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Cryptosporidium parvum is the second-most prevalent Cryptosporidium species that infects humans worldwide. In European countries, it is the most prevalent species in sheep, suggesting that these animals are a source of zoonotic infection. Preweaned lambs and goats are particularly susceptible to infection by the parasite and may suffer from severe diarrhea whilst excreting large quantities of infectious oocysts. Fifty fecal samples from preweaned lambs and goats with diarrhea from 35 farms across Israel, found to be Cryptosporidium-positive by microscopy, were tested by PCR and sequence analyses to determine the infective species and subtypes. Cryptosporidium parvum DNA was detected in most samples from both lambs and goats (46/50). Cryptosporidium xiaoi DNA was detected in three samples from kids, with co-infection detected in a single sample. Eleven different C. parvum subtypes were found, 10 in lambs and 5 in goats. All subtypes were from the IIa and IId subtype families, with subtypes IIdA20G1 and IIaA15G2R1 being the most prevalent and widespread. These subtypes were previously found in calves and humans in Israel and are considered the most prevalent C. parvum subtypes in small ruminants globally. These results underline the zoonotic potential of C. parvum from small ruminants and the high subtype diversity compared to previous reports from other Middle Eastern countries. In addition, this is the first report of C. xiaoi in Israel., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Our group has conducted several studies of sentinel node navigation surgery (SNNS) for the management of early gastric cancer. To determine the distribution of nodal metastases and micrometastases, we used immunohistochemical staining with anticytokeratin antibody to examine 2605 lymph nodes obtained from 108 consecutive patients with submucosal gastric cancer. When nodes were negative by routine hematoxylin and eosin (H&E) examination, micrometastases were confined to one regional lymphatic pathway near the primary tumor; however, when nodes were H&E-positive, micrometastases were distributed more widely. The wide and complicated lymphatic stream from a gastric tumor contributed to the relatively high (23%) incidence of micrometastases and the frequent occurrence of skip metastasis. In another study, we used a combination of blue dye and radiopharmaceutical to perform SNNS in 18 patients with early gastric cancer. The rate of sentinel node detection was 94%, and the average number of sentinel nodes per patient was three. Technical issues included size of particles, method of injection, accuracy of frozen section examination, and standard criteria for defining a sentinel node. SNNS for gastric cancer is a promising technique; further study of various anatomic and pathologic factors will indicate whether it can be used to determine the extent of lymphadenectomy necessary in patients with early gastric cancer.