Biomedical subjects
Publications and source records attributed to A C NEWELL.
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.
The ABO blood group and ABH secretor status have been determined for 368 patients with a duodenal ulcer, 202 patients with a gastric ulcer, 83 patients with a stomal ulcer, 105 patients with gastric cancer, 102 patients with diabetes mellitus, and a control group of 610 subjects consisting of healthy persons and of patients with other conditions attending the same hospital. The results have been analysed in conjunction with those reported in two other large series. For duodenal ulcer the results show that the relative incidence among non-secretors compared with secretors is 1.80 to 1, with 95% confidence limits of 1.55 to 1 and 2.03 to 1. For gastric ulcer the relative incidence is 1.42 to 1, with 95% confidence limits of 1.16 to 1 and 1.74 to 1. Comparison of the results for the two types of peptic ulcer shows that they are significantly different from one another. For both types of ulcer, the estimated risk among non-secretors was similar for blood group O and for the other blood groups and the results suggest that the specific risks associated with blood group O and with non-secretion multiply one another. It is concluded that the mechanisms by which blood group O and non-secretion affect the risk of developing a gastric or duodenal ulcer are related to one another; but that they do not depend on the presence of the blood group substances in the secretions. The proportion of non-secretors among patients with a stomal ulcer (49%) was higher than among patients with a duodenal ulcer (37%) and the order of the relationship between non-secretion and the three types of peptic ulcer (stomal, duodenal, and gastric) was the same as that for blood group O. Other data suggest that there may be a slight increase in the risk of gastric cancer among non-secretors, but that the occurrence of diabetes mellitus is independent of ABH secretion.
There is increasing evidence that blood group substances play a rôle in the causation of disease or in the protective mechanism against it. This paper records the special liability for patients of blood group O to develop stomal ulceration. Other data studied failed to confirm previous work suggesting that in gastric ulceration or neoplasm blood group A was a characteristic of an antral lesion.
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.