disease and could become the first-choice examination in patients with suspected Crohn's disease after conventional endoscopic investigations. Other indications currently under evaluation include celiac disease, pediatric indications, and examination of other parts of the gastrointestinal tract.

L’intestin grele reste, pour reprendre les expressions des auteurs americains, «la derniere frontiere» [1], «le bout du tunnel» [2], du gastroenterologue. En effet, les differents moyens de l’explorer sont difficiles a mettre en œuvre pour plusieurs motifs: a) fragilite du materiel comme la sonde d’enteroscopie [3]; b) morbidite non negligeable comme l’enteroscopie chirurgicale [4], c) caractere incomplet de l’examen parce que limite aux premieres anses jejunales comme l’enteroscopie par voie haute ou aux dernieres anses ileales pour l’ileoscopie retrograde au cours d’une coloscopie [5]; d) evaluation insuffisante de l’enteroscopie par double ballon [6]. C’est dans ce contexte qu’est commercialisee la video-capsule endoscopique (VCE) (Given Imaging LTD Yoqneam Israel) fruit du travail initial de 2 ingenieurs israeliens: Iddan et Meron [7]. Elle est actuellement mise a notre disposition ainsi que la station de traitement de l’image par la Firme Given Imaging® (Gastrointestinal Videoendoscopy). Son utilisation clinique est approuvee par la FDA depuis aout 2001, le marquage CE est obtenu depuis mai 2002.

La capsule endoscopique est une technologie innovante qui n’est qu’au debut de son histoire. Elle constitue un progres reel pour le diagnostic des maladies de l’intestin grele. Cependant des etudes de validation sont necessaires pour essayer de cerner son champ d’application par comparaison aux autres methodes endoscopiques et a l’exploration radiologique (entero-scanner, IRM) qui beneficie d’un developpement constant. Le developpement de cette nouvelle technique repousse les limites de l’exploration endoscopique du tractus digestif. Comme le disait J.D. Waye dans un article recent [29]: «On peut considerer que l’intestin grele n’est plus la boite noire» car jusqu’a present l’intestin grele restait pour l’endoscopiste «la derniere frontiere» [1].

Micro- and nano-structures composed of polyaniline (PANi) have been prepared by chemical and electrochemical oxidative polymerization of aniline within the pores of particle track-etched membranes (PTM). Their morphology has been studied by field-emission scanning electron microscopy. Hollow tubules are formed because PANi initially deposits on the surface of the pore walls. Raman spectroscopy was used to probe the oxidative state of PANi in order to optimize the chemical polymerization conditions with respect to the electrical conductivity. The nanoscopic materials show an enhancement of the electronic conductivity compared to analogous polymer bulk conductivity. (C) 2000 Elsevier Science S.A. All rights reserved.

Background and study aims Standardization of the endoscopic report is a key issue for future research in the field of digestive endoscopy. The Minimal Standard Terminology (MST) has been proposed by the European Society for Gastrointestinal Endoscopy (ESGE) as a structured language for production of computerized endoscopic reports. The aim of this study was to validate version 1.0 of this terminology prospectively, by collecting cases in a multicenter, multilingual trial. Methods Endoscopic cases (esophagogastroduodenoscopy [EGD], colonoscopy, endoscopic retrograde cholangiopancreatography [ERCP]) were prospectively collected in nine university hospitals in Europe, using the same software. Reports were produced in the local language, but the software allowed comparison of reports between languages, and global analysis of the database. Outcome measures were the adequacy of terms proposed in the MST to describe "reasons for performing an endoscopy", "findings", and "endoscopic diagnoses", frequency of use and content of free-text fields, and types of lesions described. Results A total of 6,232 reports were analyzed, including 3,447 gastroscopies, 1,743 colonoscopies, and 1,042 ERCPs. Overall, terms originally contained in the MST were adequate to describe fully 91.0% of all examinations where "reasons for endoscopy" were described, 99.5 % of examinations where "findings" were described, 95.8% of all examinations containing descriptions of "endoscopic diagnosis", 98.9% of examinations containing descriptions of "additional diagnostic procedures", and 94.8 % of examinations containing descriptions of "additional therapeutic procedures". Free-text fields were only used in the other cases (less than 5% of cases in average). Conclusions The MST appeared adequate to cover a large part of routine endoscopy reports, and could thus be used as a tool for standardization of endoscopic reports in clinical practice. The latter could be significantly improved by the use of a structured and standardized terminology for the production of endoscopic reports.

The interest of the international gastrointestinal endoscopy community in developing standards for endoscopic reporting resulted in a standard lexicon for describing endoscopic findings. It became clear that in order to facilitate the widespread use of this lexicon, a messaging standard which could link images to text had to be adopted. The DICOM 3.0 Standard (digital imaging and communication in medicine) was extended by the introduction of the Visible Light Supplement and the SNOMED-DICOM microglossary. These two standards should expand the ability of DICOM to accomodate endoscopic images and the clinical description of these images.

The wider use of computers for the management of endoscopic data and the use of electronic endoscopes for the production of high quality endoscopic images has made the standardization of terminology and images formats necessary in digestive endoscopy reports. The European Society for Gastrointestinal Endoscopy and the American Society for Gastrointestinal Endoscopy have combined their efforts to propose a Minimal Standard Terminology for Computerized Databases in Endoscopy. This terminology is based on the following principles: no term describing findings less frequent than 1%, of the daily practice, and no term based on subjective impressions. The Minimal Standard Terminology has been developed according to the natural process of constructing an endoscopic report in natural language and deals with the following: reasons for performing the examination, endoscopic findings, endoscopic diagnosis, additional therapeutic and diagnosis procedures (biopsies, etc.). It is subdivided according to the main organs examined with an endoscopy. Until now, the Minimal Standard Terminology was tested in many centers and was shown to accurately cover 95% of routine examinations for the upper gastrointestinal tract, colonoscopy and cholangio-pancreatography. It is currently being tested in an a prospective way in several centers in Europe (with a grant from the European Commission DGXIII-C4) and in the USA (with grant from the AHDHF).

Genetic diversity and structure within a Lima bean (Phaseolus lunatus L.) base collection have been evaluated using allozyme markers. The results obtained from the analysis of wild and cultivated accessions confirm the existence of Andean and Mesoamerican gene pools characterised by specific alleles. Wild and cultivated accessions of the same gene pool are grouped. The Andean natural populations have a very limited geographic distribution between Ecuador and northern Peru. The Mesoamerican wild form extends from Mexico up to Argentina through the eastern side of the Andes. Andean and Mesoamerican cultivated accessions of pantropical distribution contribute substantially to the genetic diversity of the Lima bean base collection. Population genetic parameters, estimated from allozymes, confirmed the predominant selfing mating system of the Lima bean. The selfing mating system, the occurrence of small populations, and low gene flow lead to an interpopulation gene diversity (DST=0.235) higher than the intrapopulation gene diversity (HS=0.032). On the basis of the results, guidelines are given to preserve and exploit the genetic diversity of this threatened species. The results also confirm the independent domestication of the Lima bean in at least two centres, one of which is located at medium elevation in the western valleys of Ecuador and northern Peru.

For the catalytic synthesis of carbon nanotubes having fullerene- like diameters, a detailed description of the catalyst preparation is given. Silica-supported catalyst samples (prepared from Co-acetate solution of different pH) were tested in the decomposition of acetylene. Catalysts with various pretreatments (different calcination temperature, time and atmosphere) were compared in the carbon nanotubes production and characterized by X-ray photoelectron spectroscopy (XPS). The quality and the quantity of the bucky tubes were studied by transmission electron microscopy (TEM). As a final conclusion, it is possible that changing the pH of the solution during catalyst preparation allows control of the quality of the carbon nanotubes, namely the amount of turbostratic straight and helical tubes.