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Volume 75 - 2012 - Fasc.3 - Case series

Genomic instability in ulcerative colitis: a prerequisite for cancer in the inflammatory colon ?

Ulcerative colitis (UC), a chronic and relapsing idiopathic inflammatory disease of the colon, although not associated with an increased mortality compared to the general population, has a sub- stantial morbidity leading to sizable health care costs, as it carries an increased risk for development of colorectal cancer (CRC). The pathophysiology behind this carcinogenic pathway is multifactori- al. This review summarizes the major pathogenetic steps from which the inflamed colonic epithelium is transformed to a dysplas- tic and/or cancerous one. The role of the inflammatory and immune system, the oxidative stress generated as well as the genomic stability observed in UC-associated CRC is presented so as to provide a more spherical view of the tumorigenic process and, if possible, offer new diagnostic approaches for the early detection of CRC. (Acta gastroenterol. belg., 2012, 75, 293-299).


Halitosis - a common medical and social problem. A review on pathology, diagnosis and treatment

Bad breath is a condition that has health and social implications. This paper provides a comprehensive review of the classification of halitosis, it's etiology, it's prevalence, diagnosis and treatment strategies for the condition. Halitosis is affecting about 25-30% of world's population. It includes categories of genuine halitosis, pseudo-halitosis and halitophobia. It is believed that in 80-90% of cases halitosis origins in the oral cavity and the most common caus- es are : gingival pathologies, caries and poor oral hygiene. Extra- oral sources of halitosis are responsible for 10-20% of all cases and are caused by poor diet, alcohol abuse, tobacco smoking, certain drugs and diseases of other parts of digestive tract as well as some systemic conditions. Diagnostics of halitosis includes subjective methods (examiner's sense of smell) and objective methods (instru- mental analysis). Simple, subjective examination is considered a "golden standard" in clinical practice. In case of pathological hali- tosis identifying the direct cause of halitosis is essential. After excluding, or after successful treatment, of all oral pathologies, in case of remaining fetor ex ore identification and treatment of hali- tosis often requires multidisciplinary approach. Many unknowns remain in causes and mechanisms of halitosis. It can significantly impair quality of life, social interactions, lead directly to depres- sion, low self-esteem or other mood disorders, therefore it is impor- tant to properly identify, treat and continue research on halitosis. (Acta gastroenterol. belg., 2012, 75, 300-309).


Eosinophils in the gastrointestinal tract : friends or foes ?

Eosinophils play an important role in the mucosal immune sys- tem of the gastrointestinal tract under resting and under inflam- matory conditions. Under steady-state conditions, the mucosa of the digestive tract is the only organ harboring a substantial number of eosinophils, which, if need be, get activated and exert several effector and immunoregulatory functions. The precise function of these late- phase inflammatory cells is not yet completely understood. Nevertheless, it has recently been demonstrated that lipopolysac- charides from gram-negative bacteria activate eosinophils to rap- idly release mitochondrial DNA in the extracellular space. Released mitochondrial DNA and eosinophil granule proteins form extracellular structures able to bind and inactivate bacteria. These findings suggest a novel mechanism of eosinophil-mediated innate immune responses that might be important in maintaining the intestinal barrier function.