Primary Gastrointestinal Tract Lymphoma

Extranodular lymphomacanbe found in almostallorgan. One third of the cases found in gastrointestinal(GI) tract, whichisthemost commonformofextranodular lymphoma.All thesubtypesof lymphomamayoccurasprimarylesionalongingastrointestinaltract,butthemostcommonformis B-celldiffuse largecelllymphoma.DiseasesthatlinkedwithGItractlymphomaareinflammatorybowel disease, celiac disease,Helicobacter pylori, virus infection,collagen diseaseandionicradiation.This reportdescribed a40yearsoldmanwith recurrentbloodystoolandcolon lymphomawasblamedas the sourceofbleeding withitsmanagementoflymphoma

Nutrition and the gastrointestinal tract

In this year’s issue, we again have a high-calibre collection of topical reviews. Gracie and Ford commence with an assessment of the role of symbiotics (i.e. probiotics and prebiotics given together) in patients with irritable bowel syndrome. They first review the many randomized trials of probiotics and the significant and persistent reductions in symptoms that (on balance) these yield – that may persist after the end of treatment. Pain, bloating and flatulence are all better than with placebo with a range of different regimens. However, although symbiotics appear promising, their current conclusion is that the evidence for superiority over probiotics alone is lacking. Jin and Vos then consider the pathophysiology of nonalcoholic fatty liver disease and specifically the role of fructose. Their synthesis of the literature includes the conclusion that unregulated lipogenesis is key to nonalcoholic fatty liver disease, linked to generalized increases in visceral adiposity – in turn probably secondary to changes in the intestinal microbiota. Dietary fructose seems an important determinant of these phenomena, and early-in-life exposure appears of most significance. Although dogmatic advice is not justified, continuing to argue for limitation of dietary fructose seems wise. Barrett et al. consider the immune response in patients on artificial nutrition in the current context wherein we aim for enteral nutrition whenever possible – thus recognizing that patients who need parenteral nutrition are then an especially high-risk group. They conclude from AQ3 a wide consideration of animal and human data that the intestinal epithelial barrier is significantly compromised and to a clinically relevant extent in patients on exclusive parenteral nutrition. They encourage targeted new work to exploit the mechanisms that have now been unearthed, such that future parenteral nutrition could be used with fewer adverse immunological consequences. Plank and Russell look at nutrition in liver transplantation incorporating new data from patients with concomitantmorbid obesity. It is of course clear that obesity is a perioperative risk factor but we lack proof that pretransplant weight loss would change this. The main issue here is probably the sarcopenic element, and weight loss without muscle preservation (or growth) would be unlikely to help. As obese patients are AQ4 being transplanted, better data are clearly needed to guide optimal nutritional strategies. After a comprehensive review on the state of the art on gluten sensitivity in the absence of coeliac disease by David Sanders, the issue finishes with a intriguing article by Murphy et al. in which they consider the evidence that chronic disease is made more likely by changes in the gut microbiota driven by a high-fat diet. Although dysbiosis is present and linked to obesity, on present evidence, this falls short of a direct causal relationship. We feel confident that readers will find plenty to provoke thought and hopefully to stimulate research in the many loci where data are sparse or inconclusive

Gastrointestinal stromal tumor (GIST) of the Treitz’s angle– a very rare cause of high bowel obstruction

Gastrointestinal stromal tumors (GIST) are somewhat rare gastrointestinal tumors - approximately 1% to 3% incidence, but they are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs are usually found in the stomach or small intestine but can occur anywhere within the gastrointestinal tract, even in extremely uncommon locations like duodeno-jejunal flexure. Only 3% – 5% of GISTs are located in the duodenum and tumors occurring in the angle of Treitz are even rarer, most published studies being case reports. These tumors have a size ranging from small lesions to large masses and can cause digestive bleeding or high bowel obstruction. This paper is a case presentation illustrating an emergency situation involving a high bowel obstruction caused by a small tumor with an unusual location in the Treitz’s angle. A large percentage of duodenal GISTs are localized in the third and fourth part of the duodenum and may not be found through standard upper endoscopy; only the barium study of the upper gastrointestinal tract highlights the obstruction point. Preoperative diagnosis is difficult but non-invasive imaging techniques like ultrasonography and computed tomography of the abdomen can be helpful. Recently, targeted therapy with inhibitors of tyrosine kinase receptors (IMATINIB) has been introduced for the management of advanced and metastatic tumors. In our opinion the surgical resection with curative intent is the treatment of choice

Computer-Assisted Segmentation of Videocapsule Images Using Alpha-Divergence-Based Active Contour in the Framework of Intestinal Pathologies Detection

Visualization of the entire length of the gastrointestinal tract through natural orifices is a challenge for endoscopists. Videoendoscopy is currently the “gold standard” technique for diagnosis of different pathologies of the intestinal tract. Wireless Capsule Endoscopy (WCE) has been developed in the 1990's as an alternative to videoendoscopy to allow direct examination of the gastrointestinal tract without any need for sedation. Nevertheless, the systematic post-examination by the specialist of the 50,000 (for the small bowel) to 150,000 images (for the colon) of a complete acquisition using WCE remains time-consuming and challenging due to the poor quality of WCE images. In this article, a semiautomatic segmentation for analysis of WCE images is proposed. Based on active contour segmentation, the proposed method introduces alpha-divergences, a flexible statistical similarity measure that gives a real flexibility to different types of gastrointestinal pathologies. Results of segmentation using the proposed approach are shown on different types of real-case examinations, from (multi-) polyp(s) segmentation, to radiation enteritis delineation

Upper gastrointestinal tract bleeding in Ilorin, Nigeria - a report of 30 cases

Background: Upper gastrointestinal tract bleeding refers to blood loss within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament of Treitz. The onset and severity of blood loss varies widely.Acute gastrointestinal bleeding is a potentially life-threatening abdominal emergency that remains a common cause of hospitalization. There is no local data on the clinical presentation, endoscopic findings and the risk factors for upper gastrointestinal tract bleeding in Ilorin. This study was therefore to review the cases of upper gastrointestinal tract bleed in Ilorin. Aim: To reviewthe cases of upper gastrointestinal tract bleeding seen in Ilorin. Methodology: A retrospective review of the cases of upper gastrointestinal tract bleeding who had upper gastrointestinal tract endoscopy as part of their workup was undertaken to cover a eighteen month period from June 2006 to November 2007. Their clinical presentation, endoscopic findings, and the risk factors which predisposed themto bleedingwere evaluated.The endoscopy register and the request formswere reviewed. Results: Atotal of thirty patients had upper gastrointestinal tract bleeding for which upper gastrointestinal tract endoscopy was performed during the period under review. Twenty-three of the patients were males (76.7%) while seven were females (23.3%). Sixteen patients (53.3%) presented with malaena only; eleven patients (36.7%) with malaena and haematemesis only; while three patients (10.0%) presented with malaena, haematemesis and haematochexia. However all the patients presented with malaena, haematemesis or haematochexia. The commonest clinical presentation of patients with upper gastrointestinal tract bleeding passage of malaena (53.3%). The commonest endoscopic finding was multiple sources of bleeding (66.7%)while the commonest risk factor for upper gastrointestinal tract  bleeding was NSAIDuse (36.7%). Conclusion: The passage of malaena, multiple source of bleeding, and NSAID use are the commonest clinical presentation, endoscopic findings and risk factors respectively in patients with upper gastrointestinal tract bleeding in Ilorin. The spectrum of clinical presentation, endoscopic findings and risk factors for upper gastrointestinal tract bleed found in this study is similar to that found by other workers.Keywords: Upper, gastrointestinal tract, bleeding, Ilori

Invited review: Aspects of gastrointestinal tract growth and maturation in the pre- and postweaning period of pigs

The growth and development of the gastrointestinal tract (GIT) of the young pig, both before and after parturition, is critical for the ani-mal’s future growth and development, efficiency of feed conversion to body depots, and, ultimately, its survival. The perinatal development of the GIT encompasses a prenatal phase, a neonatal phase, and the postweaning phase, which is associated with the adaptation of the GIT to utilize solid feed after the piglet is weaned. The consumption of colostrum, initially, and then milk after birth provides nutrients and compounds for piglets that are critically important as stimuli and substrates to the GIT that in turn evoke a suite of anatomical, immunological, biochemical, physiological, and regulatory processes that advance the overall maturity of the GIT. However, at weaning the combined influence of the various stressors imposed causes a hiatus in the growth and development of the GIT, such that the newly weaned pig endures a “growth check” while exposing it to a greater disease and health risk. Low and variable feed intake is a major outcome of the weaning process, but nevertheless, there are numerous nutritional/manage-ment interventions producers can implement in an attempt to overcome this major issue. This review summarizes some major aspects of, and influences on, GIT growth, development, and maturation in the pre- and postweaning period of pigs, demonstrating that postnatal influences occur in utero and that evolution of the GIT continues to occur after weaning

Intestinal macromolecular transport supporting adaptive immunity

The gastrointestinal tract performs opposing functions of nutrient absorption, barrier maintenance, and the delivery of luminal substances for the appropriate induction of tolerogenic or protective adaptive immunity. The single-layer epithelium lining the gastrointestinal tract is central to each of these functions by facilitating the uptake and processing of nutrients, providing a physical and chemical barrier to potential pathogens, and delivering macromolecular substances to the immune system to initiate adaptive immune responses. Specific transport mechanisms allow nutrient uptake and the delivery of macromolecules to the immune system while maintaining the epithelial barrier. This review examines historical observations supporting macromolecular transport by the intestinal epithelium, recent insights into the transport of luminal macromolecules to promote adaptive immunity, and how this process is regulated to promote appropriate immune responses. Understanding how luminal macromolecules are delivered to the immune system and how this is regulated may provide insight into the pathophysiology of inflammatory diseases of the gastrointestinal tract and potential preventative or therapeutic strategies. Keywords: Antigen Transport, Mucosal Tolerance, Goblet Cell

Purinergic signaling in the gastrointestinal tract

Geoffrey Burnstock completed a BSc at King's College London and a PhD at University College London. He held postdoctoral fellowships with Wilhelm Feldberg (National Institute for Medical Research), Edith Bülbring (University of Oxford) and C. Ladd Prosser (University of Illinois). He was appointed to a Senior Lectureship in Melbourne University in 1959 and became Professor and Chairman of Zoology in 1964. In 1975 he became Head of Department of Anatomy and Developmental Biology at UCL and Convenor of the Center of Neuroscience. He has been Director of the Autonomic Neuroscience Institute at the Royal Free Hospital School of Medicine since 1997. He was elected to the Australian Academy of Sciences in 1971, the Royal Society in 1986, the Academy of Medical Sciences in 1998 and an Honorary Fellow of the Royal College of Surgeons and the Royal College of Physicians in 1999 and 2000. He was awarded the Royal Society Gold Medal in 2000. He is editor-in-chief of the journals Autonomic Neuroscience and Purinergic Signalling and on the editorial boards of many other journals. Geoffrey Burnstock's major research interest has been autonomic neurotransmission and he is best known for his seminal discovery of purinergic transmission and receptors, their signaling pathways and functional relevance. He has supervised over 100 PhD and MD students and published over 1400 original papers, re-views and books. He was first in the Institute of Scientific Information list of most cited scientists in Pharmacology and Toxicology from 1994-2004 [59.083 citations (March 2011) and an h-index of 109]

Studies of liver and gastrointestinal tract irradiated with protons Progress report

Proton irradiation effects on cells of gastrointestinal tract and live

Effect of chronic restraint on gastrointestinal function

Rat experiments to determine effects of prolonged restraint on gastrointestinal tract functio