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Balsalazide (BSZ) is a pro-drug which releases 5-aminosalicylic acid (5ASA) and 4-aminobenzoyl-~-alanine (an inert carrier) in the colon of various species including man. BSZ was compared with sulphasalazine (SASP) (both I g b.d. orally) in the maintenance of remission in patients with ulcerative colitis (UC). Seventy-nine patients (53 male, 26 female), mean age 49 years (range 19-79 years), with UC were randomly allocated to either treatment (41 BSZ, 38 SASP) for 6 months. The groups were similar in respect of age, sex, duration and extent of disease. Seven patients defaulted (3 BSZ, 4 SASP) leaving 38 on BSZ and 34 on SASP.Two male patients, both receiving SASP, were withdrawn because of severe side-effects. One of these patients, with an exfoliative rash, was maintained satisfactorily on open BSZ. Remission rates at 6 months (5 1 % BSZ, 63 % SASP) were not significantly different (life-table analysis P < 0.1). Twelve patients (15 %) reported troublesome side-effects (2 BSZ 5 YO, 10 SASP 26%, P = 0.017 Fisher Exact Test). Mean haemoglobin concentrations, similar on entry, increased after 6 months with BSZ (0.2 g/dl) but decreased with SASP (0.5 g/dl) (P < 0.0OOZ). BSZ was not significantly different from SASP in maintaining remission in patients with UC but had fewer side-effects. Correspondence to: Professor 1. E. Lennard-Jones, St Marks Hospital, City Road, London EC1V ZPS, LJK 23 7 238 P. B. McINTYRE ef al.

The clinical, virological, and biochemical course of 3 chronic HBsAg carriers who developed acute hepatitis A is described. Two of the patients had pre-existent chronic active hepatitis. The clinical course in each case was benign with resolution within one month, and there was a marked fall in HBsAg titre in one of the patients with chronic active hepatitis.

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omeprazole has not been shown to cause any changes in endocrine cell density,'6 but further studies are needed to elucidate the possible consequences of prolonged acid inhibition in man.We thank Mrs Rigmor Petersen and Mrs Grete Eskesen for secretarial help; the staff of our endoscopy units for their valued support; Mr Kjeld Clemmensen-Rotne, Astra-Gruppen A/S, Albertslund, Denmark, for skilfully monitoring the conduct of the study; and A B Hassle, Molndal, Sweden, for the study drugs. In all six cases small lesions were seen in the stomach at endoscopy, and histological examination of biopsy specimens taken from the lesions confirmed the diagnosis of Kaposi's sarcoma. The barium meal examinations were reported as normal in three patients and showed oesophageal candidiasis in the fourth. These findings suggest that Kaposi's sarcoma of the upper gastrointestinal tract is common in patients positive for HIV antibody, even those without cutaneous lesions. Endoscopy, with biopsy of suspicious lesions, is necessary to make the diagnosis and is recommended in all HIV antibody positive patients with persistent upper gastrointestinal symptoms. References IntroductionInfection with human immunodeficiency virus (HIV) results in a wide range ofopportunistic infections and tumours, the commonest of which is Kaposi's sarcoma. Two studies have suggested that