OVX1 and CEA in patients with colon carcinoma, colon polyps and benign colon disorders

The OVX1 tumor marker promises to complement CA125 for detection of early stage ovarian carcinoma. OVX1 has also been shown to be elevated in colon cancer patients. This study is designed to assess serum OVX1 levels in patients with specific stages of colon cancer, colon polyps or other GI disorders. Serum OVX1 and CEA were measured by radioimmunoassay or enzyme immunoassay for 206 patients at the time of colonoscopy or staging for colon carcinoma. In patients with stage I, II, III, or IV colon carcinoma, serum OVX1 was positive in 37%, 48%, 74% and 63%, respectively. Fifty-three percent of patients with colon polyps had elevated OVX1 levels, while OVX1 levels were positive in only 7% of healthy controls. If both OVX1 and CEA were considered, at least one of these markers was elevated in 36%, 60%, 79% or 89% of patients with stage I, II, III or IV colon carcinoma, respectively. The majority of patients with inflammatory bowel disease or diverticulosis also had elevated OVX1 levels. Both markers were positive in 27% of patients with colon carcinoma, and not in any patients with a normal colonoscopy or with a diagnosis of diverticulosis or hemorrhoids. In conclusion, serum OVX1 improves the sensitivity of CEA for detecting colon polyps and colon cancer; however, the use of OVX1 in this setting is hindered by its elevation in non-malignant colonic processes.     

Glucose tolerance test in the Ainu

In an attempt to find out specific characteristics in carbohydrate metabolism in the Ainu, if any, glucose tolerance test was carried out. Between the Ainu and non-Ainu Japanese no differences were observed in the blood glucose, immunoreactive insulin and human growth hormone levels in the plasma after glucose load. Fasting levels of plasma FFA were significantly lower in the Ainu than in the Japanese. Changes in the FFA after glucose load were less in the Ainu, while the Japanese showed a marked rebound of the plasma FFA.

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Zusammenfassung Der Glukosetoleranztest wurde bei 10 Ainu und 20 Japanern (Studenten) durchgeführt. Signifikante Unterschiede im Blutzucker, immunreaktiven Insulin und humanen Wachstumshormon im Plasma wurden nach der Glukosegabe nicht gefunden. Die Nüchternwerte der freien Fettsäuren waren in den Ainu signifikant tiefer als bei den Japanern. Die Aenderungen der freien Fettsäuren nach Glukose waren bei den Ainu geringer, während die Japaner einen ausgeprägten "rebound effect" aufwiesen.

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Resume On a appliqué un test de tolérance à la glucose à 10 Aïnous et à 20 Japonais d'autres races (tous étudiants). On n'a pas décelé de différence significative après administration de glucose ni dans la teneur en sucre du sang, ni dans le taux d'insuline immunoréactive, ni dans les hormones humaines de croissance contenues dans le plasma. Les coefficients d'acides gras libres (FFA), après un jeûne ont été plus bas chez les Aïnous que chez les Japonais et cela de façon significative. La modification des acides gras libres après administration de glucose a été moins marquée chez les Aïnous alors que les Japonais présentaient un net "effet de rebondissement".

     

Glucose tolerance in patients with cystic fibrosis: five year prospective study.

OBJECTIVES--To study prevalence and incidence of diabetes mellitus in patients with cystic fibrosis. DESIGN--Five year prospective study with annual oral glucose tolerance tests. SETTING--CF Center Copenhagen, Denmark. SUBJECTS--191 patients with cystic fibrosis aged above 2 years. MAIN OUTCOME MEASURES--Glucose tolerance, plasma glucose concentrations after fasting and after glucose loading, and haemoglobin A1c levels. RESULTS--Prevalence of diabetes increased from 11% (n = 21) to 24% (n = 46) during study, with annual age dependent incidence of 4-9%. Diabetes was diagnosed at median age of 21 (range 3-40). At diagnosis of diabetes, symptoms of hyperglycaemia were present in 33% of patients, fasting hyperglycaemia (> or = 7.8 mmol/l) was seen in 16%, and increased haemoglobin A1c levels (> 6.4%) were seen in 16%. Impaired glucose tolerance implied higher risk for development of diabetes than normal glucose tolerance (odds ratio 5.6). In 58% of cases with impaired glucose tolerance, however, glucose tolerance was normal at next annual test. Normal glucose tolerance was found in only 37% of patients at all five tests. Within this group of patients, median plasma glucose concentrations after fasting and after glucose loading and haemoglobin A1c levels increased by 6-8% during study. CONCLUSIONS--Prevalence and incidence of diabetes in cystic fibrosis patients was high and increased with age. Since hyperglycaemic symptoms, fasting hyperglycaemia, and increased levels of glycated haemoglobin did not reliably identify diabetes mellitus, we recommend annual oral glucose tolerance tests in all cystic fibrosis patients aged over 10 years.     

Glucose tolerance disorders in individuals chronically exposed to carbon disulfide (CS2)

An incidence of glucose tolerance disorders was investigated in the group of 47 employees of the viscose fibres of the mean duration of exposition exceeding 20 years. Control group included 31 employees uniform in the age and body weight. Carbohydrate metabolism was tested with the oral load with 100 g of glucose and intravenous glucose administration according to Conrad. Glucose tolerance disorders were noted in 11 employees (23.4%) chronically exposed to CS2 in the concentrations slightly exceeding acceptable levels whereas glucose intolerance was noted in 2 individuals (6.5%) of the control group. The difference was statistically significant. No difference in the glucose absorbability index was noted. Exposition time to the studied CS2 concentrations did not affect the incidence of the glucose tolerance disorders.     

Calcitonin activity assessed by calcium tolerance test in patients with thyroid disorders.

The calcium tolerance test was performed in 34 healthy subjects and in 103 patients with simple goitre, thyrotoxicosis, hypothyroidism, subacute thyroiditis, medullary carcinoma and in patients after subtotal or total thyroidectomy and after radioiodine therapy. Calcium lowering activity which reflects mainly the activity of clacitonin, was significantly impaired in thyrotoxic and totally thyroidectomized patients. An abnormal calcium tolerance test in a patient with medullary carcinoma corresponded with large amounts of released calcitonin.     

Net survival in recurrence-free colon cancer patients

PurposeConditional net survival in recurrence-free patients (CNS-RF) provides relevant clinical information and has never been assessed yet in a non-selected colon cancer population. We aimed to estimate conditional 5-year net survival in recurrence-free patients with colon cancer in the population-based Digestive Cancer Registry of Burgundy (France).MethodsCNS-RF was estimated in the 3736 patients resected for cure for primary colon cancer between 1976 and 2006, using a flexible parametric model of net survival for every additional year survived at diagnosis and from 1 to 5 years thereafter.ResultsThe net probability of surviving 5 more years increased from 72% at diagnosis to 92% for recurrence-free patients who survived 5 years after diagnosis. CNS-RF was over 90% 3 years after diagnosis in patients aged 75 and below. CNS-RF was over 95% in patients diagnosed after 2000 who were recurrence-free 3, 4 or 5 years after diagnosis. CNS-RF was similar between patients with stage I and II disease from 2 years after diagnosis and patients with stage III disease from 5 years after diagnosis. The initial differences in net survival related to gross features, clinical presentation, number of harvested nodes in stage II, and number of involved nodes in stage III disappeared after 2 years.ConclusionsCNS-RF is a relevant measure of prognosis in patients who have already achieved a period of remission. Providing an updated estimation of prognosis in the years following diagnosis may improve the survivors’ quality of life and access to credit or insurance.     

Glucose tolerance and insulinemia in patients with hepatic cirrhosis and portal hypertension treated by portacaval anastomosis]

Development of diabetes mellitus is a common complication of side to side porta-caval anastomosis (PCA). Five patients with liver cirrhosis and portal hypertension have been studied with intravehous (IVGTT, 0,5 g/Kg B.W.) and oral (OGTT, 1 g/Kg B.W.) glucose tolerance tests before and three weeks after PCA. Fasting plasma glucose was 84 +/- 7 before and 87 +/- 3 mg/dl after PCA. Fasting IRI increased from 17 +/- 3 to 31 +/- 6 microU/ml. The pattern of plasma glucose and IRI response to IVGTT did not change after PCA. Plasma glucose resonse to OGTT after PCA showed only an earlier rise at 60 instead of 90 minutes, whereas IRI resonse (area under the insulin curve) was significantly enhanced (from 12.4 to 19.8 U/l, p < 0.05). These data suggest a role of gut polipeptides in determining hyperinsulinemia and insulin resistence in PCA patients.     

Cytoreductive surgery with intraperitoneal chemotherapy in patients with colon cancer and peritoneal carcinomatosis]

The efficacy of cytoreductive approach for colon cancer with carcinomatosis was assessed. 34 patients (the main group) underwent colon resections, peritonectomy, omentectomy and intraperitoneal chemotherapy (mitomycin and 5-fluorouracil). 22 patients (control group) underwent palliative colon resections only. The spread of peritoneal dissemination was assessed in all patients, basing on Peritoneal Cancer Index (PCI). It was found, that the rate of postoperative morbidity is higher in the main group, but it was not accompanied by enhanced postoperative mortality. It was also detected, that cytoreductive approach permits to prolong the survival (17.0 +/- 3.5 months in main group vs. 7.5 +/- 2.1 months in controls). The main prognostic factor in these patients was the PCI. The most favorable prognosis is identified if PCI < 5 (few discrete implants are present); the survival in this group was 23.0 +/- 4.5 months and disease-free interval was 14.0 +/- 2.5 months. When PCI was higher then 5, the survival was 14.5 +/- 2.5 months and disease-free interval was 7.0 +/- 1.3 months.     

Glucose tolerance tests during gestation in the unanesthetized rat.

To establish the temporal stages at which changes in insulin/glucose interactions may appear during gestation in the rat, unanesthetized animals were subjected to oral glucose tolerance tests (2 g glucose/kg) at days 15 and 21 of gestation and were compared to virgin female controls. On day 15 glucose tolerance is enhanced in the pregnant rat whereas plasma insulin levels are like those in control animals. On day 21 glucose tolerance does not differ between the two groups although insulin is higher in the pregnant animals. Results show 2 differentiated stages of insulin/glucose relationships throughout gestation in the rat with enhanced insulin sensitivity on day 15 and enhanced insulin resistance during late gestation. It is suggested that these changes contribute to the anabolic tendencies of the mother during mid gestation and her catabolic condition during late gestation.