There is significant interobserver variation in the histological diagnosis of colonic IBD. This may have a profound effect on clinical patient care and, especially, on the choice of operation. More accurate diagnostic criteria are needed to facilitate patient care and to optimize treatment outcome.

Computerized testing of 20 élite male athletes was performed to determine the effect of 7 mg kg-1 caffeine on strength and power of the knee extensors and flexors. Subjects received counterbalanced administrations of either caffeine or a placebo on two separate occasions. Peak torque (T) was measured for knee extension (ET) and flexion (FT) at angular velocities of 30 degrees, 150 degrees and 300 degrees s-1. Additionally, performance for the first 125 ms (TAE) and power (W) were recorded during 300 degrees s-1. Testing sessions were held 1 week apart, at which time the placebo/caffeine administration was reversed. A 2 x 2 repeated measures analysis of variance supplemented with a Neuman-Keuls post hoc test showed the following--significant caffeine-related increases (P < 0.05) for ET at 30 degrees s-1, ET at 300 degrees s-1, and ETAE, and EW at 300 degrees s-1. Dependent t-tests performed for pre- to post-test means showed significant changes for the caffeine group in ET at 30 degrees s-1, FT at 30 degrees s-1, FT at 150 degrees s-1, ET at 300 degrees s-1, FT at 300 degrees s-1, E and FTAE, and EW at 300 degrees s-1. No significant effects were found for the placebo trial in any variable. It was concluded that caffeine can favourably affect some strength parameters in highly resistance-trained males. However, differences in subject fibre type, motivation and caffeine sensitivity need to be elucidated.

Ligation excision haemorrhoidectomy can be performed successfully as a day-case procedure.

Background/Aims: Many tumor markers have been utilized in the follow-up care of colorectal cancer patients. No marker, however, has proven reliably accurate in detecting recurrent disease. Methods: The strengths and weaknesses of currently available tumor markers are reviewed, with attention to related cost and efficacy. Results: Tumor antigens, enzymes, and genetic markers have been used as tumor markers. CEA and CA 19.9 are the most widely utilized; however, genetic markers are the most promising for the future. Conclusions: Currently available markers have significant limitations. Development of genetic markers may greatly enhance our ability to predict prognosis and the need for adjuvant therapy. Marker-guided therapy may play an increasing role in this disease.

This pilot study provides evidence that transcutaneous tibial nerve stimulation with a new ambulatory device is safe and acceptable for the management of fecal incontinence. Additional study is warranted to investigate clinical effectiveness.