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Svanes and coworkers (1) suggest that more perforations of peptic ulcer (PU) occur in early summer and early winter. This pattern is mainly caused by the high proportion of duodenal and pyloric ulcers taken together, On the contrary, no clear seasonal variation of gastric and prepyloric ulcers was documented. We present our findings on seasonal variation of symptomatic peptic ulcers observed during an 8-year period in our endoscopy unit.

Michieletti et al. (I) recently described a group of 17 patients who were initially thought to have primary biliary cirrhosis (PBC); however, the immunological findings differed from those usually associated with PBC. In particular, they did not have antimitochondrial antibody (AMA) and they did have antinuclear antibodies (often at very high titers), smooth muscle antibodies (30%), and comparatively low serum immunoglobulin (Ig) M and aspartate aminotransferase (AST). The investigators believe that patients with AMA-negative PBC may have a distinct syndrome of autoimmune cholangitis. We report a case of AMA-negative PBC in a patient with Sjogren’s syndrome with immunological findings compatible with the diagnosis of autoimmune cholangitis.

The phenotypes and gene frequencies of three serum protein systems - Hp, GC and C3 - were studied in 184 consecutive patients from all over Greece with colon cancer. Healthy Greeks studied previously in our department served as controls. No significant differences were found between patients and controls concerning GC and C3. Significant differences were found in the Hp system; the frequencies of the Hp * 1 gene and the Hp 1-1 phenotype were significantly higher in patients than in controls.

The phenotypes and gene frequencies of 3 serum protein systems (Hp, GC and C3) were studied in 114 consecutive patients from all over Greece with gastric carcinoma. Healthy Greeks studied previously in our Department served as controls. No significant differences were found between patients and controls concerning Hp. Significant differences were found in the GC and C3 systems; GC 2-1 and C3F phenotype as well as C3*F gene frequencies were significantly higher in patients than in controls.

Sucralfate and ranitidine were compared in the treatment of gastric ulcer (GU) in this multicenter randomized double-blind study. Sixty-four patients with endoscopically diagnosed GU initially included in the trial were randomly assigned to treatment with sucralfate, 2 g b.i.d. (morning and evening on an empty stomach), or ranitidine, 150 mg b.i.d. Nine patients were subsequently excluded for various reasons. The remaining 55 were examined endoscopically after 4 and, if unhealed, 8 weeks. At 4 weeks, 54.2% (13 of 24) of the sucralfate group had a healed ulcer, in comparison to 45.2% (14 of 31) of the ranitidine group (NS). At 8 weeks, cumulative healing rates were 87.5% (21 of 24) and 84% (26 of 31), respectively (NS). No differences were found in the healing effects of the drugs on smokers and nonsmokers or in side effects. These results suggest that both drugs are equally effective in the short-term treatment of GU.

The phenotypes and gene frequencies of two serum protein systems (GC, C3) were studied in 238 consecutive patients with peptic ulcer from all over Greece. 173 patients had duodenal ulcer and 65 had gastric ulcer. Healthy Greeks studied previously in our department served as controls. No significant differences were found between the studied groups and the controls as far as GC was concerned. However, significant differences emerged in C3; the C3*F gene was almost twice more common and the C3F phenotype almost three times more frequent in patients than in controls.

Sucralfate and ranitidine were compared in the treatment of duodenal ulcer in this multicenter, randomized, double-blind study. A total of 165 patients with endoscopically proven duodenal ulceration were included in the trial and randomized to treatment with sucralfate, 2 g b.i.d. (morning and evening with an empty stomach), or ranitidine, 150 mg twice daily. All patients were endoscopically examined after 4 and, if unhealed, 8 weeks. Of the patients considered suitable for analysis at 4 weeks, 73.5% (61 of 83) of the sucralfate group demonstrated healing of the ulcer in comparison with 63.3% (50 of 79) of the ranitidine group. At 8 weeks cumulative healing rates were 89% (74 of 83) and 84.8% (67 of 79), respectively. When smokers were considered separately, healing rates at 4 weeks were 69.2% (36 of 52) for sucralfate and 53.3% (24 of 45) for ranitidine. At 8 weeks cumulative healing rates were 92.3% (48 of 52) and 77.7% (35 of 45), respectively (p < 0.05). Overall, there was no difference in the two groups regarding symptom relief and side effects. These results suggest that these drugs are equally effective in the short-term treatment of duodenal ulcer, although in smokers sucralfate appears to be more effective than ranitidine.