The Vermont colorectal cancer project: self-portrait.

Hypothesis: A prospective statewide quality assessment and improvement project requiring active participation and case entry by surgeons is feasible provided that confidentiality and peer review protection are provided.

Design: Inception cohort.

Setting: Acute-care hospitals in Vermont.

Prospective analysis of colorectal carcinoma. Determination of an age-site and stage relationship and the correlation of DNA index with clinicopathologic parameters.

Purpose: A prospective study of colorectal cancer (1987-1991) using flow cytometry was performed to determine the relationship of age with DNA index (DNA-I), sites of disease, Dukes stage, grade, and survival.

Methods: The flow cytometry was performed on 138 fresh, unfixed, surgical specimens using 4',6'-diamidino-2-phenylindole, a DNA fluorochrome.

Results: The mean age was 66.

Neoplasms of the anus.

Anal cancers can be grouped into three major categories. First, anal margin lesions are usually well-differentiated, keratinized squamous cell carcinomas that are amenable to local treatment measures. Second, anal canal cancers distal to the dentate line are mostly epidermoid, nonkeratinizing, moderately differentiated tumors.

Simple technique for anvil insertion in stapled circular colorectal anastomoses.

The benefits of circular stapling devices are obvious. The introduction of staplers with detachable anvils has simplified the stapling procedure even more than the original instruments. A simple technique for placing the anvil and pursestring are described.

The admission department--"billers of the future".

As the turn of the century approaches, one fact is becoming clear: change will demand that healthcare managers must boldly go where no one has gone before. The place where change will be most prevalent will be the admission department.