These findings provide clues regarding the clinical development of regenerative repair strategies for RC injury.

Although calcium antagonists reduce systemic blood pressure, the effects of calcium antagonists on renal preglomerular and postglomerular microcirculation have been suggested to differ. In the present study we examined the vasodilator action of dihydropyridine-type calcium antagonists, including nifedipine, nicardipine, amlodipine, and efonidipine, on afferent and efferent arterioles during angiotensin II (A-II)- and norepinephrine (NE)-induced renal vasoconstriction. Isolated perfused hydronephrotic kidneys were used to directly visualize renal microcirculatory response to calcium antagonists. Both A-II and NE caused marked vasoconstriction of afferent (A-II, 27 +/- 2% decrement; NE, 28 +/- 2% decrement) and efferent arterioles (A-II, 25 +/- 4% decrement; NE, 22 +/- 2% decrement). The subsequent addition of nifedipine, nicardipine, and amlodipine reversed the afferent arteriolar vasoconstriction in a dose-dependent manner, and elicited complete vasodilation at 10(-6) M. In contrast, efferent arteriolar vasoconstriction was relatively refractory to the dilator action of these calcium antagonists; maximal dilation observed at 10(-6) M was 21 +/- 1% (A-II) and 22 +/- 3% (NE) for nifedipine, 25 +/- 3% (A-II) and 20 +/- 6% (NE) for nicardipine, and 39 +/- 6% (A-II) and 37 +/- 3% (NE) for amlodipine. In striking contrast, efonidipine dilated not only afferent arterioles, but also efferent arterioles in a dose-dependent manner. At 10(-6) M, efonidipine completely inhibited the afferent (A-II, 89 +/- 7% reversal; NE, 99 +/- 8% reversal) and efferent arteriolar vasoconstriction (A-II, 93 +/- 4% reversal; NE, 87 +/- 9% reversal). These findings clearly demonstrate that calcium antagonists dilate the afferent arteriole. Unlike the effects on the afferent arteriole, efferent arteriolar responsiveness to calcium antagonists differ, depending on the type of calcium antagonist. The efonidipine-induced efferent arteriolar vasodilation is probably not related to voltageoperated calcium channels, and may act, in concert with blood pressure lowering effect, to ameliorate glomerular capillary hypertension.

The minimum ADC is useful for evaluating the chemotherapeutic response of osteosarcoma.

Rapid right ventricular pacing could induce congestive heart failure in conscious dogs with significant increase in plasma concentration of arginine vasopressin (AVP) (from 1.2 +/- 0.2 to 3.4 +/- 0.6 pg/ml). In this experimental model of heart failure, oral administration of the selective AVP V1 receptor antagonist OPC-21268 significantly increased cardiac output and improved renal function without significant changes in serum electrolytes and hormones. Oral administration of the selective AVP V2 receptor antagonist OPC-31260 induced marked water diuresis, which resulted in significant increases in serum sodium concentration, plasma renin activity, and plasma concentration of AVP, although it did not produce hemodynamic improvement. Combined administration of OPC-21268 and OPC-31260 showed supra-additive hemodynamic responses as well as additive renal and metabolic responses, i.e., it showed prolonged decrease in mean arterial pressure and profound increase in cardiac output. These results suggest that AVP plays a significant role in elevation of vascular tone through V1 receptors and plays a major role in retaining free water through V2 receptors in this model of heart failure. Furthermore, combined administration of V1 and V2 receptor antagonists could induce not only metabolic and hormonal responses but also more beneficial hemodynamic responses than those observed following treatment with V1 receptor antagonist alone.

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Although valid measurement of the severity of terminal delirium is of great importance in palliative care settings, existing instruments have considerable limitations. In order to quantify patients' communication capacity and agitated behaviour, two new operational observer-rating scales, the Communication Capacity Scale (Communication Scale) and Agitation Distress Scale (Agitation Scale), were validated. Thirty terminally ill cancer patients diagnosed with delirium were evaluated simultaneously by two palliative care physicians blinded to each other's coding using the Communication Scale and Agitation Scale. In addition, the Memorial Delirium Assessment Scale (MDAS), Delirium Rating Scale (DRS) and Sedation Scale were rated by one researcher. Both scales achieved high internal consistency and inter-rater reliability with Cronbach's alpha coefficients of 0.91 and 0.96, and Cohen's kappa values on each item of 0.72-1.00. The principal components analysis resulted in the emergence of only one component for each scale. The total score on the Communication Scale was highly associated with that of the MDAS (rho = 0.78), Sedation Scale (rho = 0.86), and cognitive items from the MDAS and DRS (rho = 0.83). The whole score on the Agitation Scale was significantly correlated with that of the DRS (rho = 0.61) and agitation items from the MDAS and DRS (rho = 0.61). In conclusion, the Communication Scale and Agitation Scale have acceptable reliability and validity to quantify patients' communication capacity and agitation symptoms of terminally ill cancer patients with delirium.

PurposeTo evaluate the potential of diffusion‐weighted imaging (DWI) in distinguishing chronic expanding hematomas (CEHs) from malignant soft tissue tumors.Materials and MethodsWe performed conventional MRI and DWI of six CEHs and 31 malignant soft tissue tumors from 37 patients seen between May 2000 and November 2006. DWI was obtained with a single‐shot echo‐planar imaging (EPI) sequence using a 1.5T MR imager. The mean apparent diffusion coefficient (ADC) value was also calculated. We evaluated MRI findings of CEHs and compared ADC value of CEHs with malignant soft tissue tumors.ResultsOn conventional MRI, two of six CEHs were difficult to differentiate from malignant soft tissue tumors based on imaging findings. The mean ADC value of CEHs and malignant soft tissue tumors was 1.55 ± 0.121 × 10−3 mm2/sec and 0.92 ± 0.139 × 10−3 mm2/sec (mean ± SD), respectively. The mean ADC value of CEHs was significantly higher than that of malignant soft tissue tumors (P < 0.01). There was no overlap in the minimum ADC values among CEHs and malignant soft tissue tumors.ConclusionDWI is useful for differentiating between CEHs and malignant soft tissue tumors. J. Magn. Reson. Imaging 2008;28:1195–1200. © 2008 Wiley‐Liss, Inc.

Purpose: To evaluate the usefulness of diffusion-weighted imaging (DWI) for differentiating between desmoid tumors and malignant soft tissue tumors. Materials and Methods:Conventional MRI and DWI were performed for 8 desmoid tumors and 74 malignant soft tissue tumors. DWI was obtained with a single-shot echoplanar imaging sequence using a 1.5 Tesla (T) MR imager. DW images were acquired with motion-probing gradient pulses applied along three directions (x, y, and z axes) with three b-factors (0, 500, and 1000 s/mm 2 ). Two observers blinded to clinical information measured three regions of interest within the solid tumor and selected a minimum apparent diffusion coefficient ( ) in each lesion. The mean ADC of desmoid tumors was calculated and compared with that of malignant soft tissue tumors using the Mann-Whitney U test. Results:The mean ADC of desmoid tumors and malignant soft tissue tumors was 1.36 6 0.48 Â 10 À3 mm 2 /s and 0.88 6 0.20 Â 10 À3 mm 2 /s (mean 6 SD), respectively. The mean ADC of the desmoid tumors was significantly higher than that of malignant soft tissue tumors (P < 0.01).Conclusion: DWI is considered to be useful for differentiating between desmoid tumors and malignant soft tissue tumors. In the future, further investigation in a large series is necessary.