Cancers of the anal canal: diagnosis, treatment and future strategies.

Anal cancer is an uncommon cancer; however, it is rising in incidence. There is confusion regarding nomenclature and the distinction between anal canal cancer and anal margin cancer. This article discusses the modern definition, etiology and staging of anal canal and anal margin cancers.

Rectal cancer: prognostic indicators of long-term outcome in patients considered for surgery.

Purpose: Patients and clinicians seek an accurate prognosis after resectional surgery for rectal cancer. The aim of this study was to determine long-term outcomes after potentially curative surgery for rectal cancer with particular focus on factors associated with longer-term survival that are available to surgeons in the early post-operative setting.

Methods: We conducted a retrospective review of a prospectively gathered database of all primary rectal adenocarcinomas considered for surgery in the University Hospitals of Leicester National Health Service (NHS) Trust between 1998 and 2007.

Linkage analysis of glucokinase gene with NIDDM in Caucasian pedigrees.

NIDDM has a strong genetic component, as evidenced by the high level of concordance between identical twins. The nature of the genetic predisposition has remained largely unknown. Recently, the glucokinase gene locus on chromosome 7p has been shown to be linked to a subtype of NIDDM known as MODY in French and British pedigrees, and glucokinase mutations have been identified.

Capillary and venous blood glucose measurements using a direct glucose-sensing meter.

The aim of the study was to evaluate the precision and accuracy of the ExacTech home blood glucose meter when used with either capillary or venous blood and to compare this with a reference whole blood glucose assay. Non-fasting glucose measurements were used since a validation study showed no capillary-venous differences between fasting and post-prandial states. In a cross-sectional study, blood was taken from 182 patients and measured in duplicate on three batches of strips.

Dose-dependent increase in in vitro platelet sensitivity to adenosine-5'-diphosphate in young complication-free diabetic males.

In vitro platelet aggregation in response to a wide range of final adenosine-5'-diphosphate (ADP) concentrations was assessed in 11 young, diabetic males without detectable vascular complications and in 11 closely-matched controls. First phase aggregation was assessed using a particle collision theory model and the "sigmoid Emax" dose-response equation. Platelets from the diabetics required a significantly lower ADP concentration to attain a sticking probability of 0.

An amperometric needle-type glucose sensor tested in rats and man.

An amperometric glucose-measuring 25 gauge (0.5 mm diameter) needle-type sensor has been developed using a glucose oxidase and dimethyl ferrocene paste behind a semi-permeable membrane situated over a window in the needle. Electron transfer results in direct current generation.

Normal calcium-activated potassium channel in red cells in type 2 diabetes.

The diminished insulin secretion of type 2 diabetes might result from abnormal regulation of the potassium permeability which leads to beta-cell depolarization. The possibility of a generalized defect has been investigated in vitro by the stimulation of 86Rb efflux from red cells of type 2 diabetic patients by calcium ionophore and its inhibition by quinine. Diabetic subjects and control subjects had identical 86Rb efflux stimulated by 0.

Determinants of ADP-induced platelet aggregation in diabetes mellitus.

ADP-induced platelet aggregation was measured in 15 Type 1 (insulin-dependent) diabetic patients, 15 Type 2 (non-insulin-dependent) diabetic patients and in 15 non-diabetic control subjects. Simultaneous measurements were made of fasting blood glucose, glycosylated haemoglobin, serum insulin, total plasma cholesterol, cholesterol in the lipoprotein subfractions, total triglycerides and platelet phospholipid fatty acid levels. Regression analysis of aggregation against the biochemical variables within the three groups revealed that there was no significant difference in the associations with aggregation between the groups.

Glycosylated haemoglobin: comparison of five different methods, including measurement on capillary blood samples.

Glycosylated haemoglobin was measured in venous blood samples and in blood collected in 'Unistep' bottles by isoelectric focusing (IEF), as the reference method, and by electroendosmosis (EEO), the thiobarbituric acid method (TBA), ion-exchange chromatography (IEC) and affinity chromatography (AC). Isoelectric focusing, electroendosmosis and thiobarbituric acid gave similar results. Affinity chromatography gave lower results than isoelectric focusing for normal values but similar results for diabetics.

Platelet aggregation in non-insulin-dependent diabetes is associated with platelet fatty acids.

Platelet aggregation was measured in 15 patients having non-insulin-dependent diabetes mellitus (NIDDM) at the time of diagnosis and after three months of dietary treatment. Mean fasting plasma glucose fell from 13.0 to 8.

Continuous infusion of glucose with model assessment: measurement of insulin resistance and beta-cell function in man.

Continuous infusion of glucose with model assessment (CIGMA) is a new method of assessing glucose tolerance, insulin resistance and beta-cell function. It consists of a continuous glucose infusion 5 mg glucose/kg ideal body weight per min for 60 min, with measurement of plasma glucose and insulin concentrations. These are similar to postprandial levels, change slowly, and depend on the dynamic interaction between the insulin produced and its effect on glucose turnover.

Platelet sensitivity in vitro to adenosine-5'-diphosphate and prostacyclin and diabetic retinopathy.

Platelet sensitivity to adenosine diphosphate and prostacyclin in diabetes has been assessed using collision theory and the concept of 'sticking probability' (the probability of particle union). Twenty Type 1 (insulin-dependent) diabetic men (10 with no or minimal retinopathy and a matched group of 10 with proliferative retinopathy) and 10 age-matched nondiabetic men were studied. Platelets from the 20 diabetic patients required, on average, 37% less adenosine diphosphate to achieve a sticking probability of 0.

Patient-orientated metered capillary blood collection.

A small collector bottle, with a precision-moulded top, allows capillary blood from a finger-prick to be automatically metered into a diluent for subsequent laboratory analysis. This device, which has been successfully used by patients to obtain full blood counts, glycosylated haemoglobin values and blood glucose measurements, may have wide application.

Prostaglandin synthesis inhibition reduces platelet aggregation in diabetes mellitus.

Platelet aggregation, platelet prostaglandin precursor fatty acids, glycaemia and lipid levels were studied in a group of insulin dependent diabetics whilst taking Aspirin (900 mg daily) and Dipyridamole (300 mg daily) and again two months after discontinuing this treatment.

Analysis of platelet aggregation using particle collision theory.

The aggregometer monitors changes in light transmission through stirred suspensions of aggregation platelets. Arbitrary measurements from aggregometer recorder tracings have been used to investigate platelet aggregation without regard to mechanisms involved. To determine the applicability of particle collision theory to assessment of in vitro platelet sensitivity to proaggregating agents, platelet-rich plasma (PRP) from five volunteers was used to obtain recorder tracings after addition of ADP in five doses (0.

Islet changes induced by hyperglycemia in rats. Effect of insulin or chlorpropamide therapy.

To investigate the effect of hyperglycemia on normal islets, rats were made diabetic by a 95% partial pancreatectomy and treated with insulin, saline, or chlorpropamide for 3 mo. Histologic examination and morphometry of the residual pancreas showed islet enlargement and fibrosis that correlated with the mean lasting plasma glucose during the experimental period. Treatment of diabetes with insulin prevented the islet disorganization.

In-vitro venous prostacyclin production, plasma 6-keto-prostaglandin F1 alpha concentrations, and diabetic retinopathy.

Previous studies have shown that vessels from diabetics produce less prostacyclin in vitro than those from normal controls. To determine whether this decreased production is related to complications elective biopsy of a superficial forearm vein was performed on 12 insulin-dependent male diabetics, six with nil or minimal and six with proliferative retinopathy, and seven male controls. Vein segments from the diabetics and controls produced similar amounts of prostacyclin in vitro (medians 0.