Serum and plasma protein adsorption on materials was analyzed using gel electrophoresis and ion trap mass spectrometry. Following incubation of polypropylene, polyethylene terephthalate (PET), or polydimethylsiloxane (PDMS) with 5% serum for longer than 4 h, we found unexpectedly high amounts of the pentraxin serum amyloid P. It was previously shown that serum amyloid P is constitutively expressed in humans, functions as an opsonin, and interacts with the Fcgamma receptors on leukocytes. We demonstrate that serum amyloid P adsorbed to tissue culture polystyrene, PDMS, and PET promotes the adhesion of granulocytes and monocytes in the presence of calcium. The methods developed for these studies may be useful for the large-scale study of protein adsorption and do not rely on radiolabeling or the availability of antibodies.

SUMMARYThe clinical manifestations and natural history of acute aortic intramural hemorrhage are not well characterized. Therefore, we have evaluated the differences in the clinical features and prognosis between acute intramural hemorrhage and acute classic aortic dissection.One hundred two consecutive patients with acute aortic syndrome were diagnosed between November 1994 and May 1999. The clinical features, treatment modalities and survival of these patients were analyzed.Thirty one of the 102 patients (30%) had intramural hemorrhage and 71 (70%) had aortic dissection. Patients with intramural hemorrhage were older than those with aortic dissection (mean ages 67 and 55 years, respectively) (p < 0.001), and intramural hemorrhage showed a lower proportion of type A than did aortic dissection (32% and 58%, respectively) (p = 0.018). The incidence of severe complications was significantly lower in patients with intramural hemorrhage than in those with aortic dissection (19% and 27%, respectively) (p < 0.001). Mean follow-up duration was 23.1 ± 16.0 months.The overall death rate for patients with intramural hemorrhage (2 / 31; 6%) tended to be lower than those with aortic dissection (14 / 71; 20%) (p = 0.104). The Stanford classification and treatment modalities were not correlated with death. Late follow-up imaging studies in intramural hemorrhage showed partial to complete resolution of intramural hematoma (9/15; 60%).In this study, intramural hemorrhage was fairly common, more frequent among older patients, had a lower proportion of type A, and showed a lower incidence of severe complications and a more favorable prognosis in terms of mortality, than aortic dissection. (Jpn Heart J 2001; 42: 91-100)

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Background and Objectives Neurocardiogenic syncope is believed to be caused by a transient imbalance of autonomic nervous system. Actually, there were significant differences in heart rate variability HRV indices during head-up tilt test between patients with neurocardiogenic syncope and normal controls. But there was no definite evidence for it during daily activity. So, we tried to evaluate HRV during daily activity with 24-hour ambu-latory electrocardiography monitoring. Materials and Methods 27 patients with neurocardiogenic syncope or presyncope mean age 45 3 and 25 normal volunteers mean age 47 2 comparable for age and sex underwent 24-hour ambulatory electrocardiography. Head-up tilt test was used to diagnose neurocardiogenic syncope or presyncope in patients group. HRV was analysed over the whole 24 hours, using time and frequency domain parameters. Student's t-test was applied. Results There were no significant differences in HRV measures between two groups, over 24-hour period and day-time and night-time period. But the hourly HRV measures showed a transient decrease of LF, LFnorm and LF HF ratio in patients group compared to normal control group. Conclusions These results indicate that patients with neurocardiogenic syncope or presyncope suffer from temporarily decreased sympathetic tone with normal parasympathetic tone. So, transient additive change of autono-mic nervous tone may cause syncope or presyncope in these patients. Korean Circulation J 2000 ; 30 6 : 716-723

Background and Objectives This study was designed to evaluate the appropriate dose and dose-dependent effect of benidipine hydrochloride, a Ca -channel blocker, in patients with mild moderate essential hypertension. Material and Methods Benidipine was administered in 2 mg, 4 mg and 8 mg once daily with 1 month interval in 41 hypertensive patients with diastolic blood pressure over 90 mmHg and systolic blood pressure from 140 to 210 mmHg. Blood pressure, heart rate, subjective symptoms and adverse effects were checked every 4 weeks after benidipine administration. Laboratory examinations were performed before and after benidipine administration. Results The dose-dependent, antihypertensive effect of benidipine was evaluated in 41 patients. The blood pressure significantly reduced from 166 15 mmHg/103 7 mmHg to 13815 mmHg/88 11 mmHg at 12 weeks administration of benidipine and overall effective rate was 95%. The systolic and diastolic blood pressure was reduced significantly in proportion to dose of benidipine p 0.0001 . Antihypertensive effect was prominent at 4mg of benidipine. The heart rate was not affected by benidipine. No significant laboratory changes were observed. Conclusion Benidipine has a dose-dependent effect in the treatment of mild-moderate hypertension, and the dosage to be needed may be 4mg or more for sufficient antihypertensive effect. Korean Circulation J 2000 ; 30 5 : 586-591

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Background and Objectives Climacteric women often suffer from vasomotor symptoms. These symptoms are thought to be related to an imbalance of autonomic control of the cardiovascular system and are effectively controlled with hormonal replacement therapy. Heart rate variability HRV reflects the autonomic integration of the cardiovascular system. In this study, we attempted to compare the HRV indices of postmenopausal women before and after hormonal replacement therapy. Subjects and Methods Eighteen patients with postmenopausal syndrome mean age 53 4 years received estrogen and/or progesterone replacement therapy. They underwent 24-hour ambulatory electrocardiographic monitoring at baseline and after the early period of therapy mean 112 19 days and eleven patients underwent the examination after the later period of therapy mean 213 23 days . HRV was analyzed over a full 24-hour period, using time and frequency domain para-meters. Results No statistically significant HRV change was observed during the early period of therapy. However, during the later therpy period , HRV indices such as rMSSD from 27.6 to 31.3 msec , HF from 4.8 to 5.05 ln ms 2 , LF/HF ratio from 1.17 to 1.12 were significantly changed p value 0.05 . Conclusion HRV was significantly changed in postmenopausal women during the later period of hormonal replacement therapy.