Up to a third of patients undergoing coronary angiography for angina-like chest pain are found to have normal coronary arteries and a substantial proportion of these individuals continue to consult and even attend emergency departments. Initially, these patients are usually seen by cardiologists but with accumulating evidence that the pain might have a gastrointestinal origin, it may be more appropriate for them to be cared for by the gastroenterologist once a cardiological cause has been excluded. This review covers the assessment and management of this challenging condition, which includes a combination of education, reassurance, and pharmacotherapy. For the more refractory cases, behavioral treatments, such as cognitive behavioral therapy or hypnotherapy, may have to be considered.

C. Shekhar

P. J. Whorwell

Evaluation and Management of Patients with Noncardiac Chest Pain

<i>Clostridium difficile</i> (<i>C. difficile</i>) infection of the small bowel is very rare. The disease course is more severe than that of <i>C. difficile</i> colitis, and the mortality is high. We present a case of <i>C. difficile</i> enteritis in a patient with with ileal pouch-anal anastamosis (IPAA), and review previous case reports in order to better characterize this unusual condition.

Elena Boland

Jon S. Thompson

Fulminant <i>Clostridium difficile</i> Enteritis after Proctocolectomy and Ileal Pouch-Anal Anastamosis

We demonstrated the feasibility of a new methodology for isolating colonocytes from feces. To reduce costs and improve the recovery rate of colonocytes from feces, we attempted to develop new immunomagnetic beads. Several sizes of magnetic beads were prepared and tagged with a monoclonal antibody against EpCAM. We made several new monoclonal antibodies against EpCAM, and each monoclonal antibody was tagged to the magnetic beads. In the simulation, the most efficient recovery of HT-29 cells was obtained using the smallest size of beads. Also, beads tagged with a monoclonal antibody with a higher affinity against EpCAM had a higher recovery rate. Similar results were obtained when the smallest size of beads with the highest-affinity monoclonal antibody was applied to clinical samples. The newly developed immunomagnetic beads may be useful for isolating colorectal cancer cells from feces, enabling the cytological or molecular biological diagnosis of CRC.

Yoshikatsu Koga

Masahiro Yasunaga

Satoshi Katayose

Yoshihiro Moriya

Takayuki Akasu

Shin Fujita

Seiichiro Yamamoto

Hideo Baba

Yasuhiro Matsumura

Improved Recovery of Exfoliated Colonocytes from Feces Using Newly Developed Immunomagnetic Beads

Recommendations for anticoagulation following major venous
reconstruction for pancreatic adenocarcinoma (PA) are not clearly
established. The aim of our study was to find out the relation
between postoperative anticoagulant treatment and thrombosis rate
after portal venous resection. <i  >Materials and methods</i>. Between 1986
and  2006, twenty seven portal vein resections were performed
associated with pancreaticoduodenectomies (<svg     style="vertical-align:-0.1638pt;width:44.400002px;" id="M1" height="11.125" version="1.1" viewBox="0 0 44.400002 11.125" width="44.400002"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><path id="x1D45B" d="M495 86q-46 -47 -87 -72.5t-63 -25.5q-43 0 -16 107l49 210q7 34 8 50.5t-3 21t-13 4.5q-35 0 -109.5 -72.5t-115.5 -140.5q-21 -75 -38 -159q-50 -10 -76 -21l-6 8l84 340q8 35 -4 35q-17 0 -67 -46l-15 26q44 44 85.5 70.5t64.5 26.5q35 0 10 -103l-24 -98h2&#xA;q42 56 97 103.5t96 71.5q46 26 74 26q9 0 16 -2.5t14 -11.5t9.5 -24.5t-1 -44t-13.5 -68.5q-30 -117 -47 -200q-4 -19 -3.5 -25t6.5 -6q21 0 70 48z" /></g><g transform="matrix(.017,-0,0,-.017,13.305,10.862)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,28.008,10.862)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g><g transform="matrix(.017,-0,0,-.017,36.168,10.862)"><path id="x37" d="M447 623l8 -12l-283 -613l-74 -10l-7 11q174 283 297 551h-216q-48 0 -62.5 -12t-33.5 -63h-29q10 60 18 148h382z" /></g>

		
	
</svg>) (PD).We defined
four types of venous resection: type I was performed 1&#x2009;cm above
the confluent of the superior mesenteric vein (SMV) (<svg     style="vertical-align:-0.1638pt;width:44.400002px;" id="M2" height="11.125" version="1.1" viewBox="0 0 44.400002 11.125" width="44.400002"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45B"/></g><g transform="matrix(.017,-0,0,-.017,13.305,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,28.008,10.862)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g><g transform="matrix(.017,-0,0,-.017,36.168,10.862)"><use xlink:href="#x32"/></g>

		
	
</svg>); type
II  lateral resection and venorrhaphy at the level of the
confluent SMV (<svg     style="vertical-align:-0.1638pt;width:44.400002px;" id="M3" height="11.125" version="1.1" viewBox="0 0 44.400002 11.125" width="44.400002"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45B"/></g><g transform="matrix(.017,-0,0,-.017,13.305,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,28.008,10.862)"><use xlink:href="#x31"/></g><g transform="matrix(.017,-0,0,-.017,36.168,10.862)"><use xlink:href="#x32"/></g>

		
	
</svg>); type III (<svg     style="vertical-align:-0.1638pt;width:36.237499px;" id="M4" height="11.125" version="1.1" viewBox="0 0 36.237499 11.125" width="36.237499"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45B"/></g><g transform="matrix(.017,-0,0,-.017,13.305,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,28.008,10.862)"><use xlink:href="#x31"/></g>

		
	
</svg>) resulted from a primary
end-to-end anastomosis above confluent and PTFE graph was used for
reconstruction for type IV (<svg     style="vertical-align:-0.1638pt;width:36.237499px;" id="M5" height="11.125" version="1.1" viewBox="0 0 36.237499 11.125" width="36.237499"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45B"/></g><g transform="matrix(.017,-0,0,-.017,13.305,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,28.008,10.862)"><use xlink:href="#x32"/></g>

		
	
</svg>). Curative anticoagulant treatment
was always indicated after type IV (<svg     style="vertical-align:-0.1638pt;width:36.237499px;" id="M6" height="11.125" version="1.1" viewBox="0 0 36.237499 11.125" width="36.237499"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x1D45B"/></g><g transform="matrix(.017,-0,0,-.017,13.305,10.862)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,28.008,10.862)"><use xlink:href="#x32"/></g>

		
	
</svg>) resection, and after
resection of type II when the length of venous resection was
longer than <svg     style="vertical-align:-0.546pt;width:14.825px;" id="M7" height="10.15" version="1.1" viewBox="0 0 14.825 10.15" width="14.825"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,9.413)"><path id="x2265" d="M531 285l-474 -214v56l416 183l-416 184v56l474 -215v-50zM531 -40h-474v50h474v-50z" /></g>

		
	
</svg>2&#x2009;cm. <i  >Results</i>. Venous thrombosis rate reached: 0&#x25;,
41&#x25;, and 100&#x25; for type I, II, IV resections, respectively. Among
them four patients received curative anticoagulant treatment.
<i  >Conclusion.</i> After a portal vein resection was achieved in the
course of a PD, curative postoperative anticoagulation does not
prevent efficiently the onset of thrombosis.

Mehdi Ouaïssi

Igor Sielezneff

Nicolas Pirro

R&#xe9;mi Bon Mardion

Jean Batiste Chaix

Abdelrhame Merad

St&#xe9;phane Berdah

Vincent Moutardier

Silvia Cresti

Olivier Emungania

Loundou Anderson

Brunet Christian

Sastre Bernard

Therapeutic Anticoagulant Does not Modify Thromboses Rate Vein after Venous Reconstruction Following Pancreaticoduodenectomy

Various gastrointestinal infiltrations have been described in patients with chronic lymphocytic leukaemia (CLL). Here, we report a 69-year-old man with CLL and anaemia in whom the macroscopic finding of colonoscopy was normal, but the histological specimens revealed lymphocytic leukemia in ileum and in colon. If a CLL patient has any symptoms suggesting a possible GI manifestation of the haematologic disease or anaemia not explained by bone marrow infiltration or hemolysis, the diagnostic evaluation should include endoscopies with adequate biopsies.

P. E. T. Arkkila

H. Nuutinen

F. Ebeling

E. Elonen

P. K&#xe4;rkk&#xe4;inen

M.-L. Karjalainen-Lindsberg

Colonic Involvement in a Patient with Chronic Lymphocytic Leukaemia

<i  >Objective</i>. Gastric acid plays an important part in the prevention of bacterial colonization of the gastrointestinal tract. If these bacteria have an ability of hydrogen (H2) fermentation, intraluminal H2 gas might be detected. We attempted to measure the intraluminal H2 concentrations to determine the bacterial overgrowth in the gastrointestinal tract. <i  >Patients and methods</i>. Studies were performed in 647 consecutive patients undergoing upper endoscopy. At the time of endoscopic examination, we intubated
the stomach and the descending part of the duodenum without inflation by air, and 20&#x2009;mL of intraluminal gas samples of both sites was collected through the biopsy channel. Intraluminal H2 concentrations were measured by gas chromatography. <i  >Results</i>. Intragastric and intraduodenal H2 gas was detected in 566 (87.5&#x25;) and 524 (81.0&#x25;) patients, respectively. The mean
values of intragastric and intraduodenal H2 gas were <svg     style="vertical-align:-0.3003pt;width:66.199997px;" id="M1" height="11.2875" version="1.1" viewBox="0 0 66.199997 11.2875" width="66.199997"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
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</svg> and <svg     style="vertical-align:-0.3003pt;width:74.362503px;" id="M2" height="11.2875" version="1.1" viewBox="0 0 74.362503 11.2875" width="74.362503"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x31"/></g><g transform="matrix(.017,-0,0,-.017,8.222,10.862)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g><g transform="matrix(.017,-0,0,-.017,16.381,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,20.257,10.862)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g><g transform="matrix(.017,-0,0,-.017,32.19,10.862)"><use xlink:href="#xB1"/></g><g transform="matrix(.017,-0,0,-.017,45.942,10.862)"><use xlink:href="#x35"/></g><g transform="matrix(.017,-0,0,-.017,54.102,10.862)"><use xlink:href="#x38"/></g><g transform="matrix(.017,-0,0,-.017,62.261,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,66.137,10.862)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g>

		
	
</svg>&#x2009;ppm, respectively. The intraduodenal H2 level was
increased with the progression of atrophic gastritis, whereas the intragastric H2 level was the highest in patients without atrophic gastritis. <i  >Conclusions</i>. The intraduodenal hydrogen levels were increased with the progression of atrophic gastritis. It is likely that the influence of hypochlorhydria on bacterial overgrowth in the proximal small intestine is more pronounced, compared to that
in the stomach.


Yoshihisa Urita

Toshiyasu Watanabe

Tadashi Maeda

Tomohiro Arita

Yosuke Sasaki

Takamasa Ishii

Tatsuhiro Yamamoto

Akiro Kugahara

Asuka Nakayama

Makie Nanami

Kaoru Domon

Susumu Ishihara

Hirohito Kato

Kazuo Hike

Norikok Hara

Shuji Watanabe

Kazushige Nakanishi

Motonobu Sugimoto

Kazumasa Miki

Extensive Atrophic Gastritis Increases Intraduodenal Hydrogen Gas

There is an obvious, significant, and diachronic reduction of <i>the
prevalence of HBV infection</i> in Greece, concerning the general population as
well as some traditionally high-risk groups, mainly as a result of constant
informing and the widespread initiation of preventive and prophylactic
measures, as well as the improvement of health care services. Nevertheless,
there are special groups and populations (economical refugees, religious
minorities, HIV-positive patients, abroad pregnant women, prostitutes, etc.) who
represent sacs of high HBV endemicity and need epidemiological supervision and intervention, in order to limit the spread of the infection and to further
improve the existing epidemiological data.

Konstantinos D. Pantazis

Ioannis S. Elefsiniotis

Hero Brokalaki

New Data concerning the Epidemiology of Hepatitis B Virus Infection in Greece

<i>Background</i>. Smoking has a detrimental effect in Crohn's disease (CD), but this may be due to factors in smoking other than nicotine. Given that transdermal nicotine benefits ulcerative colitis (UC), and there is a considerable overlap in the treatment of UC and CD, the possible beneficial effect of nicotine has been examined in patients with Crohn's colitis. <i>Aims</i>. To assess the efficacy and safety of nicotine enemas in active Crohn's colitis. <i>Patients</i>. Thirteen patients with active rectosigmoid CD; 3 patients were excluded because they received antibiotics.
<i>Methods</i>. Subjects were given 6&#x2009;mg nicotine enemas, each day for 4 weeks, in an open pilot study. At the beginning and end of the trial, a Crohn's disease activity index (CDAI) score was calculated, sigmoidoscopy was performed, and haematological inflammatory markers measured. <i>Results</i>. Mean CDAI decreased from 202 to 153—the score was reduced in 6 patients, unchanged in 3, and increased in one.  Frequency of bowel movements decreased in 8 patients and the sigmoidoscopy grade was reduced in 7. Mean C-reactive protein decreased from 22.0 to 12.3&#x2009;mg/L. There were no withdrawals due to adverse events. <i>Conclusions</i>. In this relatively small study of patients with active Crohn's colitis, 6&#x2009;mg nicotine enemas appeared to be of clinical benefit in most patients. They were well tolerated and safe.

J. R. Ingram

J. Rhodes

B. K. Evans

G. A. O. Thomas

Nicotine Enemas for Active Crohn's Colitis: An Open Pilot Study

Dimitrios Papaioannou

Gerasimos Bonatsos

Christos Mavrogiannis

Large Intestine Histopathology of Pegylated-Interferon-Alpha Plus Ribavirin Treated Chronic Hepatitis C Patients

About this journal

<p><em>Gastroenterology Research and Practice </em>provides a forum for researchers and clinicians working in the areas of gastroenterology, hepatology, pancreas and biliary, and related cancers.</p>


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<p>Chief Editor, Dr Kahaleh’s research is focused on interventional endoscopy and the use of new devices to diagnose and treat biliary and pancreatic diseases primarily focusing on preventing and treating complications of advanced endoscopic procedures.</p>


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Gastroenterology Research and Practice - Table of contents 2008

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title

Gastroenterology Research and Practice provides a forum for researchers and clinicians working in the areas of gastroenterology, hepatology, pancreas and biliary, and related cancers.

Gastroenterology Research and Practice