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In order to test vaccines against enterotoxigenic Escherichia coli (ETEC)-10 CFU B7A or either dose of H10407. B7A had a shorter incubation period than H10407 (P ‫؍‬ 0.001) and caused milder illness; the mean diarrheal output after H10407 challenge was nearly twice that after B7A challenge (P ‫؍‬ 0.01). Females had more abdominal complaints, and males had a higher incidence of fever. Ciprofloxacin generally diminished or stopped symptoms and shedding by the second day of antibiotic treatment, but four subjects shed for one to four additional days. The immune responses to colonization factors CS6 and colonization factor antigen I (CFA/I) and to heat-labile toxin ( Enterotoxigenic Escherichia coli (ETEC)-induced diarrhea is recognized frequently in individuals who travel in developing countries around the world (4,7,8,26,29,47) and is a major medical problem for military personnel deployed in these countries (26,44,45). Since strict personal hygiene and avoidance of local water and fresh and undercooked foods are recommendations with which travelers have difficulty complying, other means to reduce the ETEC attack rate must be considered. The use of short-term chemoprophylaxis and self-treatment for diarrhea are effective for travelers who are unwilling to accept even a short period of illness because of the serious impact it would have on their overall mission. However, the routine use of antimicrobial prophylaxis for the general traveler is not recommended because of the potential for associated adverse drug reactions and the potential to worsen the problem of antibiotic resistance of enteric bacteria (8,25,29,43,47). These factors make development of vaccines against ETEC a priority.

A patient with primary gastric carcinoma exhibiting he‐patoid differentiation is described. The tumor itself was not associated with a high serum alpha‐fetoprotein, but the cells stained positive for alpha‐fetoprotein and alpha‐1 antitrypsin. The patient underwent a total gastrectomy and wedge excision of the liver metastasis. The presence of metastatic hepatoid adenocarcinoma of the stomach should be considered in a patient who, during surgery for a primary gastric carcinoma, is found to have a liver metastasis that is diagnosed by frozen‐section biopsy as a hepatoma. Because of lymph node and liver metastasis, prognosis appears to be poor for such patients.

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