The accuracy and performance of the A&D TM 2421, a new ambulatory blood pressure monitoring device based on the cuff-oscillometric method and the Korotkoff sound technique

The accuracy and performance of the A&D TM 2421, a new ambulatory blood pressure (BP) monitoring device using both the cuff-oscillometric method (O) and the Korotkoff sound method (K) were evaluated. The device was tested for accuracy under static and dynamic conditions by simultaneous comparison with two observers using a standard mercury column sphygmomanometer (standard method) and by the objective recording method (ORM). The performance of the device was also evaluated under ordinary ambulatory conditions. The mean differences in BP of standard method from K-method were -1.2 +/- 4.7 mm Hg systole and 1.3 +/- 4.7 mm Hg diastole (n = 323, mean +/- SD) and those of standard method from O-method were -0.4 +/- 5.3 mm Hg systole and 1.4 +/- 5.1 mm Hg diastole (n = 323). The agreement between each of the two methods of the device and the standard method was within 10 mm Hg for more than 90% of both systolic and diastolic readings. During bicycle exercise, the mean differences in BP of standard method from K-method were -3.4 +/- 4.8 mm Hg systole and 1.8 +/- 5.2 mm Hg diastole (n = 71) and those of standard method from O-method were -1.1 +/- 7.3 mm Hg systole and 1.7 +/- 7.8 mm Hg diastole (n = 67). There was a greater scatter in the individual comparisons of the device and the standard method during exercise, especially in diastolic BP. The relation between the device and ORM was almost similar to that between the device and the standard method.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired cystic disease of the kidney and renal carcinoma in haemodialysis patients: ultrasonographic evaluation

Ultrasonography was performed in 661 dialysis patients and acquired cystic disease of the kidney was found in 156 (125 men and 31 women). A higher incidence of cystic disease was found in males. There was no significant difference between the patients with and those without acquired cystic disease in terms of average age, but the duration of haemodialysis in those with acquired cystic disease was significantly longer. There was an increased incidence of cystic disease in patients with glomerulonephritis and the duration of haemodialysis in these patients was significantly longer. This suggests that the increased incidence of acquired cystic disease of the kidneys in the patients with glomerulonephritis is simply related to the longer duration of treatment. Twelve patients with renal carcinoma were found in this study. The average age at diagnosis of renal carcinoma was not significantly different between the patients with and those without acquired cystic disease, but the duration of dialysis was significantly longer in renal carcinoma patients with acquired cystic disease. The incidence of renal carcinoma in dialysis patients with acquired cystic disease was 3.85% and in those without it was 1.19%. These rates are considerably higher than those found in the general population and indicate that the risk of renal carcinoma is higher in dialysis patients both with and without acquired cystic disease.

The effects of intrarenal infusion of recombinant human erythropoietin on mean arterial pressure and renal hemodynamics in anesthetized rabbits

The effects of recombinant human erythropoietin (rHuEPO) on mean arterial pressure (MAP) and renal hemodynamics were studied in anesthetized rabbits without renal failure. Intrarenal infusion of rHuEPO at a rate of 100 U/min for 30 min resulted in no change in MAP, renal blood flow, or renal vascular resistance. rHuEPO also produced no significant change in glomerular filtration rate filtration fraction, or arterial hematocrit. These results demonstrate that rHuEPO has no direct effects on MAP or renal hemodynamics in anesthetized rabbits without renal failure.

[Application of nasal intermittent positive pressure ventilation to a case of limb-girdle muscular dystrophy]

We applied nocturnal ventilation (NV) with nasal intermittent positive pressure ventilation with custom molded mask (NIPPV-C Mclermott, 1989), as well as NV with tracheostomy intermittent positive pressure ventilation (TIPPV) to a male patient with limb-girdle muscular dystrophy who had developed chronic respiratory failure at the age of 47. NV with both methods successfully corrected nocturnal hypoxemia, improved daytime arterial blood gas values, and achieved a stable clinical course without marked deterioration for four years. Daytime PaO2 higher than 60 Torr and PaCO2 lower than 70 Torr while breathing room air were maintained with both methods, whereas PaO2 was lower than 50 Torr and PaCO2 higher than 70 Torr before the implementation of NV. TIPPV was safely suspended repeatedly for as long as two weeks, maintaining daytime PaO2 higher than 50 Torr. NIPPV-C was also repeatedly suspended for two weeks. Occasionally PaO2 dropped as low as 40 Torr after periods without NV; however, it was restored to higher than 60 Torr after one or two nights' NIPPV-C. These facts suggest that NV had a restorative effect on respiratory muscle fatigue in the present case. While on NIPPV-C, nighttime SaO2 was higher than 90% for 94% of the total time, and between 80% and 90% for the remaining 6% of the time. Desaturation for short periods was thought to be due to oral air leakage, which made the method slightly less effective than TIPPV. However, the overall clinical effectiveness of NIPPV-C was comparable to that of TIPPV.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative study of magnetic resonance and CT scan imaging in cases of severe head injury

The distribution, frequency, and appearance of head injuries were evaluated with MRI and CT in a prospective study of 155 patients with acute (n = 124) and chronic (n = 31) head injuries. MRI was significantly more sensitive than CT in the detection of intraaxial injury at any stage. In severe cases, central structure lesions were detected in approximately 80% of patients. Severity on admission was compatible with MR findings. However it was difficult to decide on neurobehavioural prognosis from initial MRI findings only.

Hydroxyl radical-induced characteristic chemiluminescent spectra from plasma of hemodialysis patients

Plasma from hemodialysis patients evoked weak photon emissions (chemiluminescence) in a characteristic emission spectrum with a peak at 430 nm, attributed to attack by hydroxyl radicals generated from the iron-catalyzed breakdown of hydrogen peroxide (Fenton reaction), whereas plasma from normal healthy subjects showed a rather weak red chemiluminescence peak at around 680 nm, similar to that resulting from attack by hydroxyl radicals. However, the addition of hydrogen peroxide in the absence of divalent irons induced almost the same red chemiluminescent emission spectrum in both plasmas. The HPLC-gel-filtration chromatography carried out with both plasmas revealed that a primary emitter evoking a peak emission at 430 nm was located in the fraction of lower-molecular-mass substances in fractionated plasma from hemodialysis patients. In contrast, the elution peaks evoking red chemiluminescence with the addition of hydrogen peroxide were mainly observed for the higher-molecular-mass fraction, as determined by gel chromatography of both plasmas. Therefore, the observation of a chemiluminescence peak at 430 nm, induced by the generation of hydroxyl radicals, correlated well with chemiluminescent emissions in plasma samples from patients with chronic renal failure. Spectral analyses of clinical samples that show weak chemiluminescence by forced oxidation by such an active oxygen may provide a new and more sensitive method for diagnosing metabolic disorders.

The Influence of Antihypertensive Agents on Circadian Rhythms of Blood Pressure and Heart Rate in Patients with Essential Hypertension

The effects of once-daily administration of calcium (Ca) channel blockers, beta-blockers and and angiotensin-converting enzyme (ACE) inhibitors on circadian rhythms of blood pressure (BP) and heart rate (HR) were studied using the cosinor method. Sixty-two recruited patients with essential hypertension (WHO stage I or II) were divided into three groups based on the class of administered drugs. In the Ca channel blocker group (n = 37, age 54 +/- 9.0 years), 18 patients were given YM 730 at a mean dose of 11 +/- 4.0 mg/day (mean +/- S.D.), 8 were given nitrendipine (11 +/- 6.7 mg/day), and 11 were given nisoldipine (8 +/- 6.4 mg/day). In the beta-blocker group (n = 15, age 42 +/- 13.5 years), 13 patients were given atenolol (44 +/- 11.0 mg/day), 1 was given nadolol (30 mg/day), and 1 was given sustained-release propranolol (60 mg/day). In the ACE inhibitor group (n = 10, age 56 +/- 8.7 years), 7 patients were given enalapril (6 +/- 2.8 mg/day), and 3 were given lisinopril (20 mg/day). Ambulatory BP monitoring (ABPM) was performed before and during treatment. Mean arterial pressure (MAP) and HR were monitored under ambulatory conditions every five minutes for 24 hr with a finger volume oscillometric device. In all three groups, the mesor of MAP decreased significantly, while the amplitude and acrophase did not change during treatment. beta-Blockers reduced the amplitude as well as the mesor of HR. Ca channel blockers increased the amplitude of HR without influencing the mesor. ACE inhibitors had no effect on the circadian rhythm parameters of HR. These results suggest that Ca channel blockers, beta-blockers and ACE inhibitors lowered BP throughout the day without changing the circadian BP rhythm. However, the three drug classes may have different influences on the autonomic nervous system that regulates circadian cardiac rhythm.

Synthesis of rat parathymosin alpha fragment 1-28 and examination of its inhibitory activity towards the restoring activity of thymosin alpha 1 on the impaired T-lymphocytes of uremic patients

A fragment corresponding to N-terminal octaeicosapeptide of rat parathymosin alpha was synthesized by assembling 5 peptide fragments, followed by deprotection with 1 M trifluoromethanesulfonic acid-thioanisole (molar ratio 1:1) in trifluoroacetic acid in the presence of dimethylselenium. Incubation of impaired T-lymphocytes isolated from uremic patients with the synthetic parathymosin alpha fragment 1-28 showed no immunological restoring effect, but when it was administered together with thymosin alpha 1, it appeared to suppress the restoring effect of the thymosin alpha 1 on the impaired T-lymphocytes of uremic patients.

[Blood kinetics of free-platinum in CDDP hepato-arterial injection therapy]

In CDDP hepato-arterial injection therapy, platinum (Pt) concentration in hepatic and peripheral venous blood were determined in two groups with different injection rates, and the blood kinetics of Pt was examined. Seven cases of digestive cancers having liver metastases were given CDDP (100 mg) selectively into the proper hepatic artery at a constant rate (10 or 40 min). After injection, concentration of non-protein-bound Pt in hepatic and peripheral venous blood were determined. Pt concentration and AUC value were higher in hepatic venous blood at injection rate than peripheral venous blood. On the other hand, Pt concentration in hepatic venous blood in the cases 10 min-injection were higher than those received 40 min-injection, but neither Pt concentration in peripheral venous blood nor incidences of the side effects and abnormal clinical findings were influenced by the injected rates.

Solid-phase synthesis of biologically active fragment 29-111 of rat prothymosin alpha

Rat prothymosin alpha fragment 29-111, an 83-residue polypeptide corresponding to desthymosin alpha 1-prothymosin alpha, has been synthesized by a solid-phase method. Hydrogen fluoride was used to deprotect and cleave the peptide from the resin. The crude product was purified by gel-filtration, ion-exchange chromatography and high-performance liquid chromatography. A 3.2-mg sample of a ca. 96% pure peptide was finally obtained. The overall yield of the synthesis was less than 1%. An increase of E-rosette-forming lymphocytes was obtained after incubation of peripheral blood from uremic patients with the synthetic prothymosin alpha fragment 29-111. The restoring effect of the synthetic prothymosin alpha fragment 29-111 was greater than that of our synthetic thymosin alpha 1.

Assessment of age-dependent changes in circadian blood pressure rhythm in patients with essential hypertension

The effects of age on the circadian blood pressure rhythm of patients with untreated essential hypertension (n = 133, World Health Organization stage I or II) were compared with those of normotensive subjects (n = 91). Subjects were classified into three groups by age: young (less than 40 years old), adult (40-59 years old) and old (greater than or equal to 60 years old). Blood pressure was monitored every 5 min for 24 h, using a finger volume oscillometric device under fixed external conditions. The single cosinor method was used to evaluate circadian rhythm. There was no difference in the amplitude of circadian systolic or diastolic blood pressure rhythm among the different normotensive and essentially hypertensive age groups although a wide distribution of amplitude was noted within each group. The distribution of amplitude was wider in the hypertensive than in the normotensive groups. The amplitude of circadian blood pressure rhythm was independent of the mesor level. On the other hand, the amplitude of circadian heart rate rhythm decreased with increasing age both in normotensive subjects (P less than 0.05, young versus adult or old) and hypertensive patients (P less than 0.01, young and old versus adult). The acrophase of circadian systolic blood pressure rhythm in young hypertensives was greater than that in adult or old hypertensives (P less than 0.05, for both). Such age-dependent changes were not observed in the normotensive groups. Consequently, the acrophase of circadian systolic or diastolic blood pressure rhythm in young hypertensives was larger than that in young normotensives (P less than 0.05, for both systolic and diastolic blood pressure).(ABSTRACT TRUNCATED AT 250 WORDS)

Synthesis of an immunologically active fragment analog of prothymosin alpha with enhanced enzymatic stability

A fragment analog, [D-Arg30]prothymosin alpha fragment 1-30, containing D-arginine in place of arginine residue at position 30 was synthesized by the liquid phase procedure and studied for immunological effect on the impaired blastogenic response of T-lymphocytes isolated from uremic patients after treatment of human serum. Deacetyl-thymosin alpha 1, a synthetic octaeicosapeptide corresponding to deacetyl-prothymosin alpha fragment 1-28, has restoration ability for the impaired blastogenic response of T-lymphocytes of uremic patients but is susceptible to proteolytic digestion. On the other hand, the fragment analog, [D-Arg30]prothymosin alpha fragment 1-30 retained activity and was shown to exhibit a high degree of stability when incubated in human serum. These results indicate that N-terminal acetylation and the introduction of D-residue into the C-terminal residue of prothymosin alpha fragment 1-30 increase resistance to proteolytic degradation by exopeptidases.

Circadian blood pressure variations under different pathophysiological conditions

The daily variation in blood pressure (circadian blood pressure rhythm) is characterized by a nocturnal fall and a diurnal rise. The circadian blood pressure rhythm seems to be mediated mainly by the circadian rhythm of sympathetic tone, linked to changes in physical and mental activities, e.g. the waking-sleeping cycle. Statistically significant circadian blood pressure rhythms have been confirmed in approximately 80% of mild to moderate essential hypertensive patients as well as in normal subjects. However, the normal pattern of circadian blood pressure rhythm is reversed in elderly people and in those with Cushing's syndrome, those undergoing glucocorticoid treatment, and those with hyperthyroidism, central and/or peripheral autonomic dysfunction (Shy-Drager syndrome, tetraplegia, diabetic or uremic neuropathy, etc), chronic renal failure, renal or cardiac transplantation, congestive heart failure, eclampsia, sleep apnea syndrome, malignant hypertension, systemic atherosclerosis and accelerated hypertensive organ damage. However, in those with primary aldosteronism, renovascular hypertension, pheochromocytoma without paroxysmal hypertension, or those with cardiac pacing, a nocturnal blood pressure fall is ordinarily observed. It may be that a fall in cardiac output rather than in peripheral resistance may be mainly responsible for the nocturnal fall in blood pressure. It also seems that a nocturnal heart rate fall is not responsible for it, since the nocturnal blood pressure fall remained unchanged in patients undergoing cardiac pacing and was disturbed in patients with Cushing's syndrome or hyperthyroidism in whom the circadian heart rate rhythm remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Does ambulatory blood pressure monitoring improve the diagnosis of secondary hypertension?

Ambulatory blood pressure monitoring can determine the average blood pressure level and the short- and long-term blood pressure variability (circadian rhythm). The circadian blood pressure rhythm appears to be mediated mainly by the circadian rhythm of the sympathetic tone which is linked to changes in physical and mental activity, e.g. the waking-sleeping cycle. A statistically significant circadian blood pressure rhythm was observed in approximately 80% of mild to moderate essential hypertensive patients as well as in normal subjects. However, in patients with Cushing's syndrome, under glucocorticoid treatment, or with hyperthyroidism, central and/or peripheral autonomic dysfunction (Shy-Drager syndrome, spinal cord injury, brainstem lesions, diabetic neuropathy, uremic neuropathy, etc), chronic renal failure, eclampsia, malignant hypertension, sleep apnea syndrome or systemic atherosclerosis, the normal circadian blood pressure rhythm appears to be eliminated or reversed, while in those with primary aldosteronism, renovascular hypertension, pheochromocytoma without paroxysmal hypertension, diabetes insipidus, acromegaly, hyperparathyroidism or hyperprolactinemia, the nocturnal blood pressure fall has been observed as in normal subjects. The alteration in the circadian blood pressure rhythm was observed with different pathophysiological conditions, although no specific pattern was observed for any condition. A disturbance in any part of the hierarchy of factors that regulate the circadian rhythm of sympathetic neural tone seems to disturb the circadian blood pressure rhythm. We conclude that ambulatory blood pressure monitoring is not critically important in the diagnosis of secondary hypertension although it does help in screening for secondary hypertension.

Immunological effect of two synthetic peptides containing alanine or D-alanine instead of acetyl group of thymosin beta 4 after treatment of human serum

Two analogs of thymosin beta 4 the N-terminal acetyl groups of which were substituted by Ala or D-Ala, were synthesized by the solution method and studied for their immunological effect on the impaired blastogenic response of T-lymphocytes isolated from uremic patients after treatment of human serum. One of the synthetic analogs, D-Ala-thymosin beta 4 demonstrated a restorative effect on these patients when incubated in human serum, but the other analog, Ala-thymosin beta 4, showed no restorative effect under the same conditions. These results seem to suggest that D-Ala-thymosin beta 4 increases resistance to proteolytic degradation by exopeptidases more than Ala-thymosin beta 4.

Synthesis of a thymosin beta 4-like peptide, thymosin beta Met9, and its effect on low E-rosette-forming lymphocytes of lupus nephritis patients

A thymosin beta 4-like peptide, thymosin beta Met9 isolated from pork spleen, was synthesized using a conventional solution method. The deprotection of the protected thymosin beta Met9 was achieved by treatment with Zn-90% AcOH to remove C-terminal p-nitrobenzyl ester and then with 1 M trifluoromethanesulfonic acid-thioanisole (molar ratio, 1:1) in trifluoroacetic acid in the presence of dimethylselenium. Finally, the deprotected peptide was incubated with dithiothreitol to reduce sulfoxide on the methionine side chain. The increase of the E-rosette-forming lymphocytes was obtained after incubation of peripheral blood from lupus nephritis patients with the synthetic thymosin beta Met9. The synthetic thymosin beta Met9 was approximately equal in potency to that of our synthetic calf thymosin beta 9.

Cosinor analysis of changes in circadian blood pressure rhythm with aging in spontaneously hypertensive rats

Evolution of circadian rhythm of blood pressure with age in male spontaneously hypertensive rats (SHR) was compared with that in male Wistar Kyoto rats (WKY). Three different age groups (5-6 week old, 19-22 week old, 29-31 week old) were provided for each strain. Chronogram and cosinor method were used for time series analyses. In all age groups of WKY, a diurnal fall and a nocturnal rise in blood pressure (BP) as well as in heart rate (HR) were observed. There was no significant difference in acrophase between BP and HR in each age group of WKY. Regarding SHR, however, each age group demonstrated a different relation between circadian BP rhythm and HR rhythm. In 5-6 week old SHR, a difference in acrophase between BP and HR (about 6.9 hr, p less than 0.1) was observed, which became more conspicuous with the increase in age, eventually presenting an inverted relation between BP and HR in 19-22 week old SHR. The relation between circadian BP rhythm and circadian HR rhythm in 29-31 week old SHR was almost identical with that in 19-22 week old SHR. In other words, a phase lag of acrophase of BP from that of HR already observed in young SHR increased with aging. The results indicate that parasympathetic periodicity remained unchanged even in SHR since circadian HR rhythm was similar in all groups, while the periodicity of sympathetic neural tone relating to the regulation of circadian BP rhythm seems to be disturbed. The mechanism responsible for development and maintenance of high BP in SHR may be linked to a disturbance in the sympathetic mechanism which regulates BP periodicity.

Determination of clinical accuracy and nocturnal blood pressure pattern by new portable device for monitoring indirect ambulatory blood pressure

The accuracy and clinical application of a new portable device for measuring ambulatory blood pressure (BP) (ABPM 630, Nippon Colin, Nagoya, Japan) were assessed. The device uses a conventional arm cuff inflated by CO2 gas from a compact cartridge and is based on a cuff-oscillometric as well as a Korotkoff sound (microphone) technique. Blood pressure values obtained by ABPM 630 were compared with those measured by the auscultatory method. With the microphone method the mean differences from the auscultatory method were -0.28 +/- 6.15 mm Hg (mean +/- SD) for SBP and 0.96 +/- 6.28 mm Hg for DBP (n = 256), while for the cuff-oscillometric method the mean differences were -1.77 +/- 6.07 mm Hg for SBP and 3.06 +/- 6.87 mm Hg for DBP (n = 297). There was a highly significant correlation between BP values measured by the auscultatory method and ABPM 630. In 40 untreated subjects, 24 h BP was monitored simultaneously with the ABPM 630 and with a finger volume-oscillometric device (UBP-100, UEDA, Tokyo, Japan). The daytime average of SBP with the former (126 +/- 11.6 mm Hg) was almost the same as that with the latter (123 +/- 16.0 mm Hg), while the nighttime average in the former (117 +/- 9.7 mm Hg) was significantly higher than that in the latter (108 +/- 14.1 mm Hg, P less than .01). Only 4 out of 40 subjects experienced no sleep disturbance from the arm-cuff inflation. Five of the 40 subjects complained that their sleep was frequently interrupted by the arm-cuff inflation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Bone metabolism in thyroidectomized patients--evaluation of bone mineral content by quantitative CT]

The bone mineral content in the patients who had undergone operation for thyroid carcinoma was measured by quantitative CT. Thirty-eight cases were enrolled as the subjects. All cases were papillary adenocarcinoma of the thyroid. The totally thyroidectomized group consisted of 3 males and 14 females, and the non-totally thyroidectomized group (post-lobectomy) 3 males and 18 females. Thirty-eight healthy males and females were assigned to the control group. For evaluation of bone mineral content, quantitative CT was used and bone mineral content in the patient's lumbar vertebrae was measured. Concurrently, bone metabolic parameter in serum was determined. No significant difference was observed in the mean bone mineral content among the above three groups. To make correction by sex and age, BMC-index was defined as the value that the bone mineral content in each case was divided by the standard mean by the same age and sex. No significant difference was observed in BMC-index among the above three groups. No significant correlation was observed in serum calcitonin level with the bone mineral content and BMC-index. It suggests that no influence is exerted on bone metabolism if serum calcitonin is maintained in the physiological level.

Comparison of histamine release induced by synthetic polycations with that by compound 48/80 from rat mast cells

We compared the histamine release induced by polyethylenimines and polyallylamines with that induced by compound 48/80. Lidocaine inhibited the histamine release induced by polyethylenimine with a molecular weight of 600 (PEI6), but disodium cromoglycate did not. The histamine releases induced by all polyethylenimines and polyallylamines tested were inhibited by lidocaine, but not by disodium cromoglycate. Islet activating protein inhibited the histamine release induced by PEI6. Its effects on the release by other polyethylenimines and polyallylamines were less than that on PEI6. It is likely that the inhibition of G proteins by islet activating protein resulted in a decrease of the histamine release. This possibility was supported by the finding that guanyl-5'-(beta, gamma-imino) triphosphate enhanced the histamine release. An inhibitor of polyphosphoinositide phosphodiesterase, neomycin, did not affect the histamine releases induced by these polymers. The effect of PEI6 seemed to resemble that of compound 48/80. After pretreatment of mast cells with wheat germ agglutinin and with Limax flavus agglutinin, releases of histamine induced by PEI6 and compound 48/80 decreased, suggesting that the binding sites of PEI6 and compound 48/80 had sialic acid and/or N-acetyl glucosamine residues. The binding site for PEI6 seemed to especially overlap those of compound 48/80.

Cardiovascular depression and stabilization by central vasopressin in rats

The role of endogenous vasopressin in cardiovascular homeostasis was examined using vasopressin-deficient rats (Brattleboro) (n = 194) and their parent strain, Long-Evans rats (n = 181). Mean arterial pressure (blood pressure) and heart rate were measured every 4 seconds with or without infusion of drug solution for 21 hours, and mean values and their standard deviations (lability) were calculated. Blood pressure in Brattleboro rats (116 +/- 1.1 mm Hg, mean +/- SEM) was significantly higher than that in Long-Evans rats (96 +/- 0.7 mm Hg, p less than 0.001), whereas heart rates (381 +/- 3.3 and 375 +/- 2.9 beats/min, respectively) were similar. The lability of blood pressure and heart rate in Brattleboro rats (9.2 +/- 0.1 mm Hg and 42.3 +/- 0.7 beats/min) was also greater than that in Long-Evans rats (6.7 +/- 0.1 mm Hg, p less than 0.001 and 38.4 +/- 0.8 beats/min, p less than 0.01, respectively). In Brattleboro rats, intravenous vasopressin (0.1 ng/kg/min or 0.6 ng/kg/min) did not affect blood pressure, although it did reduce heart rate and decreased lability of blood pressure and heart rate. Intracerebroventricular (central) infusion of vasopressin (2 pg/kg/min) in Brattleboro rats induced initial hypertension and tachycardia followed by long-lasting hypotension and bradycardia, whereas in Long-Evans rats it induced only hypertension and tachycardia. In both strains, central vasopressin dramatically decreased the lability of blood pressure and heart rate. Neither intravenous (0.2 ng/kg/min) nor central desmopressin (2 pg/kg/min or 0.2 ng/kg/min), a V2 renal receptor agonist, changed any of these parameters in Brattleboro rats, although both diminished urinary volume. Neither intravenous (50 ng/kg/min) nor central (3.3 pg/kg/min) d(CH2)5-Tyr(Me)-arginine vasopressin, a vasopressin V1 receptor antagonist, modulated any of these parameters in Long-Evans rats. These results suggest that endogenous as well as exogenous vasopressin acts centrally as a cardiovascular inhibitor and stabilizer through a receptor mechanism other than V1 or V2 receptor mechanisms.

Synthesis of human splenin (hSP) and examination of its immunological effects on the impaired T- and B-lymphocytes in uremic patients

Human splenin (hSP) was synthesized by assembling eight peptide fragments followed by deprotection with 1M trifluoromethanesulfonic acid-thioanisole (molar ratios, 1:1) in trifluoroacetic acid in the presence of m-cresol and dimethylselenium. Finally, the deprotected peptide was incubated with dithiothreitol to reduce sulfoxide on the methionine side chain. Incubation of peripheral lymphocytes isolated from uremic patients with the synthetic hSP showed an enhancing effect on the reduced B-lymphocytes, but had no restoring effect on the impaired blastogenic response of T-lymphocytes.

A cross-sectional survey of home blood pressure in a rural community in northern Japan

A cross-sectional survey was performed on home blood pressure recordings (home BP) in a rural community in northern Japan. In total, 1190 participants (495 men and 695 women which consist 61.5% of the greater than or equal to 15 year-old regional population, n = 1933) were asked to measure home BP every morning for a month, using a semiautomatic BP measuring device. The actual measurements were done 16.8 +/- 10.2 times (mean +/- SD) for men and 19.0 +/- 9.4 times for women. Home systolic (SBP) and diastolic BP (DBP) was elevated gradually with age in both sexes, although DBP tended to fall after reaching 70 years old in men. SBP and DBP thus measured were significantly lower than those of casual BP of ordinary Japanese people reported by the Ministry of Health and Welfare, Japan, by 11.4 +/- 4.3 mmHg SBP (mean +/- SD) and 5.9 +/- 1.6 mmHg DBP in men, and 12.7 +/- 5.1 mmHg SBP and 8.1 +/- 2.5 mmHg DBP in women. When WHO criteria were applied to the home BP, 2.8% of men and 0.6% of women were considered to be definitely hypertensive, and 7.9% of men and 6.4% of women as of borderline cases, indicating the underestimation of hypertensive population by means of home BP. Based on these data, we demonstrated the values equal to 1SD or 2SDs above the mean in each age group to tentatively determine biological normalcy. It is necessary to define the relationship between home BP and target organ disease or hypertensive complications. A long-term prospective study is also necessary to define the relationship between home BP and long-term morbidity or mortality.