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Reptiles are popular exotic pets and green iguanas (Iguana iguana) are amongst the top ten most popular reptiles. Here we describe a captive 8-year-old female green iguana that was referred for treatment of a non-healing, discharging lesion on the side of the body. The lesion was surgically excised and histopathological analysis revealed an epidermal proliferation of neoplastic keratinocytes, with focal infiltration through the basement membrane, into the underlying superficial dermis. Marked dysplastic changes, characterized by multifocal dyskeratosis and keratin pearl formation were also noted. A diagnosis of cutaneous squamous cell carcinoma (SCC) was made. Two years later, the iguana has shown no signs of recurrence. This is the first report of successful treatment of cutaneous SCC in a green iguana and contributes to the limited knowledge of cutaneous neoplasms in green iguanas.

Canine spirocercosis is caused by the nematode Spirocerca lupi. Migration results in oesophageal fibro-inflammatory nodules that may undergo neoplastic transformation. No studies have assessed pre- or post-surgical prognostic indicators in dogs that undergo intervention for S. lupi induced oesophageal neoplasia. This observational, multi-center study aimed to assess the outcome of dogs with Spirocerca induced sarcoma undergoing endoscopic-guided ablation (n = 12) or surgery (n = 18), and identify prognostic indicators. Parameters evaluated included: age, weight, gender, presenting complaints, duration of clinical signs, complete blood count, serum biochemistry, neoplasia size, placement of percutaneous endoscopically-placed gastrostomy tube, histopathological mitotic indices, days to discharge and chemotherapy administration. Kaplan-Meier survival curves showed no difference in survival between ablation and surgery {(median: 73.5 days (range: 0–1511) vs. 108 days (range: 0–1550), respectively (p = 0.982)}. Reduced survival was documented in patients presenting with weight loss (P = 0.027), hypochromasia (MCHC 15 × 109/L, P = 0.017) with a hazard ratio of 2.51 (CI95% = 1.071–6.018, P = 0.034), 2.71 (CI95% = 1.10–6.65, P = 0.03) and 4.39 (CI95%: 1.21–15.97, P = 0.025) respectively. In the dogs surviving more than 21 days, Ht 15.0 × 109/L at presentation were associated with reduced survival (p = 0.016, p = 0.021 respectively) and hazard ratio of 3.29 (CI95% = 1.18–9.2, P = 0.023) and 3.81 (CI95% = 1.15–12.55, P = 0.028) respectively. Intra-intervention-group survival analysis identified increased survival time in dogs receiving chemotherapy, but only within the surgical group (P = 0.02).The hospitalisation time of dogs undergoing ablation (median: 0 days, range: 0–4) was significantly shorter than dogs undergoing surgery (9 days, 1–21) (P In this study, no clear benefit was identified for surgery, thus when ablation is technically possible it should be considered advantageous, as hospitalisation time is significantly shorter. Weight loss, hypochromasia and leucocytosis were identified as long-term prognostic indicators at presentation.

Background: Cleaning and disinfection procedures play an essential role in the prevention of infection transmission in gastrointestinal endoscopy. In spite of published detailed guidelines, several variants and weak points still exist. Methods: Cleaning-disinfection procedures were carried out according to "Working Party, Sydney 1990." A microbiologic surveillance protocol tested the contamination of endoscopes and of automatic washing machines. To assess and improve the efficacy of disinfection, we adopted a quality assurance program. Results: During a 2-year follow-up, the outside surfaces of gastroscopes were contaminated in 60.5% and channels in 41.3%; the outside areas of colonoscopes were contaminated in 62.3% and channels in 40.3%. Isolated bacteria were gram-negative organisms, particularly Pseudomonas species, and gram-positive organisms, mostly Staphylococcus species. The water reservoirs of automatic washing machines were frequently contaminated by Pseudomonas aeruginosa . The disinfection of washing machines and alcohol rinsing of endoscopes after standard procedures significantly reduced the bacterial contamination. Conclusions: The microbiologic surveillance pointed out the main weak points that could be improved by the adoption of corrective interventions. Quality assurance is a feasible method to assess the efficacy of cleaning-disinfection, and its wide application would improve quality of care. (Gastrointest Endosc 1996;43:457-62.)

Impaired gallbladder emptying is implicated in gallstone disease. Ultrasonography and scintigraphy have shown conflicting results because the former is influenced by postprandial refilling, whereas the latter is not influenced by refilling. The aim of this study was to measure postprandial refilling and turnover of bile by combining the two techniques.Simultaneous scintigraphy and ultrasonography were used in 14 patients with gallstones and 11 healthy controls. Measurements were performed while the patients were fasting and at 10-minute intervals after a standard meal for 90 minutes, and the measurements were used to calculate postprandial refilling, turnover of bile (in milliliters), and turnover index.Ultrasonography and scintigraphy provided different gallbladder emptying patterns. Compared with controls, patients with gallstones had impaired emptying by both scintigraphy (P0.0001) and ultrasonography (P0.01). Postprandial refilling and turnover were both reduced between 60 and 90 minutes (P0.05), and the turnover index was markedly reduced (1.8 vs. 3.5; P0.001).Simultaneous scintigraphy and ultrasonography provide a new model of gallbladder motor function showing that refilling begins immediately postprandially. In healthy controls, the gallbladder postprandially handles up to six times its basal volume within a period of 90 minutes, but this turnover of bile is markedly reduced in cholelithiasis causing a reduced washout effect of the gallbladder contents, including cholesterol crystals.

A method was developed for the direct analysis of the common free bile acids by high-performance liquid chromatography coupled with electrochemical detection (HPLC-ED). The compounds were separated on an Ultrasphere ODS column with a methanol-acetonitrile-acetate buffer eluent and detected at a porous graphite electrode set at an oxidation potential of + 1.4 V. This new technique is applicable to the assay of ursodeoxycholic acid and related impurities in capsule and tablet formulations. Compared with conventional UV detection, the electrochemical detector was found to achieve enhanced specificity and sensitivity.

A rapid and simple on-line purification procedure was developed for determining the conjugated bile acids in human fluids by high-performance liquid chromatography (HPLC). Biological samples were diluted and directly injected without further treatment onto a pre-column dry-packed with 40-μm octadecylsilica and installed at the injector loop position. After washing the pre-column with 40% methanol in acetate buffer and then with water, the retained compounds were back-flushed by the mobile phase onto the analytical column during the normal course of chromatography. The method was found to be accurate and reproducible. The levels of conjugated bile acids in serum, duodenal bile and gastric juice from patients with hepatobiliary and gastric diseases were determined by on-line pre-column clean-up and reversed-phase HPLC.

Patient infection from contaminated GI endoscopes can generally be attributed to failure to follow appropriate reprocessing guidelines, but the application of cleaning-disinfection procedures requires adequate staff training and a specific work organization. In 1996 we adopted a quality assurance program to assess the effectiveness of our procedures, and suggested to perform a yearly microbiologic surveillance of disinfection ( Gastrointest Endosc,1966;43:457 ). In the last two years the number of procedures performed at our endoscopy unit increased significantly, with important changes in work organization. We therefore defined a quality assurance program to re-assess the effectiveness of cleaning and disinfection. Every 3 months bacteria contamination was tested by sampling: -the distal end of the endoscope by contact-plate and of biopsy channel by washing with 10 mL saline; -water in the automatic washing machine reservoir. During the first 6 months of monitoring, a significant contamination (bacterial load >20 CFU/mL) was found on the surface and/or in channels of both colonoscopes (in 5 out of 6 random tests) and duodenoscopes (in 1/6 tests),whereas on gastroscopes a light contamination ( Pseudomonas spp (mainly P aeruginosa ), but in one occasion also Escherichia coli and Klebsiella oxitoca were isolated.In the same period, no significant contamination was found in the water reservoir of the washing machine. Two corrective interventions of the disinfection procedures were then applied: 1)prolonged exposure to 2% glutaraldehyde (from 20 to 30 min) for both colonoscopes and duodenoscopes; 2)use of dedicated washing machines for gastroscopes, colonoscopes and duodenoscopes. After these interventions, Pseudomonas spp was virtually eliminated (isolated only in 1 out of 37 random tests performed in a 15-month period, and only a light contamination of the endoscopes was found (in 3 out of 37 tests) by Staphilococcus spp . This prompted us to pay more attention to post-processing endoscope manipulation and storage. In conclusion, our observations suggested that: -a microbiologic surveillance program should be intensified when the workload and work organization in the endoscopy suite change significantly; -increasing time of exposure of colonoscopes and duodenoscopes to glutaraldehyde, and the adoption of a regimen of washing machines dedicated to specific endoscopes would result in a significant reduction in the level of contamination.