F. Avery Jones

An Assessment of Prednisone, Salazopyrin, and Topical Hydrocortisone Hemisuccinate Used as Out-patient Treatment for Ulcerative Colitis

Two consecutive trials of out-patient treatment for mild cases of active ulcerative colitis are described. In the first trial oral prednisone gave significantly better results than a placebo. In the second trial “salazopyrin” gave final results approaching those of prednisone, although over a longer time and with a higher incidence of unpleasant side-effects, but topical hydrocortisone gave disappointing results, probably because the technique of administration was not suitable for ordinary out-patient use.

Five cases of alpha chain disease

Five patients suffering from alpha chain disease are described. Clinically the patients presented with clubbing and the symptoms of malabsorption. There was a characteristic, predominantly plasma cell infiltrate of the wall of the small intestine. Spread of the plasmacytosis beyond the small intestine to bone marrow (1), peripheral blood (1), and probably the nasopharyngeal lymphoid tissue (1) is described. Fragments of the heavy chain of IgA (alpha chain) were found in serum (5), urine (3), jejunal fluid (2), and saliva (1). The jejunal biopsy of one patient was shown to synthesize free alpha chain in tissue culture. A new and simple immunoselection technique for the identification of free alpha chain is described. Marked clinical remissions were achieved in two patients treated with intermittent cytotoxic and steroid therapy, and in a third patient who received intermittent cytotoxic therapy and tetracycline.

Observations on idiopathic proctitis

This paper presents the natural history of idiopathic proctitis and concludes that this disease and idiopathic procto-colitis are two manifestations of one disease differing only in the extent of the colon involved.

A double blind controlled trial of prednisolone-21-phosphate suppositories in the treatment of idiopathic proctitis

A double blind trial of prednisolone suppositories in out-patients with idiopathic proctitis is reported. Significant improvement was noted. When prednisolone suppositories were given after the patient had already used suppositories of base alone for three weeks the active treatment was no longer so effective.

The gastric mucosa in radiologically negative acute gastrointestinal bleeding

EDITORIAL SYNOPSIS This is a studv of acid secretion and gastric mucosal histology in patients who had gastrointestinal bleeding. Patients with normal biopsies had high acid secretion and were believed to have acute or chronic duodenal ulcer; those with chronic gastritis and lower acid secretion suggested that the bleeding was due to acute gastric ulceration. The gastric mucosae of 22 additional patients with bleeding acute gastric ulcers removed surgically all showed chronic gastritis. In the main group of 30 patients studied there was no clear-cut histological difference between those patients taking aspirin and those who had not.