No abstract available.
Alprostadil ; Gastrointestinal Motility ; Lubiprostone

Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating.
Alprostadil ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Metagenome ; Peptides ; Reflex ; Rifamycins ; Lubiprostone

No abstract available.
Allopurinol* ; Alprostadil* ; Skin*

No abstract available.
Alprostadil* ; Lower Extremity* ; Thromboangiitis Obliterans*

Lubiprostone is a chloride (Cl-) channel activator derived from prostaglandin E1 and used for managing constipation. In addition, lubiprostone affects the activity of gastrointestinal smooth muscles. Interstitial cells of Cajal (ICCs) are pacemaker cells that generate slow-wave activity in smooth muscles. We studied the effects of lubiprostone on the pacemaker potentials of colonic ICCs. We used the whole-cell patch-clamp technique to determine the pacemaker activity in cultured colonic ICCs obtained from mice. Lubiprostone hyperpolarized the membrane and inhibited the generation of pacemaker potentials. Prostanoid EP1, EP2, EP3, and EP4 antagonists (SC-19220, PF-04418948, 6-methoxypyridine-2-boronc acid N-phenyldiethanolamine ester, and GW627368, respectively) did not block the response to lubiprostone. L-NG-nitroarginine methyl ester (L-NAME, an inhibitor of nitric oxide synthase) and 1H-[1,2,4]oxadiazolo[4,3,-a]quinoxalin-1-one (ODQ, an inhibitor of guanylate cyclase) did not block the response to lubiprostone. In addition, tetraethylammonium (TEA, a voltage-dependent potassium [K+] channel blocker) and apamin (a calcium [Ca2+]-dependent K+ channel blocker) did not block the response to lubiprostone. However, glibenclamide (an ATP-sensitive K+ channel blocker) blocked the response to lubiprostone. Similar to lubiprostone, pinacidil (an opener of ATP-sensitive K+ channel) hyperpolarized the membrane and inhibited the generation of pacemaker potentials, and these effects were inhibited by glibenclamide. These results suggest that lubiprostone can modulate the pacemaker potentials of colonic ICCs via activation of ATP-sensitive K+ channel through a prostanoid EP receptor-independent mechanism.
Alprostadil ; Animals ; Apamin ; Calcium ; Colon* ; Constipation ; Glyburide ; Interstitial Cells of Cajal* ; Membranes ; Mice* ; Muscle, Smooth ; Nitric Oxide ; Patch-Clamp Techniques ; Pinacidil ; Potassium ; Tetraethylammonium ; Lubiprostone

The survival of flap has a vital importance in the reconstructive surgery. This study was designed to investigate the relation of the survival area and the variation of flow value measured by laser Doppler flowmetry and to elucidate the effect of PGE1 on flap survival with an objective index. Sixteen New Zealand White rabbits were divided into 3 groups (8 of control group, 4 of intravenous PGE1 group and 4 of topical PGE1 group). The lower abdominal island flap (10 x 5 cm) based on the superficial epigastric pedicle was elevated and reset again at the previous location. The flow values were checked and it was taken as the value of LD. LD ratio was obtained by calculating the ratio of LD value in each experimental period to that of the baseline data taken before flap elevation. Finally, the data of flap survival area on the 8th experimental day was collected by using the plannimetry method. The results: the survival areas of intravenous PGE1 group (72.0 +/- 22.3%) and topical PGE1 group (78.0 +/- 22.7%) showed a significant increase compared to that of control group (46.5 +/- 14.3%, p < 0.01). The flap survival has the close relationship of the LD ratio measured immediately after flap elevation. The neovascularization period for the survival is considered at least 6 days. In conclusion, these experimental results can show an evident relation between the survival area of the flap and the LD ratio value measured immediately after the flap elevation. The LD ratio value measured immediately after flap elevation has the great significance as a critical limit for expecting the fate of flap survival. Therefore this value will be used as one of the beneficial standards for expecting the prognosis of microsurgical reconstruction in clinical trials.
Alprostadil* ; Laser-Doppler Flowmetry* ; Prognosis ; Rabbits

PURPOSE: Intracavernosal self injection therapy is now being widely used to treat patients with erectile dysfunction. However, there is a large number of patients who give up the self injection program due to the fear of injection. Therefore, less invasive route of drug administration is highly recommended. We investigated the efficacy of intraurethral instillation of Prostaglandin El (PGE1 ) solution in the patients who showed full erection with intracavernosal injection of PGE1. MATERIALS AND METHODS: Twenty-nine impotent patients who showed full erection with intracavernosal injection of PGE1 were included in this study. We estimated the grades and durations of the penile erection after intraurethral instillation of PGE1 RESULTS: Sixteen out of 29 patients(55.2%) showed full erection with intraurethral instillation. Two patients(6.9%) showed urethral pain which disappeared within 24 hours. But there was no systemic side effect CONCLUSIONS: Intraurethral instillation of PGE1 appears to be safe, well tolerated, and less invasive treatment modality Thus it can be selected as an alternative treatment of impotence in selected cases.
Alprostadil* ; Erectile Dysfunction* ; Humans ; Male ; Penile Erection

PURPOSE: To evaluate whether radial rigidity measured using RigiScan(R) represents the intracorporeal pressure effectively. MATERIALS AND METHODS: From January 1998 to May 1999, total of 23 patients with erectile dysfunction were evaluated by RigiScan(R) and duplex ultrasonography after the intracorporeal injection of prostaglandin E1. Peak systolic velocity and end diastolic velocity were measured by duplex ultrasonography and then the resistance index was calculated as (peak systolic velocity-end diastolic velocity)/(peak systolic velocity). Radial rigidity of penile tip and base was measured by RigiScanR . The results were analyzed statistically by PC-SPSS version 7.5. RESULTS: There were statistically significant correlations between radial rigidity of penile tip and base and the resistance index by Spearman's correlation analysis, respectively (r=0.680, p<0.001)(r=0.703, p<0.001). When radial rigidity of penile tip and base exceeded 60% of maximum, radial rigidity of penile tip and base again correlated well with the resistance index, respectively (r=0.659, p=0.020)(r=0.759, p=0.011). Based on clinically determined degree of erection, radial rigidity of penile tip and base represented the intracorporeal pressure effectively. CONCLUSIONS: Radial rigidity measured by RigiScan(R) represents the intracorporeal pressure effectively.
Alprostadil* ; Erectile Dysfunction ; Humans ; Male ; Ultrasonography

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by episodic abdominal pain or discomfort in association with altered bowel habits (diarrhea and/or constipation). Other gastrointestinal symptoms, such as bloating and flatulence, are also common. A variety of factors are believed to play a role in the development of IBS symptoms, including altered bowel motility, visceral hypersensitivity, psychosocial stressors, altered brain-gut interactions, immune activation/low grade inflammation, alterations in the gut microbiome, and genetic factors. In the absence of biomarkers that can distinguish between IBS subgroups on the basis of pathophysiology, treatment of this condition is predicated upon a patient's most bothersome symptoms. In clinical trials, effective therapies have only offered a therapeutic gain over placebos of 7-15%. Evidence based therapies for the global symptoms of constipation predominant IBS (IBS-C) include lubiprostone and tegaserod; evidence based therapies for the global symptoms of diarrhea predominant IBS (IBS-D) include the probiotic Bifidobacter infantis, the nonabsorbable antibiotic rifaximin, and alosetron. Additionally, there is persuasive evidence to suggest that selected antispasmodics and antidepressants are of benefit for the treatment of abdominal pain in IBS patients. Finally, several emerging therapies with novel mechanisms of action are in development. Complementary and alternative medicine therapies including probiotics, herbal therapies and acupuncture are gaining popularity among IBS sufferers, although concerns regarding manufacturing standards and the paucity of high quality efficacy and safety data remain.
Abdominal Pain ; Acupuncture ; Alprostadil ; Anti-Bacterial Agents ; Antidepressive Agents ; Carbolines ; Complementary Therapies ; Constipation ; Diarrhea ; Flatulence ; Gastrointestinal Diseases ; Humans ; Hypersensitivity ; Inflammation ; Irritable Bowel Syndrome ; Metagenome ; Parasympatholytics ; Placebos ; Probiotics ; Rifamycins ; Serotonin ; Biomarkers ; Lubiprostone

BACKGROUND/AIMS: Lubiprostone, a chloride channel type 2 (ClC-2) activator, was thought to treat constipation by enhancing intestinal secretion. It has been associated with increased intestinal transit and delayed gastric emptying. Structurally similar to prostones with up to 54% prostaglandin E2 activity on prostaglandin E receptor 1 (EP1), lubiprostone may also exert EP1-mediated procontractile effect on intestinal smooth muscles. We investigated lubiprostone's effects on intestinal smooth muscle contractions and pyloric sphincter tone. METHODS: Isolated murine small intestinal (longitudinal and circular) and pyloric tissues were mounted in organ baths with modified Krebs solution for isometric recording. Basal muscle tension and response to electrical field stimulation (EFS; 2 ms pulses/10 V/6 Hz/30 sec train) were measured with lubiprostone (10(-10)-10(-5) M) +/- EP1 antagonist. Significance was established using Student t test and P < 0.05. RESULTS: Lubiprostone had no effect on the basal tension or EFS-induced contractions of longitudinal muscles. With circular muscles, lubiprostone caused a dose-dependent increase in EFS-induced contractions (2.11 +/- 0.88 to 4.43 +/- 1.38 N/g, P = 0.020) that was inhibited by pretreatment with EP1 antagonist (1.69 +/- 0.70 vs. 4.43 +/- 1.38 N/g, P = 0.030). Lubiprostone had no effect on circular muscle basal tension, but it induced a dose-dependent increase in pyloric basal tone (1.07 +/- 0.01 to 1.97 +/- 0.86 fold increase, P < 0.05) that was inhibited by EP1 antagonist. CONCLUSIONS: In mice, lubiprostone caused a dose-dependent and EP1-mediated increase in contractility of circular but not longitudinal small intestinal smooth muscles, and in basal tone of the pylorus. These findings suggest another mechanism for lubiprostone's observed clinical effects on gastrointestinal motility.
Alprostadil ; Animals ; Baths ; Chloride Channels ; Constipation ; Contracts ; Dinoprostone ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Intestinal Secretions ; Intestine, Small ; Isotonic Solutions ; Mice ; Muscle Tonus ; Muscle, Smooth ; Muscles ; Pylorus ; Receptors, Prostaglandin E ; Receptors, Prostaglandin E, EP1 Subtype ; Lubiprostone