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A novel type of cytokeratin, cytokeratin 20 (CK20), was added in 1990 to the classic catalog of human cytokeratins, a heterogeneous group of proteins present in almost all epithelia. In man, the expression of CK20 is almost entirely confined to the gastro-intestinal epithelium, to the urothelium and to Merkel cells. Since only few data are available regarding the expression of CK20 in the developing human intestinal mucosa, we studied CK20 immunoreactivity in fetal and neonatal human gut. Immunoreactivity for CK20 was tested in fetuses and newborns, from the twelfth up to the fortieth week of gestation. In each subject, a specimen from the oesophagus, stomach, small intestine, colon, appendix was studied. Tissue samples were routinely processed and paraffin sections were stained with the CK20-specific antibody IT-Ks 20.8. CK20 immunoreactivity was absent in the oesophageal epithelium and it was unevenly distributed in the gastrointestinal mucosa. Three main patterns of immunoreactivity were observed during normal development: the first, found in the stomach and in the small bowel, is characterized by a progressive increase in CK20 expression during gestation; the second pattern, found in the duodenum, shows a progressive decrease in CK20 expression during gestation; in colon and appendix (third pattern), we did not find significant changes in the degree of immunoreactivity for CK20 during gestation. CK20 is unevenly expressed in developing human intestinal mucosa. The degree of positivity for CK20 appears to be related to the epithelial maturation stage only in gastric and small bowel mucosa. Further studies are needed to verify if the uneven CK20 immunoreactivity in the gastrointestinal tract persists even in adulthood.

Functional assessment of pelvic pouch procedures for FAP is not different from that of UC and consists of clinical, manometric and radiologic investigations. Ileo-rectal anastomosis and pelvic pouch operation are equally effective for the disease, but function is still questionable after restorative proctocolectomy. Based on a personal series of 43 patients, relevant technical aspects influencing functional results are discussed and guidelines for a correct follow-up of these patients are presented.

The Authors report their experience concerning the rehabilitation of patients with temporary or definitive colostomy. Mechanical and psychosocial implications as well as different rehabilitative methods are discussed and literature data are reviewed. Surgery should play a major role in this rehabilitation programme, either in terms of prevention or definitive treatment; nonetheless only through a multidisciplinary approach these patients will achieve a better quality of life.

Twenty-two subjects (8 males, 14 females, mean age 36 years, range 21-57) with symptoms of diffuse pain or fullness in a lower abdominal quadrant, without repercussions on general health but with chronic anxiety of which the subjects complained or which emerged during confidential conversation with the physicians, were enrolled in our outpatient department for liver and gastroenterologic pathology at the Institute of Internal Medicine and Metabolic Disorders, II Faculty of Medicine, Naples University. After an average 30-day wash-out period, patients were treated with etizolam, a new psychoactive drug for somatized anxiety. Mean dosage and duration of treatment were 1 tablet twice daily for 25 days. Painful symptoms disappeared in 16.3% of patients, decreased in 38.3% and remained stationary in 22.7% and became worse in 22.7%. Number of bowel motions decreased in 14 patients (63.6%, from an average of 2.04 to 1.56). It can therefore be concluded that etizolam treatment was effective in subjects with colon disorders accompanied by chronic anxiety syndrome or that became acute as result of stressful socio-economic or affective situations or personal disappointment.