The results of a 67 hour cyclic somatostatin continuous infusion in a patient with a bleeding ulcer are reported. The subject was a 65 year old male with very heavy gastrointestinal bleeding on the 9th postoperative day following a high BI-resection. Endoscopy revealed the bleeding to be caused by two residual ulcers in the area of the anastomosis. Somatostatin treatment led to an immediate cessation of the bleeding after 1 hour. Gastric secretion as well as gastrin, insulin and growth hormone levels were significantly inhibited by somatostatin. Endoscopy at the end of the treatment period showed two ulcers in the process of healing. The raised blood glucose levels caused by somatostatin were easily controlled with max. 14 IU cristalline insulin daily. Except for dryness in the mouth, no adverse side effects were apparent. There was no evidence from laboratory investigations of hemostatic defects or bleeding tendency in the patient.
The effect of short- and long-term somatostatin (GIF) administration on haemostatic function in man was investigated. The dosage programme applied in this study was 250 mug GIF as a bolus injection and 250 mug GIF/h by way of infusion. In five healthy volunteers a short-term (3h) treatment resulted in a statistically significant drop of platelet count and impairment of platelet aggregation at the end of infusion. However, these changes were within the physiologically normal range and disappeared after two hours on all subjects. Other parameters such as bleeding time, thromboplastin and partial thromboplastin time, fibrinogen, fibrin/fibrinogen split products, plasma factor XIII, ethanol gelation test were not affected. In two patients with gastric haemorrhage and persistent amylasaemia a 67 or 120-h treatment induced no remarkable haemostatic defect. By contrast, peptic ulcer bleeding in one patient stopped 60 min after starting the GIF infusion. These studies indicated that somatostatin administration in man at the dosage programme used neither results in clinical evidence indicating bleeding tendency nor does it influence laboratory parameters in an apparent way.
This article discusses the connections between collaboration and the prisoner of war question in the early Vichy period by tracing the evolution of the Franco-German agreement of 16 November 1940 and its repercussions on French POWs. Based on the Scapini Papers and French and German archival materials, the article argues that the agreement happened in the context of a voluntary policy of collaboration initiated by the Vichy authorities, who hoped that collaboration would trigger German concessions on the POW question, but did not push collaboration to ease the fate of the POWs. Hitler likely offered the agreement as a concession that would allow Vichy to demonstrate to the French public an apparent success of collaboration, detracting from some hostile German measures that occurred at the same time. Vichy took the bait because it hoped to win over the French POWs in Germany to Pétainist ideology and because it was eager to bolster its own legitimacy. But humanitarian considerations also played a role in the French consent to this agreement, which to some extent can be seen as preventive collaboration. Plausibly, the agreement and the framework it established, despite undeniable dangers, represented a lesser evil for the French POWs.
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