MUC1 mucin is frequently observed in adenocarcinomas, and its association with metastasis has been postulated through the interaction between sialyl Lewis oligosaccharides present on this glycoprotein and selectins. Levels of soluble MUC1 recognized by anti-KL-6 monoclonal antibody were also frequently elevated in the sera of lung adenocarcinoma patients. The aim of this study was to demonstrate the presence of KL-6/MUC1 carrying sialyl Lewis a oligosaccharide, designated as SLAK, and subsequently evaluate the clinical significance of circulating SLAK in patients with lung adenocarcinoma. We developed a sandwich ELISA system using anti-sialyl Lewis a and anti-KL-6 antibodies to detect SLAK, and also measured circulating SLAK levels in 97 healthy controls and 103 patients with lung adenocarcinoma. Circulating SLAK levels were measured in the sera taken before treatment and then were evaluated to clarify whether such levels were related to the clinical outcomes. Levels of circulating SLAK were significantly higher in lung adenocarcinoma patients than in healthy subjects, and a higher serum SLAK level was correlated with the presence of distant metastasis. The overall survival rate for patients with high serum SLAK levels was significantly poorer than that of patients with low serum SLAK levels. The survival analysis restricted to the patients with distant metastasis also showed the same trend. In a multivariate survival analysis in lung adenocarcinoma patients, a high serum SLAK level was indicated as an independent prognostic factor. In conclusion, the circulating SLAK level at diagnosis is useful for predicting a poor prognosis in patients with lung adenocarcinoma. ' 2007 Wiley-Liss, Inc.Key words: MUC1; sialyl Lewis; lung cancer; metastasis; prognosis Mucins are large glycoproteins with extensive O-linked glycosylation, typically found on the apical surface of epithelial cells. During carcinogenesis, the normal topology and polarity of epithelial cells both change markedly, and aberrantly glycosylated mucins are expressed on the whole cell surface, thus leading to the shedding of these carcinoma mucins to the bloodstream.1,2 Sialyl Lewis a , also known as CA19-9, and sialyl Lewis x are sialylated fucosylated oligosaccharides that fall into this category. Both of these carbohydorate determinants present on mucins serve as ligands for the P-, L-and E-selectins expressed on the surface of platelets, leukocytes and vascular endothelial cells.3,4 As a result, carcinoma cells expressing these carcinoma mucins can interact with platelets, leukocytes and vascular endothelial cells via selectins on their cell surfaces, and this interaction is believed to mediate the adhesion of carcinoma cells to the vasculature, thereby promoting metastasis.5-8 Indeed, many studies have shown that the augmented expression of sialyl Lewis a and sialyl Lewis x on carcinomas correlate with a poor prognosis because of a high rate of metastasis. [9][10][11] MUC1 is a transmembrane mucin and its expression is known to increase in lung, breas...

Purpose The aim of the study was to evaluate serum uric acid (UA) levels before and after non-invasive positive pressure ventilation (NPPV)

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Various factors, including renal function and the combination of nonsteroidal anti-inflammatory drugs, influence the pharmacokinetics of pemetrexed. In this study, we aimed to determine the risk factors for severe adverse events associated with pemetrexed administration. We retrospectively examined the medical records of 82 patients who received pemetrexed. Multiple logistic regression analysis indicated that a creatinine clearance (CCr) of less than 45 mL/min and administration of pemetrexed as early-line treatment were significant risk factors. We then retrospectively compared the adverse events associated with pemetrexed between patients with normal renal function (CCr≥45 mL/min) and those with impaired renal function (CCr<45 mL/min). With regard to hematological toxicity, the frequency of occurrence of grade 3 neutropenia was significantly higher among patients with a CCr of <45 mL/min. With regard to non-hematological toxicity, the frequency of occurrence of grade 2 or higher nausea was significantly higher among patients with a CCr of <45 mL/min. However, the efficacy of pemetrexed did not differ significantly between the 2 groups. Our findings suggest that, for patients with a decline in renal function (CCr <45 mL/min), attention must be paid to the possibility of serious adverse events such as neutropenia and nausea when considering the administration of pemetrexed.

A 91-year-old male on treatment for type 2 diabetes mellitus was admitted to our hospital complained of general fatigue and high-grade fever since one day. He noticed hematuria for two days before admission. On physical examination, costovertebral angle tenderness pain was not observed. His body temperature was 39.1 °C, and heart rate was 110 beats per minute. Blood laboratory examination showed that white blood cell counts were 18,050/L, C-reactive protein 17.9 mg/dL, blood sugar was 254 mg/dL, and procalcitonin was 10.1 ng/mL. Urinalysis revealed moderate hematuria and proteinuria. On plain pelvic X-ray [computed tomography (CT) scan positioning image], unique linear circular-shaped gas was observed (arrow in Figure 1A). On plain abdominal CT demonstrated mildly thickened bladder wall and emphysematous region of bladder lumen (arrow in Figure 1B). We diagnosed this case as emphysematous cystitis. Urine culture revealed Staphylococcus aureus as the pathogen of this case. Intravenous administration of ampicillin sodium/ sulbactam sodium (3.0 g every 8 hour for seven days) was started and a balloon catheter was placed in the bladder. Then hematuria was improved. After seven days of treatment, administration of ampicillin sodium/ sulbactam sodium and placement of ballooned-bladder catheter were discontinued. Moreover, the patient was discharged ten days after admission.