Background
Assessment of motility alterations by functional magnetic resonance imaging (MRI) contributes to improved evaluation of inflammatory bowel disease. The aim of the study was to quantify ...motility in inflammatory bowel segments and to compare motility alterations with MR‐based parameters for activity of inflammation in Crohn's disease (CD).
Methods
Thirty consecutive patients with CD underwent bowel MRI which included a dynamic sequence for automatic generation of parametric maps facilitating quantification of bowel motility. Mean motility score (MMS) of small bowel segments with signs of inflammation was measured and compared with MMS of the whole gastrointestinal tract (GI tract). MRI‐based score of inflammatory activity and lesion length were correlated with the MMS ratio of inflammatory small bowel lesion and whole GI tract.
Key Results
Inflammatory bowel segments showed a mean value of MMSs of 1080, whereas the whole GI tract showed a mean value of MMSs of 2839 (p < 0.0001). Decrease in motility ranged between 20 and 87% in inflammatory bowel segments compared to the MMS of the whole GI tract. The MMS ratio of an inflammatory small bowel segment and whole GI tract showed negative correlation with MR activity score (r = −0.5921, p = 0.0003) and length of the lesion (r = −0.3495, p = 0.0462).
Conclusions & Inferences
Quantitative assessment of motility alterations by means of motility scoring in small bowel segments affected by CD provides additional information on inflammatory activity.
The aim of the study was to quantify motility in inflammatory bowel segments and to compare motility alterations with MR‐based parameters for activity of inflammation in Crohn's disease. The data supports the feasibility of quantitative motility assessment in inflammatory affected small bowel segments for estimation of inflammatory activity.
Aliment Pharmacol Ther 2011; 33: 722–729
Summary
Background Previous data collected in separate studies using various different survey instruments have suggested some variability in the prevalence ...of symptoms between nations. However, there is a lack of studies which assess and compare the prevalence of upper gastrointestinal symptoms contemporaneously in various countries using a uniform, standardised method.
Aim To determine the prevalence of upper gastrointestinal (UGI) symptoms in 13 European countries, and the association between socioeconomic factors and symptoms using a standardised method.
Methods A representative age‐ and gender‐stratified sample of 23 163 subjects (aged 18–69 years) was surveyed.
Results The prevalence of UGI symptoms was 38%. UGI symptoms were most prevalent in Hungary 45%, 95% confidence interval (CI): 42.2–48.4 and lowest in the Netherlands (24%, 95% CI: 21.0–26.2). UGI symptoms were more prevalent in women (39%, 95% CI: 38.4–39.6) vs. men (37%, 95% CI: 36.4–37.6). Heartburn (24%, 95% CI: 23.4–24.6) and acidic reflux (14%, 95% CI: 13.6–14.4) were most common. With age, the prevalence of UGI symptoms decreased (e.g. 18–29 years: 43%, 95% CI: 41.4–44.3 vs. 50–69 years: 33%, 95% CI: 32.3–34.4); in contrast, the frequency of symptom episodes/year increased with age (e.g. 18–29 years: 11.3 episodes per years, 95% CI: 10.5–12.1 vs. 50–69 years: 21.8, 95% CI: 20.7–22.9). Socioeconomic status as measured by gross domestic product was inversely associated with symptoms and in total, socioeconomic factors, gender, body mass index, smoking habits and alcohol consumption explained 83% of the variance of UGI symptoms.
Conclusions There are marked differences in the country specific prevalence of upper gastrointestinal complaints. Socioeconomic factors are closely associated with the prevalence of upper gastrointestinal symptoms.
Polysaccharides are a major carbon/energy-reservoir in microalgae, yet their relationship with another form of carbon/energy storage, triacylglycerol (TAG), is poorly understood. Here employing ...oleaginous microalga Nannochloropsis oceanica as a model, we probed the crosstalk between carbohydrate metabolism and TAG accumulation by tracking the temporal dynamics of lipidomes, monosaccharides and polysaccharides and transcripts of selected genes over 14days under nitrogen-depleted (N−) and nitrogen-replete (N+) conditions. Glucose, galactose and mannitol were the main monosaccharides in IMET1, and laminarin may be the storage polysaccharide that competes for carbon precursors with TAG. Transcriptional expression analysis revealed that the β-1,3-glucan degradation and pyruvate dehydrogenases pathways were the main regulatory components involved in driving carbon flow to TAG synthesis. Furthermore, temporal changes of lipidomes and transcripts of glycerolipid metabolism genes were indicative of possible conversion of membrane lipids to TAG, especially under an early stage of nitrogen deprivation conditions. A carbon partitioning model for N. oceanica was proposed, in which β-1,3-glucan metabolism, acetyl–CoA synthesis and membrane lipid turnover/degradation, in addition to de novo fatty acid synthesis, all contributed to TAG synthesis.
•Glucose, galactose and mannitol are the main mono-saccharides in IMET1.•Laminarin, the possible storage polysaccharide, competes for carbon precursors with TAG.•Beta-1,3-glucan degradation and PDH pathways drive carbon flow to TAG synthesis.•Membrane lipids are possibly converted to TAG at an early stage under N− conditions.•A model of photosynthetic carbon partitioning towards TAG was proposed.
Lipid metabolism in the liver Canbay, A; Bechmann, L; Gerken, G
Zeitschrift für Gastroenterologie
45, Številka:
1
Journal Article
Recenzirano
As a key metabolic organ, the liver is central to the imbalance of high-caloric diets, and particularly dietary fat consumption, in the industrialized countries and their association with the ...increasing prevalence of morbid obesity. By interacting with the intestinal tract and adipose tissue, the liver plays a key role in various aspects of lipid metabolism. Increasing activation of transcription factors, such as carbohydrate responsive element binding protein (ChREBP), sterol response element binding protein-1c (SREBP-1c), or forkhead box 01 (Fox01), may contribute to fatty acid synthesis. Their translocation occurs via fatty acid transporters such as fatty acid transport proteins (FATP), fatty acid translocase (FAT/CD36), caveolin-1 and fatty acid binding protein (FABP) . Eventually, the accumulation of fat in the form of lipid droplets within the hepatocytes results in hepatic steatosis which, indeed, is a hallmark of liver diseases such as non-alcoholic fatty liver disease, alcoholic fatty liver, acute fatty liver in pregnancy, and hepatitis C. In contrast, lipid accumulation within hepatocytes during liver regeneration is essential. It is thus now becoming clear that steatosis is not only a mere consequence of metabolic imbalance, but that it is also a result of discrete alterations in the beta-oxidation, transport mechanisms, and signaling pathways involved in the synthesis, systemic traffic modalities, and cellular effects of fatty acids. Such a novel insight offers potential options for improved treatment.
Introduction
Patients (pts) with locally advanced (LAPC) or metastatic pancreatic ductal adenocarcinoma (mPDAC) have a dismal prognosis. Recently, new combination chemotherapies such as FOLFIRINOX ...and nab-paclitaxel/gemcitabine have demonstrated superiority over gemcitabine monotherapy. However, a substantial proportion of pts cannot tolerate these intensive front-line protocols. Moreover, the long-term superiority of multiagent protocols over less intensive strategies remains to be shown. To provide a benchmark for future studies, we analyzed the outcome of patients with LAPC or mPDAC treated at the West German Cancer Center before the FOLFIRINOX/nab-paclitaxel + gemcitabine era.
Methods
This retrospective analysis included 201 consecutive pts with LAPC and mPDAC treated between 2007 and 2011. Efficacy parameters were correlated with type of chemotherapy, number of treatment lines and clinicopathological parameters.
Results
Gemcitabine monotherapy was given as first-line therapy in 51.1%, whereas 48.9% received combination chemotherapies such as gemcitabine/oxaliplatin or FOLFOX. Patients received a median of two lines of treatment, with 54.8% receiving second-line and 37.9% receiving third- and further-line therapies. There was no significant difference between gemcitabine monotherapy and combination therapies. Despite moderate activity of first-line treatment, median overall survival for LAPC was 11.3 months and 8.7 months for mPDAC. Multivariate analysis identified age and number of treatment lines as prognostic markers.
Conclusion
The long-term outcome of unselected pts with LAPC and mPDAC treated before the introduction of aggressive multiagent chemotherapy protocols compares favorably with the results of contemporary benchmark trials. This suggests a multifactorial benefit from interdisciplinary care provided over sequential treatment lines at high volume expert centers.
The interdisciplinary guidelines at the S3 level on the diagnosis of and therapy for hepatocellular carcinoma (HCC) constitute an evidence- and consensus-based instrument that is aimed at improving ...the diagnosis of and therapy for HCC since these are very challenging tasks. The purpose of the guidelines is to offer the patient (with suspected or confirmed HCC) adequate, scientifically based and up-to-date procedures in diagnosis, therapy and rehabilitation. This holds not only for locally limited or focally advanced disease but also for the existence of recurrences or distant metastases. Besides making a contribution to an appropriate health-care service, the guidelines should also provide the foundation for an individually adapted, high-quality therapy. The explanatory background texts should also enable non-specialist but responsible colleagues to give sound advice to their patients concerning specialist procedures, side effects and results. In the medium and long-term this should reduce the morbidity and mortality of patients with HCC and improve their quality of life.
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