Current Issue August 2010, Vol. 139, No. 2

Editor's Essential Reading

Clinical—Alimentary Tract

Oral Viscous Budesonide Is Effective in Children With Eosinophilic Esophagitis in a Randomized, Placebo-Controlled Trial
Ranjan Dohil, Robert Newbury, Lyman Fox, John Bastian, Seema Aceves
Eosinophilic esophagitis (EoE) is caused by immunologic reactions to ingested/inhaled allergens. The diagnosis is considered if ≥15 eosinophils per high-powered field (eos/hpf) are detected in mucosal biopsies. Placebo-controlled studies have not been conducted to evaluate the safety and efficacy of oral viscous budesonide (OVB).

Issue Highlights

Clinical—Alimentary Tract

Effects of Lesogaberan on Reflux and Lower Esophageal Sphincter Function in Patients With Gastroesophageal Reflux Disease
Transient lower esophageal sphincter relaxations (TLESRs) are a major mechanism behind reflux. This study assessed the effects of lesogaberan (AZD3355), a novel γ-aminobutyric acid type B receptor agonist, on reflux and lower esophageal sphincter (LES) function when used as add-on treatment in patients with reflux symptoms despite proton pump inhibitor (PPI) treatment.

Clinical—Liver, Pancreas, and Biliary Tract

Incidence and Determinants of Spontaneous Hepatitis B Surface Antigen Seroclearance: A Community-Based Follow-Up Study
Seroclearance of hepatitis B surface antigen (HBsAg) is one of the most important clinical outcomes for chronic hepatitis B treatment trials. Few studies have explored the incidence and determinants of spontaneous seroclearance using a long-term follow-up study. This study aimed to examine the natural history and predictors of HBsAg seroclearance.

Basic—Alimentary Tract

Pathogenic and Protective Roles of MyD88 in Leukocytes and Epithelial Cells in Mouse Models of Inflammatory Bowel Disease
Toll-like receptors (TLR) are innate immune receptors involved in recognition of the intestinal microflora; they are expressed by numerous cell types in the intestine, including epithelial cells, myeloid cells, and lymphocytes. Little is known about the relative contributions of TLR signaling in distinct cellular compartments to intestinal homeostasis.

Basic-Liver, Pancreas, and Biliary Tract

C/EBPα Is Up-regulated in a Subset of Hepatocellular Carcinomas and Plays a Role in Cell Growth and Proliferation
C/EBPα (cebpa) is a putative tumor suppressor. However, initial results indicated that cebpa was up-regulated in a subset of human hepatocellular carcinomas (HCCs). The regulation and function of C/EBPa was investigated in HCC cell lines to clarify its role in liver carcinogenesis.

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Discussion
Ajit Sood, Vandana Midha, Govind K. Makharia, Vineet Ahuja, Dinesh Singal, Pooja Goswami, Rakesh K. Tandon
We thank Dr Shah for her appreciation of our study and acceptance of our results. We agree that further, well-designed, randomized, controlled trials are needed to confirm our results. A recent study ...
α-Enolase Autoantibodies Cross-Reactive to Viral Proteins in a Mouse Model of Biliary Atresia
Brandy R. Lu, Stephen M. Brindley, Rebecca M. Tucker, Cherie L. Lambert, Cara L. Mack
Abstract: Background & Aims:: Biliary atresia (BA) is a neonatal cholangiopathy of unknown etiology. The bile duct injury that occurs in patients with BA might result from a hepatobiliary viral in...
Discussion
Maria Rescigno, Iliyan D. Iliev
Doctors Veny, Salas, and Panes correctly point out that in our reports (Gut 2009;58:1481–1489; Nat Immunol 2005;6:507–514) we have isolated epithelial cells from regions that were not macroscopically ...
Autophagy Reduces Acute Ethanol-Induced Hepatotoxicity and Steatosis in Mice
Wen-Xing Ding, Min Li, Xiaoyun Chen, Hong-Min Ni, Chie-Wen Lin, Wentao Gao, Binfeng Lu, Donna B. Stolz, Dahn L. Clemens, Xiao-Ming Yin
Abstract: Background & Aims:: Alcohol abuse is a major cause of liver injury. The pathologic features of alcoholic liver disease develop over prolonged periods, yet the cellular defense mechanisms...
Curbside Consultation of the Pancreas: 49 Clinical Questions
Daniel Cornett, Patrick Pfau
The pancreas is the latest focus of the Curbside Consultation series. This clinically oriented series reviews 49 topics in a question-and-answer format. The book is written not only for gastroenterolo...
Genetic Heterogeneity in Colorectal Cancer Associations in Americans of African vs. European Descent
Sonia S. Kupfer, Jeffrey R. Anderson, Stanley Hooker, Andrew Skol, Rick A. Kittles, Temitope O. Keku, Robert S. Sandler, Nathan A. Ellis
Abstract: Background & Aims:: Genome-wide association studies of colorectal cancer (CRC) have identified risk variants in 10 genomic regions. None of these studies included African Americans, who ...
Esophageal Pain
Joel E. Richter
Gastroesophageal reflux disease affects 20%–30% of Western populations and is one of the most common diseases of mankind. A subset of these patients present with esophageal chest pain, which can mimic...
Prevalence of Colorectal Cancer Surveillance for Ulcerative Colitis in an Integrated Health-Care Delivery System
Fernando S. Velayos, Liyan Liu, James D. Lewis, James E. Allison, Nicole Flowers, Susan Hutfless, Oren Abramson, Geraldine S. Perry, Lisa J. Herrinton
Abstract: Background and Aims:: The absence of grade A supporting evidence for surveillance colonoscopy in patients with ulcerative colitis (UC) has led to controversy regarding its benefit, yet it is...
Loose Stool and Periumbilical Pain
Hsing-Feng Lee, Ching-Liang Lu, Full-Young Chang, Ching-Liang Lu
Question: A 36-year-old man presented with loose stool passage and periumbilical pain off and on for 3 months. On examination, well-demarcated purpuric papules and plaques were noted on his extremitie...
MicroRNAs Control Intestinal Epithelial Differentiation, Architecture, and Barrier Function
Lindsay B. McKenna, Jonathan Schug, Anastassios Vourekas, Jaime B. McKenna, Nuria Bramswig, Joshua R. Friedman, Klaus H. Kaestner
Abstract: Background and Aims:: While the importance of miRNA for the development of several tissues is well established, its role in the intestine is unknown. We aimed to quantify the complete miRNA ...

View More Articles in Press...

Trunk Fat Is Associated With Increased Serum Levels of Alanine Aminotransferase in the United States , 11 January 2010
April 2010 (Vol. 138, Issue 4, Pages 1346-1356.e3)
Gastroenterology

Constance E. Ruhl, James E. Everhart
AGA Medical Position Statement on the Diagnosis and Management of Colorectal Neoplasia in Inflammatory Bowel Disease
February 2010 (Vol. 138, Issue 2, Pages 738-745)
Gastroenterology

Francis A. Farraye, Robert D. Odze, Jayne Eaden, Steven H. Itzkowitz, AGA Institute Medical Position Panel on Diagnosis and Management of Colorectal Neoplasia in Inflammatory Bowel Disease
Gastric Rupture , 02 March 2010
April 2010 (Vol. 138, Issue 4, Pages e3-e4)
Gastroenterology

Hirokazu Taguchi, Takao Arai, Shoichi Ohta
- Full Text
- PDF (615 KB)
Does Capsule Endoscopy Improve Outcomes in Obscure Gastrointestinal Bleeding? Randomized Trial Versus Dedicated Small Bowel Radiography , 04 February 2010
May 2010 (Vol. 138, Issue 5, Pages 1673-1680.e1)
Gastroenterology

Loren Laine, Amandeep Sahota, Abbid Shah
American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease , 16 September 2008
October 2008 (Vol. 135, Issue 4, Pages 1383-1391.e5)
Gastroenterology

Peter J. Kahrilas, Nicholas J. Shaheen, Michael F. Vaezi
Interleukin-28b: A Key Piece of the Hepatitis C Virus Recovery Puzzle , 24 February 2010
April 2010 (Vol. 138, Issue 4, Pages 1240-1243)
Gastroenterology

Chloe L. Thio, David L. Thomas
- Full Text
- PDF (770 KB)
Abdominal Distension in a 79-Year-Old Patient , 02 March 2010
April 2010 (Vol. 138, Issue 4, Page 1250)
Gastroenterology

Jung-Chun Lin, Heng-Cheng Chu, Daniel Hueng-Yuan Shen
- Full Text
- PDF (611 KB)
The FODMAP Diet for Irritable Bowel Syndrome: Food Fad or Roadmap to a New Treatment Paradigm? , 01 June 2009
July 2009 (Vol. 137, Issue 1, Pages 383-386)
Gastroenterology

Amol S. Rangnekar, William D. Chey
- Full Text
- PDF (158 KB)
History, Molecular Mechanisms, and Endoscopic Treatment of Barrett's Esophagus , 18 January 2010
March 2010 (Vol. 138, Issue 3, Pages 854-869)
Gastroenterology

Stuart Jon Spechler, Rebecca C. Fitzgerald, Ganapathy A. Prasad, Kenneth K. Wang
Trunk Fat as a Determinant of Liver Disease , 24 February 2010
April 2010 (Vol. 138, Issue 4, Pages 1244-1246)
Gastroenterology

Jacquelyn J. Maher
- Full Text
- PDF (286 KB)

On the Cover

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More Periodicals

Gastroenterology is published by Elsevier for the AGA Institute.

Image of the Week

An Insidious Pancreatic Lesion in a Young Woman With Recurrent Pancreatitis Contrast-enhanced CT depicting a bulging contour in the pancreatic tail portion with focal pancreatic duct dilation.

2 videos:

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Dr. Xiaoqun Dong discusses her manuscript "Insulin-like Growth Factor Axis Gene Polymorphisms and Clinical Outcomes in Pancreatic Cancer."

Video--flashvideo1gastro--http://www.youtube.com/v/VW5raipSnDk

Jessica Liu discusses her manuscript "Incidence and Determinants of Spontaneous Hepatitis B Surface Antigen Seroclearance: A Community-Based Follow-up Study."

Video--flashvideo2gastro--http://www.youtube.com/v/lU_aPT4X6Zs

Dr. Maurizia Rossana Brunetto discusses her manuscript "Hepatitis B Surface Antigen Serum Levels Help to Distinguish Active From Inactive Hepatitis B Virus Genotype D Carriers."

Video--flashvideo3gastro--http://www.youtube.com/v/DOZFKneqQIk

Review

Hereditary Hemochromatosis: Pathogenesis, Diagnosis, and Treatment

In the late 1800s, hemochromatosis was considered an odd autoptic finding. More than a century later, it was finally recognized as a hereditary, multi-organ disorder associated with a polymorphism that is common among white people: a 845G→A change in HFE that results in C282Y in the gene product.

Mini—Reviews and Perspectives

Achalasia: Update on the Disease and Its Treatment

Most studies that evaluate the epidemiology of achalasia are retrospective. Studies on the incidence and prevalence of achalasia come mostly from the United Kingdom, but there have been also studies of diverse populations such as Northern Europe, Israel, New Zealand, the United States, and Zimbabwe.

Editorial

MyD88 Signaling in the Intestine: Dr Jekyll and Mr Hyde?

A unique and intricate relationship exists between the host and the vast, complex microbial communities living on both the external and internal mucosal surfaces of animals. This unique relationship has formed over millions of years of co-evolution between the kingdom Prokarya and Eukarya and is perhaps best appreciated in the gastrointestinal tract, where ~1000 species of bacteria as well as members of Archaea, Eukarya, and viruses populate this organ.