Role of VIP and substance P in NANC innervation in the longitudinal smooth muscle of the rat jejunum - influence of extrinsic denervation

BACKGROUND: This study was designed to determine changes in nonadrenergic, noncholinergic (NANC) neurotransmission mediated by Vasoactive Intestinal Polypeptide (VIP) and Substance P after small bowel transplantation (SBT). MATERIALS AND METHODS: Six groups of rats (n > or = 6 per group) were studied: na?ve controls (NC); 1 wk after anesthesia/sham celiotomy (SC-1); 1 or 8 wk after jejunal and ileal transection/reanastomosis (TA-1, TA-8), or syngeneic, orthotopic SBT (SBT-1, SBT-8). Jejunal longitudinal muscle strips were studied under NANC-conditions for spontaneous contractile activity, response to exogenous VIP and Substance P, and electrical field stimulation (EFS). RESULTS: Spontaneous activity did not differ between the six groups. VIP inhibited contractile activity in all groups 1 wk postoperatively (P < 0.05), which was prevented by the NO synthase inhibitor L-N(G)-nitro arginine (L-NNA). In contrast, VIP had no effect in the other groups. Precontraction with Substance P exposed an inhibitory effect of VIP in all groups (P < 0.05 each). Substance P increased contractile activity in all groups, but to a lesser extent in SBT-8 compared with NC, TA-8, and SBT-1 (P < 0.05). The inhibitory effect of EFS at 6 Hz was prevented by L-NNA in NC and TA-8; addition of the VIP antagonist ([D-p-Cl-Phe(6), Leu(17)]-VIP) increased contractile activity in NC, but not in TA-8 and SBT-8. The Substance P antagonist ([D-Pro(2), D-Trp(7,9)]-Substance P) decreased contractile activity during EFS at 50 Hz in NC and SBT-8. CONCLUSIONS: SBT decreased response to exogenous Substance P, although release of endogenous Substance P (EFS) is preserved. Changes in VIP signaling are acute and reversible and not caused by effects of SBT.     

Cyclops : Case report

A para iv, having an uneventful prenatal course, spontaneously delivered a stillborn cyclopic monster. The important pathological findings were a single median eye above which was a median proboscis. Radiographic findings revealed a microcephalic skull containing one large orbit located in the median line.     

Gastric cancer : Contemporary aspects

Records of 403 patients with gastric cancer seen between 1957 and 1966 at the Lahey Clinic Foundation have been analyzed. While the operability rate was 94 per cent and the resectability rate was 58 per cent, the cure rate was only 11 per cent and was unchanged from the previous decade. Significant correlation occurs with location, clinical type, histologic type, size of tumor, and number of lymph node metastases. The surgical approach is aggressive in exploration and in treating extensive but resectable cancers but is conservative for the average cancers and does not include resection of spleen, omentum, pancreas, and total stomach if possible.     

Pseudoperitonitis : Due to external traumatism

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1. The type of case with which this paper deals is one which demands the minutest and most painstaking personal care of the surgeon himself.