Budesonide is a locally acting steroid with a high first-pass metabolism in the liver and low systemic effects. We performed the first pilot study comparing budesonide foam (1 mg/50 ml b.i.d.) with mesalazine enemas (4 g/60 ml o.d.). 33 patients from 3 centres were enrolled in this open randomized clinical trial. 16 patients got budesonide foam and 17 got mesalazine enemas. The drugs were administered for 4 weeks. Histological index (HI) and endoscopic index (EI) were assessed at day 1 and day 28, clinical activity index (CAI) at day 1, 14 and 28. For patients with left-sided colitis and proctosigmoiditis improvement was defined as decrease in CAI of > or = 2 points. For patients with proctitis improvement was defined as decrease in HI of > or = 1 point. The primary efficacy evaluation was performed with the intention to treat population (n = 32). Improvement was found in 67% of the patients in the budesonide group compared to 71% in the mesalazine group. There was no statistically significant difference between the groups. Adverse events were mild and rare in both groups. Both treatments had no significant influence on plasma cortisol. In this pilot study for distal ulcerative colitis budesonide foam is as safe and effective as mesalazine enema.

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To date, no published report on a trial has provided sufficiently strong evidence of the accuracy of the Haemoccult Test assessed by false-negative error, and validated on the basis of a complete colonoscopy of all patients. Total colonoscopy (up to the cecum) was performed on 534 patients whose stools had been tested for occult blood. The results of the colonoscopy were classified as follows: --expected continual bleeding (target lesions: carcinoma, polyps greater than or equal to 10 mm) --intermittant bleeding (polyps less than 10 mm, colitis, etc.), and --no source of bleeding. Results were regarded as false-negative in patients who were found to have a target lesion (carcinoma, polyp greater than or equal to 10 mm) following a negative Haemoccult test. Apart from positive and negative prognostic values, sensitivity and specificity were taken into account as characteristics for the quality of the test. Following a positive Haemoccult test result 46 of the 534 patients were found to have polyps greater than or equal to 10 mm and 22 carcinomas; following negative Haemoccult test results 31 patients were found to have polyps measuring greater than or equal to 10 mm in diameter and 2 carcinomas. On the basis of the chosen classification a false-negative Haemoccult result was established in 8.6% and a false-positive result in 4.3%. The Haemoccult test showed a sensitivity of 67% and a specificity of 93% in patients with target lesions or patients without a source of bleeding.

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J e r c h e I, K i rn Pn ig . 277 Nr. 3/1950] %her (1 : 10) umkrystallisiert. Schmp. 83-83.5O; [ a ] g : -0.86O x 1.007/0.0449 x 0.797 = -24.1° (in Mcthanol).Sehr gut loslich in Methanol, Athanol, Butanol, Pyridin, Aceton und Chloroform, gut in Essigester und Dioxan, schwer in Ather, Benzol, Wasser und Ligroin.(&&0,S9 (284.4) Ribose-diisobutyl-mercaptal: 1 g d-Ribose, 1.2 g I s o b u t y l m e r c a p t a n und 1 ccm kom. Salzsiiure werden genau wie beim vorstehenden Priiparat beschrieben behandelt. Das getrocknete Rohprodukt wiegt 1.5 g. Es wird aus Chloroform und Petrolather umkrystallisiert. Schmp. 83.5440; [a]B: -0.41 x 1.105/0.0307 x 0.792 = -18.6O (in Methanol). Ribose-dibenzyl-mercaptal: 1 g d-Ribose, 1.8 g Benzylmercaptan und 1.5 ccm konz. Salzsiiure werden 15 Min. bis zur klaren Lijsung geschuttelt. Die Liisung bleibt noch 45 Min. stehen und w i d dann mit 20 ccm Wasser verdiinnt, wobei ein dicker Sirup ausfallt. Dieser wird beim Stehen im Eisschrank nach mehreren Tagen fest. Die I(rystal1e werden noch zweimal aus vie1 heiBem Wasser umkrystallisiert. Awb. 2 g vom Schmp. 79.5-50°; [ a ] g : -0.630 x 1.405/0.0461 x 0.794 = -24.2O (in Methanol). Sehr gut loslich in Methanol, Athanol und Butanol, gut in Aceton, Essigester, Benzol, Dioxan und Chlorofonn, schwer in Wasser und Ligroin. C,,,H2,0,S2 (380.5)Die antimykotische Wirkung von verschiedenen Invertseifen wurde an Kulturen untersucht. Sie ist abhiingig sowohl vom Zentralatom der Oniumgruppe (N, P, As) als auch von der Natur der mit diesem verbundenen Reste. Die in reinster Form dargestellte Invertseife Dodecyl-triphenyl-phosphoniumbromid wurde i p Hinblick auf ihre wachstumshemmende Wirkung bei verschiedenen pathogenen Bakterien gepriift und nach Feststellung der epikutanen Vertraglichkeit fur klinische Versuche bei Heutkrankheiten verwendet.