[Investigations of Anorectal Function]. / Anorektale Funktionsdiagnostik.

Investigations of Anorectal Function Abstract. Investigations of anorectal function allows measurement of anal sphincter pressure, evaluation of rectal sensitivity and verification of rectoanal reflexes, which are essential elements in the assessment of bowel emptying. It is combined with a balloon expulsion test to ensure that the manometric findings are consistent with anorectal function. These tests are used in the diagnostic work-up of chronic defecation disorders, constipation and faecal incontinence, but can also provide clarification in the pre- and post-operative setting, for functional anorectal pain and other disorders of pelvic floor function. Most patients referred for investigation of these symptoms require a comprehensive assessment of anorectal structure and function. Because of the high variability of normal values and complexity of anorectal function, no single examination provides all the information needed to make a symptom-explaining, conclusive diagnosis and influence treatment decisions. Anorectal manometry is useful to assess the extent of impairment of anorectal function and to differentiate between organic and functional disorders (including pelvic floor dyssynergia). A preceding detailed anamnesis as well as endoscopic (procto / rectoscopy) and imaging procedures (anorectal endosonography, dynamic MR defecography) complete the diagnostic investigation instead.

Predicting glycogen concentration in the foot muscle of abalone using near infrared reflectance spectroscopy (NIRS).

Near infrared reflectance spectroscopy (NIRS) was used to predict glycogen concentrations in the foot muscle of cultured abalone. NIR spectra of live, shucked and freeze-dried abalones were modelled against chemically measured glycogen data (range: 0.77-40.9% of dry weight (DW)) using partial least squares (PLS) regression. The calibration models were then used to predict glycogen concentrations of test abalone samples and model robustness was assessed from coefficient of determination of the validation (R2(val)) and standard error of prediction (SEP) values. The model for freeze-dried abalone gave the best prediction (R2(val) 0.97, SEP=1.71), making it suitable for quantifying glycogen. Models for live and shucked abalones had R2(val) of 0.86 and 0.90, and SEP of 3.46 and 3.07 respectively, making them suitable for producing estimations of glycogen concentration. As glycogen is a taste-active component associated with palatability in abalone, this study demonstrated the potential of NIRS as a rapid method to monitor the factors associated with abalone quality.

Comparison of the dose-response pharmacodynamic profiles of detemir and glargine in severely obese patients with type 2 diabetes: A single-blind, randomised cross-over trial.

BACKGROUND: Despite their widespread use in this population, data on the pharmacodynamic (PD) properties of the insulin analogs detemir and glargine in severely obese patients with type 2 diabetes are lacking. METHODS: The primary objective of the study was to compare the PD properties of two different doses of the basal insulin analogs detemir and glargine in patients with type 2 diabetes and a BMI > 35 kg/m2. PD data were derived from euglycemic clamp studies over 30 hours and each subject was studied for four times after the subcutaneous injection of a lower (0.8 U/kg body weight) and higher (1.6 U/kg body weight) dose of both detemir and glargine using a single-blind, randomised cross-over design. RESULTS: Six male and four female patients with type 2 diabetes and a mean BMI of 43.2±5.1 kg/m2 (mean age 55.7±2 years, mean HbA1c 7.2±0.3%) completed the study. The total GIRAUC0-30 (mean difference 1224 mg/kg, 95%CI 810-1637, p = 0.00001), GIRAUC0-24 (mean difference 1040 mg/kg, 95%CI 657-1423; p = 0.00001), GIRAUC24-30 (mean difference 181 mg/kg, 95%CI 64-298; p = 0.004), GIRmax (mean difference 0.93 mg/kg/min, 95%CI 0.22-1.64, p = 0.01) and time to GIRmax (+1.9 hours, 95%CI 0.5-3.2; p = 0.009) were higher after the higher doses of both insulins, without significant differences between detemir and glargine. However, during the last 6 hours of the clamp the GIRAUC24-30 was significantly increased with glargine (mean difference 122 mg/kg, 95%CI 6-237, p = 0.043), reflecting a more pronounced late glucose lowering effect. CONCLUSIONS: A clear dose-response relationship can be demonstrated for both insulin analogs, even at very high doses in severely obese patients with type 2 diabetes. Compared to detemir, glargine has a more pronounced late glucose lowering effect 24-30 h after its injection. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN57547229.