O. Hart Hansen

Cimetidine for Severe Gastroduodenal Haemorrhage: A Randomized Controlled Trial

During a period of 12 months, 88 patients with severe haemorrhage from gastric or duodenal ulcers or from erosive gastritis completed a double-blind trial of either cimetidine or placebo. Only patients needing immediate blood transfusion were admitted to the trial. It was found that in patients with severe bleeding from gastric or duodenal ulcers neither the severity of bleeding nor the incidence of emergency surgery was reduced by cimetidine. Furthermore, the treatment did not improve the mortality rate. It is concluded that patients with severe bleeding from gastric or duodenal ulcers will not benefit from immediate treatment with intravenous cimetidine.

The Double Pylorus

Two patients with double pylorus and two with prepyloric mucosal septum are reported. Double pylorus has previously been supposed to be congenital. Our findings suggest that it is an acquired lesion, caused by penetration of an ulcer through the pyloric ring.

Changes in gastric mucosal cell proliferation after antrectomy or vagotomy in man.

The rate of gastric epithelial cell proliferation was studied in peptic ulcer patients treated by partial gastrectomy or proximal gastric vagotomy (PGV). Endoscopic biopsies were incubated in vitro with 3H-thymidine and autoradiographs were prepared. The percentage of DNA-synthesizing cells (labeling index) in the progenitor cell region was estimated. Five patients were studied before and 3 months after antrectomy, whereas six other subjects were studied before and 2 weeks and 2 months after PGV. The results indicate that epithelial cell proliferation in fundic mucosa is accelerated after antrectomy in man and that PGV is followed by an increased rate of cell renewal in fundic and antral mucosa, whereas the kinetic parameters in duodenal mucosa remain unaffected by this operation. It is concluded that the proliferative changes after these operations are most likely caused by the development of gastritis. The study did not support the hypothesis that gastrin exerts a physiological trophic action on human gastric mucosa.

Influence of the Prostaglandin E1 Analogue Rioprostil on the Human Gastric Mucosa

Ten healthy volunteers received the prostaglandin E1 analogue Rioprostil 300 micrograms b.i.d. for 1 week. Endoscopically obtained biopsies were investigated with tritiated thymidine and autoradiography to determine the rate of cell proliferation and with a texture-analyzing system to measure the intracellular amount of mucus in the epithelial cells. Rioprostil did not alter the tritiated thymidine labeling index in the antral area but did significantly depress it in the fundic area. The mucus content was unchanged in the antrum but was significantly increased in the fundus. These observations indicate that Rioprostil given orally causes an enhanced cell maturation in the fundic area as well as an increased intracellular mucus content. Rioprostil seems to have no influence on the human antral area.

Wound Infection Prophylaxis with Topical Ampicillin (PentrexylR) in Gastric Surgery

Sequential analysis of a double-blind, fixed dose, controlled clinical trial comprising 64 patients treated by truncal vagotomy and pyloroplasty demonstrated a statistically significant reduction of postoperative wound infections by topical application of ampicillin in the wound.

Effect of Cimetidine on Gastric Mucosal Cell Proliferation in Man

Seven duodenal ulcer patients were treated for 3 months with cimetidine. Before and after treatment endoscopic biopsy specimens were taken for autoradiographic estimation of cell proliferation in the gastric mucosa in the antral and fundic part of the stomach and from the duodenum. In all three areas the estimated labeling index was increased during medication with cimetidine. The increase in epithelial cell renewal may participate in the ulcer healing effect of cimetidine.

The electro-encephalogram in patients with post-traumatic fat embolism

Electro-encephalograms (E.E.G.) have been studied in 7 patients with the fat embolism syndrome. Six patients recovered and 1 died. The E.E.G. abnormalities are diffuse and consist of delta and theta waves, sometimes with an absence of the alpha rhythm. There was nothing in the E.E.G. findings which could be considered specific for the fat embolism syndrome. The E.E.G.s primarily reflected the patients state of consciousness. At follow-up examination the E.E.G.s were normal in all the six surviving patients.

The effect of acetyl salicylic acid and indomethacin on cell proliferation kinetics in the human gastric mucosa

To determine the effect of acetyl salicylic acid and Indomethacin on the rate of cell proliferation in the human gastric stomach, 6 healthy volunteers received daily 3 g of acetyl salicylic acid or 150 mg of indomethacin for one week in a double-blind crossover trial. Cell proliferation was assessed by means of tritiated thymidine and autoradiography. The labelling index did not change, indicating that cell proliferation to compensate for the exfoliation caused by ASA and indomethacin does not increase.