The natural history of insomnia and its relationship to respiratory symptoms.

BACKGROUND: Although insomnia is a frequent complaint among patients, epidemiologic study has been limited. Researchers have reported a wide range in the prevalence of this complaint in a variety of selected populations. Other parameters, such as incidence and remission rates, have not been reported. METHODS: Subjects of the Tucson (Ariz) Epidemiologic Study of Obstructive Lung Disease were asked questions about trouble sleeping in the 1984-1985 (survey I) and 1990-1992 (survey II) surveys. Answers were analyzed along with responses to questions about age, sex, respiratory symptoms, and drug and alcohol use for sleep. RESULTS: The prevalence of insomnia was similar in both surveys, 34.4% in survey I and 34.1% in survey II. Women had a higher prevalence of insomnia than men in both surveys, and insomnia was more common among older subjects (50.6% of the women aged 65 years or older had insomnia in survey II). In addition, the incidence of new insomnia in survey II was higher in the same groups. Grouping subjects by respiratory symptoms, we found that the prevalence of insomnia was significantly related to cough, dyspnea, or wheeze. Furthermore, subjects with persistent or new respiratory symptoms at survey II were less likely to have remission of insomnia by that survey (31.6% vs 51.5%; P < .05; odds ratio, 0.43) and more likely to develop new insomnia (28.6% vs 14.5%; P < 05; odds ratio, 2.36) than subjects with either no symptoms or disappearance of their symptoms by survey II. CONCLUSIONS: In our population, insomnia is a common dynamic complaint whose frequency waxes and wanes in association with respiratory symptoms.

Determinants of percent predicted FEV1 in current asthmatic subjects.

We analyzed the determinants of the percent predicted FEV1 of a large group of diagnosed asthmatic subjects in the Tucson Study of Airway Obstructive Diseases. The 261 subjects were 6 to 88 years old, and 150 (57.5 percent) were female. Although 29.1 percent of the subjects were current smokers and 24.1 percent were ex-smokers, we found that pack-years of smoking was not related to lung function. In addition, age of onset of disease, duration of asthma, eosinophil count, serum IgE level, and allergy skin test reactivity status did not influence the %FEV1. We did find that both severity of wheezing and age of the subject related significantly to %FEV1, and an interaction term of these two variables replaced wheeze and age in the multiple regression equation. Current physician-diagnosed chronic bronchitis and the reported severity of exertional dyspnea also related to %FEV1.

A descriptive analysis of the growth and decline of the FVC and FEV1.

Using data obtained during the first four complete surveys of a general population sample (2,435 spirometric studies on 916 different asymptomatic nonsmoking subjects), we have derived mathematically continuous equations designed to describe the stages of growth, maturation, and subsequent decline in the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). With this type of analysis, there appears to be a period from late childhood through adolescence in which maturation significantly increases FVC and FEV1 independent of growth, and a stage from late adolescence to the early or mid-30s in which there is relatively little change in these measurements. Progressive decline in FVC and FEV1 may not actually begin until the mid-30s. The mathematical formulae presented here were derived in a manner intended to describe biologic events and are not intended for use as prediction equations. The FEV1/FVC ratio appeared to be primarily a function of the FVC itself in young subjects. After the age of 33 years, FEV1/FVC also decreased with age, independent of the size of the FVC.

Incidence and remission of habitual snoring over a 5- to 6-year period.

Habitual snoring is associated with an increased prevalence of hypertension, stroke, and ischemic heart disease. To determine factors that influence the incidence and remission of habitual snoring, we analyzed responses to successive self-administered questionnaires with questions pertaining to snoring in a group of subjects participating in the Tucson Epidemiologic Study of Obstructive Airways Disease. In this study, 1,476 subjects were surveyed 5.8 +/- 0.6 (SD) years apart. Among subjects who habitually snored on the initial survey, 58.2% snored persistently and 35.5% remitted on the ensuing survey. Among subjects who did not habitually snore in the initial survey, 10.5% developed it on the subsequent survey. In further analyses, we found that male sex, obesity, and respiratory symptoms were significant independent risk factors for development of habitual snoring. Age over 65 years, the absence of obesity, and the absence of respiratory symptoms were associated with remission of habitual snoring.

Characteristics of asthma among elderly adults in a sample of the general population.

This article describes the characteristics and course of asthma among subjects who were older than 65 years at the time of enrollment in a longitudinal study of a general population sample. It was present in 3.8 percent of men and 7.1 percent of women. An additional 4.1 percent of men reported having "asthma," but they also had seen a physician for "emphysema" and had smoked significantly; their "asthma" diagnosis is regarded as highly questionable. They did not show the elevated rate of allergy skin test reactivity of high serum IgE levels that were characteristic of other asthmatics. Many of the elderly asthmatics (mean age, 72 years) had severe disease with marked ventilatory impairment. There was a close relationship between the severity of wheezing complaints and impairment of the FEV1. Of the 46 patients, 48 percent reported an onset before age 40 years. There was no relationship between severity and age of onset or duration of disease. A second diagnosis of "chronic bronchitis" was reported by 46 percent of the asthmatics, but this did not delineate a distinctive group with late-onset, smoking-related disease. Death rates in the asthmatics tended to be higher than in nonasthmatics (odds ratio, 1.9; CI, 0.998 to 3.70, after stratifying by sex). Over a mean follow-up of 7.44 years, most symptoms as well as the FEV1 remained relatively stable. Chronic productive cough did tend to remit (p less than 0.01), but this was noted in the nonasthmatics as well. We estimate that no more than 19 percent of the asthmatics went into complete remission during follow-up. Most of these had mild initial symptoms; there were no remissions in subjects with severe disease at the time of entry. We concluded that asthma in the elderly is not a rare disease and may be associated with severe symptoms and chronic airways obstruction. If severe, it rarely goes into complete remission but tends to remain a severe, disabling disorder.

Shoot inversion-induced ethylene in Pharbitis nil induces the release of apical dominance by restricting shoot elongation.

Shoot inversion induces outgrowth of the highest lateral bud (HLB) adjacent to the bend in the stem in Pharbitis nil. In order to determine whether or not ethylene produced by shoot inversion plays a direct role in promoting or inhibiting bud outgrowth, comparisons were made of endogenous levels of ethylene in the HLB and HLB node of plants with and without inverted shoots. That no changes were found suggests that the control of apical dominance does not involve the direction action of ethylene. This conclusion is further supported by evidence that the direct application of ethylene inhibitors or ethrel to inactive or induced lateral buds has no significant effect on bud outgrowth. The hypothesis that ethylene evolved during shoot inversion indirectly promotes the outgrowth of the highest lateral bud (HLB) in restricting terminal bud (TB) growth is found to be supported by the following observations: (1) the restriction of TB growth appears to occur before the beginning of HLB outgrowth; (2) the treatment of the inverted portion of the shoot with AgNO3, an inhibitor of ethylene action, dramatically eliminates both the restriction of TB growth and the promotion of HLB outgrowth which usually accompany shoot inversion; and (3) the treatment of the upper shoot of an upright plant with ethrel mimics shoot inversion by retarding upper shoot growth and inducing outgrowth of the lateral bud basipetal to the treated region.

Mechanical perturbation-induced ethylene releases apical dominance in Pharbitis nil by restricting shoot growth.

Mechanical perturbation (MP, rubbing) or internodes of Pharbitis nil shoots initiates release of lateral buds (LB) from apical dominance within 48 h. Evidence is presented which suggests that MP promotion of LB outgrowth is mediated by ethylene-induced restriction of main shoot growth. Ethylene production in the internodes is stimulated by MP within 2 h. Effects of MP are mimicked by treatments with 1-aminocyclopropane-1-carboxylic acid (ACC) and are negated by the inhibitors of ethylene production or action, aminoethoxy vinylglycine (AVG) and AgNO3. The fact that effects of MP, ACC, and ethylene inhibitors are observed to occur on main shoot growth at least 24 h before they are observed to occur on LB growth suggests a possible cause and effect relationship. MP also causes an increase in internode diameter. MP stimulation of ethylene production appears to be mediated by ACC synthase. The results of this study and our previous studies suggest that apical dominance may be released by any mechanism which induces ethylene restriction of main shoot growth.

Gibberellin-enhanced elongation of inverted Pharbitis nil shoot prevents the release of apical dominance.

Ethylene evolution resulting from the gravity stress of shoot inversion appears to induce the release of apical dominance in Pharbitis nil (L.) by inhibiting elongation of the inverted shoot. It has been previously demonstrated that this shoot inversion release of apical dominance can be prevented by promoting elongation in the inverted shoot via interference with ethylene synthesis or action. In the present study it was shown that apical dominance release can also be prevented by promoting elongation of the inverted shoot via treatment with gibberellic acid (GA3). A synergistic effect was observed when AgNO3, the ethylene action inhibitor, was applied with GA3. Both GA3 and AgNO3 increased ethylene production in the inverted shoot. These results are consistent with the view that it is ethylene-induced inhibition of elongation and not any direct effect of ethylene per se which is responsible for the outgrowth of the highest lateral bud.

The control of apical dominance: localization of the growth region of the Pharbitis nil shoot.

The growing region of the upright Pharbitis nil shoot extends over a distance 13 cm basipetal to the shoot apex. When the shoot is inverted, ethylene production in this region is greatly enhanced whereas stem elongation is significantly inhibited. This growth region is ethylene-sensitive and the restriction of its growth by shoot inversion-induced ethylene may mediate the release of apical dominance.

The stability of the postulated wall-loosening enzyme in acid-induced growth.

Long-term pretreatments with cycloheximide (CH) caused inhibition of subsequent acidinduced growth of Avena coleoptile segments, but only after 6 or more h of CH treatment. These results together with previous, published evidence with frozen-thawed tissue are consistent with the hypothesis that there exists a wall-loosening enzyme responsible for acid-induced elongation and that it has a half-life of at least 7-8 h.

Execution of the auxin replacement apical dominance experiment in temperate woody species.

The classic Thimann-Skoog or auxin replacement apical dominance test of exogenous auxin repression of lateral bud outgrowth was successfully executed in both seedlings and older trees of white ash, green ash, and red oak under the following conditions: (1) decapitation of a twig apex and auxin replacement were carried out during spring flush, (2) the decapitation was in the previous season's overwintered wood, and (3) the point of decapitation was below the upper large irrepressible lateral buds but above the lower repressible lateral buds. Although it has been suggested that neither auxin, the terminal bud, nor apical dominance have control over the outgrowth of the irrepressible buds during spring flush, there is evidence in the present study that indicates that such control over the repressible buds exists. In seedlings, second-order branching, which resulted from decapitation of elongating current shoots, was also inhibited by exogenous auxin in the three species. Hence, the auxin replacement experiments did work on year-old proleptic buds (of branches of older trees) that would have entered the bud bank and also on current buds of seedlings. Cytokinin treatments were ineffectual in promoting bud growth.

Gravistimulus direction, ethylene production and shoot elongation in the release of apical dominance in Pharbitis nil.

Release of apical dominance can be induced in Pharbitis nil by the inversion of the upper shoot. This promotion of outgrowth of the highest lateral bud adjacent to the bend of the stem appears to be mediated by ethylene inhibition of growth of the inverted main shoot. In the present investigation the existence of a direct correlation between ethylene evolution and the direction of gravistimulus is demonstrated as well as an inverse correlation between ethylene production by the inverted upper shoot and its elongation. An inverse correlation also exists between elongation of the inverted upper shoot and the outgrowth of the highest lateral bud if the lower portion of the shoot (below the bend) is oriented in an upright position. The patent period for shoot-inversion induction of ethylene production is about 2 h. These results support the hypothesis of indirect ethylene control of apical dominance release by retardation of elongation of the inverted shoot.

Kinetics of shoot inversion-induced ethylene production in Pharbitis nil.

Shoot inversion promotes a significant increase in ethylene production in the inverted part of the Pharbitis nil main shoot. The latent period for shoot inversion-induced ethylene production is ca. 2.75 h. Our results indicate that the shoot-inversion ethylene response is not persistent and can be terminated and rapidly reinitiated by appropriate alteration of the orientation of the main shoot regardless of prolonged previous exposures of the shoot to various orientations. The time course of the production of ACC (1-aminocyclopropane-1-carboxylic acid), the immediate precursor of ethylene, follows a pattern similar to that of ethylene during the various alterations of shoot orientation. Excised stem segments and intact stems are capable of induction, inhibition, and reinduction of ethylene evolution. Ethylene production reported here for shoot inversion does not result from segmenting (wounding) of the tissue.

The role of gravity in apical dominance: effects of clinostating on shoot inversion-induced ethylene production, shoot elongation and lateral bud growth.

Shoot inversion-induced release of apical dominance in Pharbitis nil is inhibited by rotating the plant at 0.42 revolutions per minute in a vertical plane perpendicular to the axis of rotation of a horizontal clinostat. Clinostating prevented lateral bud outgrowth, apparently by negating the restriction of the shoot elongation via reduction of ethylene production in the inverted shoot. Radial stem expansion was also decreased. Data from experiments with intact tissue and isolated segments indicated that shoot-inversion stimulates ethylene production by increasing the activity of 1-aminocyclopropane-1-carboxylic acid synthase. The results support the hypothesis that shoot inversion-induced release of apical dominance in Pharbitis nil is due to gravity stress and is mediated by ethylene-induced retardation of the elongation of the inverted shoot.

Shoot inversion inhibition of stem elongation in Pharbitis nil: a possible role for ethylene-induced glycoprotein and lignin.

Inversion of the upper shoot of Pharbitis nil results in the inhibition of elongation in the inverted stem. The objective of the present study was to determine how shoot inversion-induced gravity stress inhibited elongation and to elucidate the possible role of ethylene-induced glycoprotein and lignin in this process. Determinations of hydroxyproline, peroxidase, phenylalanine ammonia-lyase (PAL), phenol, and lignin content/activity were carried out by appropriate spectrophotometric methods. It was found that inversion and Ethrel treatments of upright shoots caused significant increases in hydroxyproline content, peroxidase, and PAL activity in 12 hours and in phenol and lignin contents in 24 hours. All of these increases except for that of cytoplasmic peroxidase activity were partially reversed by AgNO3, the ethylene action inhibitor. It is concluded that possible cross-linking associated with the accumulation of the ethylene-induced hydroxyproline-rich glycoprotein and lignin may be responsible for the later stages of cessation of elongation in the inverted Pharbitis shoot.

Post-transcriptional modifications of oat coleoptile ribonucleic acids. 5'-Terminal capping and methylation of internal nucleosides in poly(A)-rich RNA.

Evidence is presented for the occurrence of 5'-terminal capping structures in poly(A)-rich RNAs from oat coleoptile tissue. Similar to the cap structures in mRNA from other eukaryotic organisms, the 5' terminus of these oat coleoptile RNA molecules consists of 7-methylguanosine joined 5' to 5' with the adjacent (penultimate) nucleoside by means of three phosphate groups in two pyrophosphate linkages. The penultimate nucleoside contains primarily purine bases, but small amounts of pyrimidines (cytidine) are also detectable. Some monophosphorylated 5'-termini were also detected, however, they appear to occur as a result of RNA degradation. In addition to the 5 cap, oat RNA molecules are also post-transcriptionally modified with a low frequency of N6-methylations of internal adenosines.

Rapid Inhibition of Auxin-induced Elongation of Avena Coleoptile Segments by Cordycepin.

The effects of cordycepin (3'-deoxyadenosine), an RNA synthesis inhibitor, on auxin-induced elongation in Avena coleoptile segments were studied with a position-sensing transducer. Cordycepin rapidly inhibited auxin-stimulated growth in the coleoptile segments whether added before, at the same time as, or after, the 2 mum auxin treatment. Midcourse additions of 100, 50, and 25 mug/ml cordycepin inhibited auxin-promoted elongation in an average of 18, 22, and 35 minutes, respectively. Additions of cordycepin before or at the same time as the auxin treatment partially inhibited the magnitude of the subsequent auxin-promoted growth but did not appreciably alter the latent period of the auxin response. It was concluded that if cordycepin is inhibiting the synthesis of RNA required for growth, the decay time for this RNA may be considerably shorter than that suggested in the literature from actinomycin D experiments. Preliminary kinetic evidence indicated that cordycepin does not inhibit auxin-induced elongation by acting as a respiratory inhibitor. Studies in mung bean shoot mitochondria demonstrated that cordycepin has no effect on respiration, respiratory control, or ADP/oxygen ratios.

Rapid growth inhibition of Avena coleoptile segments by abscisic Acid.

An angular position sensing transducer was used to make continuous measurements of elongation of a column of Avena sativa coleoptile segments. Elongation stimulated by 2 mum indoleacetic acid was inhibited by 0.1 mm abscisic acid with a latent period of about 4 or 5 minutes at pH 6.0, 30 C. Full growth inhibition was not established until about 1 hour after the addition of the abscisic acid. The same degree of final growth inhibition could be obtained under the above conditions using 10 muM and 1 muM abscisic acid, but the latent period was longer. Pretreatments with abscisic acid affected the growth rate but did not extend the latent period of a subsequent response to auxin. The short term kinetics of inhibition by abscisic acid were not similar to those of any of the inhibitors of RNA and protein synthesis tested in this system.