The protein product of oncogene c-myc is believed to be important in regulation of the cell cycle. However, its direct role in DNA synthesis has not been explored. Experiments presented here show that the addition of affinity-purified antibodies against the human c-myc protein to nuclei isolated from several types of human cells reversibly inhibited DNA synthesis and DNA polymerase activity of these nuclei. This suggests that c-myc encodes a protein that is functionally involved in DNA synthesis.

The human promyelocytic cell line HL 60 can be induced to differentiate toward more mature myeloid or monocytic forms by a variety of agents. This process is thought to require several days of exposure to the inducer, thus making it difficult to identify the early cellular changes which are fundamental to the differentiation program, and to relate the induction to phases of the cell cycle. In order to study the kinetics of leukemic cell differentiation we have developed a system for the induction of rapid monocytic maturation in a subpopulation of HL 60 cells. The cells are exposed to lo-' M 1,25-dihydroxycholecalciferol for 4 hr in serum-free medium. Subsequent incubation in a complete medium results in cellular differentiation recognizable by several criteria (phagocytosis, nonspecific esterase reaction, adherence to substratum, cell morphology) beginning at 10 hr from the exposure to the inducer. Approximately 20 hr later 30-40% of the cells in culture show the differentiated phenotype 288

Double lumen esophagus or esophagogastric fistula is a very rare endoscopic finding. Approximately 11 cases have been reported in the past. Formation of an esophagogastric fistula is predisposed by previous esophagogastric surgery, persistent gastroesophageal reflux, esophageal ulcer or esophageal carcinoma. Dysphagia and odynophagia are common symptoms. Endoscopy is the procedure of choice for diagnosis. Symptomatic management is the mainstay of treatment. Early diagnosis andmanagement of gastroesophageal reflux is essential to prevent reflux-related fistulas. We report the case of a 48-year-old man with a history of dysphagia who was found to have esophagogastric fistula on endoscopy. He was treated conservatively with proton pump inhibitors leading to symptomatic improvement.

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Abstract. HL 60 cells were subcloned into variants with different sensitivities to the differentiation-inducing effect of 1,25 dihydroxyvitamin D3 (I,25(OH)2D3), as shown by increased oxidative and phagocytic activity and the appearance of cytoplasmic a-naphthyl butyrate esterase. Brief treatment (4 h) with 1,25(OH)2D3 or 5-azacytidine (5-Aza CR) of sensitive sublines induced monocytic differentiation in a fraction of treated cells. The phenotypic differentiation induced by 1,25(OH)2D3 was preceded by altered expression of oncogenes c-myc and c-fos, but not of c-Ha-ras or of the constitutively expressed p72 gene. Treatment with 5-Aza CR had similar effects but in addition increased the rate of transcription of the c-Ha-ras oncogene. In partially resistant sublines exposure to 1,25(OH)2D3 or 5-Aza CR resulted in changes in the levels of c-myc and c-fos mRNA, but the expression of c-Ha-ras gene did not correlate with the phenotypic differentiation. When induction of differentiation in responsive cells was delayed by cycloheximide, a temporal correlation could be made between changes in the expression of the c-myc gene and differentiation. These results suggest that a reduction of the elevated levels of c-myc gene transcription in HL 60 cells is required for the initiation of monocytic differentiation, that the induction of c-fos gene expression is an early step in this process, and that the transient increase in the expression of c-Ha-ras gene by 5-Aza CR is not related to differentiation.