This month in the Scandinavian Journal of Gastroenterology

The paper by Waldum et al. [1] is a review of the experimental results of the regulation of gastric acid secretion. The historical analysis of different theories on the role of gastrin and gastrin receptor has focused on the role of enterochromaffin-like cells (ECL cells) as mediators by means of histamine release of gastrin-dependent gastric acid secretion. The review underscores the negative role on progress in gastric physiology of Dr Grossman’s theory supporting a direct effect of gastrin, histamine and acetylcholine on the parietal cells. In a population study from Denmark, Reimer & Bytzer [2] first explore the characteristics that may render GORD symptoms troublesome and then compare the different ways of categorizing them. Conducted via an Internet-based questionnaire, the study highlights the poor concordance between a definition of troublesome symptoms based on frequency and severity and the subject’s own perception. The authors suggest that symptoms perceived as troublesome frequently impact on work productivity and occur at or during the night. The article by Florentson et al. [3] suggests that, at least in high anxiety Wistar Kyoto (WKY) rats, the gastrin may stimulate ECL cells by an additional factor which is absent in WKY rats. The authors cast doubt on the role of acid in stress-related gastric ulcer while suggesting a potential role for ghrelin. Sun et al. [4] assess the effect of nitric oxide (NO) on regularity, amplitude and contraction-related activity of gastric motility in dogs. In this animal model, it appears that exogenous NO does not affect the frequency, amplitude and regularity of gastric slow waves, suggesting a limited involvement in the nitrergic mechanisms in modulating gastric myoelectrical activity. Kull et al. [5] show that lactase genotype and phenotype have no effect on bone mineral density in the Estonian population and that milk consumption is a significant determinant of bone mineral density. They show that self-perceived milk intolerance, rather than molecularly defined hypolactasia, can lead to self-imposed reduction in milk consumption with deleterious effects on bone metabolism and risk of fracture. They suggest the usefulness of counselling on diet to avoid deleterious self-imposed food restrictions. Vorobjova et al. [6] demonstrate that children with CD, or with T1D in combination with CD, show a higher FOXP3 mRNA expression than do normal children, suggesting an impaired regulation of the immune system in children with CD and T1D or CD alone. In analyses of the clinical course of newly diagnosed ulcerative colitis (UC), Solberg et al. [7] suggest a better prognosis for UC than expected, although extensive colitis or elevated ESR levels at diagnosis predict a less favourable course. Danelius et al. [8] shed some light on the impact of upper endoscopy in the controversial context of unclassified IBD. Biopsies from gastric and duodenal mucosa reveal that focal cryptitides can be found in more than half of patients with colorectal CD, but also in 20 40% of patients with UC, microscopic colitis or even in patients without IBD. Caution must therefore be exercised in interpreting all gastric or duodenal inflammation as indicative of CD. Perminow et al. [9] in their analyses on 100 paediatric, treatment-naı̈ve, patients underline that the latency between disease onset and diagnosis remains too high, thus negatively affecting early effective control of the disease. In this context, the role of non-invasive biochemical markers or faecal calprotectin is stressed. Sodergren et al. [10] characterize clinical presentation of Enterobius vermicularis (pinworm) of the appendix as resembling acute appendicitis. They show that patients with this condition who undergo appendicectomy have a significantly lower white cell count and more frequent recurrent episodes of pain and previous presentation to hospitals than patients with acute suppurative appendicitis. These findings bring us to consider E. vermicularis infestation in the differential diagnosis of recurrent abdominal pain. The study by Xu et al. [11] is a comprehensive investigation of the changes in gene expression in the course of liver regeneration. The study has two substantial merits: (i) the choice of target genes is very wide and is based on the current knowledge; and (ii) the proposed data provide broad and Scandinavian Journal of Gastroenterology, 2009; 44: 388 389