Between January 1983 and December 1985, 305 patients were admitted to our hospital because of bleeding duodenal ulcer. A subgroup of 69 patients aged 50 or above in whom emergency endoscopy showed non-arterial bleeding or signs of recent haemorrhage without a visible vessel entered a prospective therapeutic trial. The patients were randomized to receive either (1) early surgery, implying immediate operation, or (2) expectant management, with surgery reserved only for patients with further haemorrhage. The two groups were homogeneous with respect to age, sex, prior ingestion of ulcerogenic drugs, mode of bleeding, admission haematocrit, number with hypovolaemic shock and number with active bleeding on initial endoscopy. Overall mortality was 8.6 per cent. Mortality in patients submitted to early surgery was five times higher than that in those allocated to expectant therapy (14.7 per cent versus 2.9 per cent; risk ratio 5.07). The results suggest that expectant management is advisable in patients with bleeding duodenal ulcer not bleeding massively and in whom endoscopy does not disclose spurting arterial bleeding or a visible vessel.

No abstract

1994. Nitrate reductase in cotyledons of cucumber seedlings as affected by nitrate, phytochrome and calcium. -Physiol. Plant. 91: 257-262.Regulation by the active form of phytochrome (PRJ) and the effect of Ca-* was examined with nitrate re.ducta.se (NR) in etiolated cucumber (Cucumis sativus cv. Beilpuig). Nitrate reductase activity (NRA) was studied in excised coty'iedons of cucumber seedlings grown io distilled water and in darkness for seven days at 24 ± 0.5°C. All experiments were performed in the dark and a dim green safeiight was used during analyses, lo etiolated cucumber cotyledons NRA was induced by nitrate and a brief irradiation (15 min) with red light (R) resulted in 62% increase in NRA. This effect was nullified when R was followed immediately by a brief (5 min) far-red light (FR). NRA also showed a semidian (12 h) rhythmicity. Both PpR, and nitrate effects were age depefideot. Calcium seemed to be involved since the phytochrome effect was only obseri'ed when calcium was supplied in the external solution. The effect of R on NRA depended on the period of calcium nitrate incubation. An extensal supply of calcium ionophore mimicked the effect of R and, if supplied to R-irradiated cotyledons, produced a higher NR level than that caused by R alone. This suggested that intracellolar free calciutn was involved.