No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

The pulmonary arterial pressure(PAP) was reported to be higher in essential hypertensives than in normotensives, but the underlying mechanisms for the higher PAP were not known exactly. In order to observe the changes of pulmonary hemodynamics and to get an insight into the mechanism of the pulmonary hypertension, if any, in essential hypertensive patients, the autors performed the cardiac catheterization in 13 normal controls(group A), 14 coronary patients with normal systolic left ventricular function and systemic blood pressure(group B), and 15 essential hypertensives with normal coronary artery and systolic left ventricular function(group C). 1)Pulmonary arterial pressure(PAP) was 19.2+/-3.2/8.1+/-1.9/12.0+/-1.9(s/d/m)mmHg in group A, 25.0+/-6.2/12.8+/-4.0/16.3+/-4.5mmHg in group B, 29.3+/-6.1/12.8+/-4.0/18.2+/-3.6mmHg in group C. The PAP was higher in group B and C than that of group A(p<0.005). 2) Pulmonary vascular resistance(PVR) was 88.2+/-34.9 dyne.sec.cm(-5) in group A. 137.8+/-74.5 dyne.sec.cm(-5) in group B and 173.9+/-77.5 dyne.sec.cm(-5) in group C. In group B and C, PVR was increased compared to that of group A(p<0.05, p<0.005, respectively). 3) Pulmonary capillary wedge pressure(PCWP) was 6.6+/-2.8 mmHg in groupa A. 9.9+/-2.9mmHg, and 9.6+/-3.6 mmHg in group C. PCWP in group B and C were higher than that of group A(p<0.005). 4) Systemic vascular resistance(SVR) was 1298+/-340 dyne.sec.cm(-5) in group A, 1466+/-362 dyne .sec.cm(-5) i group B and 2255+/-439 dyne.sec.cm(-5) in group C. In group C, SVR was increased compared to that of group A and B(p<0.002). 5) Significant correlation was demonstrated between PVR and PCWP in group A(r=-0.74, p<0.05). 6) In group B, significant correlations were shown between PAP and PCWp(r=0.55, p<0.05), between PAP and PVR(r=0.69, p<0.05). 7) In group C, significant correlations were demonstrated between PAP and PCWP(r=0.55, p<0.05), between PVR and SVR(r=<0.51, p<0.01). Above results revealed that PAP and PVR were increased in essential hypertensives without left ventricular failure and this elevated PAPseemed to be affected in part by increased PCWP, and increased PVR in accordance with increased SVR.
Capillaries ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Hemodynamics* ; Humans ; Hypertension* ; Hypertension, Pulmonary ; Ventricular Function, Left

BACKGROUND: The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of the radioallergosorbent test(RAST). The CLA permits quick, siultaneous detection of total and specific IgE in human serum up to 35 different allergens, as well as their semiquantitative concentrations into classes from 0(negative) to 4(very high). The CLA has shown sensitivity, specificity, and a good correlation with the RAST and also with skin pick testing. OBJECTIVE: The purpose of this study was to find the causatix llergens and to evaluate the clinical significance of CLA comparing the results of tbe CLA wi! h hose of the prick test in patients with chronic urticaria. METHODS: We performed the CLA with 35 allergens(MAST immunosunosystems, Inc., California, America) and the prick test with 51 allergens(Bencard Ltd., Bricantord, England) in 70 patients with chronic urticaria. The CLA detects the allergen-IgE reactic say the use of an enzyme-labeled anti-IgE and a coupled photoreagent mixture. lhe amount of the luminescent energy is measured by exposing a polarcid film and then semiquantitation is a sessed by using a densitometer. RESULTS: Except for those over the age of 60, all age-groups ealed a similar positive reaction to the CLA and prick test, but the positive reaction rate o the prick test(91.4%) was higher than that of the CLA(38.6%). The positive reaction rate oringle allergen and compound allergens was 10.0% and 28.6% in the CLA, but 10.0% and 81.4% in the prick test, respectively. In the CLA, the rate of positive reaction was 17(24.3%) in Dermatophagoides(D.) farinae, 15(21.4% ) in D. pteronyssinus, 5(7.1% ) in house dust, an 13(4.3%) in shrimp in that order. In the prick test, the rate of positive reaction was 39(55.7%) in house dust, 35(50.0%) in D. farinae, 29(41.4%) in D. pteronyssinus, and 21(30.0%) in haydrst(30.0%) in that order. The results of the CLA to 3 comrnon allergens showed a concordance rare of 67.6%, sensitivity of 34.3%, and specificity of 97.3% compared with those of the prick case. The levels of total IgE and eosinophils were elevated in 59(n=70, 843%) and in 5(n=56, 84.3%), respectively. CONCLUSION: The results of this study suggest that the CLA may be used as an alternative method for the diagnosis of chronic urticaria because it is and coiomic, safe, simple procedure with very high specificity and trelative low sensitivity, and is sirnilt. neously capable of testing to multiple allergens.
Allergens ; California ; Diagnosis ; Dust ; Eosinophils ; Humans ; Immunoglobulin E ; Luminescent Measurements* ; Sensitivity and Specificity ; Skin ; Urticaria*

Ki-1 antigen was found by a monoclonal antibody, made against a Hidgkin' disease-derived cell line (L428) that reacted with Reed-Sternberg cells in Hodgkins disease and a few lymphocytes around lymphoid follicle. In 1985, Stein et al identified a large cell anaplastic lymphoma showing a distinctive pleomorphic appearance, sinus growth pattern, and reactivity to Ki-l. We report a case of Ki-1 positive large cell anaplastic lymphoma, which was presenting as a elevated plaque on the skin of popliteal fossa in a 69-year-old female.
Aged ; Antigens, CD30 ; Cell Line ; Female ; Hodgkin Disease ; Humans ; Lymphocytes ; Lymphoma* ; Reed-Sternberg Cells ; Skin

Cardiac output depends on the ability of systolic ejection and diastolic filling of the heart. M-mode echocardiography can provide accurate clinical assessment of left ventricular systolic and diastolic functions. To see whether there are changes of the left ventricular function in asymptomatic hypertensives and if any kind of dysfunction and whether any relationship between the pattern of the ventricular hypertrophy and type of ventricular dysfunction exists, the authors examined the systolic and diastolic function indices of the left ventricle in 50 normotensives and 88 hypertensives composed of 18 patients without left ventricular hypertrophy(group 1), 40 patients with disproportionate septal thickening (group 2) and 30 patients with concentric left ventricular hypertrophy(group 3). Obtained results were as follows : 1) Blood pressure & left ventricular mass index were increased significantly in each hypertensive group compared to normal control. 2) Ejection fraction & fractional shortening in the hypertensive groups were not different from the normotensive control group. 3) Left ventricular isovolumic relaxation time(A2D time) was prolonged in each hypertensive group, especially in group 3. 4) Left atrial emptying index (AEI) was decreased in each hypertensive group. 5) Left ventricular percent ventricular A wave (% VAW) was increased in all hypertensive groups. Above study suggested that the left ventricular diastolic function could be impaired in the hypertensives without associated systolic dysfunction, and the degree of the diastolic dysfunction was not much affected by the type of left ventricular hypertrophy, but the more prolonged A2D time in the concentric hypertrophy group.
Blood Pressure ; Cardiac Output ; Echocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Ventricular Dysfunction ; Ventricular Function, Left

Two factors of the ventricular function, systolic contractile and diastolic relaxing functions, cooporate in pumping the adequate blood volumes to suffice bodily demands. In some hypertensive patients with marked left ventricular hypertrophy, the intact systolic function of the ventricle associated with clinical symptom of congestive heart failure(CHF), which is considered to be a consequence of diastolic dysfunction. In this study 10 hypertensive patients(group A) complaining of exertional dyspnea or chest pain with increased left ventricular mass index and normal systolic function and 6 normotensive controls(group B) were examined by cardiac catheterization and echocardiography to assess the left ventricular systolic and diastolic function and ventricular responses to constant infusion of nitroprusside. Various systolic and diastolic function indices were measured by cardiac catheterization and echocardiography. 1) The ejection fraction(EF), fractional fiber shortening, mean velocity of circumferential fiber shortening, left ventricular(LV) peak+dp/dt, change of slope of LV peak systolic pressure-volume and pressure-dimension relations in group A were not different from those of group B in the resting states. 2) Diastolic dysfunction was evidenced by prolonged A2D time, decreased OR slope, decreased peak negative dp/dt and increased diastolic time constant 'T' in group A. 3) Cardiac index by thermodilution method was negatively related to left ventricular mass index(LVMI) measured by echocardiography, whereas time constant T was positively related to LVMI. 4) With constant infusion of nitroprusside, LV systolic pressure, LV end-diastolic pressure and pulmonary arterial pressure were decreased, and left ventricular end-systolic stress and stroke work index(SWI) derived from left ventricular pressure-volume loop area were decreased, EF was increased, but time constant T was prolonged and cardiac output(CO) by thermodilution method was decreased in group A. 5) In group B, with constant infusion of nitroprusside, EF, SWI and CO were pratically unaffected and time constant T was not prolonged significantly. These reults suggest that patients with hypertensive hypertrophic left ventricle is associated with diastolic dysfunction, which could further be exacerbated by a vasodilator such as nitroprusside.
Arterial Pressure ; Blood Pressure ; Blood Volume ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dyspnea ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Diseases* ; Heart Ventricles* ; Heart* ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Nitroprusside* ; Stroke ; Theophylline ; Thermodilution ; Ventricular Function

Hypertensive left ventricular hypertrophy(LVH) was considered to be a physiologic adaptation to the increased afterload of left ventricle, but recent studies revealed that LVH was one of the most important target organ damage in essential hypertensive patients & cardiovascular morbidity was increased in patients with hypertensive LVH. Hypertensive LVH could be classified into three types : concentric LVH, disproportionate septal thickening(DST), and left ventricular dilatation. Relatively high incidence of DST in hypertension has bee reported after clinical introduction of echocardiogram. But, the mechanisms for the development of DST and its clinical significance have not been elucidated exactly. In order to assess left ventricular diastolic function in hypertensives with DST, the authors performed phonocardiogram, M-mode, and pulsed Doppler echocardiogram in 15 normotensive control(group A : 5 male, 10 female, 44.4+/-7.7 years), 15 hypertensives without LVH(group B : 5 male, 10 female, 45.5+/-8.6 years), 85 hypertensives with DST(group C : 9 male, 16 female, 47.5+/-8.6 years) and 15 hypertensives with concentric LVH(group D : 8 male, 7 female, 47.7+/-6.1 years). The obtained results were as follows : 1) Left ventricular ejection fraction was 71.6+/-6.3% in group A, 71.9+/-7.5% in group B, 731+/-7.0% in group C, and 70.3+/-10.3% in group D. Ejection fraction was not significantly different in each other group. 2) Left ventricular mass index(LVMI) by echocardiogram was 87.8+/-20.6g/m
Adaptation, Physiological ; Bees ; Deceleration ; Dilatation ; Female ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Incidence ; Male ; Relaxation ; Stroke Volume

To evaluate the hypertensive effect of guanbenz acetate, we performed a prospective clinical study for 10 weeks or more in 27 patients with essential hypertension(mean age: 51, mean supine blood pressure: 176/105mmHg). The daily dose of guanabenz acetate was 8-49 mg. The results were as follows; 1) After 2, 4, 6 and 8 weeks of treatment, average supine systolic and diastolic blood pressures reduced to 156/94, 150/94, 149/93 and 144/93mmHg respectively(all P<0.05). 2) Pulse rate decreased slightly from pre-treatment average of 75 beats per minute to 71 beats per minute at the end of the study(P<0.05). 3) Average body weight, serum levels of total cholesterol, AST, ALT, BUN, creatinine, sodium and potassium were not significantly changed from pre-treatment values. 4) A few side effects in order of frequency were dry mouth, dizziness, sedation, weakness, etc. We conclude that guanabenz acetate may be used as an effective first line antihypertensive agent in essential hypertension.
Blood Pressure ; Body Weight ; Cholesterol ; Creatinine ; Dizziness ; Guanabenz* ; Heart Rate ; Humans ; Hypertension ; Mouth ; Potassium ; Prospective Studies ; Sodium

Congenital atresia of left main coronary ostium is a rare congenital coronary anomaly. This anomaly was detected during elective coronary angiogram in a 40 year-old female patient with chest pain and exertional dyspnea. Treadmill exercise test demonstrated 2 mm upslope depression of ST segment at stage I and the test was terminated due to chest pain. Myocardial stress SPECT using 201 Tl-dipyridamole showed reversible perfusion defects at anterior, apex and lateral wall. It was impossible to select left coronary artery ostium and right coronary angiogram revealed 30% eccentric stenosis at proximal right coronary artery with grade 3 collateral flow to left anterior descending and circumflex arteries. Operative finding revealed totally occluded left coronary ostium with membrane-like, non-atheromatous tissue similar to aortic wall. The patient was successfully treated with coronary artery bypass grafts (CABG) using left internal mammary artery and great saphenous vein. She underwent follow-up coronary angiogram, which revealed patent grafts, at one year after CABG and no cardiovascular event was observed on 5-year clinical follow-up.
Adult ; Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Vessels ; Depression ; Dyspnea ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Mammary Arteries ; Perfusion ; Saphenous Vein ; Tomography, Emission-Computed, Single-Photon ; Transplants

BACKGROUND: Reciprocal ST-segment depression in precordial leads is a common finding in acute inferior myocardial infarction. The responsible mechanism and the significance of this finding, however, are still controversial. METHODS: Clinical characteristics, serial eletrocardiograms, angiographic findings of coronary artery and left ventricle were reviewed in 33 patients with acute inferior myocardial infarction. Reciprocal ST-segment depression was defined as ST-segment depression > or =1.0mm in two or more adjacent chest leads, I and aVL in patients with acute inferior myocardial infarction showing ST-segment elevation in II, III, aVF. Coronary angiography and left ventriculography were performed 15,2+/-16.9 hours after arrival. RESULTS: Eleven patients did not have reciprocal ST-segment depression(group A) and 22 patients had reciprocal ST-segment depression(group B). There was no significant difference in the demographic data of the patients except age and peak CK-MB, which were significantly higher in group B than group A. Left anterior descending coronary artery(LAD) stenosis was significantly more frequent in group B than group A(54.5% vs 18.2%, p<0.05). However the distribution of left ventricular regional wall motion abnormality and global ejection fraction showed no difference between two groups. In addition, there was no difference in in-hospital complications. CONCLUSIONS: These results suggest that reciprocal ST-segment depression in acute inferior myocardial infarction can be explained by anterior ischemia due to concomitant LAD stenosis in some cases, but its clinical significance is limited at least in terms of in-hospital complications.
Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Depression* ; Heart Ventricles ; Humans ; Inferior Wall Myocardial Infarction* ; Ischemia ; Thorax