Elevation of carcinoembryonic antigen coinciding with disease activity of ulcerative colitis.

We report on three cases of ulcerative colitis who presented with increased levels of serum carcinoembryonic antigen (CEA) during the active stage. All cases were pancolitis with a moderate to severe disease course. After remission induction with medical therapies, serum CEA levels decreased to the normal reference range. Immunohistochemical analyses demonstrated the existence of CEA not only along with the apical surface of the colonic epithelia but also at the cytosol of the inflamed epithelia where goblet cells were depleted during the active stage. We speculate that CEA was up-regulated by inflammatory response particularly in the process of epithelial regeneration.

The impact of disease activity of Crohn's disease during pregnancy on fetal growth.

Although it is known that women with inflammatory bowel disease have an increased risk of adverse outcome of pregnancy, the relationship between disease activity during pregnancy and the adverse outcome is not well known. A 29-year-old woman with Crohn's disease presented with flare-up at the end of the first trimester. Although the disease had been rendered inactive by maintenance infusion of infliximab, the drug was discontinued at the time of conception because of the patient's fear of the adverse effects of infliximab. Because retardation of fetal growth was observed at the flare-up, we re-started infliximab therapy. As disease activity reduced with therapy, the retardation of fetal growth subsequently improved. The patient finally delivered a newborn of 2550 g in weight and no adverse outcome was noted. The case supports the notion that disease activity is a risk factor for adverse outcome in pregnancy and that infliximab may be safely used in pregnancy.

[Two cases of gastric cancer expressing Glypican 3, but producing AFP with different lectin affinity].

We encountered 2 cases of AFP-producing gastric cancer. In the first patient, an 82-year-old man was found to have advanced type II advanced carcinoma in the stomach with a massive tumor embolus in the portal vein. In the second case, an 80-year-old man was given a diagnosis of multiple liver metastases of gastric cancer with portal vein thrombosis. Our diagnosis of gastric cancer in both cases was AFP-producing. It was supposed that the elevation of serum level of AFP might be caused by enteroblastic differentiation in the first case and hepatoid differentiation in the second case. Although, in both cases, the biopsy specimens of the gastric neoplasm proved moderately to poorly differentiated adenocarcinoma without hepatoid differentiation, the localization of Glypican 3 in gastric cancer cells was observed using immunostaining with a monoclonal antibody. In both cases, Glypican 3 was a sensitive and useful marker for AFP-producing gastric cancer with or without hepatoid differentiation.

[Black sheep effect and ingroup favoritism in social identity perspective].

Black sheep effect (Marques, Yzerbyt, & Leyens, 1988) and ingroup favoritism (Tajfel, Billig, Bundy, & Flament, 1971) appear to contradict each other with respect to the evaluation of inferior ingroup members. In addition to examining the relationship between the two phenomena, this study also examined the effect of ingroup identification on them. Sixty-one female student-nurses participated in the study. To measure black sheep effect, superior and inferior ingroup and outgroup members were rated on 20 adjectives. Distribution matrices (Tajfel et al., 1971) were used to measure ingroup favoritism. The participants were median split according to their level of group identification. Black sheep effect was found only among high-identification participants, who also showed ingroup favoritism. Ingroup identification had a positive correlation with both ingroup favoritism and black sheep effect. Overall, ingroup favoritism had a positive correlation with the evaluation of superior members, while it had a negative correlation with that of inferior ingroup members.