Cisapride stimulates motility of the intestine via the 5-hydroxytryptamine receptors

The effects of cisapride on intestinal contractility and on release of acetylcholine (ACh) were examined using the longitudinal muscle with the myenteric plexus preparation from the guinea pig ileum, as related to the 5-hydoxytryptamine (5-HT) receptor. 5-HT exerted a dual effect, transient increase in ACh release (EC50 = 2 X 10(-6)M) via the 5-HT3 receptor, followed by inhibition (EC50 = 5 X 10(-9)M) via the 5-HT1 receptor. Cisapride at low concentrations (10(-9)M to 10(-8)M) enhanced electrical stimulation -evoked contraction and ACh release. The effect of cisapride was mimicked by methysergide and was not altered by ICS 205-930. Cisapride antagonized the 5-HT (5 X 10(-9) M)-induced inhibitory effect and the IC50 of cisapride was 1.5 X 10(-9) M. These findings indicate that enhancement by low concentrations of cisapride may be due to a block of the inhibitory 5-HT1 receptor. Cisapride at medium concentrations (10(-8) M to 3 X 10(-7) M) induced enhancement of electrical stimulation-evoked twitch contractions and ACh release evoked by electrical stimulation which were antagonized by 10(-6) M ICS 205-930, while this compound antagonized the 5-HT (2 X 10(-6) M)-and 2-methyl-5-HT-induced excitatory effects, and the IC50 of cisapride was 5.2 X 10(-8) M. Thus, cisapride acts on the putative 5-HT4 receptor as an agonist and the 5-HT3 receptor as an antagonist. Cisapride at high concentrations (10(-6) M to 10(-5) M) evoked contraction and the release of ACh, and these effects were antagonized by ICS 205-930 (10(-6) M).(ABSTRACT TRUNCATED AT 250 WORDS)     

Renin Release during Acute Reduction of Arterial Pressure in Normotensive Subjects and Patients with Renovascular Hypertension

In normotensive subjects, acute reduction of mean arterial pressure to from 60 to 75 mm Hg by infusion of sodium nitroprusside caused significant increase in renin activity of renal venous plasma and also in the renal-systemic difference of renin activity. At the same time, the products of the renal-systemic difference of renin activity and renal plasma flow increased significantly, whereas renin substrate activity of plasma was unchanged, indicating that there was an increase in renin release during reduction in pressure. Renin activity of renal venous plasma, expressed in logarithms, showed a significant correlation with the degree of reduction in pressure; an increase in renin activity became significant when mean arterial pressure was reduced to below a level of 70 to 75 mm Hg.     

Successful preservation of human skin by vitrification

The vitrification technique was applied to the preservation of human skin. This technique was simple, and no expensive equipment was needed. Split-thickness human skins from 8 patients were immersed in vitrification solution for 10 minutes at room temperature, immediately plunged into a liquid nitrogen tank, and cryopreserved for 3 weeks. The vitrification solution consisted of 40% ethylene glycol (vol/vol) and phosphate buffered saline solution that contained 30% Ficoll 70 (vol/vol; Wako Junyaku, Co, Tokyo, Japan) and 0.5 mol/L sucrose. The viability of vitrified and cryopreserved skin was evaluated with the trypan blue dye exclusion test, the methyl-thiazoldiphenyl-tetrazolium (MTT) colorimetric assay, and a culture test of the keratinocytes obtained from vitrified skin. The results of the trypan blue dye exclusion test showed 87.4% of viable cells, and MTT developed an average 0.817 absorbance. When vitrified skin was compared with 4 degrees C refrigerated skins after 3 weeks of storage, the difference of viability was significant both on the trypan blue dye exclusion test (P < .05) and on the MTT assay (P < .01). However, there was no significant difference in the viability of vitrified skins compared with fresh skin. Furthermore, keratinocytes from vitrified skin grew uneventfully in culture test. We used these vitrified skin allografts for patients with flame burns and electric burns. These allografts took well in both cases and promoted wound healing. We concluded that the vitrification method for skin preservation is simple and reliable, and this method could contribute to skin banking.     

Transdiaphragmatic liver scanning: a new intraoperative imaging technique for examination of the liver from the thoracic cavity

In order to examine the liver during thoracotomy, a new intraoperative imaging technique called "transdiaphragmatic liver scanning" was developed. Transdiaphragmatic scanning performed with high-frequency transducers provided clear visualization of the entire liver from the thoracic cavity through the diaphragm. In our study, transdiaphragmatic scanning was used in 27 thoracotomy operations performed for the treatment of malignant diseases, including lung and esophageal cancers. One 5-mm liver cyst, one 3-mm x 4-mm hemangioma, and one 5-mm x 6-mm ill-defined lesion (possible metastasis), all of which were unrecognized preoperatively, were detected. In 3 operations, preoperatively suspected liver metastases were excluded by transdiaphragmatic scanning. Because transdiaphragmatic scanning provides high-resolution images of the liver and is the only method capable of examining the liver during thoracotomy, this intraoperative scanning technique may become a useful tool in the evaluation of liver metastases from thoracic or mediastinal malignancies.     

Contrast-enhanced dynamic MR imaging parameters and histological types of invasive ductal carcinoma of breast.

The diagnosis of breast cancer has progressed owing to the improvement of both MRI equipments and MR techniques. CE-MRI is expected to be more useful for diagnosis of the existence and characteristics of breast cancer than mammography and ultrasound. Forty-three breast cancer patients, who underwent breast MRI examination before surgery and had histologically confirmed invasive ductal carcinomas, were included in this study. In 19, seven and 17 of them, carcinomas were histologically classified as papillotubular, solid-tubular, and scirrhous type, respectively. In dynamic MRI studies, the MR parameters were calculated from the signal intensity determined before and at five time-points after a bolus of 0.1 mmol Gd-DTPA/kg in the chosen region of interest (ROI). The differential analysis of MR parameters with reference to histopathology was performed by one-way analysis of variance (ANOVA) in dynamic studies. Four of 15 parameters analyzed, ENH1-2, ENH1, MSLP, and SAT3, were significantly different between papillotubular and scirrhous carcinoma. The dynamic curve of papillotubular carcinoma reached a maximum in the very early phase and then decreased slowly (linear pattern), while that of scirrhous carcinoma peaked in the slightly later phase and then decreased (parabolic pattern). In the differential analysis by Kruskal-Wallis test, although no significant differences were found in any morphological parameters among three histological types, spicula formation and rim enhancement tended to appear comparatively frequently in scirrhous and solid-tubular carcinoma. CE-MRI might reveal the differences of growth characteristics among different histological types of breast carcinomas and provide a diagnostic method useful for estimation of the prognosis of breast cancer.     

Topography of Prostate Cancer Recurrence After Radiation Therapy: A Detailed Mapping Study of Salvage Radical Prostatectomy Specimens

In men who do not respond to initial radiation therapy, accurate knowledge of the site of cancer recurrence or persistence is necessary to understand treatment failure. We evaluated the pathologic characteristics of recurrent/persistent prostate cancer with tumor maps from the whole-mount slides of salvage radical prostatectomies performed between 2000 and 2014. Of 216 consecutive patients, detailed tumor maps were available for 77. Sixty-nine patients (90%) were found to have tumor in the apex, of which 46% occurred in the most apical 3 mm. Fifty-three patients (69%) had tumors at a distance of ≤5 mm from the urethra. Five patients had tumor directly involving the urethra, all of whom had urethral invasion at the apex. Seminal vesicle involvement was seen in 32 patients (42%), two of whom had tumor only in the seminal vesicles. Sixty-two patients (81%) had tumors in the distal apex, periurethral area, or seminal vesicles, that is, areas that are not routinely biopsied. Targeting these areas could improve the accuracy of biopsy when cancer recurrence is suspected.