The antihypertensive effects of a telmisartan 80 mg/hydrochlorothiazide (HCTZ) 12.5 mg fixed-dose combination and telmisartan 80 mg monotherapy were compared in patients with a history of mild-to-moderate essential hypertension and inadequate BP control (DBP у90 mm Hg) following 8 weeks of telmisartan monotherapy. At the end of this period, 491 patients (62.9% men; mean age 55.3 years) whose DBP was у90 mm Hg were double-blind randomised to once-daily telmisartan 80 mg/HCTZ 12.5 mg (n ‫؍‬ 246) or telmisartan 80 mg (n ‫؍‬ 245). Trough (24 h post-dose) clinic BP was measured after 4 and 8 weeks of double-blind therapy. At the end of double-blind treatment, patients receiving telmisartan 80 mg/HCTZ 12.5 mg had significant additional decrements in clinic SBP/DBP over telmisartan 80 mg of ؊5.7/؊3.1 mm Hg (P Ͻ 0.01). Most of the additional

Unfortunately our patient was too ill for studies of pancreatic function immediately before and after radiotherapy, but irradiation clearly resulted in a rapid inhibition of exocrine pancreatic secretion. The effect was transient: 12 weeks later pancreatic function was only slightly impaired. Though pancreatic ascites has resolved after conservative management and after diagnostic laparotomy (Barua et al, 1962; Cameron et al., 1969) the rapid cessation of pancreatic secretion after irradiation in our case clearly suggests a cause and effect relationship and that irradiation of the pancreas may be a useful treatment of pancreatic ascites, particularly when surgery is inadvisable or impossible. We should like to thank Dr. H. M. Salmon, superintendent of the Johannesburg Hospital, for permission to report this case, and Mrs. Rosemarie Bunker for expert technical assistance. We are indebted to the photographic unit, department of medicine, University of the Witwatersrand, for the Chart.

No abstract

SUMMARY The effect of lysolecithin (100 mg%) on the guinea-pig gastric mucosa was studied by instilling a solution for 30 minutes, preceded and followed by 100 MN HC1 into 10 total gastric pouches. Ten control animals had HCI throughout. Lysolecithin produced a significant change in transmucosal potential difference, macroscopic erosions, and mucosal damage on histology and electron scanning microscopy. None of these changes was seen in the control animals. This is further evidence that the reflux of lysolecithin from the duodenum is an important factor in causing active gastritis and gastric erosions.

Carcinoembryonic antigen (CEA) has been measured by radioimmunoassay in samples obtained from all patients suffering from ulcerative proctocolitis and seen within a four-month period. The characteristics of this group of patients have been compared with reported epidemiological studies in this disease, and have been found to have a similar sex ratio and age of onset, but a more limited disease. Among 59 patients, 11 were found to have elevated circulating CEA values. One of the 11 had a colonic carcinoma and another was pregnant. Excluding these two patients, an overall prevalence of elevated CEA levels of 17.5% was found. The prevelance in ulcerative proctitis was 7.1%, and in colitis was 19.9%. The patients in whom elelvated plasma CEA values were found were compared with the remaining patients in relation to factors known to be associated with an increased propensity for the development of colorectal carcinoma complicating ulcerative colitis. There was no difference in mean age of the patients at disease onset, nor was there any difference in disease duration, extent, and control. A significant correlation was found between elevated plasma CEA levels and the severity of the initial attack. One patient with premalignant changes in the rectal mucosa had consistently normal concentrations of plasma CEA. There was no significant correlation between elevated plasma CEA values and disease activity. The mean age of the two groups of patients was similar. No carcinoma has manifested in any patient during follow-up periods of at least 18 months.