Stem cell transplantation in patients with severe congenital neutropenia with evidence of leukemic transformation

Severe congenital neutropenia (SCN) is a hematologic condition characterized by arrested maturation of myelopoiesis at the promyelocyte stage of development. With appropriate treatment using recombinant human granulocyte-colony-stimulating factor (r-HuG-CSF), SCN patients are now surviving longer, but are at increased risk of developing myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML). Hematopoietic stem cell transplantation (HSCT) is the only curative option for these patients, but transplantation outcomes after malignant transformation are not well established. We report results for six patients with SCN who underwent HSCT for MDS or AML between 1997 and 2001 at two transplant centers. Two patients transplanted for MDS survived. Both of these patients were transplanted without being given induction chemotherapy. Four patients, who all received induction chemotherapy for AML prior to HSCT, died. Administering induction chemotherapy prior to HSCT resulted in significant morbidity. Rapid transplantation should be the goal for the SCN patient once the diagnosis of MDS/AML is established. SCN patients should be monitored carefully for progression to MDS in order to be treated with HSCT as soon as they have progressed and before developing AML. For SCN patients who progress to AML, HSCT should still be considered, even though the risks appear to be greater.

EPR characterization of the catalytic activity of clays for PCE removal by gamma-radiation induced by acid and thermal treatments

Clays from tidal flat sediments showed efficient catalytic activity in the decomposition of PCE by gamma-radiation. The highest PCE removal of 98.6% was obtained with clays heated to 700 degrees C after acid treatment. The improved catalytic activity was identified by electron paramagnetic resonance (EPR) spectroscopy. The EPR spectra of clays were significantly changed by the acid and thermal treatments. The intensity of a narrow signal at g=2 (signal III) was decreased with increasing thermal treatment temperature and this increased the PCE removal efficiency. The acid treatment completely removed a broad signal at g=2 (signal II), decreased the intensity of signal III, and improved the gamma-radiation treatment of PCE.

Development of counterpulsation algorithm for a moving-actuator type pulsatile LVAD

A pulsatile left ventricular assist device (LVAD) was used to support the aortic blood pumping function of an injured left ventricle, and as a result helped its recovery. It is important to observe a left ventricle's pumping status and to adjust the operating status of a LVAD to reduce the left ventricle's pumping load and thus to enhance its recovery. To observe the left ventricle's pumping status, an electrocardiogram (ECG) signal is generally used because it is a result of the natural heart's blood pumping function. In this paper, we describe the development of an ECG based counterpulsation control algorithm that prevents simultaneous aortic blood co-pumping by a left ventricle and a moving-actuator type pulsatile LVAD and as a result, reduces the natural heart's pumping load. In addition, to verify the algorithm's applicability for LVAD control we designed three ECG based automatic pump control algorithms that use a developed counterpulsation control algorithm. These algorithms control the operating status of a LVAD automatically and, at the same time, maintain a counterpulsing status. The results of in vitro experiments show that the counterpulsing effect between a left ventricle and a LVAD was successfully produced and that the newly designed automatic pump control algorithms met their own control purposes with a counterpulsing effect.

Vitamins C and E: acute interactive effects on biomarkers of antioxidant defence and oxidative stress

Oxidative stress is implicated in the aetiology of many diseases; however, most supplementation trials with antioxidant micronutrients have not shown expected beneficial effects. This randomized, double-blinded, placebo-controlled study evaluated acute effects (at 90, 180min and 24h [fasting] post-ingestion) of single doses of Vitamins C (500mg) and E (400IU), alone and in combination, on biomarkers of plasma antioxidant status, lipid peroxidation and lymphocyte DNA damage in 12 healthy, consenting volunteers. Plasma ascorbic acid increased significantly (P < 0.01) within 2h of ingestion of Vitamin C, and alpha-tocopherol was significantly (P < 0.01) higher at 24h post-ingestion Vitamin E. The pattern of response was not significantly different whether Vitamin C (or Vitamin E) was taken alone or in combination, indicating no augmentation of response to one by co-ingestion of the other vitamin. No significant changes were seen in plasma FRAP in the group overall (although increases (P < 0.05) were seen at 90 and 180min post-ingestion in women after Vitamin C ingestion) or in MDA across treatments, and no evidence of increased DNA damage, or of DNA protection, was seen at any time point after Vitamin C and/or E ingestion. In conclusion, the data from this first controlled study of acute effects of single doses of Vitamin C and/or E show no evidence of either a protective or deleterious effect on DNA damage, resistance of DNA to oxidant challenge, or lipid peroxidation. No evidence of a synergistic or cooperative interaction between Vitamins C and E was seen, but further study is needed to determine possible interactive effects in a staggered supplementation cycle, and study of subjects under increased oxidative stress or with marginal antioxidant status would be useful. It would be of interest also to study the effects of these vitamins ingested with, or in, whole food, to determine if they are directly protective at doses above the minimum required to prevent deficiency, if combinations with other food components are needed for effective protection, or if Vitamins C and E are largely surrogate biomarkers of a 'healthy' diet, but are not the key protective agents.

Plutonium isotopes in seas around the Korean Peninsula

239+240Pu concentrations and 240Pu/239Pu atom ratios in coastal seas adjacent to the Korean Peninsula were determined, during the period 1999 to 2002, to assess the current distribution and to identify sources of Pu isotopes. 239+240Pu concentrations in surface waters ranged from 3.1 to 22.3 mBq m(-3) with higher concentrations in winter than in summer. 239+240Pu concentrations in seawaters around the Korean Peninsula are greater than that in the western North Pacific. 240Pu/239Pu atom ratios ranged from 0.18 to 0.33 with an average value of 0.25+/-0.03, which is significantly higher than the global fallout average. The 240Pu/239Pu atom ratios of the 2000 m deep entire water column in the south western part of the East Sea (Sea of Japan) was comparable to that observed in waters near Bikini Atoll. The higher 240Pu/239Pu atom ratios than that of global fallout may be explained by the hypothesis that the earlier input signal of low 240Pu/239Pu atom ratio (0.18-0.19) of global fallout plutonium in seas adjacent to the Korean Peninsula is being gradually diluted by the high 240Pu/239Pu atom ratio plutonium transported from the tropical Pacific Proving Grounds via prevailing ocean current.

Effects of Defatted Safflower Seed Extract and Phenolic Compounds in Diet on Plasma and Liver Lipid in Ovariectomized Rats Fed High-Cholesterol Diets

Six polyphenolic compounds were isolated from ethylacetate extract secondary to 80% ethanol extraction of defatted safflower seeds. They were categorized into three types: lignans, flavones and serotonin derivatives. Female Sprague-Dawley rats weighing 163.4 +/- 6.3 g were ovariectomized (Ovx) and fed either ethylacetate extract at a level of 1% (w/w) or three types of safflower polyphenolic compounds at a level of 200 mg/kg in a diet containing 0.5% (w/w) cholesterol for four wk. The sham and Ovx control groups were fed the same diet without safflower components. Plasma GOT and GPT levels did not differ among the six experimental groups. The plasma levels of total cholesterol were reduced in the four safflower groups by 20-30% as compared to the Ovx control. The plasma level of HDL-cholesterol was higher in the Ovx+ethylacetate extract group or appeared to be in the three Ovx+safflower polyphenolic groups than in the Ovx control. The level of plasma triglyceride was also significantly lower in the Ovx+lignan group than in the Ovx control. The liver level of cholesterol was significantly reduced in the Ovx+ethylacetate extract group. Fecal excretion of cholesterol increased by the safflower lignans and flavones, whereas that of bile acid was not significantly changed by the safflower polyphenols. Matairesinol and acacetin isolated from safflower seeds reduced the cholesterol content in cultured HepG2 cells at a concentration of 0.01-0.1 microM and all three safflower polyphenolics decreased triglyceride content at the concentration of 0.1 microM. These results suggest that safflower polyphenols have the effect of improving blood lipid status via increasing HDL-cholesterol formation and cholesterol excretion without significant uterotropic action in estrogen-deficient animals.

Effects of forsythia fruit extracts and lignan on lipid metabolism

A primary methanol extract (F-ME), secondary butanol-soluble fraction (F-BU), and lignans were prepared from forsythia fruit (Forsythia viridissima L.) and added to 0.5% (w/w) cholesterol diets for male Sprague-Dawley rats weighing 121 +/- 12 g. There were six experimental groups: a control group, 0.2%, 0.4% F-ME supplemented groups, 0.1%, 0.02% F-BU groups and 0.02% lignan group. After 3 weeks of feeding, body weight gains, serum GOT and GPT levels were not different among the groups. HDL-/total cholesterol ratios increased in the 0.2% F-BU and lignan groups compared with the control groups. Liver triglyceride level lowered in most of forsythia groups. Fecal cholesterol excretions increased in the lignan group. Arctiin isolated from the forsythia fruit reduced cholesterol and triglyceride contents in cultured HepG2 cells at 0.01-0.1 microM. These results indicated that the forsythia lignan, arctiin is effective on improving blood lipid status without a significant hepatotoxicity and is to be utilized for the functional foods for lipid-lowering action.

Applications of the pulsatile flow versatile ECLS: in vivo studies

INTRODUCTION

T-PLS (Twin-Pulse Life Support) is the first commercial pulsatile ECLS (Extra Corporeal Life Support) device (1). The dual sac structure of T-PLS can effectively reduce high membrane oxygenator inlet pressure and hemolysis. To verify both the use of T-PLS for ECLS and the advantages of T-PLS, we tested various models.

METHOD AND RESULTS

In the partial CPB (cardio pulmonary bypass) model (swine), T-PLS (N = 6), and Biopump (N = 2), a single pulsatile pump (N = 2), were compared. In the case of single pulsatile flow, during pump systole, pressure increased to 700 - 800 mmHg at the inlet port of the membrane oxygenator. fHb, a hemolysis measurement value, was about 80 mg/dL at 3 hours. On the contrary, because of T-PLS's dual sac system, the pressure of T-PLS had a maximum value of about 250 mmHg and fHb was similar to that of the commercial centrifugal pumps. In the total CPB model (bovine, N = 6), the heart was stopped via cardioplegia (Kcl). T-PLS flow was maintained at 3.0-4.5 L/min. T-PLS functioned like a natural heart, having a pulse pressure of 26-43 mmHg and a pulse rate of 40-60 bpm (beats per minute). In the emergency case model (canine, N = 6), T-PLS was started 10 minutes after cardiac arrest from electronic shock. In spite of cardiac arrest for a period of 40 minutes, the heart was recovered after defibrillation. In the ARDS (Acute Respiratory Distress Syndrome) model (canine, N = 6), minimal ventilator parameters were set: tidal volume 130 ml, respiration rate = bpm, FiO2 = 10%. Three hours after starting T-PLS, PO2 of the carotid artery blood (after 2 hours: 195 +/- 89.4; after 3 hours: 258 +/- 99.3 mmHg) was above half the value of the femoral artery but was within normal range.

CONCLUSION

It is suggested that a portable pulsatile ECLS like T-PLS may be used as a CPB device and as an alternative CPR (cardiopulmonary resuscitation) device in the case of cardiac arrest. Due to the pulsatile flow, oxygenated blood is delivered to the patient without overloading the ARDS patients heart.

Fibroblast culture on surface-modified poly(glycolide-co-epsilon-caprolactone) scaffold for soft tissue regeneration

Novel porous matrices made of a copolymer of glycolide (G) and epsilon-caprolactone (CL) (51 : 49, Mw 103000) was prepared for tissue engineering using a solvent-casting particulate leaching method. Poly(glycolide-co-epsilon-caprolactone) (PGCL) copolymer showed a rubber-like elastic characteristic, in addition to an amorphous property and fast biodegradability. In order to investigate the effect on the fibroblast culture, PGCL scaffolds of varying porosity and pore size, in addition to surface-hydrolysis or collagen coating, were studied. The large pore-sized scaffold (pore size >150 microm) demonstrated a much greater cell adhesion and proliferation than the small pore-sized one. In addition, the higher porosity, the better the cell adhesion and proliferation. The surface-hydrolyzed PGCL scaffold showed enhanced cell adhesion and proliferation compared with the unmodified one. Type I collagen coating revealed a more pronounced contribution for increased cell interactions than the surface-hydrolyzed one. These results demonstrate that surface-modified PGCL scaffold can provide a suitable substrate for fibroblast culture, especially in the case of soft tissue regenerations.

Bone-protecting effect of safflower seeds in ovariectomized rats

Safflower (Carthamus tinctorius L.) seeds have long been clinically used in Korea to promote bone formation and prevent osteoporosis. However, the beneficial effect has not been scientifically evaluated. Thus, in the present study we investigated whether phytoestrogen rich safflower seeds reduce bone loss in ovariectomized rats. Female Sprague-Dawley rats were subjected to bilateral ovariectomy or sham surgery. One week after the operation, ovariectomized rats were either fed a diet containing defatted safflower seeds or injected with 17b-estradiol (E2) for 4 weeks. As expected, ovariectomy resulted in a dramatic reduction in trabecular bone mass of the proximal tibia, increase in deposition of marrow fat, and in uterine atrophy. E2 treatment almost completely prevented bone loss as well as marrow adiposity, as examined by scanning electron microscopy and histomorphometry. Safflower seeds partially prevented ovariectomy-induced bone loss and slightly reduced marrow adiposity. Safflower seeds, in contrast to E2, exerted very weak uterotrophic action. In an attempt to elucidate the underlying mechanisms, effect of polyphenolic compounds extracted from safflower seeds on proliferation of osteoblast-like cells was also assessed in vitro. The mixed polyphenolic compounds stimulated growth of ROS 17/2.8 osteoblast-like cells in a dose-dependent manner (5-100 mg/ml), as potently as E2 and genistein. The present data provide the first direct in vivo evidence that safflower seeds have a protecting effect on bone loss caused by estrogen deficiency, without substantial effect on the uterus. The beneficial effect of safflower seeds may be mediated, at least in part, by the stimulating effect of polyphenolic compounds on proliferation of osteoblasts.

Disturbance detection and isolation in the activated sludge process

This paper proposes a new fault detection and isolation (FDI) method. This method monitors the distribution of process data and detects changes in this distribution, which reflect changes in the corresponding operating condition. A modified dissimilarity index and a FDI technique are defined to quantitatively evaluate the difference between data sets. This technique considers the importance of each transformed variable in the multivariate system. The FDI technique is applied to a benchmark simulation and to data from a real wastewater treatment plant. Simulation results show that it immediately detects disturbances and automatically distinguishes between serious and minor anomalies for various types of fault. The method not only detects the disturbances, but also isolates the scale of the disturbance, facilitating the interpretation of the disturbance source. The proposed monitoring technique is found to be appropriate for analyzing the biological wastewater treatment process, which is characterized by a variety of fault and disturbance sources and non-stationary characteristics.

The wound-healing effect of a glycoprotein fraction isolated from aloe vera

BACKGROUND

Aloe vera has been used as a family medicine for promoting wound healing, but it is not known which component of the plant is effective for this purpose.

OBJECTIVES

To isolate and characterize the component effective in wound healing.

METHODS

Chromatography, electrophoresis and spectroscopic methods were used. The cell-proliferation activity of each component isolated was measured by a [3H]thymidine uptake assay. The cell-proliferation activity of the effective component was tested on a three-dimensional raft culture (cell culture technique by which artificial epidermis is made from keratinocytes). The effect of the active component on cell migration and wound healing was observed on a monolayer of human keratinocytes and in hairless mice.

RESULTS

A glycoprotein fraction was isolated and named G1G1M1DI2. It showed a single band on sodium dodecyl sulphate-polyacrylamide gel electrophoresis, with an apparent molecular weight of about 5.5 kDa. It exhibited significant [3H]thymidine uptake in squamous cell carcinoma cells. The effect of G1G1M1DI2 on cell migration was confirmed by accelerated wound healing on a monolayer of human keratinocytes. When this fraction was tested on a raft culture, it stimulated the formation of epidermal tissue. Furthermore, proliferation markers (epidermal growth factor receptor, fibronectin receptor, fibronectin, keratin 5/14 and keratin 1/10) were markedly expressed at the immunohistochemical level. The glycoprotein fraction enhanced wound healing in hairless mice by day 8 after injury, with significant cell proliferation.

CONCLUSIONS

It is considered that this glycoprotein fraction is involved in the wound-healing effect of aloe vera via cell proliferation and migration.

Ultrastructural changes of hepatic stellate cells in the space of Disse in alcoholic fatty liver

BACKGROUND

Hepatic stellate cell (HSC) has been suggested to play a role in fibrogenesis in alcoholic liver disease. We evaluate the correlation with fibrogenesis and ultrastructure of hepatic stellate cells in alcoholic fatty liver.

METHODS

We studied 6 patients with alcoholic fatty liver and 5 non-alcoholic fatty liver. The numbers of fat droplets in hepatic stellate cell was determined by electron microscopy. We also studied the grading of deposition of collagen fibers in the space of Disse. We were to evaluate the structure of hepatic stellate cells in the space of Disse by light and electron microscopy.

RESULTS

Wider distribution of fat droplets in hepatic stellate cells in alcoholic fatty liver than in normal liver. The hypertrophied endoplasmic reticulum in hepatic stellate cells is a prominent findings in alcoholic fatty liver. We observed basement membrane-like materials in patients with alcoholic fatty liver with hepatic fibrosis.

CONCLUSION

The results demonstrate that, in patients with alcoholic fatty liver by alcoholic liver injury, the hepatic stellate cells may play an important role in the fibrogenesis of perisinusoidal spaces in the liver.

Topographical anatomy of the fibula and peroneal artery in Koreans

Vascularized fibula flaps have many advantages in the restoration of the contour and function of the mandible. Potential disadvantages include, unreliable skin paddle and the limited volume of the fibula. This study was designed, to clarify the anatomy of the peroneal artery to the fibula and lateral leg skin, and to measure the dimensions of the fibula available for dental implant placement in Korean. Through the dissection of 63 legs of Korean cadavers, we demonstrated that in most cases the musculoperiosteal (mp) and septocutaneous (sc) branches of the peroneal artery were distributed at the middle and lower thirds of the fibula. There were double the number of mp perforators to the skin compared to sc branches. This indicates the inclusion of a generous > 1 cm cuff of Peroneous longus and flexor hallucis longus (FHL) in the distal and middle third of the fibula. The location of the nutrient foramen was just proximal to the midpoint. Thus, a 15-20 cm length of the fibula is available in Koreans and an 8 12 mm length of implant can be placed to the fibula, which provides sufficient bone to reconstruct a large mandibular defect.

Determinants and prognostic implications of terminal QRS complex distortion in patients treated with primary angioplasty for acute myocardial infarction

Terminal QRS complex distortion on admission has an impact on a patient's prognosis after primary angioplasty for acute myocardial infarction (AMI). We evaluated the determinants and prognostic significance of terminal QRS complex distortion in 153 consecutive patients with AMI after primary angioplasty. The study population was divided into 2 groups according to the presence (group I, n = 41) or absence (group II, n = 112) of terminal QRS complex distortion. The primary end points were the occurrence, within 6 weeks after AMI, of death, nonfatal reinfarction, or congestive heart failure. Baseline characteristics were similar between the 2 groups. However, patients in group I had higher peak levels of serum creatine kinase than those in group II (5,100 +/- 3,100 vs 3,000 +/- 1,800 U/L, respectively, p <0.01). The rate of angiographic no-reflow (Thrombolysis In Myocardial Infarction flow grade < or =2) was 31.7% in group I and 10.7% in group II (p <0.01). The predischarge left ventricular ejection fraction was 45.0 +/- 12.0% in group I and 54.0 +/- 8.0% in group II (p <0.01). Multivariate analysis identified the pressure-derived fractional collateral flow index and the culprit lesion in the left anterior descending coronary artery as independent determinants of the terminal QRS complex distortion. No patients died during 6 weeks of follow-up. The 2 groups were similar for life-threatening arrhythmia or reinfarction. However, there were more patients in group I than in group II with congestive heart failure (26.8% vs 5.4%, respectively, p <0.01) or who reached the primary end points (29.3% vs 5.4%, respectively, p <0.01). In conclusion, terminal QRS complex distortion on admission is associated with poor clinical outcome after primary angioplasty for AMI, and collateral flow may have a major influence on terminal QRS complex distortion during AMI.

Characteristics of body heat balance of paraplegics during exercise in a hot environment

The purpose of this investigation was to clarify the characteristics of body temperature regulation in paraplegics due to spinal cord injury (SCI) during an arm cranking exercise in a hot environment. Twelve paraplegics with lesions located between Th3 and L1,2 and seven able-bodied subjects (AB) participated in this study. The subjects were exposed to a hot (33 degrees C) or a moderate temperature (25 degrees C) environment for one hour and during the last 10 min of the exposure, the subjects performed arm cranking exercises at an exercise intensity of 40 W. The skin temperatures at the chest, the upper arm, the thigh and the calf, the tympanic membrane temperature (Tty), and the skin blood flow of the thigh (SBFT) were continuously monitored during the experiment. Although no systematical variation was found in the Tty at 25 degrees C, the Tty at 33 degrees C in paraplegics during exercise was significantly greater than that at rest (P < 0.01), which indicated a pronounced heat stress for paraplegics at 33 degrees C. SBFT of paraplegics with high lesions of the SCI remained unchanged during the experiment at 25 degrees C and 33 degrees C, while paraplegics with low lesions in this study showed consecutive increases in SBFT during exercise in both environmental conditions similar to AB. The increased core temperature in paraplegics with high lesions was considered to be due to a lack of sweat response and vasomotor activity in the paralyzed area. On the basis of the findings in this study, it can be suggested that high core temperature without any increment of SBFT may be characterized as body heat balance of paraplegics with high lesions during exercise in a hot environment.

An improved method for determination of ethyl carbamate in Korean traditional rice wine

An improved extraction method for ethyl carbamate, a genotoxic and carcinogenic compound found in various fermented foods and beverages, was investigated for its determination in the two most typical Korean traditional rice wines, takju and yakju. When the rice wines were extracted twice with chloroform at 30 degrees C for 60 min, the recovery of ethyl carbamate was less than 16%. When they were saturated with NaCl before extraction, the recovery of ethyl carbamate increased to 24.4% in takju and 67.2% in yakju. Adjustment of pH to 9.0 after NaCl saturation in takju resulted in a dramatic increase of recovery to 81.2%, but not in yakju. When the contents of ethyl carbamate and its precursor, urea, in various Korean traditional rice wines were determined, there was no correlation between the two contents. This is due to the fact that storage time is more important than urea content in the formation of ethyl carbamate in rice wine. In addition, its storage at high temperature resulted in a dramatic increase in ethyl carbamate content according to the prolonged storage time, suggesting that storage time and temperature play a key role in the formation of ethyl carbamate in Korean traditional rice wine.

Purinoceptor-mediated calcium mobilization and proliferation in HaCaT keratinocytes

To investigate the effect of nucleotides on cytosolic free calcium mobilization and proliferation activity in HaCaT keratinocytes, nucleotides-induced intracellular free calcium concentration ([Ca(2+)](i)) and cell proliferation observed. [Ca(2+)](i) to the extracellular nucleotides was determined using Ca(2+) sensitive indicator, Fura-2/AM with digital video fluorescence imaging microscopy, and cell proliferation was evaluated by counting of cell number. An adenosine 5'-triphosphate (ATP)-induced [Ca(2+)](i) increase was observed from the concentration of 10(-8) M and was more conspicuous at higher concentrations in a concentration-dependent manner. Additionally, other nucleotides such as ADP, UTP, and 2-me-S-ATP also induced a [Ca(2+)](i) increase in a concentration-dependent manner. However, adenosine induced a slight increase of [Ca(2+)](i) only at 10(-3) M. alpha,-methylene-ATP did not evoke any rise in [Ca(2+)](i). The maximal response observed occurred with ATP and UTP at a concentration of 10(-4) M. The ATP-induced transient [Ca(2+)](i) increase was attenuated by the pretreatment with phospholipase C (PLC) inhibitor, U-73122 (10 microM) for 30 min. ATP-induced [Ca(2+)](i) increase and cell proliferation were inhibited by putative P2Y receptor antagonist, suramin (10(-4) M). When the HaCaT cells were stimulated with nucleotides on a concentration of 10(-4) M and cultured for 5 days, the order of effect on cell proliferation was observed to be ATP>UTP>ADP>2-me-S-ATP. Based on these results, we suggest that extracellular ATP stimulate HaCaT keratinocytes proliferation via purinoceptor-mediated [Ca(2+)](i) mobilization

Lower gastrointestinal bleeding due to cytomegalovirus ileal ulcers in an immunocompetent man

Cytomegalovirus (CMV) infections are commonly reported in severely immunocompromised hosts and ulcers of the alimentary tract are frequently observed in systemic CMV infections. However, invasive and ulcerative disease of the gastrointestinal (GI) tract caused by CMV has also been reported in healthy adults. Many reports show that a CMV infection can produce localized ulcerations in the esophagus, stomach, small intestine, and colon in nonimmunocompromised individuals. The most common site of involvement by CMV infection in the GI tract is the colon followed by the upper GI tract and the least common site is the small intestine. Although GI bleeding is one of the major presenting symptoms of patients with CMV infections of the GI tract, lower GI bleeding due to CMV ileal ulcers in immunocompetent patients, to our knowledge, has not been reported in the English literature. Recently, we experienced a case of lower GI bleeding due to CMV ileal ulcers in a 57-year-old man who had no evidence of immunocompromise. This case suggests that small intestinal ulcers due to CMV infection should be included in the differential diagnosis of lower GI bleeding even in immunocompetent hosts.

Hypomethylation of p53 in peripheral blood DNA is associated with the development of lung cancer

Alterations in DNA methylation have been associated with cancers at almost all tumor sites and represent one of the most consistent changes in neoplastic cells. The underlying etiological mechanisms for alteration of DNA methylation patterns are not understood, but experimental studies in animals suggest potential environmental and genetic influences. The purpose of this study was to investigate whether DNA hypomethylation in peripheral blood DNA (potentially representing status at the lung) was associated with increased risk for the development of lung cancer. We evaluated genome-wide and p53 gene-specific hypomethylation in 100 lung cancer cases and controls selected from a large clinical trial of male smokers, the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Genome-wide methylation status was assessed using the in vitro methyl acceptance capacity assay and p53 gene-specific methylation status using the HpaII quantitative PCR assay. Hypomethylation was evaluated as a risk factor using multivariate conditional logistic regression analyses. Genome-wide methylation status was unrelated to lung cancer risk; the odds ratio was 1.25 and the 95% confidence interval was 0.48-3.21 for those in the highest versus lowest quartile of hypomethylation status. Hypomethylation of the p53 gene in exons 5-8, the hypermutable region, was associated with a 2-fold increased risk for lung cancer (odds ratio, 2.20; 95% confidence interval, 1.04-4.65), whereas there was no risk increase for hypomethylation at exons 2-4, a region of the gene not known for its mutability or functional significance in cancer. Our results indicate that hypomethylation status within exons 5-8 of p53 from peripheral lymphocyte DNA may be a relevant predictor of lung cancer among male smokers.