A randomised trial to compare the results of injection sclerotherapy with a bulk laxative alone in the treatment of bleeding haemorrhoids

In a prospective randomised trial, 43 patients with bleeding haemorrhoids were allocated to receive either a bulk laxative with injection of phenol (5%) in arachis oil (20 patients) (Group 1), or a bulk laxative alone (23 patients) (Group 2). Treatment was given by one author and patients were assessed blind by the other at 6 weeks, 3 months and finally at 6 months. At 6 weeks 12 (48%) in Group 1 and 12 (57%) in Group 2 were still bleeding (NS; ²= 0.54). At 3 months 10 (40%) in group 1 and 6 (35%) in group 2 (NS; ²=0.10), and at 6 months 10 (43%) in group 1 and 7 (47%) in group 2 were still bleeding (NS; ²=0.04). No significant difference in bleeding at 6 months after either injection sclerotherapy with bulk laxative or bulk laxatives alone was found.     

Do patients with globus sensation respond to hypnotically assisted relaxation therapy? A case series report

Globus sensation is a bothersome and difficult symptom to treat. The aims of this study were to evaluate the acceptability and utility of hypnotically‐assisted relaxation (HAR) in decreasing the perception of globus sensation and the effect of HAR on interdeglutitive upper esophageal sphincter (UES) pressure. Sixteen subjects with persistent globus sensation unresponsive to therapy for reflux disease and with normal esophageal/laryngeal imaging studies were invited to participate in a 7‐session clinical protocol. Before and after HAR, subjects completed standard questionnaires including the esophageal symptoms questionnaire. High‐resolution manometric assessment of respiratory augmentation and average resting UES pressure were assessed before and after HAR. Ten of the 16 subjects agreed to participate in the protocol. All participants were women with median age 51.5 (range 30–72 years). The participants found HAR acceptable and completed the entire 7‐session trial. Globus symptom severity varied widely pre‐treatment (median = 52.5, range 16–72), and 9 of 10 subjects reported a reduction in globus symptomatology following treatment (median = 14.0, range 3–19; P = .007). Only 1 subject exhibited abnormal respiratory augmentation of UES pressure (>27 mm Hg) prior to treatment and was normal following treatment (9.9 mm Hg). Resting UES pressure was normal in all subjects (<118 mm Hg). Group respiratory augmentation and average resting UES pressure were unaffected by HAR (P = .48, .89). This case series suggests that HAR can provide a substantial improvement in globus sensation irrespective of cause. UES function was unaffected. We suggest that HAR therapy is an acceptable and useful intervention for patients with globus sensation.     

HLA-DR4-DQw8, but not DR4-DQw7 haplotypes occur in Indian patients with rheumatoid arthritis

Summary The distribution of HLA class II antigens in the Asian Indian patients with rheumatoid arthritis (RA) was studied in the present investigation. The results demonstrated that DR4 was significantly increased in both northern (²=36.9, P<0.00001) as well as southern Indian (²=17.3, P<0.0001) patients. HLA haplotype analysis revealed the presence of B17-DR4 among southern Indians. Amongst northern Indians, four DR4 haplotypes occurred significantly: A1,B17,DR4; A19,B7, DR4; A30,B13,DR4; and A33,B44,DR4. An analysis of TA10 and DQ'Wa' specificities revealed that all the DR4-DQw3 positive northern Indian RA patients were DQw8 positive association observed between DR4-DQw7 and RA in some western Caucasian populations was not present in this series. A group of three DR4 positive RA patients were found to be DQw3 negative and DQ'Wa' or DQw4 positive. These results indicated that susceptibility to RA may be controlled by genes in the DR locus independent of any DQ associations.     

Spine Abnormalities and Damage in Patients Cured from Cushing's Disease

The skeletal system is a common target of glucocorticoids. Structural and functional impairment of skeletal system is a relevant cause of morbidity and disability in patients with Cushing's syndrome.Thirty-six patients long-term (3.9 ± 0.5 yrs) cured from Cushing's disease (CD), 26 with adulthood-onset CD (AOCD) and 10 with childhood-onset CD (COCD) and 2 groups of controls, 24 age- and sex-matched patients with nonfunctioning pituitary adenomas (NFA) and 36 age- and sex-matched healthy subjects (HS), entered this open transversal controlled study to evaluate the prevalence of spine abnormalities and damage by standard radiography in subjects with a history of Cushing's syndrome.Symptoms and signs of backache were present in 86.1% CD patients (100% COCD and 80.8% AOCD), in 30.5% HS (² = 20.6, p < 0.0001) and 37.5% NFA patients (² = 13.2, p < 0.0001). The prevalence of trabecular bone rarefaction (² = 6.5, p < 0.01 and ² = 4.5, p < 0.05), vertebral collapse (² = 10.7, p < 0.01 and ² = 7.0, p < 0.01) and scoliosis (² = 10.9, p < 0.01 and ² = 11.1, p < 0.01) resulted significantly increased in CD patients as compared both to HS and NFA patients. In CD patients, the number of collapsed vertebral bodies was significantly correlated to age of disease onset (r = –0.63, p < 0.0001), disease duration (r = 0.33, p < 0.05) and urinary free cortisol levels at disease diagnosis (r = 0.72, p < 0.0001). The prevalence of cortical bone sclerosis was significantly increased in AOCD than in HS (² = 6.5, p < 0.01) and COCD (² = 7.7, p < 0.01) whereas that of trabecular bone rarefaction was significantly higher in COCD patients than in HS (² = 18.3, p < 0.0001), NFA (² = 14.2, p < 0.0001) and AOCD patients (² = 9.1, p < 0.01).Patients cured from CD have increased prevalence of spine damage, mostly when the disease developed before the completion of skeletal growth. Therefore, a periodical radiological follow-up of the skeleton and a specific treatment for the bone damage should be included in the management of patients with Cushing's syndrome.     

Association of Susceptibility Locus for Inflammatory Bowel Disease on Chromosome 16 with Both Ulcerative Colitis and Crohn's Disease

A susceptibility locus for inflammatory bowel disease (IBD) on chromosome 16 (IBD1) has been linked to Crohn's disease in genome-wide linkage studies. We performed a case–control study with two markers for this locus using leukocyte DNA from 127 Crohn's patients, 83 ulcerative colitis patients, and 74 control patients. Allele, genotype, and haplotype frequencies of the polymerase chain reaction products were determined using autoradiography. Haplotype frequencies differed for ulcerative colitis and Crohn's disease, particularly for haplotype CC (22% ulcerative colitis vs 10% Crohn's disease, P = 0.002 ² = 10.0) and haplotype CD (18% Crohn's disease vs 9% ulcerative colitis, P = 0.025 ² = 5.02). These data demonstrate the association of the IBD1 locus with both ulcerative colitis and Crohn's disease in a group of unrelated IBD patients. The use of such microsatellite markers when combined with others, might help distinguish ulcerative colitis from Crohn's disease in patients with ambiguous clinical and histological features.     

Upper esophageal sphincter tone and reactivity to stress in patients with a history of globus sensation

Anxiety and abnormal upper esophageal sphincter function have been ascribed ill- defined roles in the etiology of globus sensation. In this study, we examined the psychological profile and effect of acute mental stress (dichotic listening task) on UES tone in seven patients reporting to the clinic with globus sensation and 13 healthy controls. Alterations in heart rate, blood pressure, frontalis EMG, and skin conductance confirmed the effectiveness of the stress test in patients and controls. During resting conditions, UES pressure (mean±SE) in patients (40.4±4.6 mm Hg) did not differ significantly from controls (46.5±4.7 mm Hg). In response to stress, UES pressure rose by 31% in patients (P=0.04) and by 25% in controls (P=0.002). The stress- induced rise in UES pressure in patients (9.5±3.8 mm Hg) was not significantly different to that observed in controls (11.8±3.0 mm Hg). Psychological profiles of globus patients presenting to the clinic revealed them to be more introverted, anxious, neurotic, and depressed than normal controls. We conclude that in patients with a history of globus sensation, resting UES pressure and its response to stress is normal. Although individuals presenting to the clinic with globus sensation showed increased levels of psychoneurosis, acute, predictable stress is not a factor in the genesis of globus sensation. UES hyperresponsiveness to other stimuli or subjective intolerance to changes in UES pressure could account for symptoms of globus sensation.Dr. Cook is supported by a University of Sydney, Postgraduate Medical Foundation Award. Dr. Dent was supported as a Visiting Professor to McMaster University by a Visiting Scientist Award from the Canadian Medical Research Council.     

Are Manometric Parameters of the Upper Esophageal Sphincter and Pharynx Affected by Age and Gender?

The effects of age and gender on the upper esophageal sphincters (UES) and pharyngeal manometric parameters were investigated in 84 healthy subjects (45 men, 39 women, mean age=44 years, range = 18–91). Manometric recordings were performed with solid-state circumferential transducers. Subjects older than 60 years (n = 23) showed a significant lower UES resting pressure. In addition, during water swallows they had a higher UES residual pressure, shorter UES relaxation interval and UES relaxation duration, and a decreased UES relaxation rate. Furthermore, pharyngeal contraction had significant higher amplitude and longer duration in subjects older than 60 years during water swallows. Some of these findings were also observed during cookie and pudding swallows. Women had a higher UES resting pressure and a longer UES relaxation interval than men. The observed changes with increasing age indicate loss of basal tone and decreased compliance of the UES. Increased pharyngeal contraction amplitude and its prolonged duration in the elderly might be compensatory to this. These physiologic effects of age and gender on UES and pharyngeal parameters should be taken into account during analysis of manometric studies. The first author was financially supported by the Netherlands Digestive and Disease Foundation and the Netherlands Organization for Scientific Research (NWO).     

Histocompatibility locus antigens (HLA) in the epidermoid type of lung carcinoma

Summary HLA-A and B antigens were determined in a study of 162 patients (93 epidermoid type, 20 adenocarcinoma, 26 small-cell carcinoma and 23 undifferentiated types) with lung cancer. Differences between antigen frequencies in cancer and control populations were studied by _Y ² analysis or Fisher's exact test. Survival data were analyzed using Cox's model for censored data. Cancer patients had a decreased frequency of the antigen HLA-B40 ( _Y ² =14.15,P=0.00018,P _c=0.003, relative risk=0.21). Patients with HLA-A10, A 11 and B27 had a shortened mean survival time. Patients with HLA-B12 had a prolonged survival time.     

Apolipoprotein E polymorphism in patients with neuropsychiatric SLE

The aim of this study was to investigate a relationship between neuropsychiatric SLE (NPSLE), characterized by many different neurological and psychiatric disorders, and the polymorphism of apoE as a neurobiologically important molecule conferring increased risk and a worse prognosis of a variety of CNS diseases. One hundred and forty-six SLE patients and 93 healthy controls were studied. Out of the SLE cohort, 48 patients (32.8%) were diagnosed with NPSLE and further classified according to criteria of onset, extent, relapsing tendency and type of neuropsychiatric impairment. Apolipoprotein E (apoE) polymorphism was determined by PCR-RFLP and confirmed by isoelectrofocusing. The frequency of the 4 allele was significantly higher in the NPSLE group than in the non-NPSLE group (17.7% vs. 3.1%, ²=19.05, p<0.0001). Distribution of apoE genotypes was significantly different between NPSLE and non-NPSLE groups (²=80.95, p<0.0001). Both 4 allele frequency (17.7% vs 8.6%, ²=5.082, p<0.024) and genotype distribution (²=7.202, p<0.027) were significantly different between NPSLE group and the controls. The allele 4 was also associated with earlier disease onset (Fishers test, p<0.036) and peripheral nervous system involvement (²=8.242, p<0.0041), but not with relapse frequency (p<0.37) or major/minor subtype of the disease (p<0.90). The 4 allele carriers did not develop significantly more neuropsychiatric syndromes than non- carriers (1.75±0.23 sy (mean ± SD) in 4 vs 1.85±0.19 sy (mean ± SD) in non-4 carriers, Mann–Whitney test, p<0.78). In conclusion, the data suggest an association between apoE polymorphism and NPSLE.Abbreviations apoE Apolipoprotein E - NPSLE Neuropsychiatric SLE - SLE Systemic lupus erythematosus     

Distribution of blood and serum protein group characteristics in patients with diabetes

Summary In a sample of 1.033 diabetic patients characteristics of 10 group specific systems (ABO, MNS, Rh, P, K and Fy blood groups and Hp, Gc and Gm serum types) were tested in order to verify any association of hereditary group specific traits and diabetes. The patients were subgrouped for sex, seriousness of diabetes, age of manifestation and body type. The frequencies of the group specific traits were statistically compared with those of an appropriate control group using the ² test. Resulting from that investigation an increase of blood group 0 was found in diabetics below average in corpulence (basing upon the Rohrer index), and a confirmation was found for an already suspected association of diabetes and the Gm (a + x +) type.     

Serum Antibodies Against Helicobacter pylori Proteins VacA and CagA Are Associated with Increased Risk for Gastric Adenocarcinoma

Infection with Helicobacter pylori is associatedwith the development of gastric cancer. To study whetherthe infection with H. pylori strains expressing thevacuolating cytotoxin (VacA) and/or thecytotoxin-associated protein (CagA) is associated with an increasedrisk of developing gastric adenocarcinoma, sera of 90patients with gastric cancer and 90 matched controlswith cardiovascular diseases were investigated for the presence of antibodies to VacA and CagA byimmunoblot. Although no significant difference in theoverall H. pylori seropositivity was found betweencancer patients and controls, antibodies against VacA or CagA were significantly more frequent incancer patients than in control subjects. Seventyfive(97.4%) of 77 H. pylori-positive patients in the cancergroup, but only 60 (84.5%) of 71 H. pylori-positive control patients had antibodies against eitherVacA or CagA (² 6.63; relative risk,2.00; 95% confidence interval, 1.18–3.39; P =0.01). The presence of antibodies against VacA or CagAalone was also associated with an increased cancer risk (92.2%vs 80.3%; ² = 5.30; relative risk, 1.74;95% confidence interval, 1.08–2.78; P = 0.021, forVacA; and 87.0% vs 74.6%; ² 4.90;relative risk, 1.61; 95% confidence interval, 1.06–2.45; P =0.037, for CagA). The relative risk for gastric cancerwas mainly elevated in patients under 65 years, but notin patients at or over 65 years. There is evidence that infection with VacA- or CagA-producing H.pylori strains increases the risk of developing gastriccancer, especially in younger patients.     

Prevalence of fatty liver in Japanese children and relationship to obesity

The prevalence of fatty liver in children is unknown and its relationship to obesity is poorly defined. The present study of 810 northern Japanese children (4–12 years old) determined the prevalence of fatty liver in the pediatric population and its relationship to obesity. Diagnosis of fatty liver was based on established real-time ultrasonographic criteria. The overall prevalence of fatty liver was 2.6% and was higher for boys (3.4%) than for girls (1.8%), although not statistically significant (P=0.15). Fatty liver was found in children as young as 6 years of age. There was no significant association between the prevalence of fatty liver and height (physical growth). There was a strong positive correlation between fatty liver prevalence and established obesity indices: Rohrer's index-² linear trend =59.2,P<0.0001; body mass index-² linear trend =91.6,P<0.0001; and age-gender-adjusted Japanese standard index of weight for height-² linear trend =93.2,P<0.0001. However, direct measurement of abdominal subcutaneous fat thickness by ultrasonography was the best predictor of fatty liver: ² linear trend =159,P<0.0001. These results indicate that fatty liver may develop very early in life, and there is a direct relationship between degree of obesity and fatty liver in children.     

Increased incidence of hepatitis B markers in children with sickle-cell anemia

Summary Screening of 143 children 6 months to 12 years of age with sickle-cell anemia showed that 39.2% were HBsAg-positive as compared with 19.3% of the 161 control children of the same age group, who had Hb genotype AA (²=14.7383; P<0.001). Fifty percent of the HbSS children under the age of 1 year were HBsAg-positive as opposed to 4.3% of the control group (²=9.1955; P<0.001), while 28.6% of patients were HBsAg-positive at the age of 4 years compared with only 7.4% of the controls at the same age. The incidence of anti-HBc in both groups was similar. Markers of HBV infection (HBsAg + anti-HBc) were, however, on the whole higher in the patients with sickle-cell anemia [88/118 (74.6%)] than in the controls [54/88 (61.3%; P<0.005)].     

Progesterone receptor determined by immunocytochemical and biochemical methods in human breast cancer

Summary Immunocytochemical assay (ICA) of the progesterone receptor (PgR) was performed on 152 patients with stage I–II breast cancer. We employed the rat monoclonal antibody KD-68 and a peroxidase/antiperoxidase displaying system. The results obtained by ICA (PgR_ICA) were compared with those by the biochemical dextrancoated charcoal assay (PgR_DCC). Comparing the two methods we found an overall agreement (accuracy) of 77.5%, a PgR_ICA sensitivity of 83.5% and a specificity of 73%. Both methods were significantly associated with oestrogen receptor expression, detected by DCC (P<0.001 for PgR_DCC andP=0.0014 for PgR_ICA). No significant association was found between PgR_ICA or PgR_DCC and the other clinicopathological features analysed. After a median follow-up of 36 months, the overall survival probability was 91% in PgR_DCC-positive versus 81.5% in PgR_DCC-negative patients (log-rank test, ²=0.91) compared to 87.5% in PgR_ICA-positive versus 82% in PgR_ICA-negative ones (log-rank test, ²=0.93). Disease-free survival probability was 74.5% in both PgR_DCC-positive and PgR_DCC-negative patients (log-rank test, ²=0.02) compared to 78% in PgR_ICA-positive versus 71.5% in PgR_ICA-negative cases (log-rank test, ²=0.37). The present study demonstrates that ICA is a reliable method to detect PgR, correlating well with the DCC assay. Moreover, the ICA assay seems to provide clinical information complementary to the biochemical method. The definition of its prognostic value in operable breast cancer needs additional studies, particularly in node-negative patients.Abbreviations PgR progesterone receptor - ER oestrogen receptor - ICA immunocytochemical assay - DCC dextran-coated charcoal - OS overall survival - DFS disease-free survival - CMF cyclophosphamide/methotrexate/5-fluorouracil     

Carcinoma of the Gallbladder—Is It a Sequel of Typhoid?

Gallbladder diseases, including carcinoma, are common in the northern part of India and so are Salmonella typhi infection and typhoid carrier state. This study was aimed to find out the association of typhoid carrier state in patients with cholelithiasis, carcinoma of the gallbladder, and controls. The three groups are comparable in age and sex composition. This is the first study of its kind from an area of high endemicity for both typhoid infection and carcinoma of the gallbladder. A case–control study was carried out to detect typhoid carrier state among the patients with biliary diseases and healthy controls, using indirect haemagglutination assay measuring antibodies against highly purified S. typhi Vi polysaccharide antigen. A significantly high Vi positivity was observed in patients with gallbladder carcinoma (29.4%) compared to controls (5%) (² = 6.325, P < 0.004, OR = 7.19) and patients with cholelithiasis (10.7%) (² = 5.066, P < 0.01, OR = 3.86). There is 8.47 times more risk of developing carcinoma of the gallbladder in culture-positive typhoid carriers than the noncarriers. The present study suggests the typhoid carrier state to be one of the possible mechanisms of gallbladder carcinogenesis.     

Association between a polymorphism in the angiotensin-converting enzyme gene and microvascular complications in Japanese patients with NIDDM

Summary The relationship between diabetic nephropathy and an insertion (I)/deletion (D) polymorphism in intron 16 of the angiotensin-converting enzyme (ACE) gene is still under debate. The association of ACE gene polymorphism with nephropathy and retinopathy was therefore examined in 362 Japanese patients with non-insulin-dependent diabetes mellitus (NIDDM) and 105 healthy control subjects. Distribution of the ACE genotype did not differ between healthy control subjects and diabetic patients without complications. However, the frequency of the D allele was significantly higher in the diabetic subjects with nephropathy than in those without (0.32 in normoalbuminuric patients vs 0.44 in albuminuria patients with albuminuria) (²=7.7; p=0.006). There was no significant association between ACE genotype and retinopathy. These observations thus demonstrate a significant association of the ACE gene polymorphism with nephropathy, but not with retinopathy, in Japanese patients with NIDDM.Abbreviations ACE Angiotensin-converting enzyme - IDDM insulin-dependent diabetes mellitus - NIDDM non-insulin-dependent diabetes mellitus - UAI urinary albumin index - PCR polymerase chain reaction     

Angiotensin-Converting Enzyme Gene Polymorphism and Plasminogen Activator Inhibitor 1 Levels in Subjects with Cerebral Infarction

It has been suggested that the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is an independent risk factor for coronary artery disease, but its relation to cerebral infarction is still controversial. Plasminogen activator inhibitor 1 (PAI-1) is also a predictor of risk of atherothrombotic disease. In this study we investigated the association of the ACE gene polymorphism and plasma PAI-1 levels in subjects with cerebral infarction. We evaluated the genotype of the ACE gene in 26 subjects with and 28 subjects without a history of ischemic stroke. The ACE genotype was analyzed by the polymerase chain reaction. Plasma PAI-1 antigen levels were measured by ELISA. There were no differences in accepted risk factors between the groups with or without cerebral infarction. However, the frequency of the D allele was significantly higher in subjects with cerebral infarction (0.63) than in those without infarction (0.39) (² = 6.306, P = 0.012). The frequency of the DD genotype of the ACE gene was also significantly higher in subjects with than in those without cerebral infarction (DD: 46.2%, ID: 34.6%, II: 19.2% vs. DD: 14.3%, ID: 50.0%, II: 35.7%, ² = 6.689, P = 0.035). Plasma PAI-1 levels were not significantly different between groups with and without cerebral infarction. There was no association between the ACE genotype and PAI-1 levels. The DD genotype of the ACE gene is associated with cerebral infarction, which is independent of plasma PAI-1 level.     

Methylenetetrahydrofolate reductase C677T polymorphism and predisposition towards esophageal squamous cell carcinoma in a German Caucasian and a northern Chinese population

Purpose Folate deficiency is considered to increase the risk of developing esophageal cancer. Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme involved in folate metabolism. A single C T substitution at nucleotide 677 of the MTHFR cDNA influences enzyme activity. The purpose of this study is to compare the association of the MTHFR C677T polymorphism with susceptibility to esophageal squamous cell carcinoma (ESCC).Methods Using real-time PCR and melting curve analysis, the MTHFR C677T genotypes were determined in 430 patients with ESCC (241 German Caucasians and 189 northern Chinese) and 397 unrelated healthy controls (256 German Caucasians and 141 northern Chinese).Results A significant difference in MTHFR C677T genotype distribution was observed between German Caucasian controls (C/C, 41.8%, C/T, 44.9%, T/T, 13.3%) and northern Chinese controls (C/C, 17.7%, C/T, 38.3%, T/T, 44.0%) (²=52.19, P<0.001). The distribution of the MTHFR C677T genotypes among German ESCC patients (C/C, 39.0%, C/T, 48.1%, T/T, 12.9%) was not significantly different from that among healthy controls (²=0.531, P=0.767). In contrast, the frequency of the C/C genotype among Chinese ESCC patients (8.5%) was significantly lower than among Chinese healthy controls (17.7%) (²=6.37, P=0.012). The C/C genotype was correlated with a significantly reduced risk for the development of ESCC as compared to the combination of C/T and T/T genotypes (adjusted OR=0.38, 95% CI=0.16–0.88).Conclusions Our results suggest that, in contrast to German Caucasians, the MTHFR 677CC homozygous wild-type plays a protective role in the development of ESCC in the northern Chinese population.Abbreviations CI Confidence interval - ESCC Esophageal squamous cell carcinoma - MTHFR Methylenetetrahydrofolate reductase - OR Odds ratio - PCR Polymerase chain reaction     

Activated Protein C Resistance, Thrombophilia, and Inflammatory Bowel Disease

Thromboembolic events frequently complicate theclinical course of patients with inflammatory boweldisease (IBD). Hereditary thrombophilia may contributeto this tendency. Resistance to activated protein C is the most recently described thrombophilicstate and may account for up to 40% of patients withthrombophilia. Thirty-seven patients with IBD werestudied (mean age 44 years, range 18-82 years). Three patients had a history of thrombotic episodes.The 37 controls included 23 men and 17 women (mean age48 years, range 16-89 years). Disease activity wasassessed using the Harvey Bradshaw index for patients with Crohn's disease and the Truelove and Wittsgrading system for patients with ulcerative colitis.Levels of fibrinogen, antithrombin III (ATIII), proteinC, protein S, activated protein C resistance (APCR), and the presence of a lupusanticoagulant (LA) were determined. Median ATIII levelsin patients with IBD were significantly lower thancontrols (98% vs 106%, P = 0.007), while fibrinogen waselevated (4.2 vs 3.3 g/liter, P = 0.026) despitequiescent disease activity. LA was detected in 7/37patients in the IBD group compared to 0/37 controls.(² = 5.68, P = 0.017). No significantdifference was observed in levels of inherited thrombophilic factorsand in particular APCR between IBD patients andcontrols. In conclusion, the presence of inheritedthrombophilic defects, in particular APCR, is uncommonin patients with IBD and does not merit routinescreening.     

Type 2 (non-insulin-dependent) diabetes mellitus and glucose transporter gene (GLUT 1 andGLUT 4) polymorphism

Glucose transporter genes have been proposed as candidate genes for type 2 (non-insulin-dependent) diabetes mellitus. We chose to study the adult skeletal muscle glucose transporter gene (GLUT 4) andGLUT 1 in consideration of previous conflicting results obtained by different authors. We studied 68 patients with type 2 diabetes, and 66 non-diabetic controls matched for age, sex, and body mass index (BMI). Women and men were considered separately, according to BMI (24.0 and >24.0 for women; 25.0 and >25.0 for men). Allele and genotype frequencies were not significantly different in controls and in type 2 diabetic patients. ForGLUT 1 allele 1 and genotype x1x1 were more frequent, although not significantly (P=0.064 at ²,P=0.025 at Fisher exact test) in overweight/obese diabetic women than in overweight/obese non-diabetic women. These data do not support the hypothesis that these genes play a major role in genetic susceptibility to type 2 diabetes mellitus, but suggest a possible association, at least in women, of allele 1 ofGLUT 1 with obese type 2 diabetes mellitus.