AGA Abstracts information, medications and investigations. Results: Assessment of duodenal eosinophil counts showed excellent agreement (unweighted kappa = 0.76). The majority of patients (71%) were referrals from general practice, 25% for investigation of iron deficiency anaemia; the remainder for upper gastrointestinal alarm symptoms. On biopsy, 11/42 (27%) had duodenal eosinophilia, mean count 25 (range18-37), 4 (9%) with clusters. In those with a count <18, the mean was 8 (range 2-17). After endoscopy there were 5 cases with FD; duodenal eosinophilia was associated with FD in 3/5 patients (p=0.5). Duodenal eosinophilia was significantly associated with a history of atopy and allergy (p=0.003) or any medication (p=0.01), especially NSAIDs (p=0.02). No association was found with irritable bowel syn- drome, upper or lower abdominal pain, gastroesophageal reflux, abdominal pain, H. pylori infection smoking, alcohol, recent gastrointestinal infection or depression. Conclusions: Histological eosinophilia is relatively common in routine duodenal biopsy practice and associated significantly with medications, particularly NSAIDs and history of atopy and allergy. FD may be suspected if this fits the clinical history and other causes excluded. W1294 The Role of Faecal Lactoferrin in the Evaluation of Hospitalised Patients with Diarrhoea Daniel R. Van Langenberg, Richard B. Gearry, Peter R. Gibson Defining the cause of diarrhoea in hospitalised patients is problematic due to the range of differential diagnoses, and the low yield and sensitivity of routine faecal testing for inflammat- ory diarrhoea. Faecal lactoferrin (FL), a neutrophil-associated protein resistant to proteolysis, is an established marker of gastrointestinal (GI) inflammation. AIM: To define the utility of FL in the evaluation of hospitalised patients with diarrhoea. METHODS: Consecutive faecal samples sent to Eastern Health Pathology were also assayed for FL (IBD-SCAN, Techlab®). Definitive diagnoses and 48 clinicopathological variables were extracted from the patients' medical records. The manufacturer's cut-off value was used to determine relevant correlation (Pearson) and odds ratios. Receiver-operator curve (ROC) analyses were performed on FL results from patients where a decision about low (n=38) or high risk of inflammation (n= 59) could be confidently made. RESULTS: 511 consecutive faecal samples from 433 patients obtained over 5 months were evaluated. Median age was 67 y. 48% were men. 7% had confirmed IBD, 6% Clostridium difficile (CD) toxin A positive, 6% positive bacterial cultures. FL was a median 23 (range 0-288) mcg/g. Elevated FL (using manufacturer's cut-off ≥7.25 mcg/g) was associated with detection of CD toxin A OR=17.3 [95% CI=2.2-133], other bacteria culture positive (9.8 [2.3-42]) and IBD (3.5 [1.2-8.7]). Potential confounders included concurrent aperient use OR=0.6 [0.4-0.99] and diabetes mellitus (0.46 [0.3-0.8]). FL correlated with faecal leukocytes (r =0.3; p<0.001) but was more sensitive for proven inflammatory diarrhoea (75% vs 55%; p=0.011). A lower cut-off at 1.25 mcg/g improved performance characteristics to 92% sensitivity, 76% specificity and 97% negative predictive value. Where FL was normal and the first faecal M&C was negative, further faecal tests were non-contributory in excluding GI inflammation. However, an elevated FL still necessi- tated faecal microbiological studies, which if negative, should strengthen the indication for colonoscopy given the increased likelihood of detection of clinically relevant pathology. CONCLUSIONS: The FL cut-off for clinical usefulness in hospitalised patients should be reduced to 1.25 mcg/g. For patients with diarrhoea, FL is more sensitive than faecal micro- scopy for leukocytes in detecting GI inflammation, can reduce the need for repeated faecal microbiological studies and thus potentially reduce cost, and can better direct the clinician to identify those in need of colonoscopy. Prospective evaluation is needed. W1295 Defining the Soluble Proteome of Human Stool Patrick S. Quint, Jonathan J. Harrington, H. R. Bergen, David A. Ahlquist The aqueous compartment of human stool remains largely uncharacterized while having the potential to be the most relevant fecal compartment for diagnosis of gastrointestinal disease. In particular, our understanding is limited regarding the composition and variability of the soluble fecal proteome. AIMS: To identify the common proteins/polypeptides in human stool using proteomic methods and to assess both inter- and intra-individual variability. METHODS: From 27 asymptomatic subjects between the ages of 30-70 years and with no history of gastrointestinal disease, stool samples were collected and frozen promptly at -80°C. Thawed fecal aliquots were centrifuged, and aqueous supernatant from each was analyzed. Polypeptides were separated by 1-D electrophoresis, excised from gels, and digested for mass spectrometric analysis using an Orbitrap LTQ. Data outputs were searched using Mascot, Seaquest and X!Tandem programs against an updated Swissprot database that included all cataloged species. Identities were based on at least 2 unique spectral counts for each protein. Intra-individual variability was assessed by the same methods using two samples collected seven days apart from each of 3 subjects. RESULTS: We identified 172 unique proteins with 63 commonly present in the soluble fraction of stool. Most protein species originated from the host (83%) with only a small number (17%) identified as dietary or bacterial. Among the common human proteins, 12% arose from liver, 18% pancreas, 14% small intestine, 14% stomach and saliva, and 35% serum or inflammatory cells. The 12 most abundant proteins based on spectral count were alpha-1-antitrypsin, carboxypeptid- ase A1, elastase-3A precursor, immunoglobulin components (include kappa chain, alpha- chain, gamma-chain, heavy and light chain proteins), alpha-1-antichymotrypsin, carcinoem- bryonic antigen (CEA), IgGFc-binding protein, serpin B6, maltase-glucoamylase (intestinal), trypsin 2, caldecrin, and enteropeptidase. Between subjects, 6 (10%) of the 63 common proteins were universally present and 32 (50%) were present in at least 75% of the samples tested. Within subjects, an average of 75% of proteins were consistently present between stools collected one week apart. CONCLUSIONS: The soluble fraction of human stools comprises common proteins, most of which originate from the host (rather than from diet or bacteria) and arise from supra-colonic sites. Knowledge of these common proteins may be useful for selecting internal standards, for guiding deletion strategies in discovery or detection of low-abundance proteins, and for design of clinical stool assay systems. A-674 AGA Abstracts W1296 Correlation of Biomagnetic and Bioelectric Recordings in a Patient with Ischemic Bowel Chike B. Obioha, Adam Goodale, Jon Erickson, Leonard A. Bradshaw, William O. Richards Superconducting QUantum Interference Device (SQUID) magnetometers are able to detect the minute magnetic fields associated with the intestinal electrical slow wave and brady- and tachyarrhythmias of the slow wave associated with ischemia. No studies have investigated the correlation between biomagnetic recordings using a SQUID and intestinal potentials recorded with a serosal electrode. We compared preoperative magnetic field recordings to intraoperative electrode recordings of intestinal electrical activity in a patient with ischemic ileum secondary to a volvulus. Our study was approved by the Institutional Review Board at Vanderbilt University. The patient is a rare case of midgut volvulus in a 77 year old female. She had symptoms of chronic mesenteric ischemia for six months. Abdominal CT scan established her diagnosis and she had surgical detortion of the involved small bowel segment and cecopexy. We obtained informed consent and performed pre-surgical biomag- netic intestinal slow wave recordings with a SQUID magnetometer for a 15 minute baseline. We subsequently recorded 30 minutes of postprandial data until pain prevented the patient from continuing the study. During surgery, we recorded slow waves using serosal electrodes in both ischemic and non-ischemic bowel segments. We analyzed both biomagnetic and serosal signals with autoregressive spectral analysis to determine peak slow wave frequencies. In preoperative biomagnetic recordings, multiple signal frequencies detected were indicative of ischemic bowel in both pre- and postprandial studies. However, whereas preprandial magnetic field activity was concentrated in the 11-12 cpm range, the same location exhibited slow wave frequencies spread over the range 9-12 cpm and 14-15 cpm postprandial (consid- ered tachyarrhythmic in jejunum). Serosal electrodes on a segment of proximal jejunum without evident ischemic impact exhibited a slow wave frequency of 12.4 cpm in every electrode over the 5 cm extent of the electrode array. A visibly ischemic segment of ileum showed multiple brady, normo- and tachyarrhythmic frequencies of 7.0, 12.0, 14.3, and 19.4 cpm that varied with electrode location, whereas a normal ileal rhythm should appear between 8 and 10 cpm. This case study indicates multiple slow wave frequencies present in both biomagnetic and serosal electric recordings of ischemic bowel suggestive of uncoup- ling. This study represents the first demonstration of tachyarrythmias and uncoupling of the intestinal slow wave associated with ischemia in humans. It further demonstrates for the first time the correlation of biomagnetic and bioelectric signals in a human subject. W1297 The Utility of Polymerase Chain Reaction in the Diagnosis of Colonic Tuberculosis Among Patients with Typical and Atypical Endoscopic Presentations Raquel R. Adaza Gastrointestinal TB is a major health problem in many underdeveloped countries and is proving to be a rising threat in countries heavily-inflicted with AIDS. The diagnosis is often difficult to establish immediately and accurately. This is primarily due its widely-varying colonoscopic profiles, acknowledged limitations of the traditional microbiological methods, and often non-conclusive histopathology reports. BACKGROUND The amplification of spe- cific DNA sequences by polymerase chain reaction (PCR) is a novel tool for the detection of mycobacterial DNA sequences in clinical specimens such as body fluids and tissues. PCR has several advantages over culture as results can be available within 1 to 3 days as compared to 6 weeks with conventional culture techniques. In terms of histopathology, definitive diagnosis is limited only to the presence of casseation necrosis or Langhans type giant cells. The picture of “chronic granulomatous inflammation” is inadequate and non-conclusive because it is found in various conditions and diseases other than TB. In this study, we investigated the value of TB-PCR in the rapid and accurate diagnosis of colonic tuberculosis with typical and atypical endoscopic presentations. METHODS 68 consecutive patients who underwent colonoscopy for various indications with colonoscopic findings warranting biopsy were included in the study. They were divided into two groups those with colonic tuberculosis (n=38) and those with other colonic disorders (n=30). Colonic biopsy specimens underwent acid-fast stain and culture, histopathology and PCR assay using primers from IS6110. RESULTS The sensitivity and specificity of TB-PCR in the diagnosis of colonic tuberculosis in all cases are 84% and 77%, respectively. In the sub-analysis of patients presenting with typical colonoscopic findings for tuberculosis, the sensitivity and specificity are 88% and 77%, respectively. For those patients with atypical colonoscopic findings for tuberculosis the sensitivity is 73% and the specificity is 77%. CONCLUSION Our study shows that TB- PCR is fairly sensitive and specific for the diagnosis of colonic tuberculosis and has a potentially important role in improving the diagnostic accuracy in biopsy specimens of patients presenting with either typical or atypical forms of colonic tuberculosis. W1298 Antitumor Effect of a Statistic Magnetic Field-Assisted, Immunodelivery System Using Magnetized T Lymphocytes and Cytokines Takeshi Ohdaira Objective: To develop antitumor therapy that evades a series of escape phenomena of tumor cells by magnetizing immunocytes and cytokines with nanomagnets and by forming a static magnetic field at the site of tumor. Methods: Two types of tumor cells HT29 cells of intense major histocompatibility complex (MHC) expression and DLD1 cells of slight MHC expression were used to prepare a corporeal circulation model in which a statistic magnet was placed on cultured tumor cells. Antigen presentation cells (APCs), cytotoxic T lympho- cytes (CTLs), and natural killer cells (NK cells) were collected from hemocytes in the peripheral blood of healthy adults. These immunocytes were then allotted into the APC and CTL combination group and the NK cell-alone group, and were surrounded by nanomagnets of 2800 nm. Furthermore, IL-12 and IL-18 were prepared as magnetized cytokines and were then introduced into the circuit of each group. The following two conditions for