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The article presents a case study of a 49-year-old man presented with epigastric discomfort and underwent into esophagogastroscopy. The patient was diagnosed with an exophytic lesion similar to squamous papilloma which was characterized as verruciform xanthoma in the esophagus. The article discusses the presence of human papilloma virus in the epithelial cells.

Conventional treatment of moderate-severe ulcerative colitis (UC) has resulted in only a limited therapeutic benefit. Advancing knowledge of UC pathogenesis and recent advances in biotechnology have led to the development of biological agents that selectively target individual inflammatory pathways. In particular, the role of tumor necrosis factor alpha (TNF-alpha) in UC pathogenesis has been clarified by serological and immunohistochemical studies in humans and by experimental models. Clinical efficacy of anti-TNF-alpha therapy with infliximab has been assessed in two large controlled trials, showing a good compromise between therapeutic gain and safety. The aim of this review is to provide an insight into the role of TNF-alpha and anti-TNF-alpha therapy in patients with UC and diverticular disease associated colitis.

In the third decade of the Helicobacter pylori era several informations are available on its pathogenetic mechanisms, as well as on therapeutic approaches. A 7-14 day triple or quadruple regimens (proton pump inhibitor together with 2 antibiotics) are currently suggested as first-line treatment, but the success rate following these therapy is constantly decreasing worldwide. Therefore, new drugs are needed to treat such a widespread infection. Several patents of new antibiotics have been claimed in the last 5 years, and some of them showed a very powerful antibacterial activity in vitro, even against clarithromycin and metronidazole resistant strains. Among the new compounds, thienylthiazole derivatives, benzamide derivatives and pyloricidins should be regarded as very promising molecules.

Detection of Trichuris trichiura during colonoscopic examination is an unusual finding, at least in developed countries. We report a case of a coincidental endoscopic diagnosis of whipworm infestation performed in a patient referred to our open-access endoscopy even before a faecal examination for ova and/or parasites had been performed. Review of literature on colonoscopic diagnosis of T. trichuria is provided.

This study was undertaken to evaluate autonomic nervous system function in patients with gastroesophageal reflux disease. Based on clinical criteria, 28 consecutive patients with no history of heart, metabolic, or neurologic disease (mean age 41 y, range 20-62 y) reporting with upper gastrointestinal symptoms typical of gastroesophageal reflux underwent esophageal manometry, ambulatory 24-hour pH study with electrocardiographic monitoring, power spectral analysis of heart rate variability, and cardiovascular tests. Twelve healthy subjects served as controls. A positive result of prolonged esophageal pH study (pH in the distal esophagus less than 4, lasting more than 4.2% of recording time) was observed in 21 patients (reflux group); seven patients were categorized in the nonreflux group. No patient showed arrhythmias or any correlation between heart rate variability changes during electrocardiographic monitoring and episodes of reflux (pH less than 4, lasting more than 5 minutes). A decrease of sympathetic function occurred only in the reflux group (p <0.05) supported by the lower increase of systolic/diastolic blood pressure at sustained handgrip. No other cardiovascular tests showed statistically significant differences in the control or nonreflux groups. Total time reflux showed an inverse correlation with sympathetic function in the reflux group (r = -0.415, p <0.028). We concluded that there is some evidence for a slightly decreased sympathetic function in patients with gastroesophageal reflux disease that is inversely correlated with total time reflux. In these patients, decreased sympathetic function may cause dysfunction of intrinsic inhibitory control with increased transient spontaneous lower-esophageal sphincter relaxations, thus resulting in gastroesophageal reflux disease.

The case is described of a 32-year-old man suffering from alcoholism who came to the Emergency Unit with vomiting, fever and sharp epigastric pain irradiating to the chest and upper abdomen. A diagnosis of acute pancreatitis was made after high amylase and lipase levels were observed and the results of computed tomography scan revealed images typical of acute pancreatitis. Findings upon admission and after the initial 48 hours did not correlate with a severe or complicated course according to Ranson's criteria. On the third day after admission he suddenly developed decreased vision. A fluorescein angiogram showed arteriolar occlusion, retinal and choriocapillary ischaemia. Purtscher's retinopathy was suspected. After 4 weeks, the patient had recovered from acute pancreatitis, ophthalmoscopic examination showed normal results, and visual acuity had almost returned to normal. Activation of complement in acute pancreatitis could account for many haematologic acute disorders due to leucocyte emboli or other complement-mediated aggregates. Coagulation abnormalities may range from isolated intravascular thrombosis to severe disseminated intravascular coagulation. Purtscher's retinopathy, due to microembolizations in the choroidal and retinal arterioles, should be included among the various systemic effects of acute pancreatitis. This visual disorder is a rare systemic manifestation of acute pancreatitis which was not correlated to a severe or complicated clinical course. Treatment of these ocular complications remains to be established and outcome, therefore, depends upon resolution of the pancreatic disease.

Two specific androgen binding sites were characterized in the ovine follicle with [3H]DHT, [3H]T and [3H]R-1881 as ligands, different incubation times and a charcoal separation step: the first, with characteristics very similar to testicular ABP in terms of its capacity, affinity, association and dissociation rates and specificity for natural and synthetic androgens, was found in serum, follicular fluid and the 27000 X g particulate and cytosol fractions of granulosa cells; the second, classic androgen receptors, were found in the cytosol with high affinity and low capacity for the synthetic androgen R-1881 and a very slow steroid-protein rate of dissociation. Saturation analysis on purified nuclei showed only the presence of the androgen receptor binding R-1881 with capacity similar to cytosol receptor. Isolated follicles showed a direct correlation between the total concentrations of androgen ([3H]-[3H]R-1881) binding sites and the follicular diameter. The complex actions which androgens exert on granulosa cell function may be mediated by interactions in vivo between these extra- and intracellular specific androgen binding proteins.

Androgen binding activity, indistinguishable from sex-hormone-binding globulin (SHBG) in serum, has been identified in human follicular fluid by binding analyses (saturation and Scatchard analyses and binding specificity), immunoradiometric assay and Con-A Sepharose chromatography. Follicular fluid was obtained at the time of oocyte recovery from either individual follicles (range 2-7) from seven patients, or as a pool obtained from follicles of several patients who had received a Clomid-human menopausal gonadotrophin treatment to stimulate follicular growth as part of an in vitro fertilization program. Concentrations of SHBG in follicular fluid varied between individual follicles (750 +/- 202 fmol mg-1 protein; mean +/- s.d.; n = 14) and ranged above and below concentrations of SHBG in serum (948 +/- 171 fmol mg-1 protein; n = 5) taken 4 h before oocyte recovery and harvest of follicular fluid. There were strong correlations (r = 0.7-0.9) between the steroid and SHBG contents in individual follicular fluids of two patients. However, the concentration of SHBG in follicular fluid was generally 100-fold lower than that of oestradiol or progesterone, suggesting that SHBG may play some role other than determining the concentration of unbound steroid in the follicle.