This month in Scandinavian Journal of Gastroenterology

In this month’s issue of Scandinavian Journal of Gastroenterology we have two reviews. The first is from the USA and deals with the possible role of vitamin D in colorectal carcinogenesis [1]. In the second, Møller and colleagues from Denmark make a thorough analysis of prognostic factors in perforated peptic ulcer [2], and their main message seems to be that most of the complications are related to sepsis. In this issue we present two papers concerning esophageal diseases. First a study from Northern Ireland on the role of HSV-1 infection in achalasia [3]. And secondly, a large Spanish-Swedish follow-up study of children with gastro-esophageal reflux symptoms [4], which describes the development of reflux esophagitis in a proportion of them. In an elegant study on COX-2 deficient mice, Hotz-Behofsits and colleagues from the UK show that COX-2 plays an important role in maintaining mucosal integrity [5]. Barros and colleagues from Portugal examined patients who had their Helicobacter pylori infection eradicated about 6 years earlier, with histological examination [6]. They found that intestinal metaplasia in contrast to the inflammation generally persisted. Based on a study using accepted questionnaires on patients with subjective food hypersensitivity, Lind and colleagues from Norway concluded that psychological factors could not explain the gastrointestinal problems of these patients [7]. The interstitial cell of Cajal (ICC) plays a central role in regulating gut motility. By blockade of the c-kit signal pathway, ICC loses its characteristics. By adding the c-kit natural ligand, the stem cell factor, Tong and colleagues from China/USA showed that the ICC regained morphological and electrical characteristics [8]. Clegg and Shafat from Ireland made studies to optimize C octanoic acid breath test for measurements of gastric emptying, and concluded that sampling every 15 min for 6 h gave optimal results [9]. Mäkitalo and colleagues from Finland examined colonic biopsies from patients with inflammatory bowel disease with respect to expression of matrix metalloproteinases and found quantitative but not qualitative differences between patients with ulcerative colitis and Crohn’s disease [10]. Sipponen and Kolho also from Finland determined fecal calprotectin in children with inflammatory bowel disease in remission [11]. They found a poor correlation between fecal calprotectin and symptoms, but those having a low excretion tended to be in remission for at least 1 year. Capsule endoscopy is a relatively new modality to examine the small bowel. In a study from Denmark, Jensen and colleagues showed good inter-observer agreement in the diagnosis of small bowel Crohn’s disease [12]. In a study from Switzerland Käser and colleagues show that C-reactive protein is superior to bilirubin for anticipation of perforation in acute appendicitis [13]. Based on the known fact that Campylobacter jejuni species produce a genotoxin, a Swedish group headed by Brauner [14] examined the occurrence of cancers in a cohort of patients infected during the period 1989–2006. They did not find any increase in gastrointestinal cancers in these patients. Jiang and colleagues from China examined the expression of NDRG1 gene, a gene playing an important role in differentiation, embryonic development, and in gastric carcinomas [15]. NDRG1 expression was reduced in gastric carcinomas, and low expression indicated bad prognosis. In another study on gastric cancer, Kim and colleagues from Korea [16] studied the superficial spreading type of early gastric cancer, and found that they were often of the undifferentiated type and that they were more prone to lymph node metastasis. Pancreatic cancer continues to have bad prognosis, and the differentiation between the different tumor types in the pancreas is still problematic. Grossjohann and colleagues from Denmark compared contrast-enhanced transabdominal ultrasound with ultrasound and CT in correct classification of pancreatic adenocarcinomas (histologically verified) [17]. They did not find that contrast improved the sensitivity of sonography with respect to the sensitivity to correctly diagnose pancreatic adenocarcinomas, but that it could have some other advantages [17]. Colorectal cancer is among the most prevalent cancers, and the 5-year survival is around 50%. The effect of chemotherapy of these cancers is hampered by the development of multi drug