A simulation approach for power calculation in large cohort studies based on multistate models

Realistic power calculations for large cohort studies and nested case control studies are essential for successfully answering important and complex research questions in epidemiology and clinical medicine. For this, we provide a methodical framework for general realistic power calculations via simulations that we put into practice by means of an R‐based template. We consider staggered recruitment and individual hazard rates, competing risks, interaction effects, and the misclassification of covariates. The study cohort is assembled with respect to given age‐, gender‐, and community distributions. Nested case‐control analyses with a varying number of controls enable comparisons of power with a full cohort analysis. Time‐to‐event generation under competing risks, including delayed study‐entry times, is realized on the basis of a six‐state Markov model. Incidence rates, prevalence of risk factors and prefixed hazard ratios allow for the assignment of age‐dependent transition rates given in the form of Cox models. These provide the basis for a central simulation‐algorithm, which is used for the generation of sample paths of the underlying time‐inhomogeneous Markov processes. With the inclusion of frailty terms into the Cox models the Markov property is specifically biased. An “individual Markov process given frailty” creates some unobserved heterogeneity between individuals. Different left‐truncation‐ and right‐censoring patterns call for the use of Cox models for data analysis. p‐values are recorded over repeated simulation runs to allow for the desired power calculations. For illustration, we consider scenarios with a “testing” character as well as realistic scenarios. This enables the validation of a correct implementation of theoretical concepts and concrete sample size recommendations against an actual epidemiological background, here given with possible substudy designs within the German National Cohort.     

Ensembles of endothelial and mural cells promote angiogenesis in prenatal human brain

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垂体后叶素和加压素对离体心肌的直接作用

本实验采用大鼠离体右心房和右心室肌条模型,观察了垂体后叶素和加压素对右心房和右心室肌的直接作用。结果表明:垂体后叶素对右心房的自主性收缩频率和幅度及右心室肌的收缩幅度均有剂量依赖性抑制作用;加压素对右心房和右心室肌收缩幅度也有剂量依赖性抑制作用,但对右心房自主节律无影响;催产素对右心房的收缩频率和幅度则均无影响。加压素V_1、V_2受体拮抗剂d(CH_2)_5Tyr(Me)AVP和d(CH_2)_5(D-Ile~2,Ile~4,Ala(NH_2)~9)AVP对垂体后叶素的负性变力作用具有不同程度的阻断作用,但对垂体后叶素的负性变时作用无阻断作用。以上结果提示,垂体后叶素的负性变力作用主要是由加压素产生的,加压素对心肌有直接的负性变力作用;垂体后叶素的负性变时作用可能是非加压素和催产素成分的作用结果。     

Single-channel analysis of a potassium inward rectifier in myocytes of newborn rat heart

Summary Unitary K⁺ currents in single cells isolated from ventricular muscle of newborn rat hearts were measured in response to different potentials and [K] _o . TheI/V curves were linear for potentials more negative than the zero-current voltage: especially in high [K] _o (150nm KCl), no clear outward currents could be detected indicating a drastic rectification in the inward direction. The channel is mainly selective to K⁺ but Na⁺ ions are also carried (P _Na/P _K=0.056). The channel conductance is proportional to the square root of [K] _o but Na⁺ ions seem to have a facilitatory effect on _K, the single-channel conductance. The channel activity, measured asP _o, i.e. the probability to find the channel in open state, decreased as the membrane was hyperpolarized. This behavior was tentatively explained by an inactivation process as the membrane becomes more negative. The rate constants of the transitions between the different states were calculated according to a C–O–C model. A control of the gating process by permeant ion K⁺ was postulated, based on the increase of one of the rate constants from the closed to the open state with [K] _o . Finally, the macroscopicI/V curves calculated fromP _o and i, the unit current, were found to be characteristic of a ion-blocked inward rectifier.     

Rigorous conformational analysis of right and left DNA helices and junction between them

On the basis of complete scanning through conformational space of dihedral angles, twelve structural genera were obtained. Subsequent energy minimization within these genera yielded a limited set of duplexes with stacking: right-handed B-form (Wilkins type), B2-form (Watson and Crick type) and left-handed Ll-form (Sasisekharan type) and the new L2-form. In the polymeric DNA only right-handed double-helices are possible, the left-handed helices are forbidden due to poor 1–5 interchain contacts. In contrast, for short fragments the left- and right-handed helicek have practically the same energies providing some physical ground for side-by-side form, which biologically is possible as recombination form and may be as replication form.     

蓝斑复合核区内微量注射去甲肾上腺素对刺激兔下丘脑诱发室性期前收缩的影响

在72只乌拉坦、氯醛糖麻醉兔,静脉注射三碘季铵酚后,在人工呼吸下进行实验。结果观察到,在家兔蓝斑复合核(Lo-So)区微量注射去甲肾上腺素(NE)或可乐宁(Clonidine)能减少刺激下丘脑诱发的室性期前收缩(HVE)数。而微量注射β-肾上腺素能受体阻断剂心得安、α_1肾上腺素激动剂甲氧胺(Methoxamine)或苯肾上腺素(Phenylephrine)、α肾上腺素能阻断剂育亨宾(Yohimbine)或阿片受体阻断剂纳洛酮则对 HVE 无明显影响。在 Lo-So 区微量注射 NE 对 HVE 的抑制效应不能被事先在该区注射心得安所阻断但能被事先静脉或 Lo-So 区注射育亨宾所阻断。NE 或可乐宁的抑制效应也均可被育亨宾所翻转。可乐宁的抑制效应还可被纳洛酮所翻转。电解损毁延髓中缝大核区可消除在 Lo-So 区微量注射 NE 或可乐宁对HVE 的抑制效应。上述结果提示,Lo-So 区α_2受体的兴奋可减少 HVE 数,这些作用可能依赖于延髓中缝大核区的完整。可乐宁对 HVE 的抑制作用可能有阿片受体的参与。     

Amino acid sequence of rabbit ventricular myosin light chain-2: Identity with the slow skeletal muscle isoform

Many studies have established a correlation of differences in the activities of various muscle types with differences in the expression of myosin isoforms. In this paper we report the sequence determination of myosin light chain-2 from rabbit slow skeletal (LC2s) and ventricular (LC2v) nmscles. We sequenced tryptic peptides from LC2v which account for all except a few terminal amino acid residues. The major part (87 residues) of the rabbit LC2s sequence, obtained from tryptic and cyanogen bromide (CNBr) peptides, was found to be identical to rabbit LC2v. Our results provide the first sequence information on LC2s from any species, and lend strong support to the hypothesis that LC2s and LC2v are identical. Comparisons of rabbit LC2v and LC2s with rabbit LC2f (from fast skeletal muscle), and also with chicken LC2f and LC2v, show clearly that LC2s and LC2v from mammalian and avian species are more closely related to each other than they are to LC2f isoforms from the same species.     

心室压力瞬时加速度的测定及其意义

本工作对国产SJ-42型四道生理记录仪进行改进,增加了记录压力二阶微分曲线的功能。经比较研究家兔左心室压力一阶微分与二阶微分指标后发现,(d~2p/dt~2)max对心肌变力作用的敏感性比(dp/dt)max高出1/3左右,两项指标对心脏前后负荷和心率均具有一定的依赖性,但两者间无明显差异,提示用心室压力瞬时加速度指标评价心脏收缩性能比用压力瞬时速率指标更为灵敏可靠。     

Mechanical effects of ET-1 in cardiomyocytes isolated from normal and heart-failed rabbits

Endothelin (ET-1) is found at elevated concentrations in the plasma of patients with heart failure and in animal models of cardiomyopathy. The peptide is a potent positive inotropic agent, the effects of which are mediated by increases in cytosolic Ca²⁺ in cardiomyocytes. The object of this study was to investigate at the cellular level, the actions of ET-1 on contractile function and on Ca²⁺ currents in heart-failed ventricular myocardium. Male New Zealand White rabbits (8 wks) were treated with twice weekly injections of epirubicin (4 mg/kg/wk, n=7) or with saline (n=7) for 6 wks, followed by a washout period of 2 wks. Ventricular cardiomyocytes were isolated from rabbit hearts using Langendorff perfusion with collagenase; contractile function was examined using a video microscopy method, and L-type Ca²⁺ currents were recorded using a whole-cell patch-clamp technique. ET-1 produced a concentration-dependent increase in contractile response (% increase from basal value) to a maximum at 1 nM ET-1 of 69 ± 11% (mean ± S.D.) in control cardiomyocytes and 33 ± 6% in heart-failed cells. However, there was no significant change in the EC₅₀ obtained with ET-1 for healthy (0.31 ± 0.1 nM) and for failed cardiomyocytes (0.24 ± 0.1 nM). The effects of ET-1 on L-type Ca²⁺ channels were similar with a peak amplitude at 1 nM ET-1 of –3.26 ± 0.8 in control cardiomyocytes and –3.32 ± 0.9 nA in heart-failed cells. The attenuation of the contractile response to ET-1 in heart-failed cells may reflect a desensitization of ET receptors as a consequence of elevated circulating levels of ET and was not reflected by alteration of transmembrane Ca²⁺ conductance. It is probable, therefore, that multiple signalling pathways are involved in the actions of ET on ventricular myocardium.Recipient of Servier Investigator Award