Long-lasting antagonistic effects of monatepil on Ca2+ current in guinea-pig ventricular cells

Monatepil maleate (CAS 103377-41-9, AJ-2615), a new derivative of dihydrodibenzothiepins, showed dose-dependent inhibition of Ca2+ current (ICa) in single cardiac cells isolated from guinea-pig ventricle. ICa was elicited by depolarization from -40 mV to +10 mV at 0.2 Hz. IC50 value of monatepil for the peak ICa at +10 mV was 18.7 nmol/l. The ICa inhibition was still sustained 30 min after washout, indicating that monatepil had long lasting activity in the mammalian single muscle cell.

Cholesterol granuloma in the middle cranial fossa: report of two cases

We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed.

Patterns of 24 h intragastric acidity in duodenal ulcers in children: the importance of monitoring and inhibiting nocturnal acidity

The objective of this study was to compare the gastric acidity patterns of patients with duodenal ulcers and normal children. Eight patients with duodenal ulcer had their intragastric pH monitored for two consecutive 24 h periods using intragastric glass electrodes. The first 24 h period elucidated pH patterns in the absence of treatment and the second period evaluated the acid suppressive effect of 15 mg/kg of cimetidine when given in three divided doses. Results showed that the ulcer patients were hyperacidic, particularly at midnight. This finding was in marked contrast to the results obtained in the study of normal controls. The mean pH of normal children was above 3 around midnight. This phenomenon is known as intragastric pH inversion. The mean pH 3 time (the cumulative duration of the time for which gastric pH is maintained at > or = pH 3) was significantly shorter in patients with ulcers. However, pH 3 time of these patients significantly increased throughout the 24 h recording period during the daytime and at night after the introduction of cimetidine. This resulted in an induction of apparent nocturnal intragastric pH inversion for the ulcer patients. This study demonstrates the usefulness of 24 h continuous intragastric pH monitoring in children. The data showed that there was a pattern of gastric hyperacidity in pediatric ulcer patients which is clearly distinct from that of normal children, particularly in the patterns occurring at midnight. Cimetidine at 15 mg/kg per day in three divided doses was effective in suppressing secretion even at night.

Overlapping and differential expression of BIG-2, BIG-1, TAG-1, and F3: four members of an axon-associated cell adhesion molecule subgroup of the immunoglobulin superfamily

Axon-associated cell adhesion molecules (AxCAMs) play crucial roles in the formation, maintenance, and plasticity of functional neuronal networks. We report here a molecular cloning of a novel AxCAM, BIG-2. BIG-2 is a member of TAG-1/F3 subgroup of the immunoglobulin (Ig) superfamily, with six Ig-like domains, four fibronectin type III-like repeats, and a glycosyl phosphatidylinositol-anchoring domain. Recombinant BIG-2 protein had a neurite outgrowth-promoting activity when used as a substrate for neurons in vitro. To survey the spatial expression pattern of BIG-2 in comparison with other TAG-1/F3 subgroup members, an in situ hybridization analysis was performed in adult and developing rat brain sections with riboprobes specific for BIG-2, BIG-1, TAG-1, and F3. The four AxCAM transcripts displayed cell type-specific expression patterns with overlapping and distinct profiles. In adult hippocampus, for example, we observed BIG-1 mRNA specifically in granule cells of the dentate gyrus, BIG-2 mRNA highly in the CA1 pyramidal cells, TAG-1 mRNA predominantly in the CA3 pyramidal cells, and F3 mRNA in neurons in all of these fields. These results suggest that BIG-2, BIG-1, TAG-1, and F3 may play important roles in the formation and maintenance of specific neuronal networks in the brain.

Novel missense mutation in alpha-tropomyosin gene found in Japanese patients with hypertrophic cardiomyopathy

We have searched for mutations in alpha-tropomyosin gene in 50 Japanese patients with hypertrophic cardiomyopathy (HCM) by means of polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) analysis. Two missense mutations of the alpha-tropomyosin gene were detected in Japanese patients with familial HCM. Sequencing analysis revealed a C to T transition at codon 63 leading to a replacement of Ala with Val residue, and a G to A transition with replacement of Asp by Asn at codon 175. These missense mutations were found at residues which were markedly conserved across the species, and have been reported to interact with troponin T. This is the first report on a mutant alpha-tropomyosin gene in a Japanese population. Familial HCM is a genetically heterogeneous disease in Japanese patients, similar to that reported in Caucasian kindreds.

Salutary effect of disopyramide on left ventricular diastolic function in hypertrophic obstructive cardiomyopathy

OBJECTIVES

The purpose of this study was to estimate the effect of disopyramide on left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy.

BACKGROUND

Although disopyramide has been reported to lessen clinical symptoms in patients with hypertrophic obstructive cardiomyopathy, few data exist regarding its effect on diastolic function in these patients.

METHODS

Thirteen patients with hypertrophic cardiomyopathy (six with and seven without left ventricular outflow obstruction) were examined. Before and after intravenous disopyramide, hemodynamic and angiographic studies were performed.

RESULTS

In patients with outflow obstruction, pressure gradient at the outflow tract decreased from a mean +/- SD of 100 +/- 45 to 26 +/- 33 mm Hg (p < 0.01). Although systolic function was similarly impaired in both groups, the time constant of left ventricular pressure decay (tau) shortened from 56 +/- 10 to 44 +/- 8 ms (p < 0.01) and the constant of left ventricular chamber stiffness (kc) decreased from 0.049 +/- 0.017 to 0.038 +/- 0.014 m2/ml (p < 0.01) only in patients with outflow obstruction. Shortening in tau correlated best with decrease in left ventricular systolic pressure (r = 0.84, p < 0.01). In contrast, tau was prolonged from 52 +/- 10 to 64 +/- 11 ms (p < 0.01) and kc was unchanged in patients without outflow obstruction.

CONCLUSIONS

The primary effects of disopyramide on the hypertrophied left ventricle were negative inotropic and negative lusitropic. However, left ventricular diastolic properties in patients with outflow obstruction were improved with a decrease in outflow pressure gradient. Relief of clinical symptoms in hypertrophic obstructive cardiomyopathy with disopyramide might be due in part to improvement of diastolic function, which appears secondary to the reduction in ventricular afterload.

Down-modulation of CD4+ T helper type 2 and type 0 cells by T helper type 1 cells via Fas/Fas-ligand interaction

Fas was recently demonstrated to be the major target molecule engaged by CD4+ cytolytic T lymphocytes (CTL). We examined Fas expression on various cloned T cell subpopulations and their susceptibility to lysis by CD4+ or CD8+ CTL. A reciprocal relationship in Fas and Fas-ligand expression was observed in CD4+ T helper (Th)1- and Th2-type clones, and Fas mRNA was predominantly detected in Th2 clones, whereas Fas-ligand mRNA was principally found in Th1 clones. The two Th0 clones tested expressed both Fas and Fas-ligand, but only one exhibited cytolytic activity, whereas both were sensitive to CD4-mediated lysis. A functional consequence of the inverse Fas-Fas-ligand expression pattern was that Th2 and Th0 cells were sensitive to lysis by both Th1 CD4+ CTL and a CD8+ CTL clone in a Fas-dependent manner. These results suggest that cytolytic CD4+ Th1 cells may play an immunomodulatory role, regulating a Th2/Th0 response by Fas-mediated lysis.

[Growing skull fracture: a case report]

An 18-day-old male baby who had fallen from his mothers arms and hit his head on the floor was admitted to our hospital. On admission, the patient was crying, but no weakness was noted in the extremities. A small fluctuant protrusion was visible in the right parietal region. The plain skull X-ray film revealed a wide linear fracture in the parietal bone. Computed tomography (CT) showed swelling of the right hemisphere and a traumatic subarachnoid hemorrhage. At 41 days old, the subcutaneous fluid collection had increased in volume and the width of the linear skull fracture was also enlarged as shown on the X-ray film. CT and magnetic resonance imaging (MRI) revealed a large cyst herniating through the wide parietal bone defect. There was also an enlarged right lateral ventricle and a torn dural margin in the brain. The cranioplasty with dural plasty was performed on the 43rd day of ago under the diagnosis of growing skull fracture of the right parietal bone. The postoperative course was uneventful, without seizure or weakness. In order to diagnose growing skull fracture, especially to show the relationship between the fracture, torn dura matter, the ventricle and the contused brain, MRI was very helpful combined with CT and plain skull X-rays. Cranioplasty with dural repair was considered the essential procedure for the treatment of such growing skull fractures.

Antihypertensive properties of a new long-acting angiotensin converting enzyme inhibitor in renin-dependent and independent hypertensive models

The antihypertensive properties of a new long-acting, angiotensin-I-converting enzyme (ACE) inhibiting agent, (2S,3aS,7aS)-1-(N2-nicotinoyl-L-lysyl-gamma-D-glutamyl) octahydro-1H-indole-2-carboxylic acid (CAS 116662-73-8, DU-1777), were investigated orally in various experimental models of hypertension in comparison to a standard ACE inhibitor, lisinopril. The hypotensive potency of DU-1777 was not as marked as that of lisinopril in renin-dependent hypertensive models, i.e., two-kidney one-clip renal hypertensive rats (2K-1C RHR) (ED-20mmHg: 3.1 versus 1.0 mg/kg) or two-kidney two-clip renal hypertensive dogs (2K-2C RHD) (ED-20 mmHg: 2.5 versus 1.0 mg/kg), though the actions of the two drugs were both long-lasting and dose-related. When spontaneously hypertensive rats (SHR) were used, however, DU-1777 was as active as lisinopril (ED-20 mmHg: 17.9 versus 13.6 mg/kg). The most distinguishing results with DU-1777 were its hypotensive effects in renin-independent hypertensive models. In contrast to lisinopril, the drug produced a sustained and dose-related hypotensive effect in DOCA salt hypertensive rats (DOCA-HR) and one-kidney one-clip renal hypertensive rats (1K-1C RHR). There exists an inconsistency between the long duration of the agent's hypotensive action in all tested hypertensive models and its short duration of ACE inhibiting activity as demonstrated both in vivo and ex vivo. The sustained antihypertensive action of DU-1777 cannot be reasoned solely with respect to ACE inhibition, suggesting some additional mechanisms of action yet to be defined.

Total auricular reconstruction with a three-dimensional costal cartilage framework

Microtia (hypoplasia of the auricle) is known to result from incomplete development of the auricle during embryonic development so that the size and shape of the deformity vary from case to case. Total auricular reconstruction for microtia is dependent on the degree of hypoplasia in comparison to that of the normal auricle on which the specific reconstruction method is based. I have classified microtia into 3 major types: 1) The lobule type. 2) The concha type, and 3) The small concha type which has been previously described [32]. Regardless of the size and shape of the deformity, the ultimate goal of total reconstruction of the auricle consists of construction of an auricle with an appearance as close as possible to that of a normal auricle. With this objective in mind, total reconstruction of the article is a science and not just a form of art as frequently considered. If it is only an art, the constructed auricle is greatly influenced by the artist's individuality and by the observer's. Thus, as a reconstructive plastic surgeon, the final outcome or result of total reconstruction of the auricle is that the constructed auricle should resemble as closely as possible the normal auricle, regardless of the observer and without any personal influence of the surgeon. I therefore consider total reconstruction of the auricle to be a field of science attained by numerous refinements and modifications in the procedures and techniques [33-36] and not just a simple form of art. The auricle constitutes only a small portion of the total body surface area, but it is probably one of the most complicated and/or sophisticated morphological structures of the body. It is necessary to fully understand the three-dimensional (3-D) morphological properties of the auricle and to pursue the ultimate goal of reconstructing an everlasting auricle as to the normal auricle. In other words, the constructed close as possible auricle must not be a sculptured object or structure, but is a living structure. A healthy constructed auricle is lasting and alive. Follow-up studies must be performed with strict standards and evaluation criteria in order to determine whether or not a reconstructed auricle is healthy.

Age-related increase in peptidylarginine deiminase in the male rat pituitary

We have measured the activity of peptidylarginine deiminase (EC 3.5.3.15) in male Wistar rat pituitaries at various ages. Pituitaries obtained from 3- and 9-month-old rats showed negligible activities. The mean enzyme activity increased appreciably by 18 months and markedly by 24 months accompanied with actual increases in the enzyme content. The peptidylarginine deiminase mRNA content showed a similar but more gradual increase appreciable from 9 months. Many enzyme-positive cells were present in the pars distalis of 24-month-old male pituitaries. Most of the enzyme-positive cells coincided with lactotrophs. The pituitary prolactin content showed a gradually increasing profile resembling that of the enzyme mRNA, but the serum prolactin concentration did not increase significantly. Neither the serum 17 beta-estradiol content nor the pituitary estrogen receptor content showed significant variation that could account for the marked increase in the pituitary enzyme content between 18 and 24 months of age. These data suggest possible presence of other factors regulating the enzyme content in old male pituitaries.

Long-term circulatory support to promote recovery from profound heart failure

In profound heart failure, ventricular assist systems (VAS) have been used to maintain the systemic circulation and promote recovery of the failing heart. The authors' data suggest that the heart may not recover sufficiently if the patient needs left ventricular assist beyond 10 days. Recently, the authors treated six patients who were supported by VAS more than 3 weeks and were weaned from VAS. Four of six patients were weaned from VAS and continue well, despite marginal cardiac function. In the other two patients, the natural heart did not sustain stable recovery, but their general conditions made them fit to be candidates for heart transplantation. Based on these data, long-term support should be considered to promote recovery of heart function with the use of VAS for profound heart failure.

Perfusion lung scanning before and after percutaneous transvenous mitral commissurotomy--early estimation of lung congestion relief

Percutaneous transvenous mitral commissurotomy (PTMC) has recently been used to treat mitral stenosis. The aim of this study was to evaluate the usefulness of radionuclide perfusion lung scanning in assessing the effect of PTMC on the relief of lung congestion. We studied 30 patients (7 males and 23 females, mean age 55 years). Perfusion lung scannings were performed within 1 week before and after PTMC. We calculated the ratio of activity in the upper quarter to that in the lower quarter of the right lung (U/L) as an index of lung congestion. After PTMC, the mean mitral valve area increased from 1.1 +/- 0.3 to 1.9 +/- 0.4 cm2, the mean left atrial pressure decreased from 14.8 +/- 6.3 to 9.1 +/- 3.5 mmHg, the mean pulmonary artery pressure decreased from 22.7 +/- 8.6 to 17.4 +/- 6.3 mmHg, and the U/L ratio decreased significantly from 0.89 +/- 0.40 to 0.68 +/- 0.24 (p < 0.0001). The U/L ratio showed greater improvement (4.5%) in patients whose NYHA class improved (n = 19) than in those whose NYHA class did not improve after PTMC. The U/L ratio was closely related to mitral valve area, and left atrial and pulmonary artery pressures. The change in the U/L ration before and after PTMC also reflected symptomatic improvement. In conclusion, U/L ratios obtained from perfusion lung scannings before and after PTMC reflect mitral valve area and pressures, and can be used to assess lung congestion relief after PTMC.

Atrial natriuretic peptide and antihypertensive action due to beta-blockade in essential hypertensive patients

The effects of beta-blocker treatment on hemodynamics were studied in relation to plasma atrial natriuretic peptide (ANP) levels in 17 outpatients with essential hypertension. Administration of propranolol for twelve weeks to untreated subjects resulted in a significant (P < 0.001) rise in plasma ANP levels (from 37.9 +/- 21.2 to 66.7 +/- 46.2 pg/mL, mean +/- SD). Systolic and diastolic blood pressures were significantly decreased (P < 0.05 and P < 0.01, respectively). Heart rate was also significantly decreased (P < 0.001). On the other hand, a significant reduction of cardiac index was detected (from 4.12 +/- 1.34 to 2.96 +/- 0.75 L/min/m2, P < 0.01) with chronic administration of propranolol, suggesting a reflection of decreased cardiac function. A significant negative correlation was observed between %changes in systolic blood pressure and %changes in plasma ANP (r = -0.594, P < 0.05). These results suggest that the increased plasma ANP levels may contribute to the antihypertensive effect with propranolol.

Involvement of an ICE-like protease in Fas-mediated apoptosis

Fas is a type-I membrane protein that transduces an apoptotic signal. Binding of Fas ligand or agonistic anti-Fas antibody to Fas kills the cells by apoptosis. Studies in the nematode Caenorhabditis elegans have suggested that proteases such as interleukin-1 beta-converting enzyme (ICE) or the product of the C. elegans cell-death gene ced-3 are involved in apoptotic signal transduction. The activity of ICE can be inhibited by the product of crmA, a cytokine-response modifier gene encoded by cowpox virus. We report here that expression of crmA inhibits cytotoxicity induced by anti-Fas antibody or tumour necrosis factor (TNF). We have found a specific ICE inhibitor tetrapeptide (acetyl-Tyr-Val-Ala-Asp-chloromethylketone) that also prevents apoptosis induced by anti-Fas antibody. These results suggest an involvement of an ICE-like protease in Fas-mediated apoptosis and TNF-induced cytotoxicity.

Hepatic fibrosis produced in guinea pigs by chronic ethanol administration and immunization with acetaldehyde adducts

Experimental hepatic fibrosis was produced in the guinea pig. We produced hepatic necrosis associated with inflammatory cell infiltration in guinea pigs immunized with acetaldehyde adducts and fed ethanol for 40 days. Extending the period of these treatments to 90 days resulted in producing hepatic fibrosis developing around individual hepatocytes in the terminal hepatic venule areas and portal areas, accompanied by an increase in hepatic hydroxyproline content. In contrast, no fibrosis was observed in the livers of the control groups that had been exposed to nothing, ethanol alone, or a combination of ethanol and immunization with unmodified human hemoglobin. Minimal fibrotic changes were observed in animals immunized with human hemoglobin acetaldehyde adducts but not fed ethanol. These results indicate that the formation of acetaldehyde adducts and the acquisition of immunity against them can produce hepatic fibrosis. Immune mechanisms against acetaldehyde adducts may, in part, be involved in the pathogenesis of hepatic fibrosis seen in alcoholics.

Expression of the Fas ligand in cells of T cell lineage

Fas ligand (FasL) is a membrane-type cytokine belonging to the TNF family, and induces apoptosis through its cell-surface receptor, Fas. To determine the cell types that express FasL, various mouse tissues and cell lines were examined by Northern hybridization using a mouse FasL cDNA as a probe. Among tissues, lymphoid organs (thymus, lymph node, spleen), lung, and small intestine express low levels of FasL mRNA, suggesting the role of FasL in the general immune system and mucosal immunity. The testis expressed FasL mRNA most abundantly; however, the size of FasL mRNA in the testis was slightly shorter than those in other tissues. Distribution of FasL mRNA in a panel of cell lines indicated that the FasL expression is rather restricted to the cells of T cell lineage. Activation of the splenocytes with the T cell activators such as PMA and ionomycin, Con A, anti-CD3, or even IL-2 alone induced the expression of the FasL. CD8+ splenocytes expressed the FasL more abundantly than did the CD4+ splenocytes upon activation by Con A and IL-2. Among CD4+ CTL cell lines, the FasL was expressed in all Th1 and Th0, and some Th2 clones.

Expression of the Fas ligand in cells of T cell lineage

Fas ligand (FasL) is a membrane-type cytokine belonging to the TNF family, and induces apoptosis through its cell-surface receptor, Fas. To determine the cell types that express FasL, various mouse tissues and cell lines were examined by Northern hybridization using a mouse FasL cDNA as a probe. Among tissues, lymphoid organs (thymus, lymph node, spleen), lung, and small intestine express low levels of FasL mRNA, suggesting the role of FasL in the general immune system and mucosal immunity. The testis expressed FasL mRNA most abundantly; however, the size of FasL mRNA in the testis was slightly shorter than those in other tissues. Distribution of FasL mRNA in a panel of cell lines indicated that the FasL expression is rather restricted to the cells of T cell lineage. Activation of the splenocytes with the T cell activators such as PMA and ionomycin, Con A, anti-CD3, or even IL-2 alone induced the expression of the FasL. CD8+ splenocytes expressed the FasL more abundantly than did the CD4+ splenocytes upon activation by Con A and IL-2. Among CD4+ CTL cell lines, the FasL was expressed in all Th1 and Th0, and some Th2 clones.

Pathways of tumour cell killing by activated macrophages: both tumour cell membrane and nucleus can be the primary target

Plasma membrane and nucleus can be primary targets of tumour cell killing by activated macrophages (AMø). Necrotic-type cytotoxicity with loss of membrane integrity and cytoplasmic swelling was expressed by AMø from normal and from perforin-deficient mice, indicating that perforin was not involved. Incubation with AMø consistently triggered the release of thymidine from prelabelled targets, whereas chromatin condensation and small DNA fragments were only occasionally detected. It is shown by means of Pulsed-Field Gel Electrophoresis that DNA degradation in target cells is a slowly progressing process that may stop at any time, indicating that nuclear-type killing doesnot necessarily lead to the formation of low molecular weight fragments. Neither Fas nor the p55 tumour necrosis factor receptor appear to be involved in signalling nuclear-type killing. Accordingly, AMø do mediate membrane- and nuclear-type killing but the mechanisms differ from those identified in T cell cytotoxicity.

Production of monoclonal antibodies specific to the carboxyl terminal region of the 85 kDa subunit of phosphatidylinositol 3-kinase: use of the antibodies in recognition of mutant p85

We have established two hybridomas producing mAb to the carboxyl terminal region of phosphatidylinositol-3 kinase 85 kDa subunit type alpha (p85 alpha). Analysis using deletion mutants of p85 revealed that epitopes for the two mAb were located on the border of the src homology 2 (SH2) sequence located at the carboxyl end of p85. They immunoprecipitated free p85 efficiently, but reactivity to p85 bound to p110 was very weak. Together with the mAb which we have reported previously, a panel of mAb that covered the various parts of p85 alpha was obtained. Using this panel, we characterized two mutants of p85 (70 and 50 kDa) expressed in the human colon carcinoma cell line, HCC2998. No wild-type p85 was detected in these cells. A mAb specific to the carboxyl terminal region detected p70 but not p50, suggesting that this region is missing in p50. The panel of mAb is a useful tool to use to analyse mutant forms of p85.

High prevalence of atrial fibrosis in patients with dilated cardiomyopathy

OBJECTIVES

We examined the extent of fibrotic changes in the left atrium of cardiomyopathic human hearts and investigated the relation of mechanical overload caused by left ventricular dysfunction to fibrosis of the left atrium.

BACKGROUND

Left atrial dysfunction in dilated cardiomyopathy may contribute to progression of heart failure. In contrast to fibrosis of the left ventricle, atrial fibrosis has not been extensively studied in cardiomyopathic hearts.

METHODS

The extent of fibrosis in the left atrium and left ventricle was determined by an automatic image analyzer in 38 autopsied hearts obtained from 9 patients who died of noncardiac illness (control group), 16 patients with dilated cardiomyopathy, 6 patients with hypertrophic cardiomyopathy with features mimicking dilated cardiomyopathy and 7 patients with a previous myocardial infarction. Transverse sections were obtained at the upper margins of the foramen ovale and left auricle in the left atrium and the median level of the left ventricle.

RESULTS

There were no significant differences in extent of left atrial dilation, left ventricular dysfunction or duration of illness among the three groups with cardiac disease. Percent area of left atrial fibrosis (mean +/- SD) was significantly greater in the specimens from patients with dilated cardiomyopathy (13.1 +/- 6.1%, p < 0.01) and hypertrophic cardiomyopathy mimicking dilated cardiomyopathy (26.5 +/- 9.5%, p < 0.01) than in those from patients with an old myocardial infarction (3.8 +/- 1.1%). Percent area of left ventricular fibrosis in hearts from patients with dilated cardiomyopathy (12.9 +/- 8.6%) was significantly smaller than that in hearts from patients with hypertrophic cardiomyopathy mimicking dilated cardiomyopathy (35.8 +/- 11.9%, p < 0.01) and a previous myocardial infarction (38.4 +/- 8.0%, p < 0.01). Percent area of atrial fibrosis was significantly correlated with left ventricular ejection fraction in the group with a previous myocardial infarction but not in the other groups.

CONCLUSIONS

There was a high degree of fibrotic change in the left atrium in the groups with dilated cardiomyopathy and hypertrophic cardiomyopathy mimicking dilated cardiomyopathy. Our findings suggest that atrial fibrosis in these patients may not have been related to mechanical overload of the left atrium but to some other, still unknown mechanisms.

Three-dimensional ultrasound image of the fetal stomach: congenital duodenal obstruction in utero

To quantitatively characterize the stereographic stomach configuration in utero, 11 fetuses (subject-group) with congenital duodenal obstruction, diagnosed antenatally, between 29 and 37 weeks' gestation were studied. Also included were 879 uncomplicated fetuses between 20 and 40 weeks' gestation as a control-group. Applying the algorithm which we devised: "Modeling a three-dimensional shape from a silhouette by detecting symmetry", we reconstructed the three-dimensional stomach configuration from a two-dimensional ultrasound image for each case. The statistical differences in two parameters, stomach volume and sphericity, between subject- and control-group fetuses, were analyzed using the Grubbs-Smirnoff's test at corresponding gestational ages. From 29 to 37 weeks' gestation, the stomach volume in the subject-group fetuses was found to increase greatly with advancing gestation, having significantly higher values than the control-group fetuses, whereas the stomach sphericity remained unchanged with no significant differences from the control-group fetuses. These findings indicate that the fetal stomach with duodenal obstruction maintains almost the same three-dimensional portrayal in utero as that seen in uncomplicated fetuses, although the stomach becomes extremely enlarged.

Expression of the functional soluble form of human fas ligand in activated lymphocytes

Fas is a type I membrane protein which mediates apoptosis. Fas ligand (FasL) is a 40 kDa type II membrane protein expressed in cytotoxic T cells upon activation that belongs to the tumor necrosis factor (TNF) family. Here, we found abundant cytotoxic activity against Fas-expressing cells in the supernatant of COS cells transfected with human FasL cDNA but not with murine FasL cDNA. Using a specific polyclonal antibody against a peptide in the extracellular region of human FasL, a protein of 26 kDa was detected in the supernatant of the COS cells. The signal sequence of granulocyte colony-stimulating factor was attached to the extracellular region of human FasL. COS cells transfected with the cDNA coding for the chimeric protein efficiently secreted the active soluble form of human FasL (sFasL). Chemical crosslinking and gel filtration analysis suggested that human sFasL exists as a trimer. Human peripheral T cells activated with phorbol myristic acetate and ionomycin also produced functional sFasL, suggesting that human sFasL works as a pathological agent in systemic tissue injury.