5 Recently, Bémeur et al.9 performed a study in mice with azoxymethane-induced ALF, where they strictly controlled the temperature (a factor that affects the outcome of this model) and could not detect immunoglobulin G extravasation, in accordance with BBB integrity. Lluis Palenzuela Ph.D.* ‡, Antoni Mas M.D.‡ §, Joan Montaner M.D.†, Juan Cordoba M.D.* §, * Liver Unit and Institut de Recerca, Hospital Universitari Vall d’Hebron, find more Barcelona, Spain, † Neurovascular Research Laboratory, Hospital

Universitari Vall d’Hebron, Barcelona, Spain, ‡ Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain, § Liver Unit and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic i Provincial, Barcelona, Spain. “
“Esophageal motility can become abnormal by either becoming “spastic” with disordered and sometimes high-pressure contractions or can become weak with either no contractions or weakly ineffective contractions. Achalasia is the best characterized motility disorder, yet the etiological agent behind click here the disorder is unknown. Diffuse esophageal spasm (DES) is a motility disorder characterized by simultaneous esophageal

contractions intermixed with more normal sequences. High pressure or “nutcracker” esophagus is characterized by normally transmitted peristaltic waves with higher than expected amplitudes. Treatment of these disorders focuses on lowering the LES pressure and may include medications (nitrates and calcium blockers), injectables (Botox), endoscopic dilation and surgical myotomy. There is another set of disorders characterized by absent or weak (ineffective) motility. Scleroderma is the classic disorder in this category, but more patients have GERD and other conditions affecting esophageal

muscles or nerves. GERD is perhaps the most common etiology of a “weak” esophagus. There are no specific treatment for ineffective peristalsis, but since many of these patients have coexisting GERD, acid suppression is reasonable. “
“We appreciate the article by Wu et al. in a recent issue of HEPATOLOGY.1 In this study, the authors demonstrated that the overexpression of epidermal growth Thymidine kinase factor–like domain 7 (Egfl7) was closely associated with poor prognosis in hepatocellular carcinomas (HCCs). In addition, they investigated the role of Egfl7 in the development and progression of HCC by silencing its expression via transfecting a specific small interfering RNA in HCC cell lines. Silencing of Egfl7 expression caused no changes in cell growth, even if it resulted in a relevant inhibition of cell migration, which appeared mediated by the phosphorylation of focal adhesion kinase (FAK). All these effects were reverted by the use of an epidermal growth factor receptor (EGFR) inhibitor.