Enhanced Mucosal Imaging and the Esophagus—Ready for Prime Time?

Innovation of endoscopic technology has recently been introduced to improve real-time visualization of mucosal architecture and subepithelial vascular structures. Since the esophagus is easily accessible using endoscopy and the length of required observation is limited, many different types of new imaging modalities have been reported and showing promising data. Early detection of neoplastic changes in the esophagus is devoted to the treatment in early stage cancer and theoretically leads to better prognosis. This review will focus on the emerging endoscopic technologies for the management of esophageal cancer.     

Role for cytoplasmic nucleotide hydrolysis in hepatic function and protein synthesis

Nucleotide hydrolysis is essential for many aspects of cellular function. In the case of 3′,5′-bisphosphorylated nucleotides, mammals possess two related 3′-nucleotidases, Golgi-resident 3′-phosphoadenosine 5′-phosphate (PAP) phosphatase (gPAPP) and Bisphosphate 3′-nucleotidase 1 (Bpnt1). gPAPP and Bpnt1 localize to distinct subcellular compartments and are members of a conserved family of metal-dependent lithium-sensitive enzymes. Although recent studies have demonstrated the importance of gPAPP for proper skeletal development in mice and humans, the role of Bpnt1 in mammals remains largely unknown. Here we report that mice deficient for Bpnt1 do not exhibit skeletal defects but instead develop severe liver pathologies, including hypoproteinemia, hepatocellular damage, and in severe cases, frank whole-body edema and death. Accompanying these phenotypes, we observed tissue-specific elevations of the substrate PAP, up to 50-fold in liver, repressed translation, and aberrant nucleolar architecture. Remarkably, the phenotypes of the Bpnt1 knockout are rescued by generating a double mutant mouse deficient for both PAP synthesis and hydrolysis, consistent with a mechanism in which PAP accumulation is toxic to tissue function independent of sulfation. Overall, our study defines a role for Bpnt1 in mammalian physiology and provides mechanistic insights into the importance of sulfur assimilation and cytoplasmic PAP hydrolysis to normal liver function.     

继续医学教育活动的有效性

继续医学教育的目的是通过向医生提供最新的医学知识和技能,使医生在其整个职业生涯中,一直保持较高的医疗水平.但目前还没有充足的证据能证明继续医学教育活动的有效性,以及在继续医学教育活动中哪些教育方法和技术能最有效地传播和记忆医学知识.为了全面、系统地评估继续医学教育活动的有效性,以及了解不同的教育手段对医生知识、态度、技能、临床表现和临床效果的作用.美国约翰·霍普金斯大学医学院、美国医疗保健研究与质量管理署和美国胸科医师学会的专家共同进行了一项系统回顾性研究.     

Acute mesenteric infarction: an important cause of abdominal pain in ulcerative colitis

We present four cases of acute mesenteric infarction in patients with active ulcerative colitis: one presenting prior to the diagnosis of ulcerative colitis, two at the time of diagnosis, and one many years after the diagnosis had been made. Intestinal ischaemia is an important part of the differential diagnosis in patients with ulcerative colitis presenting with abdominal pain. Conversely, in patients presenting with bloody diarrhoea after mesenteric ischaemia, ulcerative colitis should be considered.