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Apple is an important dietary source of carotenoids and phenolic compounds, and its regular consumption is associated with several health benefits. The aim of this study was to evaluate the phytochemical composition of fresh peels of four red-skinned (“Champion”, “Generos”, “Idared”, “Florina”) and two yellow-skinned (“Golden Delicious”, “Reinette Simirenko”) apple varieties. Antioxidant activity of apple peel extracts was determined by ferric reducing antioxidant power (FRAP) and ABTS radical scavenging capacity assays. Total carotenoid and polyphenolic contents were determined spectrophotometrically, while the profile of individual carotenoids and anthocyanins (in red-skinned varieties) was analyzed using high-performance liquid chromatography coupled to a photodiode array detector (HPLC-PDA). Carotenoid composition was specific for each variety, and total carotenoid content was slightly higher in yellow-skinned apple peels compared to red-skinned varieties. In contrast, total phenolic content was higher in the peels of red-skinned cultivars. Anthocyanin profile was predominated by cyanidin-3-O-galactoside. Antioxidant potential followed the trend of the total polyphenolic content, being highest in “Florina”, as measured by both FRAP and ABTS assays. Our results demonstrated apple peels have high phytochemical content with diverse compositions, and their regular consumption can be an excellent source of antioxidants.

Introduction: Endoscopic surveilance of esophageal varices in patients with liver cirrhosis is expensive for the health system and uncomfortable for the patients. Recently, non-invasive ultrasound-based parameters seem to offer valuable informations about the status of esophaeal varices and thus challenge the need for repetitive endoscopic monitoring. Material and method: We have performed a systematic review of the literature published in PubMed from January 2000 until March 2012 over the role of ultrasound-based parameters on the evaluation of esophageal varices in patients with liver cirrhosis. Results: Eleven papers studied the role of gray-scale and Doppler ultrasound and two further studies analyzed the relationship between liver stiffness and staging of esophageal varices. The parameters that proved to be valuable for diagnosis of esophageal varices and reached statistcal significance were: diameter of the spleen > 15 cm, congestion index of the portal vein > 0.154 cm×sec, portal hipertensive index > 2.08, liver stiffness > 43.97kPa, portal vein diameter > 13 mm, renal artery resistance index ⩾ 0.7 and development of new porto-systemic collaterals. Other parameters such as: pattern of hepatic venous waveforms or flow parameters of the hepatic or splenic veins did not reach statistical significance. Conclusions: Altough esophagogastroduodenoscopy remains the golden standard, there are some ultrasound-based parameters which, used within complex algorithms, may represent a viable alternative for the diagnosis and surveilance of esophageal varices in patients with liver cirrhosis. [ABSTRACT FROM AUTHOR]

Vertebral primary tumors or metastasis represent a difficult target for percutaneous biopsies, which are performed usually under computed tomography (CT) or ultrasound (US) guidance. To our knowledge, there are only two case reports of EBUS guided vertebral metastasis that have been published - one using a transtraheal approach, the other using a transesophageal approach with ecobronchoscopes, but none using a transesophageal ecoendoscope. A 62 year old-man presented for dorsal pain with left intercostal irradiation, associated with progressive left abdominal upper quadrant pain, symptoms that have appeared 3 months prior to the presentation in our department. A thoracic CT scan revealed a right upper lung lobe tumor with osteolytic metastasis located at lower cervical and dorsal vertebral bodies. Transthoracic US did not reveal the tumor, but after analyzing the CT scan, we considered that a transesophageal EUS-FNA biopsy of the dorsal vertebral body metastasis can be feasible. We performed the EUS examination with a linear Olympus® echoendoscope which revealed two osteolytic protruding tumors originating from vertebral bodies. We performed EUS - FNA - 3 passages with a 22G needle, procuring cylindrical tissue specimens - a core biopsy. HistoVertebral primary tumors or metastasis represent a difficult target for percutaneous biopsies, which are performed usually under computed tomography (CT) or ultrasound (US) guidance. To our knowledge, there are only two case reports of EBUS guided vertebral metastasis that have been published - one using a transtraheal approach, the other using a transesophageal approach with ecobronchoscopes, but none using a transesophageal ecoendoscope. A 62 year old-man presented for dorsal pain with left intercostal irradiation, associated with progressive left abdominal upper quadrant pain, symptoms that have appeared 3 months prior to the presentation in our department. A thoracic CT scan revealed a right upper lung lobe tumor with osteolytic metastasis located at lower cervical and dorsal vertebral bodies. Transthoracic US did not reveal the tumor, but after analyzing the CT scan, we considered that a transesophageal EUS-FNA biopsy of the dorsal vertebral body metastasis can be feasible. We performed the EUS examination with a linear Olympus® echoendoscope which revealed two osteolytic protruding tumors originating from vertebral bodies. We performed EUS - FNA - 3 passages with a 22G needle, procuring cylindrical tissue specimens - a core biopsy. Histo [ABSTRACT FROM AUTHOR]

Thoracic lymphangiomatosis (proliferation of anastomosing lymphatic vessels, of different sizes, in pulmonary, pleural and mediastinal regions) is an extremely rare disorder occurring mostly in childhood. We present a diffuse pulmonary lymphangiomatosis (DPL) case in a young adult female patient in which repeated surgical biopsies were inconclusive and transthoracic ultrasound-guided (TUS) biopsy led to the diagnosis. Even histologically, DPL is very difficult to differentiate from other lymphatic diseases such as lymphangioma and lymphangiomyomatosis, requiring an experienced pathologist and proper immunohistochemistry staining. This case highlights the importance of TUS-guided biopsies in the armamentarium of imagistic techniques in this very rare case. [ABSTRACT FROM AUTHOR]

Gastric heterotopia is defined as the presence of morphologically normal gastric tissue at a non-physiological site, coexisting with the original tissue. Although it is not uncommon to see it in the esophagus, duodenum or small intestine, it is exceptionally rare to discover gastric mucosa in the rectum. Here we report the case of a 46-year old male with a 10-year history of ulcerative colitis in whom the surveillance rectosigmoidoscopy detected a Mayo score of 1 for ulerative colitis activity and a middle rectal sessile polyp. Pathological examination revealed an active chronic colitis, and rectal mucosa with heterotopic gastric mucosa composed of oxyntic glands was depicted. A month later, the patient was reevaluated and endoscopic mucosal resection was performed. Histology confirmed the gastric body type mucosa co-mingling with rectal mucosa. [ABSTRACT FROM AUTHOR]

We report the clinical observation of a 58-year old patient who presented with upper abdominal pain and a small ecchymosis located in the umbilical area. Personal history of the patient revealed ischemic heart disease and chronic atrial fibrillation. He was under treatment with oral anticoagulants (coumarins). The clinical data and especially the imaging investigations led to a diagnosis of gastric wall hematoma, possibly occurring post-traumatically in a patient under anticoagulant treatment. A conservative therapeutic approach was adopted and ultrasound surveillance. After 6 months the gastric parietal collection manifested complete resorption, spontaneously. In relation to the case presentation, we also discuss some issues on the frequency, diagnosis and therapeutic attitude in this rare complication of anticoagulant therapy. [ABSTRACT FROM AUTHOR]

We report the clinical observation of a 58-year old patient who presented with upper abdominal pain and a small ecchymosis located in the umbilical area. Personal history of the patient revealed ischemic heart disease and chronic atrial fibrillation. He was under treatment with oral anticoagulants (coumarins). The clinical data and especially the imaging investigations led to a diagnosis of gastric wall hematoma, possibly occurring post-traumatically in a patient under anticoagulant treatment. A conservative therapeutic approach was adopted and ultrasound surveillance. After 6 months the gastric parietal collection manifested complete resorption, spontaneously. In relation to the case presentation, we also discuss some issues on the frequency, diagnosis and therapeutic attitude in this rare complication of anticoagulant therapy.