Crohn's disease. A long-term study of the clinical course in 186 patients

A series of 186 patients with Crohn's disease treated during the period 1956--1968 was followed up. During the follow-up period about 95% of the patients had undergone resection or by-pass surgery. The patients operated on between 1956--1968 were followed up with reference to recurrence rate. The mean observation time was 10.5 years. The recurrence rate after resection was 51%. "Radical" resection gave 29% recurrences. "Non-radical" resection gave 84% recurrences. Patients who had undergone a primary "radical" resection needed fewer re-operations, had fewer recurrences and a better "quality of life" than patients with a "non-radical" first operation. The total mortality in operations or due to complications of Crohn's disease in the series was 5.4%. The mortality in connection with operations was 3.4%. The general health of the patients examined in 1975 (165 patients) was estimated; 87% were in very good general health, 9.1% had moderate subjective symptoms, and 3.6% had pronounced subjective symptoms.

[Glisoxepide treatment in maturity-onset diabetics (author's transl)]

Patterns of blood glucose, serum insulin and non-esterified fatty acids (NEFA) were measured over a period of eight-and-a-half hours in eleven maturity-onset diabetics receiving 8 mg glisoxepide in the morning and 4 mg in the evening (while on a standard diet). The effects of administering the tablets in the morning with breakfast were compared to those on administering the drug half-an-hour (five patients) or one hour (six patients) before breakfast. Although there was a slightly earlier increase in serum insulin when tablets were taken half-an-hour or an hour before breakfast, different times of administration did not significantly affect the blood glucose or NEFA pattern. In particular, the extreme rise in blood glucose levels after the first breakfast could not be avoided.

HL-A frequencies in Crohn's disease and ulcerative colitis

Sixty-two patients with Crohn's disease and 51 with ulcerative colitis were HL-A typed. Phenotype frequencies were calculated and compared with those of a control group of 335 individuals. A higher frequency of HL-A17 was found among the Crohn's disease patient but this was not significant. However, HL-A17 has been included in two studies on Crohn's disease and the combined relative risk is 3.24 which significantly deviates from 1 unity. No statistically significant differences in the HL-A antigen distribution were found among the patients with ulcerative colitis.

Postoperative treatment with corticosteroids and salazosulphapyridine (Salazopyrin) after radical resection for Crohn's disease

In a prospective multicentre study, 97 patients with Crohn's disease and operated on by a radical excision of the Crohn-involved bowel were randomly divided into two groups, one treated 33 weeks postoperatively by corticosteroids and Salazopyrin and the other without any medical treatment postoperatively. The patients in the two groups were followed up during three years after the operation and an X-ray of the bowel was yearly performed. Thirteen patients were excluded for different reasons, which means that 84 patients were left for the study. There was no statistically significant difference in the number of recurrences after one, two, or three years of observation time in the two groups of patients. There was a statistically significantly longer time between diagnosis and operation in the group of patients with recurrences than in patients with no recurrences. This might mean that patients with Crohn's disease undergoing an early operation have a better chance of escaping recurrences.

[The purity of commercial insulin preparations]

Insulin preparations available in Germany were tested by polyacrylamide-disc electrophoresis. A large proportion of preparations contained proteins additional to insulin. Insulin purified chromatographically was cleaner than that by crystallization. Insulin purified by ion-exchange chromatography had the highest degree of purity: in addition to the insulin band only deamidation products of insulin were demonstrated. Deamidation occurs both in neutral and acid solvents. These observations indicate that commercial full purification of insulin is possible but not always practised.

The incidence of Crohn's disease in central Sweden

In an earlier epidemiological study covering a 12-year period from 1956-67, a gradual increase in the number of patients with Crohn's disease was found. A study of the subsequent 6 years, from 1968-73, is now presented. The mean incidence of the disease for this period is 5.0, compared with 3.1 for the preceding 6 years, 1962-67. As in the earlier 12-year series, the increasing incidence can be attributed largely to an increase in the 15-29 year age group. During the period 1956-67, the disease occurred almost as frequently in men as in women. In the 6-year period now presented, there is a predominance of women, especially over the age of 35.

Propantheline bromide in massive upper gastrointestinal haemorrhage

The effectiveness of the anticholinergic, propantheline bromide, administered parenterally in patients with upper gastro-intestinal bleeding has been investigated in a double-blind study. The basic material consisted of 99 patients. No differences were found between the group receiving propantheline bromide and the group receiving placebo in regard to clinical factors such as duration of intensive care, total hospital stay and surgical frequency. However, 21 patients under 50 years of age showed a significantly lower blood transfusion requirement with the use of propantheline bromide.

Effect of intravenous infusion of propantheline bromide on gastric secretion

The effect of 2 hours' intravenous infusion (7.5 mg/h) of propantheline bromide (Ercotina, Erco Läkemedel AB) on basal or pentagastrin-stimulated gastric secretion was studied in 7 healthy subjects and in 11 patients with acute duodenal ulcer. A moderate to marked decrease in acid secretion rate and acid output was found both in subjects and patients during the infusion period. The acidity decreased in most of the subjects but did not change much in the patients. Two other dose rates (3.75 and 15 mg/h) were studied in a few subjects and patients. The lowest dose rate gave as good an inhibition of the gastric secretion as the higher ones. No troublesome side effects were noticed. It was concluded that a dose rate of around 5-10 mg/h may be suitable for prolonged i.v. infusion, for example as trial therapy in patients with upper gastro-intestinal bleeding.