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The effect of a long acting somatostatin analogue SMS 201-995 on stomal effluents in patients with severe short bowel syndrome was investigated in a double blind placebo controlled balance study. Six patients, five with Crohn's disease and one with radiation enteropathy were studied. Five patients had a jejunostomy and one an ileostomy. The patients had a normal food intake, but because of severe malabsorption had received home parenteral nutrition for several years. Faecal mass was reduced (p less than 0.005) and intestinal net sodium absorption was increased (p less than 0.005) by intravenous infusion of SMS 25 micrograms/h. Net absorption of potassium, calcium, magnesium phosphate, zinc, nitrogen and fat was not influenced. Subcutaneous injections of 50 micrograms SMS every 12 hours had a similar effect on net intestinal absorption of sodium and water. Four patients continued with a five to six months open follow up study when subcutaneous SMS in the same dose was administered by the patients at home. The effect on faecal sodium loss persisted, but in one patient faecal mass gradually increased and finally exceeded pretreatment values. SMS may decrease net absorption of water and sodium following reduced secretion of digestive juices rather than by increasing absorptive capacity. SMS may be useful as an antidiarrhoeal drug in patients with high output jejuno- or ileostomies, but in patients who need permanent parenteral nutrition the effect is too small to significantly alter management. [ABSTRACT FROM PUBLISHER]

Ten patients with familial hypercholesterolaemia were subjected to partial ileal by-pass surgery. Plasma cholesterol fell by 41 and 38% and low-density lipoprotein cholesterol by 51 and 46% after six and 18 months respectively. High-density and very low-density lipoprotein cholesterol and plasma triglycerides were unaffected. Alanine aminotransferase increased transiently in half of the patients. Diarrhoea and slight steatorrhoea troubled most of the patients for the duration of 18 months' period of observation. Other long-term side effects were slight but significant increase in the renal excretion of oxalic acid and reduction in the intestinal absorption of calcium. The study shows that this operation has metabolic side-effects that warrant continued medical care of these patients. [ABSTRACT FROM PUBLISHER]

The article presents a study which examined the clinical symptoms and the reaction on dietary treatment of 25 patients with lactase deficiency. Diarrhea, borborygmia, bloating and flatulence were found in most of the patients, and these were either isolated or in connection with other gastrointestinal disturbances. It suggests that the exclusion of milk from cooking and baking is necessary to abolish the symptoms.

The turnover of radioiodine-labelled homologous IgM was studied on 16 occasions in 15 patients with chronic liver disease (e.g. cryptogenetic cirrhosis, chronic hepatitis, alcoholic cirrhosis). Nine were untreated, 5 received prednisone, and 2 azathioprine at the time of investigation. Serum IgM varied from 0.55 to 4.02 g per 1. Four patients had normal IgM turnover. In 6 studies the serum IgM concentration was elevated owing to an increased synthesis rate; however, in 5 of them the fractional catabolic rate, too, was accelerated. In 3 studies a normal serum concentration was combined with a high normal syn-thesis rate and increased degradation rate. One patient who was reinvestigated after 11 months of azathioprine treatment showed a decrease in serum IgM due to lowered synthesis. The IgM turnover pattern was not correctable to the type of cirrhosis or to the treatment. [ABSTRACT FROM AUTHOR]

Reports a case of generalized Pneumonitis carinii infection. Health condition of the patient; Development of hypoproteinemic edema two months before death; Presence of small abscesses during autopsy.

The serum concentration of 19 serum proteins was determined by electrophoresis in 42 patients with Crohn's disease and 36 patients with ulcerative colitis. The results were compared with 78 healthy persons as matched controls. Distinctive, but similar, changes were present in the two diseases. An increased serum concentration of orosomucoid, α-antitrypsin, easily precipitable glycoprotein, α-antichymotrypsin, haptoglobin, and haemopexin was present. The serum concentration was decreased for prealbumin, albumin, α-HS glycoprotein, caeruloplasmin, α-macro-globulin, and transferrin. No significant difference between the two diseases existed as far as the serum protein pattern was concerned. Certain proteins, `the acute phase reactants' (orosomucoid, α-antitrypsin, α-antichymotrypsin, and haptoglobin) and the immunoglobulins were clinically useful, since their serum concentration reflected the grade of activity of the disease. A pronounced elevation of haptoglobin compared with that of the other `acute phase reactants' was present in patients with Crohn's disease complicated by suppurative fistulas or abscesses. Patients with active Crohn's disease who responded favourably to medical treatment had significantly higher immunoglobulin levels than patients not responding. A similar observation, though not statistically significant, was made in patients with ulcerative colitis. [ABSTRACT FROM PUBLISHER]