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OBJECTIVE: Acute lower gastrointestinal bleeding is a rare complication of Crohn's disease, which represents a diagnostic and therapeutic challenge. The aim of this study was to define epidemiological characteristics and therapeutic options of hemorrhagic forms of Crohn's disease. METHODS: Thirty-four cases of hemorrhagic forms of Crohn's disease were studied retrospectively. Acute lower gastrointestinal hemorrhage was defined as acute rectal bleeding originating in diseased bowel and requiring a transfusion of at least 2 units of red blood cells within 24 h. Upper gastrointestinal tract hemorrhage or anal lesions and postoperative bleeding were excluded. RESULTS: Mean age at time of hemorrhage was 34.2 +/- 14 yr. Mean duration of disease before the hemorrhage was 5.6 +/- 6 yr. The hemorrhage occurred during a flare up of the disease in 35% of cases. The hemorrhage revealed Crohn's disease in 23.5% of cases. The hemorrhage was more frequent in colonic disease (85%) than in isolated small bowel disease (15%) (p < 0.0001). The origin of bleeding was identified in 65% of cases, by colonoscopy (60%), by angiography (3 patients), or at surgery (1 patient). The bleeding lesion was an ulcer in 95% of cases, most often in the left colon. The treatment was surgical in 20.5% (colectomy in 36%), endoscopical (7 patients, including 5 successes), or medical. Hemorrhage recurred in 12 patients (35%) within a mean time of 3 yr (4 days-8 yr), requiring surgery in 3 cases. No death was observed. CONCLUSIONS: This study performed in a series characterized by a nonsurgical recruitment, the largest to date, shows that hemorrhagic forms of Crohn's disease may reveal disease in 23.5%, occurs in quiescent Crohn's disease in two-thirds of cases. Given the potential efficacy of endoscopical or medical treatment, as well as the absence of mortality, a conservative approach may be suggested as first-line therapy in the majority of patients. (Am J Gastroenterol 1999; 94:2177-2181. (C) 1999 by Am. Coll. of Gastroenterology).

Plusieurs etudes de population, de cas controles, d'etudes de famille, confirment l'association entre infection aHelicobacter pylori (H. pylori) et tumeurs gastriques malignes, carcinomes et maltomes. De facon evidente l'infection aH. pylori precede le developpement des lesions malignes et le micro-organisme a ete mis en evidence a des stades precancereux: il pourrait constituer le «chainon manquant» de la premiere etape du modele de Correa. Selon les etudesin vitro, H. pylori serait implique dans le mecanisme de la carcinogenese, du moins en partie, par induction de l'inflammation chronique et une augmentation de la proliferation cellulaire au niveau de la muqueuse gastrique. La regression du lymphome a cellule B de faible degre de malignite apres eradication deH. pylori prouve le role predominant de cette infection dans cette maladie. Neanmoins, un certain nombre de facteurs jouent un role cle, en particulier dans le carcinome: la virulence des souches deH. pylori, l'action locale de l'ammonium, les facteurs environnementaux et genetiques qui conditionnent la reponse de l'hote. La prevention du carcinome gastrique a travers l'eradication de l'infection aH. pylori est insupportable du point de vue economique mais certains groupes a hout risque ont ete definis et justifient un traitement d'eradication avec un suivi soigneux.

The Area method, developed recently for solving multicomponent phase equilibrium problems, has been extended to pure fluids. The method is based on maximizing a single objective function in the Helmholtz-volume surface along any given isotherm, which reduces the number of independent variables to only two: the saturated liquid and vapour volumes. Two techniques are employed to find the maximum of the objective function, the integral and iterative. The integral always finds the thermodynamically stable solution without any prior assumptions about the values of the molar volumes. This factor distinguishes the integral from the iterative technique and also from methods based on the Maxwell equal-area principle. The method has been applied to a group of high accuracy non-cubic equations of state and some of the thermodynamic inconsistencies which occur inside the two-phase region are explored. A new inequality constraint which eliminates these inconsistencies during the development of new equations of state is proposed, and initial results with fitting a preliminary Helmholtz equation of state for benzene are encouraging.

R. Fernhndez-Prini (Argentina; 1984-97); C. Airoldi (Brazil; 1991-97); H.-K. Yan (China; 1996-97); T. Boublik (Czech Republic; 1996-97); F. RouquCrol (France; 1987-97); E. Berecz (Hungary; 1985-97); F. Gronvold (Norway; 1985-97); H. Pak (Republic of Korea; 199697); J. L. Laynez (Spain; 1994-97); I. Wadso (Sweden; 1994-97). Membership of the Subcommittee on Thermodynamic Data

The objectives and activities of the International Energy Agency-Annex 18 are summarized. One of the goals of the Annex was to determine the formulations that best represent the thermodynamic properties of HFC-134a and HCFC-123. The formulations selected were those which accurately represented the experimental data and simultaneously exhibited thermodynamic consistency. Methods of comparison include analysis of the experimental data, statistical comparisons of values calculated from the property formulations to experimental values, and graphical analyses of the thermodynamic surface. The analytical methods used are summarized in this paper. The equations of state reviewed in these comparisons represented the most accurate formulations available in December 1992. Four equations of state were reviewed for HFC-I34a and three equations of state were considered for HCFC-123. These equations represented the work of independent researchers in Germany, Japan, and the United States. The formulations selected as international standards are presented.

L’examen endoscopique du colon doit etre realise sous hypotonie pour assurer le meilleur confort au malade et une visualisation optimale a l’endoscopiste. Les effets systemiques indesirables frequemment observes lors de l’administration d’un spasmolytique intra-veineux, peuvent etre evites lorsqu’il est fait usage d’un agent local. Dans cette optique, l’instillation locale perendoscopique du bromure d’Otilonium peut constituer une alternative interessante. Son efficacite et son inocuite sont demontrees dans cette etude randomisee double-aveugle versus placebo.

A two-fluid corresponding-states model for predicting the thermodynamic properties of mixtures has been developed, which uses accurate equations of state for the reference substances of the components. A new mixing parameter has been introduced, which takes account of the differences in molecular sizes in binary fluid mixtures. The three mixing parameters for methane-ethane and methane-propane have been optimized using different types of experimental data. Comparisons of predictions with data are given for experimental densities and speed of sound.

An equation of state, in terms of a dimensionless Gibbs energy, has been developed to correlate the thermodynamic properties of benzene in the gas phase. This consists of an equation for the ideal gas properties and a 13-term polynomial in reduced pressure and reciprocal reduced temperature (ITS-90) which was fitted to PϱT, enthalpy of evaporation, enthalpy differences, isobaric heat capacity and isothermal Joule-Thomson coefficient data. The equation has been compared with an earlier non-analytic equation of state developed by Goodwin (1988) and with selected experimental data. The range of the equation is from 298 K to 700 K for densities up to 0.0023 mol cm−3, but excluding a region close to the critical point.

A new vapour pressure equation for methanol is presented which covers the fall range from the triple point to the critical point (175–512.6 K). Multiproperty fitting was used which included liquid heat capacity data near the triple point as well as vapour pressure data from around 10 kPa upwards. During the development, two forms of equation were compared; both were fitted to the same set of weighted data using the same selection algorithm to determine the number and value of the coefficients. The final equation required only 4 coefficients to represent the best data to within the experimental accuracy.

Le diagnostic differentiel entre processus infectieux et inflammatoire est souvent difficile a l’apparition d’une diarrhee. Outre le role etiopathogenique possible de certains agents infectieux dans les maladies inflammatoires chroniques du tube digestif, une surinfection peut conduire a des erreurs diagnostiques au cours d’une poussee inflammatoire. La clinique, la biologie et les techniques d’imagerie sont extremement utiles dans le diagnostic differentiel. Le contenu endoluminal et les lesions limitees a la muqueuse seront precises par les methodes de laboratoire, l’endoscopie et son support histologique et/ou l’etude radiologique barytee. En cas de suspicion de fistule ou d’abces, l’echographie represente la meilleure technique d’imagerie de premiere intention, bien que la tomodensitometrie reste la methode la plus sensible (95 %). Les signes cliniques autant que la biologie, la radiologie et la medecine nucleaire seront de grande utilite en cas de complication systemique, qu’elle soit d’origine infectieuse ou inflammatoire.

An interim analytic equation of state for Sulfurhexafluoride is given in the form of a reduced Helmholtz energy function. It represents the thermodynamic properties over the temperature range 222.38 to 525 K for pressures up to 55 MPa. The data selected for determining the linear coefficients of the equation are given, which includes some values predicted using the principle of corresponding states. The method used for the multiproperty fitting is given and, in particular, the functions used for fitting isobaric heat capacities as primary data. Comparisons with values predicted by the equation of state are given for saturation properties, second virial coefficients, densities, and isobaric and isochoric heat capacities. The accuracy of the representation of the equation of state is discussed and, also, the problems arising from inconsistencies between the different data sets. The interim status of this equation of state is due to these inconsistencies.

Acute lower gastrointestinal bleeding is a rare complication of Crohn's disease, which represents a diagnostic and therapeutic challenge. The aim of this study was to define epidemiological characteristics and therapeutic options of hemorrhagic forms of Crohn's disease.Thirty-four cases of hemorrhagic forms of Crohn's disease were studied retrospectively. Acute lower gastrointestinal hemorrhage was defined as acute rectal bleeding originating in diseased bowel and requiring a transfusion of at least 2 units of red blood cells within 24 h. Upper gastrointestinal tract hemorrhage or anal lesions and postoperative bleeding were excluded.Mean age at time of hemorrhage was 34.2 +/- 14 yr. Mean duration of disease before the hemorrhage was 5.6 +/- 6 yr. The hemorrhage occurred during a flare up of the disease in 35% of cases. The hemorrhage revealed Crohn's disease in 23.5% of cases. The hemorrhage was more frequent in colonic disease (85%) than in isolated small bowel disease (15%) (p0.0001). The origin of bleeding was identified in 65% of cases, by colonoscopy (60%), by angiography (3 patients), or at surgery (1 patient). The bleeding lesion was an ulcer in 95% of cases, most often in the left colon. The treatment was surgical in 20.5% (colectomy in 36%), endoscopical (7 patients, including 5 successes), or medical. Hemorrhage recurred in 12 patients (35%) within a mean time of 3 yr (4 days-8 yr), requiring surgery in 3 cases. No death was observed.This study performed in a series characterized by a nonsurgical recruitment, the largest to date, shows that hemorrhagic forms of Crohn's disease may reveal disease in 23.5%, occurs in quiescent Crohn's disease in two-thirds of cases. Given the potential efficacy of endoscopical or medical treatment, as well as the absence of mortality, a conservative approach may be suggested as first-line therapy in the majority of patients.

A prospective epidemiological study on inflammatory bowel diseases (IBD) patients was performed in Brussels' area from April 1st, 1992 to 30th March, 1993. The mean annual incidence for Crohn's diseases (CD) was 4.1/10(5) inhabitants/year among native Belgian people and 6.4/10(5) inhabitants/year for subjects issued from Moroccan families. For ulcerative colitis, the incidence was 3.7/10(5) inhabitants/year for native Belgian people and only 1.2/10(5) inhabitants/year for Moroccan subjects. The male/female sex ratio was 0.4 for CD and 1.9 for UC. At the time of diagnosis, the mean age was 34 years for CD and 38 years for UC. For both diseases, the age peak was between 20 and 29 years. Cigarette smoking was significantly higher in CD (48%) than in UC patients (12%). Family history was about 10% for both diseases.

In Ulcerative Colitis (UC), the rectum is always involved, but the disease may be extended to the left colon (distal colitis) or the entire organ (pancolitis). Secondary perineal lesions (erythema, fissures, hemorrhoids) are limited to local irritation related to the diarrheic syndrome; specific ano-rectal lesions are related to the mucosal inflammatory process, but others pathological situations may be observed and are due to the postoperative status (stenotic ileo-anal anastomosis, pouch inflammation). Ano-rectal localisation of Crohn's Disease (CD), sometimes underestimated, is clinically more complex (abscess, fistula, ulcer, etc) and requires precise classical (endoscopy, conventional radiology) or more modern (echo-endoscopy, nuclear magnetic resonance) investigations. The treatment is more difficult (medical conservative, "a minima" or more extended surgery). Differential diagnosis, symptoms, methods of investigation and appropriated therapeutical choices are successively developed.

Enteroliths as a cause of intermittent small bowel obstruction is a uncommon clinical entity. We present the case of a patient with Crohn's disease in whom a false primary enterolith--an apricot seed--was responsible for numerous episodes of subobstruction. The association of Crohn's disease with different types of enterolith is discussed.

In a comparative, histologically controlled study, no significant difference was found in the accuracy of conventional fiberendoscopy and videoendoscopy in the diagnosis of upper gastrointestinal tract lesions. Both techniques permitted accurate description of focal and/or ulcerative lesions, but videoendoscopy did not provide better sensitivity than fiberendoscopy in the diagnosis of superficial, non-ulcerative, inflammatory changes. The same results were obtained on checking the reproducibility of the macroscopic diagnosis by a delayed review of recorded videotapes.

In order to explore the relationship between duodenal diverticula and biliary stone disease, we reviewed 2231 endoscopic retrograde cholangio-pancreatography procedures. We found at least one juxtapapillary diverticulum per 239 patients (10.8%). The occurrence of duodenal diverticula increases with age. Patients with duodenal diverticula were older, had more gallbladder stones, more common bile duct stones, had undergone cholecystectomy more frequently, and experienced more frequently common bile duct stone recurrence after cholecystectomy. We thus confirm an association between the presence of diverticula of the second part of the duodenum, and biliary stone pathology, including gallbladder stones, common bile duct stones, and recurrent stones after cholecystectomy. We discuss the aetiopathogeny of this affection.

In a retrospective study of 702 consecutive colonoscopies, the authors observed 185 cases of diverticulosis or moderate diverticulitis. They studied the colonic diseases associated with the presence of diverticula (78 cases) and discussed the role of endoscope in the approach of colonic diverticulosis.

412 sphincterotomies endoscopiques (S.E.) consecutives, realisees pour lithiase de la voie biliaire principale ont ete revues afin d’evaluer les resultats et les complications de cette technique dans 3 situations cliniques differentes. La pancreatite aigue biliaire (P.A. n = 35), 1’angiocholite (A.C. n = 121), deux circonstances ou la S.E. a ete realisee en urgence, et la sphincterotomie sur rendez-vous (G.N.U. n = 256) y compris les patients icteriques sans signe d’angiocholite. La S.E. a ete techniquement reussie respectivement dans 97 %, 94 % et 96 % des groupes P.A., A.C. et G.N.U. et l’etat clinique des patients s’est ameliore dans 94 %, 89 % et 94 %, soit par drainage efficace ou elimination complete des calculs choledociens.

Este es un estudio prospectivo iniciado en 1981 con el fin de evaluar la eficacia de la electrocoagulacion multipolar endoscopica en una poblacion seleccionada afecta de hemorragias graves del tracto digestivo superior. Se incluyeron en este estudio 137 pacientes (13,9% de las 985 hemorragias agudas altas investigadas por nuestro grupo) de acuerdo con criterios estrictos de inclusion (visualizacion de un jet arterial en la endoscopio de urgencia, y/o recidiva hemorragica durante la hospitalizacion, y/o hematocrito al ingreso inferior al 25%, y/o PTT inferior a 50% y/o shock de grado 3–4). En esta poblacion encontramos los factores de riesgo clasicos: insuficiencia renal y trastornos de la coagulacion en 15% de los casos, insuficiencia respiratoria en 24% y aparicion de la hemorragia en el curso de la estancia hospitalaria en 28%. El tratamiento con el unico empleo de BICAP permitio una hemostasia definitiva en 94% de los 32 casos debidos a ulcera aguda, y 77% de los 82 pacientes con ulceras cronicas. Las tasas de exito son significativamente inferiores en pacientes con insuficiencia respiratoria o en los portadores de ulcus bulbar cronico (sobretodo los localizados en la cara posterior), pero no depende ni del estado hemodinamico ni de la presencia de jet arterial o de vaso visible. No se observaron complicaciones debidas a la tecnica y dada la manejabilidad de la misma, de su costo poco elevado y de su eficacia, la recomendamos en el tratamiento de urgencia de las hemorragias del tracto digestivo superior de origen ulceroso.

From a retrospective material of 418 consecutive endoscopic papillotomies, incidence, clinical course and possible causes of acute pancreatitis following endoscopic treatment are studied. The overall frequency of 2,4 %, varied from 1,8 % in gallstones diseases up to 9 % in other conditions. In ≪ one step ≫ papillotomies, acute pancreatitis occurs in 0,6 % of gallstones indications and in 5 % of other conditions. In case of difficult and/or special manipulations (pre-cutting, main pancreatic duct sphincterotomies) the incidence rises respectively to 6 and 16 % for gallstones group and other diseases. Treatments applied to prevent this complication are described. Prognosis seems to be good and no death was observed in this series. © 1986 Springer-Verlag.

A critical review of the very extensive literature on methanol reveals a lack of accurate PpT data in the gas phase. In order to utilise the available and accurate measurements of enthalpy, isobaric heat capacity and speed of sound, an equation of state has been developed for the gas phase in terms of a reduced Gibbs energy function. Comparisons are given of the experimental data with the equation of state and the problems caused by decomposition are discussed. The successful representation of the effects of association on the isobaric heat capacity is illustrated.

We retrospectively investigated digestive bleeding of obscure origin, selecting patients where at the first gastroscopy and sigmoidoscopy the definitive diagnosis was not made. We identified three clinical situations: [1] cataclysmatic upper digestive bleeding with major hemodynamic consequences; [2] upper digestive bleeding with presence of blood in the stomach without any identified focal lesion. Submucosal non erosive hemorrhagic gastritis, secondary to venous malformations or ischaemic lesions, is the most significant etiological finding. [3] recurrent digestive bleeding without blood in the stomach may be of gastric, intestinal, or colonic origin. The diagnosis of gastric lesions necessitates repeated emergency gastroscopy with stimulation of the gastric mucosa. Laparotomy identifies half of the small intestinal lesions. Pancolonoscopy identifies angiodysplastic colonic lesions.

There are more than 1000 good experimental measurements of fluid fluorine, which cover the range from the triple point to 300 K for pressures up to 23 MPa. The development of an equation of state to fit these data is described. The form of equation used is that of a reduced Helmholtz energy function which includes an equation to represent the behavior of the ideal gas. The coefficients in the equation are determined by a least-squares method where the terms used are selected statistically from a given bank, thus reducing intercorrelation. Two banks of terms were chosen and various fits made using PρT data alone, and multiproperty fits with both banks. The serious consequence of using PρT data alone is demonstrated, and the difference in quality between the two banks is described. The problems of inconsistency between the single-phase and the saturated density data are discussed. New equations are given which represent the ideal-gas properties.

A search procedure to determine the form of accurate vapour pressure equations has been extended to equations of state. A method of using statistical tests to select terms to be included in an equation, whose form is not previously known, makes it possible to produce equations containing less terms than other proposed equations of comparable accuracy. The success of the method is demonstrated for propylene with a description of a 21-term equation of state which accurately reproduces experimental results over the whole range where measurements are available. A description of the method which includes the matrices required, the application of constraints, statistical tests and a flowchart of the search procedure is given. The algorithm is efficient in terms of computer time and storage space and tests of its numerical accuracy are discussed. The procedure can be used for any equation where linear least-squares methods are applicable.

The IUPAC Thermodynamic Tables Project Centre in London has at its disposal considerable expertise on the production and utilization of high-accuracy equations of state which represent the thermodynamic properties of substances. For some years they have been content to propagate this information by the traditional method of book production, but the increasing use of the computer in industry for process design has shown that an additional method was needed. The setting up of the IUPAC Transport Properties Project Centre, also at Imperial College, whose products would also be in demand by industry, afforded the occasion for a new look at the problem. The solution has been to set up the Imperial College Thermophysical Properties Data Centre, which embraces the two IUPAC Project Centres, and for it to establish a link with the existing Physical Properties Data Service of the Institution of Chemical Engineers, thus providing for the dissemination of the available information without involving the Centres in problems such as those of marketing and advertising. This paper outlines the activities of the Centres and discusses the problems in bringing their products to the attention of industry in suitable form.

L’incidence des signes d’hypertension portale (H.T.P.) a la laparoscopie et a l’œsogastroduodenoscopie (O.G.D.) a ete etudiee chez 269 patients cirrhotiques. Aucun signe endoscopique d’H.T.P. n’a ete observe chez 85 (31 %) malades. Une circulation collaterale intra-abdominale et des varices œsophagiennes (V.O.) etaient presentes chez respectivement 153 (57 %) et 145 (53 %) malades. Il existe une correlation hautement significative entre la presence d’une circulation collaterale intra-abdominale et la presence de V.O. (p < 0,0005). Cependant 12 % des cirrhotiques sans signe d’H.T.P. a la laparoscopie sont porteurs de V.O., hemorragiques dans 1/3 cas. De meme la correlation entre la presence d’ascite, et celle de V.O. est tout aussi significative (p < 0,0005). Cependant ni la presence d’ascite, ni celle d’une circulation collaterale intra-abdominale ne permettent de prejuger de la taille des V.O. Respectivement 44 et 31 % des cirrhotiques etaient porteurs de lesions associees du tractus digestif superieur selon qu’ils presentaient ou non des signes d’H.T.P. (laparoscopie et/ou O.G.D.). Il s’agissait principalement de lesions associees eroso-exulceratives superficielles qui sont significativement plus frequentes chez les patients presentant des signes d’H.T.P. (p < 0,025). La pression sinusoidale corrigee est significativement plus elevee chez les patients presentant une circulation collaterale intra-abdominale (p < 0,02) ou une ascite (p < 0,01). Bien que la laparoscopie apporte des renseignements complementaires utiles dans le bilan d’une H.T.P., l’O.G.D. reste un examen indispensable chez tout malade cirrhotique pour rechercher et preciser la taille des V.O. et depister toute lesion eventuellement associee.

The nuclear binding of H3 actinomycin, which is closely linked to the differentiation phenomenon, was studied in human normal gastric mucosa. Actinomycin binding decreases in cells which differentiate and becomes very low in fully differentiated cells. In the gastric pits, there is a decreasing gradient of labelling from the deeper stem cells to the well-differentiated superficial cells. This indicates that migration and renewal of the surface epithelium occurs following a 'pipe-line' system. All the undifferentiated stem cells are labelled. Where the parietal cells are concerned all degrees of labelling are observed at various levels with a decreasing proportion of labelling from the surface to the bottom of the gland. With mucous cells and chief cells in the upper part of the gland a great number of poorly labelled mucous neck cells is observed. In the middle and lower part of the gland there is a new growth of heavily labelled cells. This means that in the normal human stomach chief cells probably do not originate from mucous cells.

Afin d’ameliorer la recherche clinique en endoscopie digestive, un fichier sequentiel pour micro-ordinateur 48 K a ete cree en Basic. Chaque enregistrement contient les informations relatives aux antecedents, symptomes, lesions et examens complementaires. Ces informations sont entrees sous forme d’abreviations de 2 lettres, mnemotechniques, choisies dans un catalogue de 125 mots, eventuellement extensible. Un programme de lecture standard, qu’il convient de completer pour trier le fichier selon les criteres desires a egalement ete cree: ce systeme offre de larges possibilites d’etudes cliniques puisque le tri de 3 000 protocoles et l’edition des resultats sont acheves en 2 a 3 heures. Les micro-ordinateurs, en raison de leur prix modere et de l’accessibilite de leur langage autorisent une decentralisation des moyens informatiques parmi les differents groupes de recherche d’un hopital general et permettent la, creation de logiciels personnalises, adaptes aux besoins specifiques de chacun.

Properties of the ideal gas have been considered in detail and new equations for the ideal-gas heat capacity enthalpy, and entropy are given which are valid from 100 to 1000 K. Saturation-curve data have been reviewed and an equation for the vapor pressure is given which covers the whole range from the triple point to the critical point. A tentative equation for the saturated liquid density is also given. The necessity for new experimental measurements is discussed.

Les auteurs rapportent une etude de correlation entre la pression portale et la pression intra-variqueuse chez 30 patients cirrhotiques avec hypertension portale. Les mesures ont ete effectuees par ponction directe per-endoscopique des varices et au cours d’une angiographie sus-hepatique. Une correlation positive est observee entre la pression dans les varices et la pression sinusoidale corrigee, ð l’exception des patients etudies au decours d’une hemorragie digestive sur rupture de varices. Ils mettent egalement en evidence un gradient de pression au long des colonnes variqueuses. Ils discutent les resultats obtenus sur base de la selection des patients et de criteres non retenus dans leur serie pour tenter de definir la relation hypertension portale - risque hemorragique sur rupture de varice.

We randomly assigned 45 adult patients with Campylobacter pylori-confirmed antral gastritis to 8 days of treatment with 1 g amoxycillin suspension twice a day, or placebo, according to a double-blind study design. At the end of therapy, 91% of patients treated with amoxycillin demonstrated clearance of the organism from the antrum, compared with 16% in the placebo group (p less than 0.001). Active antral gastritis resolved in 68% of patients in the amoxycillin group versus only 9% in the placebo group (p less than 0.001). No significant difference was observed when looking at the evolution of chronic only gastritis. No significant improvement was observed in the assessment of clinical symptoms and endoscopic appearance. Reappearance of C. pylori and significant worsening of the histological score of active gastritis was observed after 2 wk in all patients. In a second study phase, 18 patients initially not cleared of their bacteria received amoxycillin single blind for 14 days. Clearance of bacteria associated with improvement or resolution of active gastritis was observed in 72% of the cases. In this subgroup, all patients investigated after 1 month were recolonized with C. pylori and, again, had histological active gastritis. We conclude that amoxycillin is effective in treating active antral gastritis associated with C. pylori, but not in preventing relapses, which occur in all cases within 1 month after therapy.

Triated actinomycin binding to DNA is closely linked to the degree of repression in chromatin. 3H-AM binding to DNA is the most pronounced in nuclei of cells committed into cycle. Inversely, in cells in the last steps of their differentiation or (and) in the resting state (non-dividing cells), 3H-AM binding for DNA is diminished down to a baseline since it is limited by the deoxynucleoproteins. Epithelial cells of stomach mucosa and duodenum demonstrate an increased cell uptake of tritiated actinomycin from the surface to the bottom of the pits. In severe gastritis and in intestinalysed metaplasia this was abolished: with a uniform enhancement of 3H-AM binding. These findings seem to indicate that these cells are derepressed.