Background: Heparin given intravenously has shown beneficial effects in the treatment of refractory ulcerative colitis in open trials. Low molecular weight heparin (LMWH) offers advantages in the method of administration but have not been evaluated in inflammatory bowel disease conditions.Aim: To assess the tolerability and safety of subcutaneous self‐administered LMWH in outpatients with refractory ulcerative colitis and to evaluate any potential adjuvant therapeutic effect.Patients and Methods: Twelve patients with mild to moderately active ulcerative colitis were included in the trial. The patients had either responded poorly to treatment with conventional therapy, including oral and/or rectal glucocorticosteroids, or had experienced a rapid relapse during or shortly after GCS therapy. Dalteparin sodium 5000 units s.c. injection was administered twice daily for 12 weeks. Patients were monitored for possible adverse events and changes in clinical symptoms, and endoscopic and histological scores were analysed. Leucocyte scanning was performed at inclusion and at the end of the study.Results: Tolerability and compliance were excellent and no serious adverse events occurred. Eleven patients improved symptomatically and six (50%) attained complete remission after 12 weeks of treatment. Endoscopic, scintigraphic and histological scores were found to be significantly improved.Conclusion: Self‐administered LMWH given s.c. may be a safe adjuvant therapy for patients with active, glucocorticosteroids‐refractory ulcerative colitis. A controlled trial should be undertaken to confirm the positive effects found in this study.

Summary:splenic, 11 i.m., 12 subcutaneous 13 and i.o. routes in animals. 14 Injections of bone marrow into the testes and brain have also been investigated. 14 However, since the first BMT in Thirty-eight patients (у18 years) receiving marrow transplants from HLA-identical or one antigenman, 15 the i.v. route has been routinely used. Our aim was to infuse haematopoietic progenitor cells directly into the group (NS). The incidences of acute and chronic graft-versus-host disease, transplan-All adult (у18 years) patients who received related BMT between October 1992 and June 1995 were asked to particitation-related mortality, relapse and patient survival rates were similar in the three groups. Five patients pate. Three patients declined to participate and one was excluded, due to septicaemia. Thirty-eight consecutive examined with bone marrow scintigraphy showed the same distribution of granulocytes in the bone marrow patients were randomized after stratification for BMT with HLA-A-B and DR identical or one antigen-mismatched directly after transplantation and 3 weeks after transplantation, whether the bone marrow was given by the related donors, after conditioning with cyclophosphamide (CY) and total body irradiation (TBI) or CY and busulfan i.o. or by the i.v. route. We conclude that allogeneic bone marrow transplantation can safely be performed (Bu of delayed engraftment. The study was approved by the humans to treat pernicious anaemia by injecting a liver Ethics Committee at Huddinge Hospital and all patients preparation into the sternal bone marrow. 1 I.o. infusion was gave informed consent. introduced during the 1940s as a means of administering Erythrocyte transfusions were given when Hb was Ͻ70 fluids and blood transfusions to critically ill patients. 2 This g/l and platelet transfusions when platelet counts were technique was replaced by i.v. catheters, but it is still some-Ͻ30 × 10 9 /l. Details regarding patient care have been times used in critically ill children. 3 In the early era of bone reported. 18 Total parenteral nutrition (TPN) was defined as marrow transplantation (BMT), sporadic attempts were the administration of at least 2.5 l of a combination of intramade to administer bone marrow orally 4 as well as intralipid, amino acids and glucose (Kabimix basal, Pharmacia muscularly (i.m.), 5 intra-arterially 6 and i.o. 1,7,8 in humans and Upjohn, Stockholm, Sweden). and by intracardiac, intra-arterial, 9 intraperitoneal, 10 intraThe diagnoses were AML (n = 17), ALL (n = 1), CML (n = 14), lymphoma (n = 3), IgA myeloma (n = 1), CLL (n = 1) and metachromatic leukodystrophy (MLD, n = 1). teristics between the three groups (Table 1).

Summary:Total body irradiation (TBI) at bone marrow transplantation (BMT) is shown to cause salivary gland dysfunction in children. The aim of the investigation was to study the function of major salivary glands in long-term surviving children following treatment with TBI, using salivary gland scintigraphy (SGS). Thirteen patients (seven male, six female), who had received TBI before the age of 13 years and survived more than 4 years, participated in the study. A reference group of 10 patients (nine male, one female) was examined shortly before they were to undergo BMT. The mean age was 14.1 ± 4.1 years in the TBI-treated group and 12.8 ± 5.9 years in the reference group. Unstimulated and stimulated whole salivary secretion rates were measured for 15 and 5 min, respectively, before SGS was performed. The percentage of stimulated secretion was 44.7 ± 18.1% in the TBI-treated group compared to 58.4 ± 13.0% in the reference group (P = 0.0438). Slower reaccumulation after excretion was found in the TBItreated patients compared to the reference group (P = 0.0300). The function of the major salivary glands in long-term survivors treated with TBI at BMT before the age of 13 years was found to be diminished, as shown by the reduced trapping rate and reduced emptying capacity, compared to prior to BMT. Bone Marrow Transplantation (2000) 26, 775-779.

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