Scandinavian journal of gastroenterology. Supplement最新文献

{"title":"XXXV Nordic Meeting of Gastroenterology, XXVI Nordic Meeting of Digestive Endoscopy, XIV Nordic Meeting of Gastrointestinal Motility, Annual Endoscopy/Gastroenterology Nurses'/Assistants' Meeting. Helsinki, Finland. 11-14 June 2003. Abstracts.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 238","pages":"14-32"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22534448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomics in colorectal cancer: godsend or gimmick?","authors":"N J Maughan,&nbsp;P Quirke","doi":"10.1080/00855910310001458","DOIUrl":"https://doi.org/10.1080/00855910310001458","url":null,"abstract":"<p><p>Genomics and the new techniques it embraces, such as cDNA and tissue arrays, comparative genomic hybridization and single nucleotide polymorphism analysis, offer the opportunity to generate massive amounts of data relating to screening, aetiology, diagnosis, prognostication and optimal treatment in colorectal cancer. To make progress, studies must be designed to stringently test these new technologies and compare them to the tried and tested gold standards. This is best done in the form of large randomized controlled trials. Genomics undoubtedly offers the prospect of exciting new developments in the field of colorectal cancer but these should be regarded with caution until they are proved superior to present practices and models.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 237","pages":"26-9"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00855910310001458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22428234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of virtual histology and virtual biopsy using laser-scanning confocal microscopy.","authors":"H Inoue,&nbsp;J Y Cho,&nbsp;H Satodate,&nbsp;M Sakashita,&nbsp;E Hidaka,&nbsp;S Fukami,&nbsp;T Kazawa,&nbsp;T Yoshida,&nbsp;A Shiokawa,&nbsp;S Kudo","doi":"10.1080/00855910310001485","DOIUrl":"https://doi.org/10.1080/00855910310001485","url":null,"abstract":"<p><p>The aim of this project is to acquire a direct image of histology from in vivo gastrointestinal mucosa. In other words, the task of 'endo-microscope' is to observe the cellular architecture of tissue in vivo during routine endoscopic examination. As the first step to completing this study, resected fresh specimens from the oesophagus. stomach and colon were examined by laser-scanning confocal microscopy (LCM) (Fluoview, Olympus, Tokyo). Fresh untreated mucosal specimens obtained by endoscopic pinch biopsy, polypectomy or endoscopic mucosal resection were collected and placed in normal saline and examined by LCM, collecting the reflective light of a 488-nm wavelength argon laser beam. As the second step, a probe-type LCM 'endo-microscope' was designed and applied to observe the human oral-cavity mucosa. The probe has 4.5-mm outer diameter and 20-cm length, which enables easy access to oral cavity mucosa. The estimated special resolution of the probe is 1-5 microm. A real-time microscopic image directly from ex vivo fresh specimens was acquired. The acquired LCM images corresponded well with the conventional H-E light microscopic images. Cell wall, nucleus and cytoplasm were simultaneously visualized by LCM scanning. This novel method enables serial imaginary microscopic sections on fresh specimens. In addition, a probe-type LCM 'endo-microscope' was designed and was applied to observe human oral cavity mucosa. Virtual histological images from the living oral squamous cell were successfully obtained. LCM images from ex vivo fresh specimens demonstrated the features of the H-E staining histological image. In the next step to accomplish our project, we developed a LCM probe with 4.5-mm outer diameter to obtain a virtual image of human oral cavity mucosa.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 237","pages":"37-9"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00855910310001485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22428237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of colorectal cancer surveillance in ulcerative colitis.","authors":"J M Inadomi","doi":"10.1080/00855910310001430","DOIUrl":"https://doi.org/10.1080/00855910310001430","url":null,"abstract":"<p><p>Key issues concerning colorectal cancer in inflammatory bowel disease include determination of the risk of colorectal cancer and assessment of interventions to increase survival. No randomized, controlled trials of colonoscopic surveillance compared to no surveillance exist; however, retrospective studies illustrate that surveillance is associated with improved survival, probably as a result of detection of cancer at earlier stages of disease. In the absence of prospective clinical trials of either prophylactic colectomy or surveillance colonoscopy to detect dysplasia, quantitative analysis has been utilized to estimate the impact of competing management strategies on costs and benefits. Published analyses show that while prophylactic colectomy will likely save the greatest number of life-years, quality of life is not optimal, and thus shared decision-making between provider and patient is recommended. Surveillance colonoscopy to detect early cancer and dysplasia appears to be cost-effective, although the risk of colorectal cancer must be substantial in order for this to hold true. It is estimated that the incidence of cancer in ulcerative colitis must exceed 27% over a 30-year period in order for surveillance colonoscopy every 2 years to be cost-effective. Determination of the optimal interval between surveillance procedures is also a contentious issue. Although annual surveillance colonoscopy may not be cost-effective, 3-4 year intervals yield cost-effectiveness ratios comparable to other medical practices deemed worthwhile by society, while 5-year interval produce an incremental cost-effectiveness similar to screening strategies in other diseases.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 237","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00855910310001430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22428941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspepsia management in primary care.","authors":"J C Thijs,&nbsp;N L A Arents,&nbsp;A A van Zwet,&nbsp;J H Kleibeuker","doi":"10.1080/00855920310002690","DOIUrl":"https://doi.org/10.1080/00855920310002690","url":null,"abstract":"<p><strong>Background: </strong>Dyspepsia is common in western society. Prompt endoscopy is imperative in all patients with sinister symptoms or if symptoms first appear after the age of 50-55 years, but the optimal management of younger patients with uncomplicated dyspepsia is still open to debate.</p><p><strong>Methods: </strong>The literature on the management of uncomplicated dyspepsia is reviewed and a personal view is presented.</p><p><strong>Results: </strong>Strategies based on non-invasive detection of Helicobacter pylori are probably the most cost-effective. Currently (H. pylori prevalence 30%-40%), a 'test and treat' approach using a non-invasive test to detect H. pylori is likely to be the most efficient first step. If the patient is H. pylori-negative or if symptoms persist after successful H. pylori eradication, empirical treatment with an anti-secretory drug is justified. Endoscopy is reserved for those patients in whom this approach fails. If the prevalence of H. pylori decreases, the positive predictive value of any non-invasive H. pylori test will become too low. A 'test and scope' approach in which a positive test can be confirmed by two or more biopsy-based tests is then more appropriate. At a very low prevalence of H. pylori in the dyspeptic population, non-invasive testing for H. pylori loses its significance and empirical treatment with an antisecretory drug becomes a rational first step.</p><p><strong>Conclusions: </strong>The optimal approach to management of uncomplicated dyspepsia is dependent on the prevalence of H. pylori among the dyspeptic population. At the current prevalence rate, 'test and treat', followed by acid suppressive treatment in the case of persisting symptoms, is the most appropriate strategy.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 239","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24181050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute idiopathic pancreatitis: does it really exist or is it a myth?","authors":"S E van Brummelen,&nbsp;N G Venneman,&nbsp;K J van Erpecum,&nbsp;G P VanBerge-Henegouwen","doi":"10.1080/008559203100027","DOIUrl":"https://doi.org/10.1080/008559203100027","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis is a severe disease with considerable morbidity and mortality. Gallstones and alcohol abuse are the most frequent causes (75% of patients). Other well-known causes are: hyperlipidemia, hypercalcaemia, abdominal surgery and drugs. In 10%-40% of patients however, no cause is identified after initial diagnostic evaluation: acute idiopathic pancreatitis. Identifying a cause in these patients is important, since the recurrence rate is high.</p><p><strong>Methods: </strong>A systematic review of the current literature was performed to identify possible causes, diagnoses and treatment options of acute idiopathic pancreatitis. Relevant literature was found via Pubmed.</p><p><strong>Results: </strong>The presence of microlithiasis or biliary sludge is an important cause of acute 'idiopathic' pancreatitis (up to 80% of patients). Microlithiasis and sludge can be detected by transabdominal/endoscopic ultrasonography, ERCP or polarizing light microscopy of bile. Cholecystectomy is the treatment of choice, whereas endoscopic sphincterotomy and ursodeoxycholic acid maintenance therapy are effective alternatives. Sphincter of Oddi dysfunction can be identified as the cause of acute 'idiopathic' pancreatitis in up to 30% of patients. Manometry of Oddi's sphincter is the gold standard for its diagnosis. Endoscopic sphincterotomy prevents recurrence in most patients. Anatomic abnormalities such as major papilla stenosis, pancreas divisum, pancreatic duct strictures and tumours may also cause acute 'idiopathic' pancreatitis. Endoscopic sphincterotomy and surgery are effective treatments. Finally, genetic screening may reveal gene mutations as the cause of acute 'idiopathic' pancreatitis.</p><p><strong>Conclusions: </strong>Acute 'idiopathic' pancreatitis is a severe disease with a high recurrence rate. Extensive diagnostic investigations may lead to a cause in >90% of patients.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 239","pages":"117-22"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24181493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal cancer: towards a tailored tumour therapy.","authors":"T Seufferlein,&nbsp;G Adler","doi":"10.1080/00855910310001449","DOIUrl":"https://doi.org/10.1080/00855910310001449","url":null,"abstract":"<p><p>Major progress has been made in the treatment of metastatic colorectal cancer, but conventional chemotherapy is unlikely to lead to a major breakthrough in the treatment of gastrointestinal tumours. Prognosticators, novel means of early diagnosis of cancer which at the same time indicate prognosis, as well as novel, tumour-specific therapeutic strategies, are urgently needed. There is an increasing amount of promising data from array technology and functional proteomics suggesting that this goal could be achieved in the near future. Research into the mechanisms of cancer signal transduction over the past 20 years has enabled the identification of numerous novel targets for tumour therapy and subsequently the development of various novel drugs termed magic bullets. The in vitro results with these drugs are promising; many drugs lost their magic after the first clinical trials. The state of novel diagnostics and therapeutics in gastrointestinal cancer and the implications for the future treatment of these tumours are discussed in this review.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 237","pages":"22-5"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00855910310001449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22428233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current management of acute gastrointestinal bleeding.","authors":"S C S Chung","doi":"10.1080/00855910310001412","DOIUrl":"https://doi.org/10.1080/00855910310001412","url":null,"abstract":"<p><p>Endoscopic therapy is now the first-line treatment for the management of acute ulcer bleeding. Of the many endoscopic methods available, combination treatment using adrenaline injection to arrest the active bleeding, followed by thermal or electrical coagulation to seal the vessel, is currently the most popular. Endoscopic ulcer haemostasis is technically demanding, and indiscriminate extrapolation of results of published trials without reference to the expertise available locally may be dangerous. The cost-effectiveness of a routine second-look endoscopy has not been established, but repeat treatment in those who have rebled has shown good results in experienced hands. Current evidence supports the use of a proton-pump inhibitor to prevent acid-pepsin digestion of the blood clot plugging the eroded blood vessel. Interplay between acid, Helicobacter, NSAID and 'stress' results in peptic ulceration. Eradication of Helicobacter is an important measure in the secondary prevention of ulcer bleeding. The inability to measure blood flow in the eroded artery before and after treatment, to reliably seal a large blood vessel and to detect rebleeding before significant blood loss are limiting factors in the current management of ulcer bleeding.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 237","pages":"9-12"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00855910310001412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22428939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probiotics in gastroenterology: indications and future perspectives.","authors":"D Goossens,&nbsp;D Jonkers,&nbsp;E Stobberingh,&nbsp;A van den Bogaard,&nbsp;M Russel,&nbsp;R Stockbrügger","doi":"10.1080/00855920310002645","DOIUrl":"https://doi.org/10.1080/00855920310002645","url":null,"abstract":"<p><p>Nowadays. there is a growing interest in probiotics as a safe way of changing the intestinal bacterial flora. Probiotics may have potential in several gastroenterological conditions, especially when the intestinal flora has been disturbed. Most scientific evidence is available for diarrhoea patients treated with Lactobacillus GG, Lactobacillus reuteri or Saccharomyces boulardii. Meta-analyses have shown an overall reduction in the risk of antibiotic-associated diarrhoea during treatment with probiotics, and benefits have also been demonstrated for patients with rota-virus-associated diarrhoea. Patients with inflammatory bowel disease, an inflammatory disorder characterized by a change in the intestinal flora, are another important target group for which probiotics may be beneficial. It has been claimed that in ulcerative colitis and Crohn disease patients, lactobacilli, S. boulardii and Escherichia coli reduce relapses. but most studies were not placebo-controlled. A reduction in relapses has also been demonstrated in pouchitis patients treated with a multispecies probiotic. Irritable bowel syndrome might be another clinical indication for probiotic therapy, but results of clinical trials performed in these patients are inconsistent. Additionally, probiotics may improve lactose absorption. Helicobacter pylori eradication and constipation. Finally, in animal models of colorectal cancer, treatment with probiotics reduces the prevalence of this disease, and in humans the amount of genotoxic substances in faeces has been reduced. In conclusion, the results of studies on the effects of probiotics in gastrointestinal conditions are encouraging. but well-designed placebo-controlled studies are warranted before recommendations for therapeutic or preventive use can be given. Many issues still have to be resolved, including optimal dose and duration of treatment, selection of and differences between the several available probiotic strains, and, importantly, their mechanisms of actions have to be elucidated.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 239","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24181045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blockade of NF-kappaB activation and donation of nitric oxide: new treatment options in inflammatory bowel disease?","authors":"G Dijkstra,&nbsp;H Moshage,&nbsp;P L M Jansen","doi":"10.1080/003655202320621436","DOIUrl":"https://doi.org/10.1080/003655202320621436","url":null,"abstract":"<p><strong>Background: </strong>Inhibition of NF-kappaB activation has been suggested as an anti-inflammatory treatment strategy in inflammatory bowel disease (IBD). However, NF-kappaB regulated genes like inducible nitric oxide synthase (iNOS) are also involved in cell survival mechanisms.</p><p><strong>Methods: </strong>Review of the literature on NF-kappaB activation and iNOS induction in IBD.</p><p><strong>Results: </strong>In patients with IBD the mucosal immune response is derailed. The nuclear transcription factor NF-kappaB is a key regulator of the inducible expression of many genes involved in immune and inflammatory responses in the gut. Stimuli like oxidative stress, cytokines (IL-1, IL-6, TNF-alpha), bacteria and viruses can release NF-kappaB from their inactive cytoplasmatic form to the nucleus. Drugs like corticosteroids, sulphasalazine, mesalazine and inhibitory cytokines (e.g. IL-10, IL-11) can prevent the activation of NF-kappaB. New, more potent and selective treatment strategies with anti-sense p65, proteasome inhibitors and viral IkappaBalpha expression vectors aim at the prevention of NF-kappaB activation in mucosal macrophages and T lymphocytes. However, NF-kappaB regulated genes are also involved in survival responses of epithelial cells. For example, inhibition of the NF-kappaB mediated induction of iNOS in epithelial cells could block important anti-apoptotic and anti-microbial survival mechanisms. Nitric oxide may also serve in a negative feedback loop to antagonize prolonged activation of NF-kappaB, thereby limiting chronic inflammation.</p><p><strong>Conclusion: </strong>Luminal donation of nitric oxide could block NF-kappaB activation. Selective inhibition of NF-kappaB activation in inflammatory cells could be a treatment option in IBD.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 236","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/003655202320621436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22090479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}