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The neurotransmitter role of calcitonin gene-related peptide in the rat and guinea-pig ureter: effect of a calcitonin gene-related peptide antagonist and species-related differences in the action of omega conotoxin on calcitonin gene-related peptide release from primary afferents.

In the rat and guinea-pig isolated ureter electrical field stimulation of intrinsic nerves (10 Hz for 10 s) produces transient inhibition of evoked (20 mM KCl or 0.1-1 microM neurokinin A) rhythmic contractions by releasing transmitter(s) from peripheral endings of capsaicin-sensitive primary afferents. The C-terminal fragment of human calcitonin gene-related peptide (8-37) blocked the inhibitory effect of electrical field stimulation as well as that produced by exogenous calcitonin gene-related peptide, while leaving unaffected the inhibitory response to isoprenaline. Human calcitonin gene-related peptide (8-37) was devoid of any inhibitory activity of its own but enhanced the amplitude and frequency of KCl-evoked rhythmic contractions in the rat ureter, probably by antagonizing the inhibitory effect of endogenous calcitonin gene-related peptide released by KCl. Omega conotoxin fraction GVIA, a peptide which possesses a potent blocking activity of N-type voltage-sensitive calcium channels, prevented the inhibitory response to electrical stimulation in the guinea-pig ureter, while leaving the response unaffected in the rat ureter. Conotoxin had no effect toward the inhibition produced by exogenous calcitonin gene-related peptide indicating its prejunctional site of action, demonstrated previously in the guinea-pig ureter [Maggi et al. (1990) Neurosci, Lett. 114, 203-206]. Dermorphin, an amphibian peptide with potent agonist activity on mu-type opioid receptors, inhibited the response to electrical stimulation in the guinea-pig ureter but had no effect in the rat ureter.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Alcohol-related relative risk of fatal driver injuries in relation to driver age and sex.

The relative risks of fatal crash involvement at various blood alcohol concentrations (BACs) were examined using data on fatal driver injuries from the Fatal Accident Reporting System in conjunction with driver exposure data from the second national road-side breath-testing survey. Based on driver fatalities in single-vehicle crashes, it was estimated that each 0.02 percentage increase in the BAC of a driver with non-zero BAC nearly doubles the risk of being in a fatal crash. Crash risk was found to increase with increasing BAC among all of the six age and sex groups studied. At BACs in the 0.05-0.09 percent range, the likelihood of a crash was at least nine times greater than at zero BAC for all age groups. Younger drivers with BACs in the 0.05-0.09 range had higher relative risks than older drivers, and females had higher relative risks than males. At very high BACs (at or above 0.15 percent), the risk of crashing was 300 to 600 times the risk at zero or near-zero BACs. These relative risk estimates are considerably higher than estimated in other studies, but other studies have based their estimates on all crashes rather than single-vehicle crashes only. In this study, relative risks were also lower when based on driver fatalities in all crashes. However, when plausible assumptions were made about the BAC distributions of other participants in multiple-vehicle crashes (whose actual BAC is often unknown), the relative risks based on the maximum BAC of the crash participants were nearly as high as those estimated in single-vehicle crashes.

Accidents, Traffic

Event-related potentials in patients with Huntington's disease and relatives at risk in relation to detailed psychometry.

Event-related potentials (ERPs) were studied in patients with Huntington's disease (HD) and their offspring at risk in a simple auditory oddball paradigm requiring the counting of the rarer of two stimulus categories. Group statistical analysis revealed prolongation of latencies of components P2, N2 and especially P3 in HD patients and to a lesser extent in at-risks. In a large population of normals the age-latency relationship for component P3 showed a non-linear shape with increasing slope and scatter in the older age groups. A bipartate linear regression analysis splitting the normal population at age 50 was used for detection of abnormalities of P3 latency in individual cases. Abnormal P3 latencies were present in the majority of HD patients and also in 25% of clinically normal at-risks. Correlation analysis of ERP components with detailed psychometry revealed a particularly high association of P3 latencies with measurements requiring speeded information processing in non-verbal tasks. P3 amplitude did not covary with performance scores but unlike P3 latency showed association with depression and psychosis scores. From the results it appears that analysis of ERPs is a useful electrophysiological tool for an objective assessment of cognition both in clinically definite and subclinical stages.

Adolescent

Risk of dementia in first-degree relatives of patients with Alzheimer's disease and related disorders.

First-degree relatives of patients with Alzheimer's disease (AD) are at greater risk for dementia when compared with the relatives of their healthy peers, but not when compared with the relatives of patients with Parkinson's disease. This may indicate that the risk of dementia in these relatives is not specific to AD or that these studies are biased. We obtained a family history and vital status information on each first-degree relative of patients attending a clinic and in a group of recruited healthy elderly subjects. Patients formed two groups: probable AD and other forms of dementia or cognitive disorders without dementia. The odds of dementia in first-degree relatives did not differ between patient groups. The odds of dementia in relatives of patients with probable AD or other forms of dementia was six times that in the relatives of the healthy elderly subjects. The cumulative incidence of dementia increased with age in the first-degree relatives of all subjects. Approximately 50% of the first-degree relatives of patients with AD were demented by age 91 years, but almost the same number of the other patient group's relatives were demented as well. That figure was never reached in the healthy elderly subject's relatives. Because the risk of dementia in first-degree relatives of patients with AD was similar to that for patients with other disorders, we cannot exclude the possibility that this is the result of selection and information biases. Our investigation implies that the increased risk of dementia may not be specific to relatives of patients with AD; the risk may also be increased in first-degree relatives of patients with other neurologic disorders.

Aged

Increased morbid risk for schizophrenia-related disorders in relatives of schizotypal personality disordered patients.

To evaluate whether probands from a clinical sample diagnosed as having DSM-III schizotypal and/or paranoid personality disorder have a familial relationship to the schizophrenia-related disorders, the morbid risk for schizophrenia-related disorders and other psychiatric disorders were evaluated in the first-degree relatives of patients with schizotypal and/or paranoid personality disorder and compared with the corresponding risk for these disorders in the first-degree relatives of patients with other non-schizophrenia-related personality disorders. The morbid risk for all schizophrenia-related disorders, and specifically for schizophrenia-related personality disorders, was significantly greater among the relatives of the probands with schizotypal and/or paranoid personality disorder than among the relatives of probands with other personality disorder. The morbid risk for other psychiatric disorders did not differ significantly between the first-degree relatives of the schizotypal/paranoid personality disorder and the other personality disorder control proband samples. These results suggest a specific familial association between schizophrenia-related disorders, particularly schizophrenia-related personality disorders, and clinically diagnosed schizotypal patients.

Adolescent

The equity of diagnostic related group "All Payor" hospital payment and gynecology diagnostic related groups.

Previous work by our group had suggested that some Diagnostic Related Groups did not adequately compensate for patients with multiple complications and comorbidities. However, this question had never been studied for gynecology Diagnostic Related Groups. We analyzed resource consumption in the 15 gynecology Diagnostic Related Groups that were not stratified for complications or comorbidities using the new Diagnostic Related Group prospective "All Payor System" in effect at our hospital. Analysis of 2920 gynecology patients for a 3-year period by payor (Medicare, Medicaid, Blue Cross, and commercial insurance) in the gynecology Diagnostic Related Groups that were not stratified for complications or comorbidities demonstrated that patients with more complications and comorbidities per Diagnostic Related Group for each payor generated higher total hospital costs, a longer hospital length of stay, a greater percentage of procedures per patient, financial risk under Diagnostic Related Group payment, more outliers, and a higher mortality compared with patients in these same Diagnostic Related Groups with fewer complications and comorbidities. These findings suggest that new prospective Diagnostic Related Group All Payor Systems may be inequitable for certain groups of gynecology patients. Gynecology Diagnostic Related Groups should be stratified by the numbers and types of complications and comorbidities to more equitably reimburse hospitals under Diagnostic Related Group All Payor Systems.

Adult

Prospective pricing system by diagnosis-related groups: comparison of federal diagnosis-related groups with high-risk obstetric care groups.

Of 468 diagnosis-related groups identified by the federal government for Medicaid reimbursement, 15 are related to obstetric hospital care. Each diagnosis-related group is considered a distinct group in which cases are homogeneous with respect to resource consumption. Because the diagnosis-related group system is based primarily on data from community and secondary care hospitals, it does not differentiate sufficiently among high-risk obstetric patients seen at tertiary care institutions, such as Florida's Regional Perinatal Intensive Care Centers. We developed an alternative scheme for diagnosis-related groups, called obstetric care groups, using the federal diagnosis-related groups as the model from which to depart. Data collected for 4192 women during a 2 1/2-year period indicate that obstetric care groups provide more homogeneous groups than diagnosis-related groups for our population of high-risk patients. The obstetric care groups differentiate between no complications, one complication, and two or more complications, while the diagnosis-related groups differentiate only between no complications and one or more complications. Also, complications for obstetric care groups are based on only 19 diagnoses that contribute significantly to resource consumption, while the list of possible complications exceeds 200 for diagnosis-related groups. Although the obstetric care group classification system is simpler than that for diagnosis-related groups, it results in a more accurate reimbursement of hospitalization charges for high-risk obstetric care.

Diagnosis-Related Groups

Elevated fibrin-related and fibrinogen-related antigens in patients with liver disease.

Patients with liver disease have a variety of coagulation abnormalities. These derangements are of uncertain origin and do not always correlate with disease severity or activity. We have measured the levels and proportions of the total fibrin-related and fibrinogen-related antigens, the principal fibrin (D-dimer) and fibrinogen (D-monomer) degradation fragments and intermediates of fibrin formation (fibrin monomers) in patients with a variety of acute and chronic liver diseases in whom all known other precipitating causes of disseminated intravascular coagulation had been excluded. Fibrin-related and fibrinogen-related antigens were extracted from serum using antihuman fibrinogen-IgG covalently bound to activated amino-phenylthioether paper disks and were subjected to 4% to 11% sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions. Fibrin-related and fibrinogen-related antigen proportions were determined by densitometry, and their levels were measured by radioimmunoassay. Levels of total fibrin-related and fibrinogen-related antigens (and D-dimer) were significantly elevated (p less than 0.01) in patients with cirrhosis (121 to 641 ng/ml) and hepatocellular carcinoma (416 to 8,786 ng/ml) when compared with patients with acute viral hepatitis (84 to 322 ng/ml) and control subjects (38 to 186 ng/ml). In addition, D-monomer levels were elevated. These findings strongly suggest that disseminated intravascular coagulation is a component of the coagulopathy of certain liver diseases. Because fibrin-related and fibrinogen-related antigens have anticoagulant, vasoactive and immunosuppressive properties, their elevated presence may be biologically significant in these patients.

Adult

Long-term prosthesis-related and sudden cardiac-related complications after valve replacement for aortic stenosis.

Predictability of prosthesis-related and sudden cardiac-related complications was examined in 630 patients who were alive 30 days after valve replacement (1965 to 1986) for aortic stenosis. Follow-up totaled 4,072 patient-years. A variety of prosthetic valves, mainly mechanical, were used. The Cox regression model was used to identify independent risk factors and to estimate predicted event-freedoms relative to combinations of these risk factors. There were no risk factors for endocarditis (0.5 +/- 0.1 [number of events per 100 patient-years +/- the standard error]). Except for "other" prosthesis-related complications (0.4 +/- 0.1), adversely influenced by porcine bioprostheses (n = 15) and by the Lillehei-Kaster prosthesis (n = 25), only factors underlying diseased preoperative patient/cardiac status had predictive influence. Predicted 10-year event-freedoms for low-risk versus high-risk estimate were 86% versus 73% for thromboembolism (1.7 +/- 0.2), 95% versus 32% for anticoagulant-related hemorrhage (2.4 +/- 0.2), 69% versus 36% for all prosthesis-related complications (5.0 +/- 0.4), 93% versus 0% for sudden cardiac-related events (myocardial infarction and arrhythmia) (1.8 +/- 0.2), and 66% versus 0.5% for combined prosthesis-related and sudden cardiac-related morbidity and mortality (6.8 +/- 0.4). In 193 patients with coronary arteriography, coronary artery disease was a significant risk factor for each of the complication modalities examined except other prosthesis-related complications, prosthesis replacement, and endocarditis. Deciding to operate early in the course of aortic stenosis might "actively" reduce the rate of these complications.

Adult

Comparison between the sarcomere length-force relations of intact and skinned trabeculae from rat right ventricle. Influence of calcium concentrations on these relations.

To investigate the extent to which the properties of the cardiac myofibrils contribute to the length-force relation of cardiac muscle, we determined the sarcomere length-force relations for rat ventricular trabeculae both before and after the muscles were skinned with the detergent Triton X-100. Sarcomere length was measured continuously by laser diffraction. In the unskinned trabeculae stimulated at 0.2 Hz, the relation between active force and sarcomere length at an extracellular calcium concentration of 1.5 mM was curved away from the sarcomere length axis, with zero force at sarcomere length of 1.5-1.6 micron. At 0.3 mM calcium, the sarcomere length-force relation was curved toward the sarcomere length axis. Chemical skinning of the muscle with 1% Triton X-100 in a "relaxing solution" caused an increase in intensity and decrease in dispersion of the first order diffraction beam, indicating an increased uniformity of sarcomere length in the relaxed muscle. During calcium-regulated contractures in the skinned muscles, the central sarcomeres shortened by up to 20%. As the calcium concentration was increased over the range 1-50 microM, the relation between steady calcium-regulated force and sarcomere length shifted to higher force values and changed in shape in a manner similar to that observed for changes in extracellular calcium concentration before skinning. The sarcomere length-force relations for the intact muscles at an extracellular calcium concentration of 1.5 mM were similar to the curves at calcium concentration of 8.9 microM in the skinned preparations, whereas the curves at an extracellular calcium concentration of 0.3 mM in intact muscles fell between the relations at calcium concentrations of 2.7 and 4.3 microM in the skinned preparations. A factor contributing to the shape of the curves in the skinned muscle at submaximal calcium concentrations was that the calcium sensitivity of force production increased with increasing sarcomere length. The calcium concentration required for 50% activation decreased from 7.71 +/- 0.52 microM to 3.77 +/- 0.33 microM for an increase of sarcomere length from 1.75 to 2.15 micron. The slope of the force-calcium concentration relation increased from 2.82 to 4.54 with sarcomere length between 1.75 and 2.15 micron. This change in calcium sensitivity was seen over the entire range of sarcomere lengths corresponding to the ascending limb of the cardiac length-force relation. It is concluded that the properties of the cardiac contractile machinery (including the length-dependence of calcium sensitivity) can account for much of the shape of the ascending limb in intact cardiac muscle.

Animals

Colonoscopic screening examination of relatives of patients with colorectal cancer. II. Relations between tumour characteristics and the presence of polyps.

Colonoscopy was offered to 206 first-degree relatives of 181 patients operated on for colorectal cancer (CRC). Findings of polyps in relatives correlated with Dukes staging, extent of dedifferentiation and localization of tumour in the operated patient, and type of family relationship. Adenomas in relatives and Dukes staging of carcinoma in the patients were inversely related. Relatives of patients with Dukes stage A tumour had more than twice as many adenomas as and a higher prevalence of multiple adenomas than relatives of patients with advanced cancer at the time of operation. If the patient had polyp(s) in addition to tumour, the number of adenomas per relative was almost doubled. Hyperplastic polyps in relatives were associated with poorly differentiated carcinoma in their related patients. These results support the theory that not all CRC are derived from polyps and that adenoma-derived CRC may have a better prognosis than 'de novo' CRC. An adenoma prevalence risk table is also presented.

Adenoma

The relation between ponderosity and coronary risk factors in children and their relatives. The Muscatine Ponderosity Family Study.

A family study was conducted in Muscatine, Iowa in 1984-1985 to evaluate the relation between ponderosity in children and coronary risk factor levels in these children and in their family members, and the genetic contribution to familial clustering of levels of ponderosity (body weight relative to height). Four groups of probands were selected from the 1,783 students who participated in three consecutive biennial school surveys. A random group (n = 70), a random sample of students from the entire pool; a lean group (n = 72), students in the lowest quintile of relative weight on all three surveys; a gain group (n = 70), students who gained at least two quintiles of relative weight over the four-year period; and a heavy group (n = 72), students in the highest quintile of relative weight on all three surveys. The parents, siblings, a related aunt or uncle, and a first cousin of these probands were also examined. The data show that levels of high density lipoprotein (HDL) cholesterol, apolipoproteins A-1 and B, and systolic blood pressure in heavy group probands are consistent with increased coronary risk. This same association exists among the relatives with excess ponderosity. Levels of body mass index in the mothers, fathers, and siblings cluster with the levels in the probands, and genetic differences among persons explain 36-52 per cent of the variability in body mass index across the range of ponderosity represented by the probands and their relatives. While the contribution from genes is strong, these data suggest that the contribution from environmental factors is equally as important.

Adolescent

Phenotypic correlations between oculomotor functioning and schizophrenia-related characteristics in relatives of schizophrenic probands.

Abnormalities of visual pursuit tracking are frequent in the first-degree relatives of probands with schizophrenia. The relationship between oculomotor abnormalities and schizophrenia-related characteristics in those family members, however, has received little attention. Fifty-three first-degree relatives of 24 probands with schizophrenia were evaluated for the presence of schizophrenia-related characteristics using both interview (Schedule for Schizotypal Personalities) and questionnaire (Chapman scales). The family members also had their eye movements recorded during pursuit tracking tasks and scored for gain in both the frequency and time domains, and saccadic intrusions. Social-interpersonal schizophrenia-related features were significantly related to both time- and frequency-domain gain calculations. It appears that abnormalities in the smooth-pursuit oculomotor system may be associated with symptoms conjectured to be most closely related to a genetic diathesis for schizophrenia. These findings provide further evidence that oculomotor abnormalities may be related to risk for this disorder.

Adult

Set-related activity in the premotor cortex of rhesus monkeys: effect of triggering cues and relatively long delay intervals.

"Set-related activity" has been defined as a significant alteration in neuronal discharge rate during an "instructed delay period," a period when a previously instructed movement is being withheld. It has been argued that set-related activity in the primate premotor cortex, or at least a significant proportion of it, reflects motor preparation. In most previous investigations, however, in which visual stimuli have triggered the movement and simultaneously indicated its target, set-related activity might reflect either the anticipation of or attention to the trigger stimulus. The present report shows that set-related activity is robust and can be directionally selective when trigger stimuli do not indicate the target and when a trigger stimulus is absent. Another feature of previous studies has been the relatively brief intervals between the instruction and trigger stimuli (typically 3 sec or less). In the present study, we were able to observe the activity of a small number of cells during longer delay periods. Set-related activity persists, although it becomes less consistent, for as much as 7.5 sec after an instruction stimulus. These results support the hypothesis that set-related activity reflects the preparation for specific limb movements.

Animals

Full expression of blood group-related, transplantation-related, and carcinoembryonic antigens in human colorectal cancer cells with different degrees of phenotypic differentiation.

Seven established human colon carcinoma cell lines with distinct degrees of phenotypic differentiation were evaluated for the presence of blood group-related and transplantation-related antigens in relation to their production of carcinoembryonic antigen (CEA). All lines presented A and B antigens regardless of the patients' original red blood cell type. However, tumor cells from patients originally classified as O-type had lower expression of both A and B antigens and high production of CEA. Cells from patients with an original A type had low to undetectable CEA production and high expression of both A and B antigens. There was no particular segregation of transplantation-related antigens with respect to phenotypic expression. All lines presented HLA-A, -B, and -C, as well as -DR antigens. These results demonstrate that colon carcinoma cells have the ability to fully express both blood group-related and transplantation-related antigens, even if discordant with the donor's red blood cell phenotype. Furthermore, it appears that expression of A antigen is intimately related to synthesis of CEA.

ABO Blood-Group System

The family relations, peer relations, and criminal activities of Caucasian and Hispanic-American gang members.

Juvenile gang members present serious problems to society, yet few empirical studies have examined their criminal activity, family relations, and peer relations in comparison with other highly antisocial youths. In a 2 (Gang Membership) x 2 (Ethnicity: Hispanic-American vs. Caucasian) design, 131 incarcerated male juvenile offenders were administered a battery assessing criminal activity, family relations, and peer relations. Results demonstrated (a) higher rates of criminal behavior (i.e., general delinquency, index offenses, school delinquency) among gang members than among offenders who did not belong to gangs, (b) higher rates of general delinquency and home delinquency among Caucasian offenders than among Hispanic-American offenders, and (c) greater aggression and less social maturity in the peer relations of gang members than in the peer relations of offenders who did not belong to gangs. In addition, gang membership mediated sociocultural differences in hard drug use. Findings are integrated with the extant literature.

Adolescent

Parental longevity and polygenic longevity scores in relation to ageing-related factors in a population of 70-year-olds followed over six years: The Gothenburg H70 Birth Cohort Study.

As societies age, a deeper understanding of ageing-related factors that contribute to longevity is needed. We therefore investigated possible longevity factors (social, medical, and biological) in relation to parental longevity (PL) and polygenic longevity scores (PGLSs). We examined 1126 70-year-olds from the Swedish population-based Gothenburg H70 Birth Cohort study in 2014-2016 (response rate 72%), with follow-up in 2019-2022 (response rate 77.6%). Comprehensive examinations included self-reported information on parents' ages, socioeconomic factors, mental, cardiovascular, and neurological health, anthropometry, laboratory data, and genotyping to construct two continuous PGLSs variables (with and without the APOE locus). PL groups were categorised as high if both parents survived to age 85 (17.2%); medium if one parent had survived (43.3%), and low if neither parent had survived to age 85 (39.4%). Higher PL and higher PGLSs were related to less hypertension, higher educational level, better childhood, and current socioeconomic status. In addition, higher PL was associated with higher MMSE score, total cholesterol, HDL-cholesterol (HDL-c) and LDL-cholesterol (LDL-c), lower BMI, homocysteine and inflammatory markers (IL-6, CRP) levels, and less smoking, whereas higher PGLSs was related to less myocardial infarction. At follow-up, high-PL was associated with less increase in plasma pTau217. PGLSs were mainly related to socioeconomic and cardiovascular factors, while individuals with long-lived parents, in addition, had several other characteristics of longevity, such as less inflammation, homocysteine, and markers of dementia. PL may be a proxy for biological ageing and used as a screening for ageing-related disorders in the context of prevention.

APOE