BACKGROUND: To investigate the possibie difference, if any, between office blood pressure(BP) and home BP may be important in the diagnosis and treatment of hypersensive patients. This report deails the difference between the two BP's and the usefulness of digital electronic sphygmomanometer(DES) for self-monitoring of home BP. METHODS: The BP's of 14 patients with essential hypertension were measured with mercury sphygmomanometers at outpatient department by physician and with DES at home(twice a day) by the patients. Patients were followed up every 2 weeks for 4 weeks and previous 2 weeks' average home BP's were compared with the office BP's of each 2 weeks' end. RESULTS: There was a significant difference between office and home BP(both systolic and diastolic) ; office average BP(151/95mmHg) was higher than home average BP(136/86mmHg). CONCLUSION: Caution may be needed in the interpretation of office BP unless it is measured several times after adequate rest.
Blood Pressure* ; Diagnosis ; Humans ; Hypertension ; Outpatients ; Sphygmomanometers*

No abstract available.
Teratoma*

OBJECTIVE: Sinus pericranii (SP) is a rare vascular malformation characterized by abnormal communication between the extracranial and intracranial venous systems, usually involving the superior sagittal sinus (SSS) and occasionally, the transverse sinus. CASE REPORT: A 28-year-old man was presented with a round, fluctuant, nonpulsatile scalp mass in the frontal area near the midline, the size of which changed, depending on his head position. Magnetic resonance imaging showed an extracranial vein extending through a bony defect in the vertex of the skull and draining into the superior portion of the sagittal sinus. RESULTS: The lesion was completely removed by surgery. The presence of vascular endothelium in the pathologic specimen suggests a congenital or spontaneous origin. CONCLUSION: SP is a rare vascular malformation that requires surgical or endovascular treatment for the prevention of life-threatening complications.
Adult ; Endothelium, Vascular ; Head ; Humans ; Magnetic Resonance Imaging ; Scalp ; Sinus Pericranii ; Skull ; Superior Sagittal Sinus ; Vascular Malformations ; Veins

No abstract available.
Blood Coagulation*

No abstract available.
Bronchiolitis* ; Humans

BACKGROUND: The effectiveness for vagal stimulation by ice water aplication to face during metronome-controlled respiration of 15 breaths/minute was examed. The importance of basal vagal tone and sympathovagal interaction in the individual variability of responsiveness to the vagal stimulation was investigated. METHOD: Fifty three 12~13 year old healthy volunteers were included. Vagal tone and sympathovagal interaction before and after application of ice water to the face were assessed by power spectral analysis of RR interval(heart rate) variability. RESULT: Basal heart rate, high frequency power, and low to high frequency power ratio were 81+/-13(58~110 beats/min), 791+/-1061(56~4161 msec2) and 1.08+/-1.22(0.04~4.85) during controlled respiration. After ice water application twenty three children developed 5 more nodal escape beats due to severe bradycardia. Minimum heart rate, high frequency power and low to high power ratio changed to 42+/-12(19~72/min), 1890+/-1882(221~7258msec2) and 0.64+/-0.43(0.12~1.46). The increased ratio of high frequency power, maximum heart rate decrement and its percent after stimulation were 5.44+/-5.62(0.63~24.26), 39+/-14(10~81/min) and 47+/-15(16~81%) respectively. The increased ratio of high frequency power was correlated with basal logarithmic high frequency power(r=-0.60, p=0.0004). Maximum heart rate decrement was correlated with basal logarithmic high frequency power(r=-0.41, p=0.0018) and low to high frequency power ratio(r=0.27, p=0.04). CONCLUSION: Application of ice water to the face during controlled respiration produces powerful vagal stimulation and bradycardia, however, there is a wide individual variability of responsiveness to it. The absolute basal vagal tone contribute to this individual variability.
Bradycardia ; Child ; Healthy Volunteers ; Heart Rate* ; Heart* ; Humans ; Ice* ; Respiration* ; United Nations ; Water*

beta-adrenergic receptors (betaAR) belong to the large family of G protein-coupled receptors that form the interface between the sympathetic nervous and cardiovascular systems. G protein-coupled receptors undergo adaptation to repeated or prolonged agonist stimulation, which is termed desensitization. Significant betaAR desensitization occurs with the development of cardiac hypertrophy and heart failure, and uncoupling of betaARs and defects in this pathway might be primary elements underlying the transition from compensated to uncompensated cardiac failure. Decreasing the level of myocardial betaARK1 in established heart failure is a novel approach to improving impaired betaAR receptor function, and potentially alter the pathogenesis of this disease.
beta-Adrenergic Receptor Kinases ; Cardiomegaly* ; Cardiovascular System ; Heart Diseases* ; Heart Failure* ; Heart* ; Humans ; Receptors, Adrenergic, beta

BACKGROUND: Although postmenopausal estrogen replacement therapy is known to reduce cardiovascular mortality, the mechanism is not clear yet. Furthermore, the effect of estrogen on vascular tonus is reportedly variable according to the animal models, vascular beds and agonists used. MATERIALS AND METHOD: Bilateral ovariectomies were performed in 12 week-old, 18 spontaneously hypertensive rats (SHR) and 18 normotensive Wistar-Kyoto rats (WKY). Rats were divided into three groups according to the dose of 17beta-estradiol (E 2 ) pellets implanted subcutaneously two weeks after ovariectomy: control (no implantation), low-dose (0.5 mg) and high-dose (5 mg) E 2 replacement group. Two weeks after pellet implantation, organ bath experiments were performed using descending thoracic aortae. For endothelium-dependent relaxation, acetylcholine (10(-9) -3x10(-6) M) was cumulatively added into the vessels precontracted with 10(-7) M norepinephrine (NE). For vasoconstrictor responses, cumulative concentration-contraction curves were constructed in quiescent vessels using NE (10(-9) -10(-5) M), U46619 (10(-9) -3x10(-6) M), endothelin-1 (10(-10) -10(-7) M). In addition, contraction to angiotensin II (10(-7) M) was also obtained. Serum 17beta-estradiol levels were measured by radioimmunoassay. Blood pressure was measured by tail-cuff method in some SHRs before ovariectomy and after placebo/E 2 replacement. RESULTS: Endothelium-dependent relaxation to acetylcholine was impaired in WKY treated with 5 mg E 2 (pIC 50 : control vs 5mg E 2 : 7.75+/-0.13 vs 7.27+/-0.16: n=6: p<0.05). No significant effect was noted in SHR. Contraction to angiotensin II was inhibited by low-dose E 2 in WKY and high-dose E 2 in SHR (% of the contraction to 60 mM KCl: WKY: control vs 0.5 mg E 2 : 39+/-5 vs 25+/-2: SHR: control vs 5 mg E 2 : 34+/-4 vs 22+/-2: n=6 and p<0.05 in WKY and SHR). In contrast, NE-induced contraction was enhanced by E 2 replacement (both low- and high-dose) in WKY and SHR (WKY: control vs 0.5 mg E 2 vs 5 mg E 2 : AUC: 280+/-24 vs 387+/-26 vs 374+/-25: maximal contraction: 137+/-8 vs 166+/-8 vs 162+/-3: pD 2 : 7.63+/-0.11 vs 8.17+/-0.13 vs 8.13+/-0.13: SHR: control vs 0.5 mg E 2 vs 5 mg E 2 : AUC: 265+/-17 vs 349+/-16 vs 406+/-19: maximal contraction: 152+/-6 vs 181+/-9 vs 203+/-16: pD 2 : 7.45+/-0.13 vs 7.91+/-0.08 vs 8.04+/-0.04: n=6 and p<0.05 between control and treated groups in WKY and SHR for all parameters). Contraction to U46619 was enhanced by E 2 replacement in SHR (control vs 0.5 mg E 2 : AUC: 478+/-30 vs 574+/-23: maximal contraction: 181+/-9 vs 230+/-10: n=6: p<0.05 for both parameters). Maximal contractile response to endothelin-1 was also enhanced in SHR (control vs 0.5 mg E 2 vs 5 mg E 2 : maximal contraction: 165+/-7 vs 189+/-7 vs 199+/-8: n=6 and p<0.05 between control and treated groups) but not in WKY. Blood pressure was not different between placebo and E 2- treated SHR (171+/-2 vs 174+/-4 mmHg). CONCLUSION: In WKY, chronic high-dose estrogen replacement impairs endothelium-dependent relaxation to acetylcholine.: low-dose estrogen replacement does not affect endothelium-dependent relaxation in SHR and WKY. Estrogen replacement enhances the contraction to most of the contractile agonists tested except angiotensin II in both WKY and SHR. These results suggest that estrogen replacement affect the vascular tonus differently according to the vasoactive substances and/or hormones without significant effect on blood pressure.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Acetylcholine ; Angiotensin II ; Animals ; Aorta, Thoracic ; Area Under Curve ; Baths ; Blood Pressure ; Endothelin-1 ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Models, Animal ; Mortality ; Norepinephrine ; Ovariectomy ; Radioimmunoassay ; Rats ; Rats, Inbred SHR* ; Relaxation

BACKGROUND: It is well known that systemic blood pressure oscillates with low(0.04~0.1Hz), mid(0.1~0.15Hz), and high(respiratory) frequency range. But there has been no study about oscillation of pulmonary artery pressure(PAP). METHOD: We measured PAP for 5 minutes in 32 patients of ventricular septal defect and stored them to computer files. Power spectral density curve was obtained. Low, mid, respiratory frequency power were measured by integrating the area within each frequency range below the power density curve. RESULT: The incidence of significant low frequency power(more than 5% of total power) were higher in patients of high PAP and hign Rp/Rs than those of low PAP and Rp/Rs(p<0.01 and p<0.005 respectively). The low frequency power positively correlates with PAP and Rp/Rs(r=0.62, p<0.0005 and r=0.61, p=0.0005 respectively). CONCLUSION: It can be said conclusively that as PAP and pulmonary vascular resistance elevates, the PAP tends to definitively oscillate in low frequency range.
Blood Pressure ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Pulmonary Artery* ; Vascular Resistance

No abstract available.
Child* ; Child, Preschool* ; Humans