15 results on '"Tramontana, M"'
Search Results
2. The role of personalized Interventional Radiotherapy (brachytherapy) in the management of older patients with non-melanoma skin cancer.
- Author
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Lancellotta V, Kovács G, Tagliaferri L, Perrucci E, Rembielak A, Stingeni L, Tramontana M, Hansel K, Colloca G, Saldi S, Valentini V, and Aristei C
- Subjects
- Aged, Aged, 80 and over, Carcinoma, Basal Cell diagnostic imaging, Carcinoma, Basal Cell pathology, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell pathology, Female, Frail Elderly, Humans, Male, Radiotherapy Dosage, Skin Neoplasms diagnostic imaging, Skin Neoplasms pathology, Treatment Outcome, Brachytherapy methods, Carcinoma, Basal Cell radiotherapy, Carcinoma, Squamous Cell radiotherapy, Skin Neoplasms radiotherapy
- Abstract
Objective: Non-melanoma skin cancer (NMSC) has been rapidly increasing in incidence over the past 30 years. Mainstays of treatment remain surgery and radiotherapy, particularly in older and/or frail patients (≥75 years old) that often require a personalized treatment strategy using innovative biotechnologies. High-dose-rate interventional radiotherapy (HDR-IRT) seems to be an excellent option for NMSC., Material and Methods: Nineteen aged patients with advanced, biopsy proven NMSC were treated with exclusively HDR-IRT. A personalized double-layer mould of thermoplastic mask material was applied to the skin surface. Plastic tubes were fixed on the mould in appropriate geometry over the target area. Planning computed tomography (CT) images were acquired with 2.5 mm slice thickness and transmitted to the planning system. Treatment intention was to deliver ≥95% of the prescribed dose to the Planning Target Volume (PTV), accepting 90% as satisfactory. Toxicities were assessed using the Common Terminology Criteria for Adverse Events scale (CTCAE) v. 4.0., Results: Median age was 86 years. Acute toxicity: Grade 2 erythema appeared in all 19 patients. Towards the end of each treatment schedule, epidermolysis developed which was resolved within 6 weeks of completing HDR-IRT. Late toxicity: Grade 1 skin atrophy, pigmentation changes and alopecia in field were observed in all patients. At last follow-up, all patients were disease free., Conclusions: Personalized HDR-IRT appears to be safe and effective for frail older patients and a valid alternative to supportive care for those with contraindication to surgery. Future investigations using also large database analysis seem to be advisory., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
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3. Influence of tachykinin NK2 receptors on intestinal sensitivity and motility in newborn rats.
- Author
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Tramontana M, Evangelista S, Giuliani S, Manzini S, Robelet S, Girod V, and Maggi CA
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- Acetic Acid pharmacology, Animals, Animals, Newborn, Colon physiology, Female, Gastrointestinal Motility physiology, Gastrointestinal Transit drug effects, Gastrointestinal Transit physiology, Male, Rats, Rats, Wistar, Receptors, Neurokinin-2 physiology, Colon drug effects, Gastrointestinal Motility drug effects, Peptides, Cyclic pharmacology, Receptors, Neurokinin-2 antagonists & inhibitors
- Abstract
The effect of tachykinin neurokinin NK(2) receptors activation on intestinal propulsion and colorectal sensitivity was studied in 7-15 days old newborn rats. In a first set of experiments investigating the intestinal transit, the selective NK(2) receptor agonist, [betaAla(8)]NKA-(4-10) was used. It produced an increase of the small intestinal transit measured by charcoal test of 54%, that was inhibited in a dose-dependent manner by nepadutant ([N(4)-(2-acetamido-2-deoxy-beta-D-glucopyranosyl)-L-asparaginyl-L-aspartyl-L-tryptophyl-L-phenylalanyl-L-2,3-diaminopropionyl-L-leucyl]-C-4.2-N-3.5-lactam-C-1.6-N-2.1-lactam), a known selective NK(2) receptor antagonist, orally administered 2-48 h before the challenge with the NK(2) receptor agonist. Nepadutant did not affect the basal intestinal propulsion and showed a good oral bioavailability and long duration of action. In another set of experiments investigating visceral sensitivity, a fixed distension volume of a balloon inserted intrarectally in 14-15 days old newborns rats produced abdominal contractions (AC) that were increased after colonic application of acetic acid (50 microl, 0.5%). In this latter condition nepadutant, at 0.5 and 2.5 mg/kg p.o., significantly reduced the resulting AC. In control rats, untreated with acetic acid, nepadutant did not affect AC evoked by colorectal distension. These findings show for the first time two models to assess intestinal motility and visceral sensitivity in newborn rats and indicate nepadutant as a valuable tool to assess the role of NK(2) receptors in the intestinal propulsive and nociceptive activity in infants., (Copyright 2010 Elsevier Ltd. All rights reserved.)
- Published
- 2010
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4. Spatial and temporal expression of tachykinins and NK1- and NK2-receptor gene during TNB induced colitis in rats.
- Author
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Evangelista S, Tramontana M, and Maggi CA
- Subjects
- Animals, Body Weight, Colitis pathology, Colitis physiopathology, Colon cytology, Colon metabolism, Colon pathology, Male, Peroxidase metabolism, Rats, Rats, Sprague-Dawley, Tachykinins genetics, Colitis chemically induced, Colitis metabolism, Receptors, Neurokinin-1 genetics, Receptors, Neurokinin-1 metabolism, Receptors, Neurokinin-2 genetics, Receptors, Neurokinin-2 metabolism, Tachykinins metabolism, Trinitrobenzenesulfonic Acid pharmacology
- Abstract
The distribution and modification of the tachykinins Substance P (SP) and neurokinin A (NKA), their precursor beta-preprotachykinins (beta-PPT) and the receptors involved in their activity, NK-1 and NK-2, were studied in trinitrobenzensulphonic acid (TNB) colitis. Rats were intrarectally treated with a 120 mg/ml of TNB solution and sacrificed at various times after colitis induction. During the acute phases of colitis, a marked decrease in tissue SP and NKA levels were observed along with an increased transcription of beta-PPT mRNA in the neurons of the myenteric plexus and an increased myeloperoxidase activity, which is an index of the tissue's inflammatory status. De novo expression of both NK(1) and NK(2) receptor mRNA was observed during the acute phase of TNB-colitis in mesenchymal cells around dilated submucosal vessels but their expression in smooth muscle cells of the muscularis mucosae and propria was moderately down-regulated. The peptide levels, myeloperoxidase activity and gene expression of tachykinin receptors were then restored during the late phases (2-4 weeks after the apten administration) while beta-PPT mRNA remained highly expressed in the myenteric plexus ganglia showing that SP and NKA are involved in repair processes. These results point to the enhanced release of tachykinins during the initial phase of colitis and a restoration of this neuropeptide pool in the healing of the tissue.
- Published
- 2008
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5. Urodynamic effects induced by intravesical capsaicin in rats and hamsters.
- Author
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Lecci A, Carini F, Tramontana M, Birder LA, de Groat WC, Santicioli P, Giuliani S, and Maggi CA
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- Animals, Bronchodilator Agents pharmacology, Calcitonin Gene-Related Peptide pharmacology, Cricetinae, Male, Mesocricetus, Peptides, Cyclic pharmacology, Rats, Receptors, Neurokinin-2 antagonists & inhibitors, Species Specificity, Urinary Bladder innervation, Urinary Bladder physiology, Urodynamics physiology, Capsaicin pharmacology, Urodynamics drug effects
- Abstract
This study compared the effect of acute intravesical capsaicin administration on transvesical cystometries in urethane-anesthetized rats and hamsters, and aimed to assess whether sensory neuropeptides (tachykinins; calcitonin gene-related peptide, CGRP) play a role in the urodynamic effects of capsaicin in these species. The following urodynamic parameters were evaluated: the mean micturition interval (MI), the pressure threshold for micturition (PT), and the mean amplitude of micturition contractions (MAC). Two concentrations of capsaicin (10 and 100 microM) were evaluated in both species. Here, we demonstrate that 10-microM capsaicin decreased the PT in both rats and hamsters, and 100-microM capsaicin decreased the PT in hamsters and decreased the MI in both species. In addition, 100-microM capsaicin increased the MAC in rats but decreased the MAC in hamsters. Administration of CGRP (10 nmol kg(-1) , i.v.) significantly decreased both MAC and PT in hamsters only, while capsaicin-induced desensitization of neuropeptide-containing afferents antagonized the urodynamic effects of intravesical capsaicin. In addition, administration of the tachykinin NK2 receptor antagonist, Nepadutant (100 nmol kg(-1), i.v.), reduced the effects of capsaicin (100 microM) only in rats. These results indicate that capsaicin induces bladder hyperactivity in both rats and hamsters, but the urodynamic characteristics of this hyperactivity markedly differ in these two species. The differences observed may be due to differential expression of sensory neuropeptides in capsaicin-sensitive bladder afferents or neuropeptide receptors in smooth muscle cells and in nerve fibers.
- Published
- 2001
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6. Peripheral actions of tachykinins.
- Author
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Lecci A, Giuliani S, Tramontana M, Carini F, and Maggi CA
- Subjects
- Animals, Enteric Nervous System physiology, Peripheral Nervous System physiology, Tachykinins physiology
- Abstract
Tachykinins mediate a variety of physiological processes in the gastrointestinal, pulmonary and genito-urinary tract mainly through the stimulation of NK1 and NK2 receptors. Preclinical evidence obtained through the use of selective tachykinin receptor antagonists indicates that endogenous tachykinins are involved in augmented smooth muscle contraction, vasodilatation, chemotaxis and activation of immune cells, mucus secretion, water absorption/secretion. Recent evidence also suggests that endogenous tachykinins released at the peripheral level may play a role in visceral inflammation, hyperreflexia and hyperalgesia. Possible mechanisms underlying the stimulation of primary afferent neurons by tachykinins may involve a direct excitation of these neurons and the release of mediators which sensitise or stimulate sensory nerves. Tachykinin receptor antagonists could have a clinical utility in several human diseases such as irritable bowel syndrome, asthma, and in micturition disturbances characterized by a hyperactive bladder., (Copyright 2000 Harcourt Publishers Ltd.)
- Published
- 2000
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7. Tachykinin NK(1)receptor-mediated inhibitory responses in the guinea-pig small intestine.
- Author
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Lecci A, De Giorgio R, Barthó L, Sternini C, Tramontana M, Corinaldesi R, Giuliani S, and Maggi CA
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- Adrenergic Agents pharmacology, Animals, Enzyme Inhibitors pharmacology, Female, Gastrointestinal Motility drug effects, Guanethidine pharmacology, Guinea Pigs, Immunohistochemistry, Male, Myenteric Plexus chemistry, Myenteric Plexus cytology, Myenteric Plexus physiology, NADPH Dehydrogenase analysis, NG-Nitroarginine Methyl Ester pharmacology, Neurons chemistry, Neurons enzymology, Peptide Fragments pharmacology, Piperidines pharmacology, Quinuclidines pharmacology, Receptors, Neurokinin-1 analysis, Substance P analogs & derivatives, Substance P pharmacology, Tetrodotoxin pharmacology, Gastrointestinal Motility physiology, Intestine, Small innervation, Intestine, Small physiology, Neural Inhibition physiology, Receptors, Neurokinin-1 metabolism
- Abstract
We used in vivo, in vitro studies and immunohistochemistry to elucidate the mechanisms activated by tachykinin NK(1)receptors in evoking inhibitory motor response in the guinea-pig small intestine. In vivo, the selective NK(1)receptor agonist GR 73,632 produced a dose-dependent suppression of the distension-induced duodenal contractions, and a decrease of basal tone. These effects were reduced by pretreatment with the NK(1)receptor antagonist SR 140,333. In L-Nomega-nitro-L-arginine methylesther hydrochloride-pretreated animals, the suppressant effect of GR 73,632 on duodenal contractions was reduced, whereas the relaxation of the basal tone was unaffected. In vitro, GR 73,632 evoked a biphasic response consisting of a transient, tetrodotoxin-sensitive inhibitory effect followed by tetrodotoxin-resistant contractions. SR 140,333 blocked both inhibitory and excitatory motor responses induced by GR 73,632. NK(1)immunoreactivity was localized to myenteric and submucosal neurons and to interstitial cells of Cajal in the deep muscular plexus of the small intestine. NK(1)receptor-expressing neurons had Dogiel type I morphology and many of them were beta-nicotinamide adenine phosphate dinucleotide-diaphorase-positive, indicating they are inhibitory neurons. In conclusion, in the guinea-pig small intestine, NK(1)receptor stimulation evokes a myogenic excitatory motor response and a neurogenic inhibitory motor response that involves, at least in part, a nitrinergic pathway., (Copyright 1999 Harcourt Brace & Co. Ltd.)
- Published
- 1999
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8. Capsaicin-like effect of resiniferatoxin in the rat stomach.
- Author
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Tramontana M, Renzi D, Panerai C, Surrenti C, Nappi F, Abelli L, and Evangelista S
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- Administration, Oral, Animals, Animals, Newborn, Capsaicin administration & dosage, Capsaicin toxicity, Diterpenes administration & dosage, Dose-Response Relationship, Drug, Ethanol toxicity, Gastric Mucosa innervation, Gastric Mucosa metabolism, Gastrointestinal Hemorrhage chemically induced, Gastrointestinal Hemorrhage physiopathology, Gastrointestinal Hemorrhage prevention & control, Injections, Subcutaneous, Male, Neurons, Afferent chemistry, Neurons, Afferent drug effects, Neurons, Afferent metabolism, Neurotoxins pharmacology, Neurotoxins toxicity, Rats, Stomach Ulcer chemically induced, Stomach Ulcer physiopathology, Stomach Ulcer prevention & control, Vasoactive Intestinal Peptide biosynthesis, Calcitonin Gene-Related Peptide biosynthesis, Capsaicin pharmacology, Diterpenes pharmacology, Gastric Mucosa drug effects
- Abstract
Neurochemical and functional studies were performed to investigate and to compare the effects of resiniferatoxin and capsaicin in the rat stomach. Neonatal administration of resiniferatoxin (0.6-1.6 mumol/kg subcutaneously (s.c.)) produced a marked decrease in gastric calcitonin gene-related peptide-like immunoreactivity in both secretory and non-secretory region of the stomach. Almost complete depletion of the peptide was determined by neonatal administration of capsaicin (164 mumol/kg s.c.). Vasoactive intestinal polypeptide-like immunoreactivity was concomitantly unaffected by resiniferatoxin or capsaicin, thus showing the selectivity of action of the neurotoxins on gastric afferent fibers. Oral administration of an equimolar dose (0.3 nmol/kg) of resiniferatoxin or capsaicin together with 50% ethanol reduced at a similar extent gastric haemorrhagic lesions produced by the mucosal barrier-breaker agent. These findings provide evidence that resiniferatoxin and capsaicin may act on a common neuronal target in the rat stomach and that the acute exciting (protective) effect is of the same magnitude.
- Published
- 1994
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9. Pharmacological evidence for the involvement of multiple calcitonin gene-related peptide (CGRP) receptors in the antisecretory and antiulcer effect of CGRP in rat stomach.
- Author
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Evangelista S, Tramontana M, and Maggi CA
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- Animals, Calcitonin pharmacology, Calcitonin Gene-Related Peptide metabolism, Gastric Juice metabolism, Rats, Rats, Inbred Strains, Receptors, Calcitonin, Secretory Rate drug effects, Stomach physiopathology, Calcitonin Gene-Related Peptide pharmacology, Receptors, Cell Surface physiology, Stomach Ulcer prevention & control
- Abstract
We have investigated the effect of the C-terminal fragment of human calcitonin gene-related peptide (human-CGRP8-37), a CGRP antagonist, on alpha-CGRP and salmon Calcitonin (sCT)-induced inhibition of gastric acid secretion stimulated by pentagastrin (24 nmol kg-1 h-1 i.v.) and gastric lesions induced by acetylsalycilic acid (ASA; 25 mM) in rats anaesthetized with urethane. Close intra arterial infusion of alpha-CGRP (2-5 nmol kg-1) and sCT (5 nmol kg-1) produced a reduction in gastric acid hypersecretion induced by pentagastrin. The concomitant infusion with human-CGRP8-37 (10 nmol kg-1) reversed the effect of both agonists. ASA-ulcers were reduced in a dose-dependent manner by infusion of alpha-CGRP (1-2 nmol kg-1 i.a.), but not by sCT (10 nmol kg-1 i.a.). Human-CGRP8-37 at a dose of 10 nmol kg-1 i.a. was unable to reverse the alpha-CGRP antiulcer effect. An higher dose of human-CGRP8-37 (50 nmol kg-1 i.a.) showed agonistic properties reducing ASA ulcers. These results suggest that the inhibitory effects of alpha-CGRP on stimulated acid secretion and aspirin ulcers are mediated by different mechanisms and/or different receptors.
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- 1992
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10. Release of sensory CGRP by hypertonic NaCl is not blocked by tetrodotoxin, omega-conotoxin, nifedipine and ruthenium red.
- Author
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Del Bianco E, Tramontana M, Bertrand C, and Geppetti P
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- Animals, Calcitonin Gene-Related Peptide metabolism, In Vitro Techniques, Male, Nifedipine pharmacology, Peptides, Cyclic pharmacology, Rats, Rats, Inbred Strains, Ruthenium Red pharmacology, Calcitonin Gene-Related Peptide drug effects, Calcium Channel Blockers pharmacology, Saline Solution, Hypertonic pharmacology, Tetrodotoxin pharmacology, omega-Conotoxins
- Abstract
Hypertonic NaCl (160 mM added to the physiological salt solution) releases CGRP in a Ca(2+)-dependent manner from capsaicin-sensitive sensory nerves of the rat urinary bladder. The NaCl (160 mM)-evoked CGRP release was not affected by tetrodotoxin (0.3 microM), nifedipine (1 microM), omega-conotoxin (0.1 microM) and ruthenium red (10 microM). NaCl (160 mM)-evokes release of sensory neuropeptides without the involvement of axon reflexes, and by promoting Ca2+ influx via a dihydropyridine omega-conotoxin and ruthenium red insensitive pathway.
- Published
- 1992
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11. The effect of thiorphan on release of sensory neuropeptides from guinea-pig cerebral venous sinuses.
- Author
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Tramontana M, Del Bianco E, Ziche M, Santicioli P, Maggi CA, and Geppetti P
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- Angiotensin-Converting Enzyme Inhibitors pharmacology, Animals, Bradykinin pharmacology, Calcitonin Gene-Related Peptide pharmacology, Capsaicin pharmacology, Cranial Sinuses drug effects, Female, Guinea Pigs, Immunoenzyme Techniques, In Vitro Techniques, Male, Radioimmunoassay, Cranial Sinuses metabolism, Neurons, Afferent metabolism, Neuropeptides metabolism, Thiorphan pharmacology
- Abstract
The effect of peptidase inhibitors on neuropeptide release from peripheral endings of capsaicin-sensitive sensory neurons was studied in cerebral superior sagittal and transverse sinuses of guinea-pig. Capsaicin (1 microM)-evoked release of substance P-like immunoreactivity (SP-LI) was increased in a concentration-dependent manner by thiorphan (0.1-10 microM). Captopril (10 microM) or a mixture of bestatin (10 microM), leupeptin (10 microM) and bacitracin (10 microM) did not affect the capsaicin-evoked SP-LI release. Thiorphan (10 microM) increased also the capsaicin-evoked release of neurokinin A-like immunoreactivity (TK-LI) and calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) by 228% and 172%, respectively, while captopril (10 microM) was without effect. Thiorphan (10 microM), but not captopril (10 microM), enhanced by 239% CGRP-LI release induced by bradykinin (10 microM). In the cerebral venous vessels neutral endopeptidase (EC 3.4.24.11, NEP)-like activity was 58.8 +/- 6.1 pmol/mg protein/min, while angiotensin converting enzyme-like activity was below the detection limit of the assay. A thiorphan-sensitive mechanism, putatively attributable to NEP, plays a major role in the inactivation of peptides released from or acting on capsaicin-sensitive sensory fibres of cerebral venous sinuses of guinea-pig.
- Published
- 1991
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12. Low pH medium induces calcium dependent release of CGRP from sensory nerves of guinea-pig dural venous sinuses.
- Author
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Fanciullacci M, Tramontana M, Del Bianco E, Alessandri M, and Geppetti P
- Subjects
- Animals, Dura Mater blood supply, Female, Guinea Pigs, Hydrogen-Ion Concentration, Male, Neurons, Afferent metabolism, Potassium metabolism, Veins metabolism, Calcitonin Gene-Related Peptide metabolism, Calcium metabolism, Dura Mater metabolism, Neurons, Efferent metabolism
- Abstract
Low pH medium has been shown to activate the 'efferent' function of capsaicin-sensitive primary sensory neurons. Calcitonin gene-related peptide (CGRP) is released from capsaicin-sensitive afferents of guinea-pig superior sagittal and transverse sinuses (SSTS), by capsaicin or bradykinin. Here, we report that low pH medium produces a remarkable release of CGRP from SSTS, which was dependent on the concentration of hydrogen ions of the medium (pH 7-5). Moreover, the pH 5-evoked release of CGRP-LI was markedly reduced (by about 70%) in a calcium-free medium containing 1 mM EDTA or abolished in samples pre-exposed to 10 microM capsaicin. The present observation that lowering of the pH promotes release of a powerful vasoactive peptide from perivascular capsaicin-sensitive sensory nerves may have some relevance in the pathophysiology of brain injury and migraine headaches.
- Published
- 1991
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13. GABAA and GABAB receptors modulate the K(+)-evoked release of sensory CGRP from the guinea pig urinary bladder.
- Author
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Santicioli P, Tramontana M, Del Bianco E, Maggi CA, and Geppetti P
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- Animals, Baclofen pharmacology, Female, Guinea Pigs, In Vitro Techniques, Male, Muscimol pharmacology, Receptors, GABA-A classification, Receptors, GABA-A drug effects, Calcitonin Gene-Related Peptide metabolism, Potassium physiology, Receptors, GABA-A physiology, Urinary Bladder physiology
- Abstract
Superfusion of mucosa-free muscle slices of guinea-pig urinary bladder with 40 mM K+ produced a remarkable increase in calcitonin gene-related peptide-like immunoreactivity (CGRP-LI), that in this organ is entirely contained in capsaicin-sensitive nerves. GABA (1 mM) did neither affect the basal nor the 40 mM K+ evoked CGRP-LI release. Baclofen (0.1 mM) or muscimol (1 mM) did not affect the basal CGRP-LI outflow. However, baclofen (0.1 mM) significantly reduced by 32% and muscimol (0.1-1 mM) significantly increased by 60% and 70%, respectively the K(+)-evoked CGRP-LI release. These findings add neurochemical evidence to the functional data suggesting the existence of GABAA and GABAB receptors which modulate the efferent function of capsaicin-sensitive afferents.
- Published
- 1991
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14. Determinants of academic achievement in children with psychiatric disorders.
- Author
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Tramontana MG, Hooper SR, Curley AD, and Nardolillo EM
- Subjects
- Adolescent, Child, Child Behavior Disorders psychology, Female, Humans, Male, Mood Disorders psychology, Achievement, Intelligence, Learning Disabilities psychology, Mental Disorders psychology
- Abstract
Academic achievement within a child psychiatric sample was examined as a function of six variables: IQ, socioeconomic status, age, sex, neuropsychological status, and the severity of behavioral disturbance. As expected, the results revealed a different pattern of predictors than what is generally the case of normal school-aged children. The results underscored the importance of neuropsychological factors, more than IQ and demographic variables, in understanding the academic deficits often seen in children with significant mental and emotional disturbance.
- Published
- 1990
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15. Is major depressive disorder in adolescence a distinct diagnostic entity?
- Author
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Nurcombe B, Seifer R, Scioli A, Tramontana MG, Grapentine WL, and Beauchesne HC
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- Adjustment Disorders diagnosis, Adolescent, Bipolar Disorder diagnosis, Depressive Disorder psychology, Female, Humans, Male, Psychometrics, Psychotic Disorders diagnosis, Depressive Disorder diagnosis, Psychological Tests
- Abstract
The concept of major depressive disorder in childhood and adolescence is reviewed and it is suggested that contemporary enthusiasm for this diagnosis may have outrun the evidence that it is a distinct categorical entity. To test the hypothesis that major depression is not a qualitatively distinct disorder in adolescence, but rather a continuously distributed, noncategorical syndrome, the behavioral rating scales (CBCL-P) of 216 hospitalized adolescent patients were analyzed first by principal components analysis and then by cluster analysis. Three behavioral syndromes were isolated by principal components analysis. Of three groups of patients identified by a subsequent cluster analysis, one was consistent with the concept of a categorically distinct "nuclear" depression. However, a noncategorical continuously distributed depressive syndrome appears to affect a larger number of patients in this age group, and the "nuclear" disorder may be less prevalent than is currently assumed. One explanation of these findings would combine a categorical model of nuclear depression with a dimensional model of dysthymia.
- Published
- 1989
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