Glaucoma, Open-Angle ; etiology ; physiopathology ; Humans ; Intracranial Hypotension ; complications ; physiopathology ; Intraocular Pressure ; Male ; Middle Aged

OBJECTIVETo explore the value of anal sphincter electromyography (ASEMG), orthostatic hypotension (OH), and dizziness in diagnosing multiple system atrophy (MSA).

METHODThe characteristics of ASEMG and OH were compared among patients with dizziness (MSA and non-MSA), patients without OH (MSA and non-MSA), and patients with probable MSA (OH and non-OH).

RESULTSTotally 476 patients underwent ASEMG examinations. Dizziness was the onset symptom in 69 patients. Between the MSA group and non-MSA group, the mean duration of dizziness [(14.6 +/- 2.1) vs. (12.8 +/- 2.0) ms, P < 0.01] and satellite potential occurrence rate [(22.7 +/- 11.8)% vs. (12.2 +/- 8.9)% , P < 0.01] were significantly different, while the OH rate (84.6% vs. 55.2% ) and the difference of the blood pressure between standing and supine positions were not significantly different. In 162 patients with symptom of dizziness, the mean duration of dizziness [(15.3 +/- 2.7) vs. (12.8 +/- 1.9) ms, P < 0.001], satellite potential occurrence rate [(25.4 +/- 12.8)% vs. (13.5 +/- 10.4)%, P < 0.001] , and difference of the diastolic blood pressure [(18.5 +/- 17.0) vs. (11.7 +/- 12.7) mmHg, P < 0.05] were significantly different between the MSA group and non-MSA group, while the normal rate of blood pressure at standing position (60% vs. 41.9%) and the difference of systolic blood pressure were not significantly different. In 146 patients with abnormal blood pressure at standing and supine positions, the mean duration of dizziness [(15.0 +/- 2.4) vs. (12.8 +/- 1.7) ms, P < 0.001] and satellite potential occurrence rate [(22.0 +/- 12.2)% vs. (10.6 +/- 8.5)%, P < 0.001] were significantly different between the MSA group (n = 61) and non-MSA group (n = 85). In 125 patients with probable MSA, the mean duration of dizziness [(15.5 +/- 2.4) vs. (15.9 +/- 2.2) ms, P > 0.05] and satellite potential occurrence rate [(24.3 +/- 12.6)% vs. (22.7 +/- 12.4)%, P > 0.05] were not significantly different between those with OH and those without OH. The rates of dizziness and the percentage of dizziness as the onset symptom were 93.2% and 52.3% in OH group and 44.4% and 8.3% in non-OH group.

CONCLUSIONSASEMG is better than OH in diagnosing patients with dizziness suspected as MSA. Neurogenic lesion can be found by ASEMG in patients without OH, which is helpful in the early diagnosis of MSA.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; chemistry ; physiopathology ; Dizziness ; physiopathology ; Electromyography ; Female ; Humans ; Hypotension, Orthostatic ; physiopathology ; Male ; Middle Aged ; Multiple System Atrophy ; diagnosis ; physiopathology

A 50-year-old man had undergone lumbar vertebral surgery and was confined to bed in the supine position for three months. When he sat up from the prolonged supine position, he showed clinical signs of orthostatic hypotension and reported decreased vision in both eyes. He also had underlying anemia. Ophthalmologic findings suggested bilateral anterior ischemic optic neuropathy (ION) as the cause of the visual loss. Although there are numerous reports of ION in the setting of hemodynamic compromise, such as systemic hypotension, cases of ION-associated orthostatic hypotension are very rare.
Acute Disease ; Blindness/diagnosis/*etiology/physiopathology ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Hypotension, Orthostatic/*complications/physiopathology ; Male ; Middle Aged ; Visual Acuity

Acupuncture Therapy ; Blood Pressure ; Humans ; Hypotension ; physiopathology ; therapy ; Male ; Middle Aged ; Treatment Outcome

Blood Pressure ; physiology ; Child ; Female ; Humans ; Hypotension, Orthostatic ; diagnosis ; epidemiology ; physiopathology ; therapy ; Male

OBJECTIVETo study the clinical characteristics of orthostatic hypertension (OHT) in children.

METHODA total of 96 children with OHT who met the diagnostic criteria and clinical manifestations were recruited in the Department of Pediatrics, Peking University First Hospital. Age and sex distributions were observed. The duration of disease, the frequencies of symptoms and the predisposing factors were recorded. The hemodynamic changes from supine to up-right positions were also analyzed.

RESULTThere were 50 boys and 46 girls in the study group. The mean age was (11.8 ± 2.7) years. Thirty-two children were from 6 to 10 years old, accounting for 33.3% of all subjects, while 64 patients were from 11 to 17 years old, accounting for 66.7%. Durations of symptoms of OHT were less than 1 month in 22.9% children, from 1 month to 1 year in 51.1% children and longer than 1 year in 26.0% children. The most common clinical manifestations were syncope and dizziness. The incidence of them was 70.8% and 46.9%, respectively. Other clinical manifestations included transitional amaurosis, nausea and/or vomiting, pallor and so on. These clinical manifestations often occurred on position change (24.0%) and long-time standing (57.3%) in children. Other predisposing factors included exercise, emotion changes and fuggy environment. The baseline systolic and diastolic blood pressures were (103 ± 8) mm Hg (1 mm Hg = 0.133 kPa) and (59 ± 6) mm Hg, respectively, the up-right systolic and diastolic blood pressure at 3 min were (113 ± 8) mm Hg and (73 ± 6) mm Hg and the differences were significant (t = 27.674, P < 0.01; t = 17.936, P < 0.01). The baseline heart rate in supine position was (81 ± 11) bpm and the maximum heart rate in up-right position was (113 ± 12) bpm (t = 33.092, P < 0.01).

CONCLUSIONOHT is commonly seen in puberty of children. The chief complaints are syncope and dizziness. They were mostly induced by position change and long-time standing. Blood pressure was significantly increased from supine to up-right position.

Adolescent ; Blood Pressure ; physiology ; Child ; Dizziness ; epidemiology ; physiopathology ; Female ; Heart Rate ; Humans ; Hypotension, Orthostatic ; epidemiology ; etiology ; physiopathology ; Male ; Multivariate Analysis ; Posture ; Risk Factors ; Syncope ; epidemiology ; physiopathology

Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; complications ; drug therapy ; physiopathology ; Hypotension, Orthostatic ; complications ; drug therapy ; physiopathology ; Male ; Middle Aged ; Syncope ; complications ; drug therapy ; physiopathology

PURPOSE: We performed this study to evaluate the safety of permissive hypotension management in extremely low birth weight infants (ELBWIs). MATERIALS AND METHODS: Medical records of all inborn ELBWIs admitted to Samsung Medical Center from January 2004 to December 2008 were reviewed retrospectively. Of a total of 261 ELBWIs, 47 (18%) required treatment for hypotension (group T), 110 (42%) remained normotensive (group N), and 104 (40%) experienced more than one episode of hypotension without treatment (group P) during the first 72 hours of life. Treatment of hypotension included inotropic support and/or fluid loading. RESULTS: Birth weight and Apgar scores were significantly lower in the T group than the other two groups. In the N group, the rate of pathologically confirmed maternal chorioamnionitis was significantly higher than other two groups, and the rate was higher in the P group than the T group. After adjusting for covariate factors, no significant differences in mortality and major morbidities were found between the N and P groups. However, the mortality rate and the incidence of intraventricular hemorrhage (> or =stage 3) and bronchopulmonary dysplasia (> or =moderate) were significantly higher in the T group than the other two groups. Long term neurodevelopmental outcomes were not significantly different between the N and P groups. CONCLUSION: Close observation of hypotensive ELBWIs who showed good clinical perfusion signs without intervention allowed to avoid unnecessary medications and resulted in good neurological outcomes.
Apgar Score ; Birth Weight/physiology ; Female ; Humans ; Hypotension/*physiopathology ; Infant, Extremely Low Birth Weight/*physiology ; Infant, Newborn ; Male

Utilizing the third-order polynomial curve fitted to the experimental data, which represents the relationship between cerebral blood flow (CBF) and mean artery blood pressure (MABP), we constructed a lumped-parameter dynamic model with 5 elements. In this model; the resistance is not constants it is determined by the fitted curve. We simulated the process of CBF autoregulation numerically by solving the govern equation of this model and got quite accurate results. Furthermore, we studied the influence of hemodynamic parameters on the CBF autoregulation by this model and proved that the characteristic resistance is the most important factor.
Blood Flow Velocity ; Blood Pressure ; physiology ; Cerebrovascular Circulation ; physiology ; Homeostasis ; Humans ; Hypotension ; physiopathology ; Models, Biological ; Oxygen ; metabolism ; Regional Blood Flow

OBJECTIVEHypertension is one of the most common disorders in adults. Although it may be already present in children and adolescents, it does not often have clinical pictures. There is a lack of data on the blood pressure in children in Beijing area. This study was conducted to investigate the present situation of blood pressure of children and adolescents in Beijing area.

METHODSChildren and adolescents aged 3 to 18 years in 4 urban and 3 rural areas of Beijing were involved in the study at random. Blood pressure (BP) was measured three times with the use of mercury sphygmomanometery, and the means of the last two BP value were recorded. Systolic BP (SBP) was determined by the first Korotkoff sound, and diastolic BP (DBP) by the fourth Korotkoff sound.

RESULTSAltogether, 20 780 (99.6%) individuals with complete records were studied, including 10 582 from urban and 10 198 from rural areas; 10 398 were males and 10 382 were females. BP of boys was higher than that of girls [SBP: (106 +/- 12) mm Hg vs. (101 +/- 11) mm Hg, u = 27.14, P < 0.01; DBP: (67 +/- 9) mm Hg vs. (65 +/- 8) mm Hg, u = 14.14, P < 0.01]. BP of both boys and girls increased with age. However, SBP had a larger magnitude of increase than that of DBP. Both SBP and DBP of urban children were lower than those of rural children [SBP: (103 +/- 12) mm Hg vs. (104 +/- 12) mm Hg, u = 2.55, P < 0.05; DBP: (66 +/- 8) mm Hg vs. (67 +/- 9) mm Hg, u = 6.73, P < 0.01]. There was a positive correlation between BP and age, height, weight and BMI. SBP had a stronger relationship with each variable than DBP did. Among children aged 6 - 18 years, about 8.1% were found to have hypertension according to the criteria of blood pressure of children and adolescents by age and by gender of 1987 in Beijing.

CONCLUSIONSThe present study provided with the current information and characteristics of blood pressure of children and adolescents in Beijing area. The blood pressure was correlated with sex, age, body height, body weight and BMI of children and adolescents.

Adolescent ; Blood Pressure ; physiology ; Body Height ; Body Mass Index ; Body Weight ; Child ; Diastole ; Female ; Humans ; Hypertension ; physiopathology ; Hypotension ; physiopathology ; Male ; Rural Population