Gastrointestinal Symptom-Free Multiple Lymphomatous Polyposis: An Atypical Case Presentation of Mantle Cell Lymphoma.

Introduction: Mantle cell lymphoma (MCL), a rare non-Hodgkin's lymphoma, exhibits a genetic translocation causing CCND1 gene overexpression, affecting 5% of NHL cases, predominantly in males aged 60-70. Typically diagnosed with advanced symptoms, MCL involves widespread disease and organ spread, being aggressive and incurable with a 1.8-9.4-year average survival. Optimal treatment depends on disease aggressiveness and age. Multiple lymphomatous polyposis (MLP), a rare MCL subtype in the GI tract, is usually present with GI symptoms. Case Presentation: A 71-year-old woman was diagnosed with asymptomatic MLP during MCL staging who underwent thoracentesis due to large right pleural effusion and significant axillary lymphadenopathy and was treated with a chemotherapy regimen of rituximab/cytarabine and later transitioned to bendamustine/rituximab. This patient eventually underwent a bone marrow biopsy and later a bone marrow transplant. Conclusion: We present a unique case of asymptomatic MLP, emphasizing the importance of early detection for the poor prognosis of MLP with a mean survival of less than 3 years.

Heterotopic Pancreas in the Esophagus: What Do We Know?-A Review of the Literature.

Heterotopic pancreatic tissue is a rare phenomenon, which may occur in locations outside of the pancreas within the gastrointestinal tract. Of these locations, involvement in the esophagus is quite rare. It is paramount to improve our understanding regarding heterotopic pancreas, as some lesions may carry malignant potential. With this article, we present a case of heterotopic pancreas in the distal esophagus and review the current literature.

The Pain of Staying Alert: A Case Report and Literature Review on Energy Drink-Induced Acute Pancreatitis.

Energy drink consumption has increased over the past decade. It is associated with several common side effects including diarrhea, heartburn, and dyspepsia. Energy drinks have been proposed as a rare but potential cause of acute pancreatitis. This paper investigates a unique case of energy drink-induced pancreatitis and further explores current literature on this topic. This study stresses the importance of asking all patients presenting with acute pancreatitis about their daily energy drink consumption, especially if the cause is unknown.

Use of wide-screen, high-definition monitors for improving adenoma detection: A prospective, randomized, controlled trial.

BACKGROUND AND AIM: Colonoscopy is sensitive at detecting large polyps; however, a significant polyp miss rate is still recognized. Indicators such as the adenoma detection rate (ADR) and, more recently, the adenoma per colonoscopy rate (APC) are increasingly used to ensure quality in colonoscopy. We carried out a prospective, randomized, controlled study evaluating improvement in adenoma detection between wide-screen, high-definition (WSHD) monitors compared to standard monitors (SD). METHODS: Patients undergoing screening or surveillance colonoscopy were randomized to a WSHD room or SD. Polyp size, location, shape, and histology were recorded. Right-sided polyps were considered to be those proximal to the splenic flexure. RESULTS: A total of 152 patients were enrolled in the study, with 78 (51.3%) and 74 (48.7%) enrolled in the WSHD and SD groups, respectively. A 10% absolute difference in favor of the WSHD group was noted for the ADR (41% vs 31% patients); however, the difference was statistically not significant. In the WSHD and SD groups, APC of 0.9 ± 1.4 versus 0.7 ± 1.4 (P = 0.49) were noted, respectively. For polyps <5 mm, an ADR of 0.3 ± 0.4 versus 0.2 ± 0.4 (P = 0.34) and APC of 0.5 ± 1.1 versus 0.2 ± 0.5 (P = 0.06) were seen in the WSHD and SD groups. CONCLUSION: This study shows a trend toward improvement in ADR, with an increase in APC for small adenomas that approaches statistical significance. WSHD monitors are a one-time, low-cost intervention for improving the quality of colonoscopy with potentially favorable outcomes.

Probing dimer interface stabilization within a four-helix bundle of the GrpE protein from Escherichia coli via internal deletion mutants: conversion of a dimer to monomer.

Insight into protein stability and folding remains an important area for protein research, in particular protein-protein interactions and the self-assembly of homodimers. The GrpE protein from Escherichia coli is a homodimer with a four-helix bundle at the dimer interface. Each monomer contributes a helix-loop-helix to the bundle. To probe the interface stabilization requirements, in terms of the amount of buried residues in the bundle necessary for dimer formation, internal deletion mutants (IDMs) were created that sequentially truncate each of the two helices in the helix-loop-helix region. Circular dichroism (CD) spectroscopy showed that all IDM's still contained a significant amount of α-helical secondary structure. IDM's that contained 11 or fewer of 22 residues originally present in the helices, or those that lost at least 50% of residues with less than 20% the solvent accessible surfaces (that is, hydrophobic residues) were unable to form a significant amount of dimer species as shown by chemical cross-linking. Gel filtration studies of IDM3.0 (one that retains 10 residues in each helix) show this variant to be mainly monomeric.