Five 14C-labelled macrolide antibiotics (erythromycin, josamycin, clarithromycin (TE-031), rokitamycin and roxithromycin) were studied for their transport into human polymorphonuclear leucocytes. Intracellular/extracellular concentration ratios (transport ratios) of these macrolides were quite high: erythromycin, 6.6; josamycin, 15.5; clarithromycin, 16.4; rokitamycin, 30.5; and roxithromycin, 21.9. When polymorphonuclear leucocytes were pre-treated with formaldehyde or incubated at 4 degrees C, or at low pH, transport ratios were reduced. When extracellular macrolide was removed, intracellular macrolide concentrations became as low as 30% of the pre-wash concentrations in 5 min. KF lowered the transport ratios of josamycin and rokitamycin in particular and NaCN reduced the transport ratios of erythromycin and josamycin strikingly. Ouabain slightly lowered transport ratios of all the antibiotics tested except roxithromycin, and 2, 4-dinitrophenol decreased the transport ratio of clarithromycin markedly. The addition of various amino acids or hexose did not inhibit the transfer. Adenosine, however, inhibited the transfer of these antibiotics except erythromycin and lowered transport ratios by 83 to 92%. Puromycin reduced transport ratios of the same antibiotics by 59 to 95%. With polymorphonuclear leucocytes that had phagocytosed Legionella pneumophila serogroup 1, transport ratios of all five drugs tended to decrease. However, when Staphylococcus aureus ATCC 25923 or opsonized zymosan was phagocytosed, transport ratios for macrolides, except for roxithromycin, increased.

Our results suggest that probiotic therapy with CBM achieved favorable results with minimal side effects and might be a useful complementary therapy for the prevention of pouchitis in patients with UC who have undergone IPAA.

Serum I-FABP measurement is a non-invasive method that is potentially useful for the efficient identification of patients with acute abdomen who are at risk of small bowel ischemia.

We investigated the serum levels of the tumor-associated carbohydrate antigens sialyl SSEA-1 (SLX) and sialyl Lewis(a) (CA19-9) in patients with diffuse panbronchiolitis (DPB) and other nonmalignant lung diseases. Both antigens were high in the serum and bronchoalveolar lavage fluid (BALF) of patients with DPB, bronchiectasis (BE), idiopathic pulmonary fibrosis (IPF), and interstitial pneumonia associated with collagen vascular disease (CVD). Markedly high levels of the antigens were demonstrated in the serum and BALF from patients with DPB. An immunohistochemical study of open-lung biopsy specimens from patients with DPB indicated that these antigens were selectively expressed on the bronchiolar epithelial cells and mucinous exudates in airspaces. Low-dose, long-term erythromycin (EM) treatment was recently reported to be effective for DPB, and we investigated its influence on serum and BALF antigen levels in DPB patients. Antigen levels in both serum and BALF decreased after EM treatment, with improvement of symptoms and laboratory data, and there was a significant correlation between the reduction in the SLX level in serum and neutrophil percentage in BALF pre- and post-EM treatment. Our result suggests that secreted carbohydrate antigens from the bronchiolar epithelium in DPB may appear in the serum as a result of airway damage in the lower respiratory tract, and serum levels of the antigens may be decreased by a reduction in neutrophils in BALF after EM treatment.

Thirty-eight (designated as cases) of 60 Korean emigrants who consumed raw fresh water fish in Yangon, Myanmar developed migratory swellings and creeping eruptions on the back, abdomen, flank, and other cutaneous areas 1-10 weeks later. The symptoms included itching, nodule formation, fatigue, urticaria, fever, pain on the skin, and erythematous plaques. Skin biopsies of two cases revealed no parasites. However, the mean ± SD peripheral blood eosinophilia among the cases was 6.3 ± 6.5% (n ‫ס‬ 29) and 9.0 ± 9.8% (n ‫ס‬ 26) in two examinations. An enzyme-linked immunosorbent assay of their serum samples, using Gnathostoma doloresi adult worms as the antigen, showed mean ± SD optical densities of 0.47 ± 0.29 (n ‫ס‬ 28) and 0.32 ± 0.20 (n ‫ס‬ 30) in two examinations and 0.12 ± 0.09 (n ‫ס‬ 50) in healthy controls. Two advanced third-stage larvae of G. spinigerum were found in two of six catfish purchased at a local market in Yangon. The outbreak of the human infection is suggested to have been due to G. spinigerum, which is known to live out its life cycle in the Yangon area of Myanmar.

We report on an exceedingly rare case of noninvasive ductal carcinoma arising in malignant phyllodes tumor of the breast. The patient was a 75-year-old woman who presented with a chief complaint of an indolent tumor mass of the left breast. Papillotubular carcinoma was diagnosed by aspiration cytology, and mastectomy with preservation of the pectoral muscle was subsequently performed (Bt+Ax+Ic, R2). Histopathological examination showed proliferation of monotonous, uniform tumor cells in a cribriform pattern amid atypical and spindle-shaped cells. Neither stromal invasion of the epithelial tumor cells nor clear transition between epithelial tumor cells and non-epithelial tumor cells was seen. Immunohistochemical staining revealed that the epithelial component was positive for antibodies such as CEA, EMA and keratin, while the non-epithelial component was negative for the same antibodies. Malignant phyllodes tumor with a noninvasive ductal carcinoma was diagnosed rather than true carcinosarcoma of the breast. No metastasis was detected in the axillary lymph nodes, and the patient was classified as stage II A (T2N0M0). Although neither chemoendocrine therapy nor irradiation was employed postoperatively, no recurrence was observed two years and two months after the surgery. There is little consensus on the treatment or prognosis of the disease. Careful observation of the present case is therefore important.

Background. The alterations of carbohydrate chains in cancer cell membrane can be related, not only to the formation of tumor‐associated antigens, but also to cell biologic significance. There is, furthermore, a possibility of their relationship to tumor metastatic behavior and subsequent survival of patients with cancer. Recent clinical studies elucidated that a carbohydrate antigen, sialyl Lex, is a useful tumor marker in colorectal cancer. However, the sialyl Lex antigen immunoreactivity in colorectal carcinoma in relation to patient survival is unknown. The aim of the study was to elucidate whether sialyl Lex expression in tumors was correlated with patient survival. Methods. Immunohistochemical expression of sialyl Lex antigen, as detected by monoclonal antibody CSLEX1, was studied in 175 specimens of primary colorectal carcinoma from 120 patients who received radical surgery. Results. The positive expression of sialyl Lex was observed in 87 of 120 patients (72.5%). There was no statistically significant association between the negative or positive of sialyl Lex and clinicopathologic factors, excluding Dukes stage and histologic type. The difference between overall 5‐year survival of patients with sialyl Lex‐negative tumors and that of patients with sialyl Lex‐positive tumors (81.2% versus 60.6%) was statistically significant (P = 0.0263). In proportion to staining intensity that was expressed as a score based on the percentage of the total field stained positive with CSLEX1, 5‐year survival of patients indicated a worse outcome (P = 0.0113). The prognostic value was then studied in a Cox regression model. Dukes stage had the strongest association with patient survival, whereas sialyl Lex expression was found to be the second‐ranking parameter. Conclusions. When examining the expression of sialyl Lex antigen, as detected by monoclonal antibody CSLEX1, clinically useful information for patient survival after radical resection of colorectal cancer is given.

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