Pelvic Skin Research Articles

Water Adaptation Strategy in Anuran Amphibians: Molecular Diversity of Aquaporin

Most adult anuran amphibians except for the aquatic species absorb water across the ventral pelvic skin and reabsorb it from urine in the urinary bladder. Many terrestrial and arboreal species use a region in the posterior or pelvic region of the ventral skin that is specialized for rapid rehydration from shallow water sources or moist substrates. Periods of terrestrial activity can be prolonged by reabsorption of dilute urine from the urinary bladder. Aquaporin (AQP), a water channel protein, plays a fundamental role in these water absorption/reabsorption processes, which are regulated by antidiuretic hormone. Characterization of AQPs from various anurans revealed that the unique water homeostasis is basically mediated by two types of anuran-specific AQPs, i.e. ventral pelvic skin and urinary bladder type, respectively. The bladder-type AQP is further expressed in the pelvic skin of terrestrial and arboreal species, together with the pelvic skin-type AQP. In contrast, the pelvic skin-type AQP (AQP-x3) of the aquatic Xenopus has lost the ability of efficient protein production. The extra C-terminal tail in AQP-x3 consisting of 33 nucleotides within the coding region appears to participate in the posttranscriptional regulation of AQP-x3 gene expression by attenuating protein expression. The positive transcriptional regulation of bladder-type AQP in the pelvic skin and negative posttranscriptional regulation of pelvic skin-type AQP provide flexibility in the water regulation mechanisms, which might have contributed to the evolutionary adaptation of anurans to a wide variety of water environments.

Dilemmas about the decubitus ulcer: skin-fold ulcerations and apposition lesions

Skin lesions are often difficult to diagnose, and even decubitus ulcers (bedsores) can have different manifestations. Two such variations are ‘skin-fold’ ulcerations and those caused by the prolonged apposition of skin surfaces. When pressure is applied to apposed or folded skin, surface ulcers can occur. There is evidence that such lesions are particularly found on debilitated elderly subjects with easily tented skin, as well as on similar patients with chronic contractures. A careful consideration of skin-fold causation helps in preventing ulceration problems, especially where pelvic skin is involved. The effective treatment and/or management of underlying factors, such as pelvic deformities, contractures, dehydration and incontinence, should also help prevent both skin-fold ulcers and apposition lesions.

Immunocytochemical and Phylogenetic Analyses of an Arginine Vasotocin-Dependent Aquaporin, AQP-h2K, Specifically Expressed in the Kidney of the Tree Frog, Hyla japonica

Water movement occurs across the plasma membrane of various cells of animals, plants, and microorganisms through specialized water-channel proteins called aquaporins (AQPs). We have identified a new member of the amphibian AQP family, AQP-h2K, from the kidneys of Hyla japonica. This protein consists of 280 amino acid residues with two NPA (Asn-Pro-Ala) sequence motifs and a mercury-sensitive cysteine residue just upstream from the second NPA motif. There are two putative N-linked glycosylation sites at Asn-120 and Asn-128 and one protein kinase A phosphorylation site at Ser-262. The AQP-h2K protein was specifically expressed in the apical membrane and/or cytoplasm of principal cells in the kidney collecting ducts. After stimulation with arginine vasotocin, it was translocated from the cytoplasmic pool to the apical membrane. Phylogenetic analysis of AQP proteins from anurans and mammals identified six clusters of anuran AQPs: types 1, 2, 3, and 5 and two anuran-specific types, designated a1 and a2. The cluster AQPa2 contains Hyla AQP-h2 and AQP-h3, which are expressed in the anuran urinary bladder and ventral pelvic skin. AQP-h2K belongs to the type 2, together with mammalian (human and mouse) AQP2, suggesting that AQP-h2K is an anuran ortholog of the neurohypophysial hormone-regulated mammalian AQP2 and that the AQP2 molecule is already present in the anuran mesonephros.

Gene cloning and expression of an aquaporin (AQP-h3BL) in the basolateral membrane of water-permeable epithelial cells in osmoregulatory organs of the tree frog

An aquaporin (Hyla AQP-h3BL), consisting of 292 amino acid residues, has been cloned from the urinary bladder of Hyla japonica. In a swelling assay using Xenopus oocytes, AQP-h3BL cRNA-injected oocytes developed a sevenfold and 2.8-fold higher permeability to water and glycerol, respectively, than the water-injected oocytes. This permeability was inhibited by HgCl2. Immunofluorescence revealed that AQP-h3BL is localized in the basolateral plasma membrane of both granular cells in the ventral pelvic and dorsal skins and the secretory cells in the mucous glands. Immunopositive cells were also observed in the basolateral membrane of principal cells in the collecting ducts and in a portion of the late distal tubules in the kidneys, as well as in the principal cells of the urinary bladder. Sequence homology suggests that AQP-h3BL is a homolog to mammalian AQP3. This conclusion is supported by the observed localization of AQP-h3BL to the basolateral membrane in water- and glycerol-permeable epithelial cells. In ventral pelvic skins and urinary bladders, water enters into the cytoplasm through the apical plasma membrane at sites where AQP-h2, sometimes in association with AQP-h3, responds to stimulation by vasotocin; the water exits throughout AQP-h3BL to extracellular spaces. In the mucous glands, on the other hand, water enters throughout this AQP-h3BL and exits through AQP-x5, which is in the apical membrane of secretory cells. Thus, water homeostasis in the frog body is regulated by AQP-h3BL expressed in the basolateral membrane in concert with arginine vasotocin (AVT)-dependent or AVT-independent AQP.

Immunolocalization and mRNA expression of the epithelial Na+ channel α-subunit in the kidney and urinary bladder of the marine toad, Bufo marinus, under hyperosmotic conditions

The amiloride-sensitive epithelial sodium channel (ENaC) has previously been shown to be involved in the maintenance of body fluid volume and in Na(+) absorption across the skin and urinary bladder in amphibians. However, the function and distribution of ENaC have not been clearly described in amphibian kidney. We therefore cloned the ENaC alpha-subunit cDNA from kidney of the marine toad, Bufo marinus. The ENaC mRNA and protein were abundantly expressed in the kidney and in the urinary bladder and ventral pelvic skin. In an immunohistochemical study, the ENaC alpha-subunit protein was specifically localized to the apical membrane of the principal cells but not the intercalated cells from the late distal tubule to the collecting duct in the kidney or in the apical area of cells of urinary bladder epithelia. When toads were acclimated to dry and hyper-saline environments, the levels of ENaC mRNA expression in the kidney and urinary bladder decreased under hyper-saline acclimation, but not under dry conditions. Immunohistochemical observations indicated that the levels of ENaC protein expression were much lower in the apical area of renal distal tubules and urinary bladder epithelia of hyper-saline acclimated toad compared with controls. The present study suggests that Bufo ENaC is significantly expressed and functions during Na(+) reabsorption in the apical membrane domain in the distal nephron of normal and desiccated toads. Natriuresis may be caused by decreases in ENaC expression and its trafficking to the cell surface in the distal nephron, a response to prevent excessive Na(+) reabsorption in hyper-saline-acclimated toads.

Chemosensory function of salt and water transport by the amphibian skin

Solute and water transport mechanisms of anuran skin mediate chemosensory functions that permit evaluation of ionic and osmotic properties of hydration sources in a manner similar to taste receptors in the mammalian tongue. Histochemical observations demonstrated apparent connections between spinal nerve endings and epithelial cells of the skin and we used neural and behavioral responses as measures of coupling between transport and chemosensation. The inhibition of transcellular Na+ transport by amiloride partially reduced the neural response and the avoidance of hyperosmotic NaCl but not KCl solutions. Cetylpyridinium chloride (CPC) reduced the neural response to hyperosmotic salt solutions, suggesting a chemosensory role for vanilloid receptors in the skin. Avoidance of hyperosmotic salt solutions was reduced by impermeant anions suggesting paracellular conductance is important for chemosensation. The effects of blocking the transcellular and paracellular pathways was additive but did not eliminate the avoidance of osmotically unfavorable solutions by dehydrated toads. The timing of the neural response to deionized water was similar to the onset of water absorption behavior and increased blood flow to the pelvic skin. Water absorption from 50 mM NaCl was greater than from deionized water when toads were fully immersed, but not when contact was limited to the ventral surface.

Amphibian aquaporins and adaptation to terrestrial environments: A review

In many anurans, the pelvic patch of the ventral skin and the urinary bladder are important osmoregulatory organs. Since the discovery of water channel protein, aquaporin (AQP), in mammalian erythrocytes, 17 distinct full sequences of AQP mRNAs have been identified in anurans. Phylogenetic tree of AQP proteins from amphibians and mammals suggested that anuran AQPs can be divided into six types: i.e. types 1, 2, 3, and 5, and anuran-specific types a1 and a2. Among them, two types of anuran AQPs (types 1 and a2) are localized in the skin and urinary bladder by immunohistochemistry. Tree frog type-a2 AQPs, AQP-h2 and AQP-h3, are vasotocin-regulated water channels predominant in the osmoregulatory organs. Both the AQP-h2 and AQP-h3 are expressed at the granular cells underneath the keratinized layer in the pelvic patch, whereas only AQP-h2 is detected at the granular cells in the urinary bladder. In response to vasotocin, both the molecules seem to be translocated from the cytoplasmic pool to the apical plasma membrane of the granular cells. On the other hand, type-1 AQPs, Rana FA-CHIP and Hyla AQP-h1, are detected at the endothelial cells of blood capillaries in frog osmoregulatory organs. These findings suggest that AQP-h2 and AQP-h3 are key players for transepithelial water movement, and that FA-CHIP and AQP-h1 might be important for the transport of absorbed water into the blood flow. Comparative investigation of type-a2 AQPs in anurans further revealed that AQP-h2 and -h3-like molecules might exist at the urinary bladder and the pelvic skin, respectively, in various anurans from aquatic species to arboreal dwellers. AQP-h2-like protein is also detected in the pelvic skin of terrestrial and arboreal species. It is possible that this molecule might have occurred in the pelvic skin as anurans penetrated into drier environments.

Phase I study of irinotecan (Iri) and cisplatin (Cp) in combination with pelvic radiotherapy for the treatment (Tt) of advanced cervical cancer (ACC): A GINECO trial

5054 Background: Chemoradiotherapy with weekly Cp has become standard for ACC treatment. Combining Cp with another active drug in ACC such as Ir may increase the activity of Tt. Methods: Treatment consisted of 6 weekly cycles with escalating dose of Ir and fixed dose of Cp (20 mg/m2) administered during pelvic radiotherapy (45–50 Gy). Brachytherapy and/or surgery were allowed after pelvic chemoradiotherapy according to center policy. Cohorts of 3 to 6 pts with FIGO stage IB-IVA newly diagnosed ACC, performance status ECOG 1–2 and adequate major organ function were eligible at each dose level. Results: 15 pts were accrued at dose level I (n = 6), II (n = 3) and Intermediate (Int) (n = 6). Dose levels (DL) for Ir were 30 mg/m2 (I), 40 (II) and 35 (Int). Dose limiting toxicity (DLT) was observed in 2/3 pts at DL II (Gr 3 asthenia in 2/3 pts including Gr 3 diarrhea and abdominal pain in one). DLT was observed in 2/6 pts at DL I (NCI-CTC Gr 3 diarrhea in 2/6 pts including Gr 3 asthenia and abdominal pain in one) and DL Int (Gr 3 asthenia in 2/6 pts including febrile neutropenia in one). However, 3/4 pts without DLT at DL Int did not complete the whole chemotherapy schedule due to pelvic mucositis and skin toxicity (dose reduction: 2pts, early stopping at 3 cycles : 1 pt). In contrast, 5/6 non-progressive pts at DL I completed their scheduled chemo-radiotherapy, with dose reduction in only 1 pt who experienced a DLT. Efficacy evaluation showed complete and partial response in 6 and 5 of the 12 evaluable patients. Conclusions: the recommended dose for future phase II study of chemoradiotherapy in ACC is irinotecan (30mg/m2, weekly) with cisplatin (20 mg/m2, weekly). No significant financial relationships to disclose.

Cardiovascular and behavioural changes during water absorption in toads, Bufo alvarius and Bufo marinus

Blood cell flux (BCF) in the pelvic skin of Bufo marinus was lower than Bufo alvarius when toads rehydrated from deionised water (DI) or 50 mmol l-1 NaCl (NaCl). Despite the lower BCF in B. marinus, water absorption was not different between the species when toads rehydrated from DI or NaCl. When fluid contact was limited to the pelvic skin, water uptake from NaCl was lower than from DI, but became greater than uptake from DI as the immersion level increased. Hydrophobic beeswax coating the lateral sides reduced absorption from NaCl but not from DI. Toads settled into water absorption response posture well after maximal BCF was attained in both DI and NaCl, indicating that the behavioural response requires neural integration beyond the increase in BCF. Water exposure increased BCF in hydrated B. alvarius with empty bladders but not in those with stored bladder water. Hydrated B. marinus with an empty bladder did not increase BCF when given water. Handling stress depressed BCF but increased central arterial flow (CAF), measured using a flow probe around the dorsal aorta. In undisturbed toads, CAF increased with the same time course as BCF while heart rate remained relatively constant, suggesting redistribution of blood flow.

Semiautomatic Nonrigid Registration for the Prostate and Pelvic MR Volumes 1

Three-dimensional (3D) nonrigid image registration for potential applications in prostate cancer treatment and interventional magnetic resonance (iMRI) imaging-guided therapies were investigated. An almost fully automated 3D nonrigid registration algorithm using mutual information and a thin plate spline (TPS) transformation for MR images of the prostate and pelvis were created and evaluated. In the first step, an automatic rigid body registration with special features was used to capture the global transformation. In the second step, local feature points (FPs) were registered using mutual information. An operator entered only five FPs located at the prostate center, left and right hip joints, and left and right distal femurs. The program automatically determined and optimized other FPs at the external pelvic skin surface and along the femurs. More than 600 control points were used to establish a TPS transformation for deformation of the pelvic region and prostate. Ten volume pairs were acquired from three volunteers in the diagnostic (supine) and treatment positions (supine with legs raised). Various visualization techniques showed that warping rectified the significant pelvic misalignment by the rigid-body method. Gray-value measures of registration quality, including mutual information, correlation coefficient, and intensity difference, all improved with warping. The distance between prostate 3D centroids was 0.7 +/- 0.2 mm after warping compared with 4.9 +/- 3.4 mm with rigid-body registration. Semiautomatic nonrigid registration works better than rigid-body registration when patient position is changed greatly between acquisitions. It could be a useful tool for many applications in the management of prostate.

Cutaneous Blood Flow and Water Absorption by Dehydrated Toads

Blood cell flux (BCF) in ventral pelvic skin capillaries was measured in toads, Bufo woodhouseii and Bufo punctatus, using a chamber that allowed hydration behavior and water absorption to be observed concurrently in unrestrained animals. Dehydrated B. woodhouseii and B. punctatus placed on a rehydration solution significantly increased BCF relative to that on a dry surface in less than 2 min. Skin contact with a rehydration solution rather than dehydration alone is the primary stimulus for increased seat patch blood flow. In B. woodhouseii, the water absorption response was initiated after the increase in BCF had started but before maximum BCF was reached. BCF and water uptake across the ventral skin of both species placed on deionized water were not different from those of toads placed on 50 mM NaCl. Similarly, no significant correlation between BCF and rate of water uptake could be observed in dehydrated toads of either species. Angiotensin II (AII) injection in hydrated B. punctatus had no effect on BCF, suggesting that factors other than AII are responsible for the increase in blood flow upon water contact in dehydrated toads.

Immunocytochemical and Phylogenetic Distribution of Aquaporins in the Frog Ventral Skin and Urinary Bladder

We recently cloned three cDNAs encoding frog aquaporin (AQP-h1, BAC07470; AQP-h2, BAC82379; and AQP-h3, BAC07471) from the ventral pelvic skin of the tree frog, Hyla japonica. The present study demonstrated that Hyla AQP-h2 was translocated from cytoplasmic pools to the apical plasma membranes of the granular cells in the bladder after antidiuretic hormone stimulation and that Hyla AQP-h2 and AQP-h3 behaved similarly in the ventral pelvic skin. Further, we found that terrestrial and tree frogs, but not aquatic and semiterrestrial-adapted frogs, absorbed water from their ventral pelvic skin by AQP-h3-like protein in concert with AQP-h2-like protein.

Ertapenem: review of a new carbapenem

The carbapenems are β-lactam-type antibiotics with an exceptionally broad spectrum of activity. Ertapenem is a new carbapenem developed to address the pharmacokinetic shortcomings (short half-life) of imipenem and meropenem. Ertapenem shares similar structural features with meropenem, including its stability to dehydropeptidase-1, allowing it to be administered without a dehydropeptidase-1 inhibitor. Ertapenem, like imipenem and meropenem, demonstrates broad-spectrum antimicrobial activity against many Gram-positive and -negative aerobes and anaerobes and is resistant to nearly all β-lactamases, including extended-spectrum β-lactamases and AmpCs. However, it differs from both imipenem and meropenem in demonstrating limited activity against Enterococcus spp., Pseudomonas aeruginosa and other nonfermentative Gram-negative bacteria commonly associated with nosocomial infections. The extensive protein binding of ertapenem extends the half-life and allows for once-daily dosing. Prospective, multicenter, randomized, double-blind, comparative clinical studies demonstrate similar clinical efficacy of ertapenem compared with other agents. Clinical trials of complicated intra-abdominal infection, acute pelvic infection, complicated skin and soft-structure infection, community-acquired pneumonia and complicated urinary tract infections demonstrated that ertapenem has equivalent efficacy and safety compared with ceftriaxone and piperacillin/tazobactam. Ertapenem is a promising new carbapenem with excellent efficacy and safety for the treatment of a variety of community-acquired infections. It also appears to be of great value as an outpatient parenteral antimicrobial therapy.

Osmotically Absorbed Water Preferentially Enters the Cutaneous Capillaries of the Pelvic Patch in the ToadBufo marinus

Cutaneously absorbed water in anurans has two potential routes of movement from the skin interstitium into the body fluids, via the cutaneous capillaries and/or the lymphatic system. We investigated the lymphatic route at the pelvic patch skin under the influence of isoproterenol and arginine vasotocin in Bufo marinus by continuously aspirating lymph from the lymph sacs draining the pelvic patch while the animals absorbed water. Changes in body mass, lymph mass, and lymph osmolality were measured. If absorbed water entered the lymph space directly, we expected, relative to controls, (1) no difference in change in body mass, (2) lymph mass to be greater, and (3) lymph osmolality to be lower. None of these predictions were confirmed. We also tested the possibility that absorbed water was stored in the skin interstitium by measuring the surface density of pelvic skin immediately after it absorbed water. If water was stored, we expected the surface density of this skin to be greater than that of control skin. No difference in surface density was found. These results provide strong evidence that absorbed water does not directly enter the lymphatic system and is not stored in the skin. Consequently, osmotically absorbed water must enter via a transcapillary route.

The crab‐eating frog, Rana cancrivora, up‐regulates hepatic carbamoyl phosphate synthetase I activity and tissue osmolyte levels in response to increased salinity

The crab-eating frog Rana cancrivora is one of only a handful of amphibians worldwide that tolerate saline waters. They typically inhabit brackish water of mangrove forests of Southeast Asia, but live happily in freshwater and can be acclimated to 75% seawater (25 ppt) or higher. We report here that after transfer of juvenile R. cancrivora from freshwater (1 ppt) to brackish water (10 -->20 or 20 -->25 ppt; 4-8 d) there was a significant increase in the specific activity of the key hepatic ornithine urea cycle enzyme (OUC), carbamoyl phosphate synthetase I (CPSase I). At 20 ppt, plasma, liver and muscle urea levels increased by 22-, 21-, and 11-fold, respectively. As well, muscle total amino acid levels were significantly elevated by 6-fold, with the largest changes occurring in glycine and beta-alanine levels. In liver, taurine levels were 5-fold higher in frogs acclimated to 20 ppt. There were no significant changes in urea or ammonia excretion rates to the environment. As well, the rate of urea influx (J(in) (urea)) and efflux (J(out) (urea)) across the ventral pelvic skin did not differ between frogs acclimated to 1 versus 20 ppt. Taken together, these findings suggest that acclimation to saline water involves the up-regulation of hepatic urea synthesis, which in turn contributes to the dramatic rise in tissue urea levels. The lack of change in urea excretion rates, despite the large increase in tissue-to-water gradients further indicates that mechanisms must be in place to prevent excessive loss of urea in saline waters, but these mechanisms do not include cutaneous urea uptake. Also, amino acid accumulation may contribute to an overall rise in the osmolarity of the muscle tissue, but relative to urea, the contribution is small.

Spatial and temporal expression of the ventral pelvic skin aquaporins during metamorphosis of the tree frog, Hyla japonica.

Most adult anurans absorb water through their ventral skin to maintain the proper water balance. We examined spatial and temporal expression of frog (Hyla japonica) aquaporins, Hyla AQP-h2 and AQP-h3 proteins, in the ventral pelvic skin by using specific antibodies. Immunofluorescence indicates that AQP-h2 and AQP-h3 first appear in the granular cells of the pelvic skin of the tadpoles at Gosner stage 42, and such labeling is seen in later stages as well. These findings were confirmed by Western blot analysis. In addition, Northern blot analysis demonstrated that V2-type vasotocin (AVT)-receptor mRNA is first expressed at the same stage as are the AQP proteins, which suggests a functional relationship between expression of AQP proteins and AVT receptor. Also, AQP expression in the ventral pelvic skin is consistent with the morphological changes that occur in the skin for adaptation from life in water to that on land.

Altered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers

Objective. To determine whether the pattern of pelvic bone motion, determined by skin markers, differs between control subjects and subjects with posterior pelvic pain. Design. Cross-sectional study of three-dimensional angular and translational motion of the innominates relative to the sacrum in two subject groups. Background. Comparative in vivo analysis of the 3D patterning of pelvic motion in subjects with posterior pelvic pain and controls is limited. Methods. Fourteen males with posterior pelvic pain and healthy age and height matched controls were studied. A 6-camera motion analysis system was used to determine 3D angular and translational motion of pelvic skin markers during standing hip flexion. Results. Posterior rotation of the innominate occurred with hip flexion in control subjects and pelvic pain subjects as previously reported in the literature. On the supporting leg, the innominate rotated posteriorly in controls and anteriorly in symptomatic subjects. Conclusion. Posterior rotation of the innominate, as measured using skin markers during weight bearing in controls may reflect activation of optimal lumbo-pelvic stabilisation strategies for load transfer. Anterior rotation occurred in symptomatic subjects, suggesting failure to stabilise intra-pelvic motion for load transfer. Relevance This study found that posterior rotation of the innominate occurred during weight bearing in controls. This movement pattern is thought to optimise stability of the pelvic girdle during increased loading. Conversely, anterior rotation occurred in symptomatic subjects during weight bearing. This is a non-optimal pattern and may indicate abnormal articular or neuromyofascial function during increased vertical loading through the pelvis.

Regulation of water absorption in the frog skins by two vasotocin-dependent water-channel aquaporins, AQP-h2 and AQP-h3.

A new frog aquaporin (AQP) cDNA was cloned from a cDNA library constructed from the ventral skin of the tree frog Hyla japonica. This AQP (Hyla AQP-h2) consisted of 268 amino acid residues with a high homology to mammalian AQP2. The predicted amino acid sequence contained the two conserved Asn-Pro-Ala motifs found in all the major intrinsic protein family members and the putative six transmembrane domains. The sequence also contained a mercurial compound: cysteine, one potential N-glycosylation site at Asn-124, and a putative phosphorylation site recognized by protein kinase A at Ser-262. In a swelling assay using Xenopus oocytes, AQP-h2 facilitated water permeability, especially in response to cAMP. Expression of AQP-h2 mRNA was restricted to several tissues including the ventral skin, kidney, and urinary bladder; but with immunofluorescence staining using an antipeptide antibody (ST-140) against the AQP-h2 protein, immunopositive cells were found only in the ventral skin and urinary bladder. In the ventral pelvic skin, the label for AQP-h2 was localized in the entire plasma membrane of the granular cells beneath the outmost layer of the skin and in the basolateral membrane of the granular cells in this layer. In response to vasotocin, however, the label for AQP-h2 became more intense in the apical membrane in the granular cells of the outermost layer, similar to the case for the earlier studied AQP-h3, which was specifically expressed in the ventral skin. Taken together, these findings suggest that not only AQP-h3, but also AQP-h2 acts as a regulator of the water balance in this frog.

Sacral reflexes: physiology and clinical application.

Sacral reflexes consist of motor responses in the pelvic floor and sphincter muscles evoked by stimulation of sensory receptors in pelvic skin, anus, rectum, or pelvic viscera. These responses may be elicited by physical or electrical stimuli. They have been used in research studies of the pathophysiology of pelvic floor and anorectal disorders and many have been recommended for diagnostic use. These reflexes are described and discussed in this review. More rigorous evaluation of their value in the clinical assessment and care of patients with pelvic floor and sphincter disorders is required. Currently direct comparisons of the value of particular responses are generally not available, and few of these reflexes have proven validity for use in clinical diagnosis.

Effect of oxytocin on transepithelial transport of water and Na+ in distinct ventral regions of frog skin (Rana catesbeiana).

Thoracic, abdominal, and pelvic fragments of ventral skin of Rana catesbeiana were analysed regarding the effect of oxytocin on: (1) transepithelial water transport; (2) short-circuit current; (3) skin conductance and electrical potential difference; (4) Na+ conductance, the electromotive force of the Na+ transport mechanism, and shunt conductance; (5) short-circuit current responses to fast Na+ by K+ replacement in the outer compartment, and (6) epithelial microstructure. Unstimulated water and Na+ permeabilities were low along the ventral skin. Hydrosmotic and natriferic responses to oxytocin increased from thorax to pelvis. Unstimulated Na+ conductance was greater in pelvis than in abdomen, the other electrical parameters being essentially similar in both skin fragments. Contribution of shunt conductance to total skin conductance was higher in abdominal than in pelvic skin. Oxytocininduced increases of total skin conductance, Na+ conductance, and shunt conductance in pelvis were significantly larger than in abdomen. An oscillatory behaviour of the short-circuit current was observed only in oxytocin-treated pelvic skins. Decrease of epithelial thickness and increase of mitochondria-rich cell number were observed from thorax to pelvis. Oxytocin-induced increases of interspaces were more conspicuous in pelvis and abdomen than in thorax.