Establishment of minimal positive-control conditions to ensure brain safety during rapid development of emergency vaccines

With the increase in international human and material exchanges, contagious and infectious epidemics are occurring. One of the effective methods of epidemic inhibition is the rapid development and supply of vaccines. Considering the safety of the brain during vaccine development is very important. However, manuals for brain safety assays for new vaccines are not uniform or effective globally. Therefore, the aim of this study is to establish a positive-control protocol for an effective brain safety test to enhance rapid vaccine development. The blood-brain barrier's tight junctions provide selective defense of the brain; however, it is possible to destroy these important microstructures by administering lipopolysaccharides (LPSs), thereby artificially increasing the permeability of brain parenchyma. In this study, test conditions are established so that the degree of brain penetration or brain destruction of newly developed vaccines can be quantitatively identified. The most effective conditions were suggested by measuring time-dependent expressions of tight junction biomarkers (zonula occludens-1 [ZO-1] and occludin) in two types of mice (C57BL/6 and ICR) following exposure to two types of LPS (Salmonella and Escherichia). In the future, we hope that use of the developed positive-control protocol will help speed up the determination of brain safety of novel vaccines.

Neuronal maturation in the hippocampal dentate gyrus via chronic oral administration of Artemisa annua extract is independent of cyclooxygenase 2 signaling pathway in diet-induced obesity mouse model

Recently, we reported that Artemisia annua (AA) has anti-adipogenic properties in vitro and in vivo. Reduction of adipogenesis by AA treatment may dampen systemic inflammation and protect neurons from cytokine-induced damage. Therefore, the present study was undertaken to assess whether AA increases neuronal maturation by reducing inflammatory responses, such as those mediated by cyclooxygenase 2 (COX-2). Mice were fed normal chow or a high-fat diet with or without chronic daily oral administration of AA extract (0.2 g/10 mL/kg) for 4 weeks; then, changes in their hippocampal dentate gyri were measured via immunohistochemistry/immunofluorescence staining for bromodexoxyuridine, doublecortin, and neuronal nuclei, markers of neuronal maturation, and quantitative western blotting for COX-2 and Iba-1, in order to assess correlations between systemic inflammation (interleukin-6) and food type. Additionally, we tested the effect of AA in an Alzheimer's disease model of Caenorhabditis elegans and uncovered a potential benefit. The results show that chronic AA dosing significantly increases neuronal maturation, particularly in the high-fat diet group. This effect was seen in the absence of any changes in COX-2 levels in mice given the same type of food, pointing to the possibility of alternate anti-inflammatory pathways in the stimulation of neurogenesis and neuro-maturation in a background of obesity.

Rapid identification of spontaneously resolving capnothorax using bedside M-mode ultrasonography during laparoscopic surgery: the "lung point" sign: two cases report / 대한마취과학회지

Pneumothorax during general anesthesia is more difficult to diagnose compared with that of non-anesthetized patient. Furthermore, the early diagnosis of pneumothorax is to some extent difficult due to CO2-pneumoperitoneum during laparoscopic surgery. The use of ultrasonography to diagnose pneumothorax has increased in a variety of situations, demonstrating a better diagnostic rate than conventional chest radiography. Here, we report two cases of intraoperative capnothorax that were confirmed using the M-mode "lung point" sign. However, the insertion of a chest tube could have been avoided because the spontaneous resolution of capnothorax was quickly identified using bedside lung ultrasonography.

Anaphylactic reactions after cisatracurium administration in two patients: a report of two cases / 대한마취과학회지

Cisatracurium was initially characterized to have no evident histamine-releasing potential with excellent cardiovascular stability. However, severe anaphylactic reactions to cisatracurium that resulted in bronchospasms and cardiovascular collapse have been reported worldwide. Two cases of severe anaphylactic reactions after the administration of cisatracurium are presented. The anesthetics used in both cases were lidocaine, midazolam, propofol (microemulsion propofol in the second case), remifentanil and cisatracurium. After the administration of these drugs, bronchospasm and hypotension manifested, leading to the diagnosis of anaphylaxis and appropriate treatment. Skin intradermal testing confirmed that both cases were due to immune-mediated anaphylaxis to cisatracurium, despite the fact that neither of the patients had been exposed to the allergen previously. The anaphylaxis may be due to cross-reactivity between neuromuscular blocking agents and substances with quaternary ammonium ions. Anesthesiologists should be aware that cisatracurium has the potential to trigger severe anaphylactic reactions via an immune-mediated mechanism.

Predictors of PSA Screening Among Men Over 40 Years of Age Who Had Ever Heard about PSA

PURPOSE: The purpose of this study was to investigate social and behavioral factors associated with prostate-specific antigen (PSA) screening in men in California, United States, who were over 40 years of age and had ever heard about PSA screening. MATERIALS AND METHODS: This survey was administered as a random-digit-dialing telephone survey to produce reliable estimates of medium-sized counties. It surveyed 42,000 households and interviewed 58,407 people randomly. It considered socioeconomic status and health behavior as affecting PSA screening. Access to health care was measured as having regular health care access. The main outcome measure was self-report of ever having undergone PSA screening at least once in the respondent's lifetime. RESULTS: Of 8,864 respondents, 82.2% were White, 7.7% were Latin, 4.2% were African American, and 5.9% were Asian. The respondents' mean age was 60.13 years. Age was the significant factor for PSA screening. Respondents aged 50-59 years were 3.5 times as likely to have undergone PSA screening as were those aged 40-49 years (OR=3.49, p< or =0.001). Race was not statistically significant after considering other factors. People who had never married had statistically significantly lower screening than did people who were married (OR=0.71, p=0.001). Poverty levels were statistically significant in both the unadjusted and the adjusted analysis. People who had no regular health care access were much less likely to have undergone PSA screening than were people who had regular health care access (OR=0.22, p=0.001). CONCLUSIONS: The likelihood of PSA screening was positively associated with increased age, marital status (married), higher socioeconomic status (higher federal poverty level and higher educational attainment), and health care access. However, there was no statistically significant association of PSA screening with race, employment, exercise, smoking, or drinking status.

Comparison of the Efficacy between Risperidone and Quetiapine in Elderly Patients with Delirium

OBJECTIVES: Many studies showed that risperidone and olanzapine in the treatment of delirium were similar to haloperidol, in side effects were superior to that. Quetiapine is frequently used in delirious patients. However, the studies of quetiapine in the treatment of delirium are very few. This study was designed to compare the efficacy of risperidone and quetiapine in elderly patients with delirium. METHODS: We divided 2 groups (risperidone and quetiapine) of elderly patients with delirium. We compared the two groups of elderly patients with delirium by Korean Version of Delirium Rating Scale (K-DRS) and Korean Mini-Mental State Examination (K-MMSE) at baseline and 1 week later. RESULTS: Our results showed that risperidone and quetiapine were efficacious in the treatment of elderly patients with delirium according to using K-DRS and K-MMSE. There were no significant differences in the degree of effects in both drugs. CONCLUSION: We compared the efficacy of risperidone and quetiapine in the treatment of delirium. Quetiapine was as efficacious as risperidone in the treatment of the elderly patients with delirium. In future, the sample size need to be increased in the studies of delirium. And the evaluation of long-term side effects related to quetiapine need to be performed.

Transurethral Resection Syndrome Occurred by Bladder Perforation during Transurethral Resection: A case report / 대한마취과학회지

A transurethral resection of the prostate (TURP) is often performed to treat benign prostatic hypertrophy or prostatic carcinoma. Transurethral resection syndrome (TURS) is a rare but serious complication of TURP that has two different causes: (1) intravascular absorption of the irrigation fluid through the open prostatic venous sinus (TURP syndrome); and (2) intraperitoneal extravasation of the irrigation fluid through perforation of the bladder. In general, a laparotomy, repair of injury, or conservative approach such as bladder drainage, percutaneous drainage of the abdomen combined with medical treatment are performed to manage TURS attributed to the latter mechanism. We report a patient with TURS, who showed a gradual onset of hyponatremia after bladder perforation and intraperitoneal extravasation of the irrigation fluid, and was treated successfully using a conservative approach.

A Case of Subepidermal Calcified Nodule in Auricle / 대한이비인후과학회지

Subepidermal calcified nodule, also called as cutaneous calculi, is a rare form of calcinosis cutis, which is not associated with biochemical abnormalities, or other dermatologic disorder or systemic illness. It occurs on the face and ear of children, and is asymptomatic. It usually presents as a solitary verrucous nodule and histologically shows as basophilic granules and masses in the dermis. We experienced one case of subepidermal calcified nodule in a 9-year-old boy with auricular mass. He did not have any other dermatologic disorder or systemic illnesses. Physical examination showed a 1.5 x 3 cm sized, non-tender, hard, fixed mass on left helix. It was surgically excised. It was finally reported as calcinosis cutis. We report it with a review of the current literature.

Assessment of the Mechanism of Arterial Blood Pressure Change during Sevoflurane Induction: Beat-to-Beat Analysis of Hemodynamic Variables Using a Modelflow Method / 대한마취과학회지

BACKGROUND: A modelflow method provides beat-to-beat analysis of cardiovascular variables based on arterial pulse pressure analysis. In this study, we assessed the mechanism of arterial blood pressure (ABP) change during sevoflurane induction by the analysis of beat-to-beat hemodynamic changes using a modelflow method. METHODS: Beat-to-beat ABP was measured during a stable conscious state (baseline) and vital capacity induction with sevoflurane 6 vol% and oxygen 8 L/min in 18 healthy living liver transplant donors. Alterations of beat-to-beat systolic ABP, mean ABP, diastolic ABP, heart rate (HR), stroke volume (SV), cardiac output (CO), and total peripheral resistance (TPR) by sevoflurane induction were estimated noninvasively using a modelflow method simulating aortic input impedance from an ABP waveform. RESULTS: After sevoflurane induction, ABP, SV, CO, and TPR decreased significantly (all P < 0.05), but HR did not change significantly. After tracheal intubation, ABP, CO, and TPR did not change significantly compared with baseline, but HR increased and SV decreased significantly (both P < 0.05). CONCLUSIONS: Using a modelflow beat-to-beat analysis of cardiovascular variables, we found that ABP did not change significantly compared to baseline after tracheal intubation during sevoflurane induction, indicating the counteraction of increased HR and decreased SV, and that the reduction of SV by tracheal intubation suggests the suppression by increased HR and TPR compared with that after sevoflurane induction.

P50 and Schizophrenia

One of the most widely recognized neurophysiologic endophenotypes for schizophrenia is deficient gating or inhibition of the P50 component of the auditory event-related potential(ERP). A deficit in P50 sensory gating refers to a dysfunction in the mechanism responsible for modulating the brain's sensitivity of filtering out irrelevant or background stimuli, perhaps as a result of dysfunction in inhibitory neural circuits. In this paper, we review the neuronal and genetic aspects as well as medication effects on P50 in schizophrenia.

Surgical Treatment of Two Cases of Benign Symmetrical Lipomatosis Causing Dyspnea / 대한이비인후과학회지

Benign symmetrical lipomatosis, known as Madelung's disease, is a rare disease characterized by non-encapsulated fat tissue accumulation in a symmetrical manner around the neck, shoulders, and upper extremities, rarely involving the lower limbs and the lower body. To date, there have been approximately 200 cases reported. We experienced two cases of Madelung's disease, 57 and 59 year-old man with neck and shoulder swelling and the symptom of dyspnea. Laryngoscopic and CT scan findings showed severe narrowing of supraglottic and paraglottic area, caused by fat tissue accumulation. The fat tissues were surgically excised, one by external approach and the other by laryngomicrosurgery using LASER under direct laryngoscope, with successful result. We report it with a review of the current literatures.

Complete Atrioventricular Nodal Block in Patient Undergoing Left Vagus Nerve Stimulation: A case report / 대한마취과학회지

There are virtually no cognitive and systemic side-effects associated with vagus nerve stimulation (VNS), which makes it a valuable treatment modality for patients with a poor tolerance to antiepileptic drugs. The safety of VNS therapy have been established in clinical studies, but there are few reports on the cardiac side effect associated with the intraoperative lead testing for implantation of the device for VNS. We report a patient with refractory epilepsy who experienced a complete atrioventricular block intraoperatively as a result of inadvertently high current intensity during the initial testing for implantation of a left vagus nerve stimulator.

Management of Contralateral N0 Neck in Tonsillar Squamous Cell Carcinomas / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is well established that tonsillar squamous cell carcinoma has high probability to be disseminated to the neck. An ipsilateral neck treatment is mandatory during initial treatment stages of II-IV tonsillar carcinomas. However, no consensus exists as to whether an elective contralateral neck management should be performed. SUBJECTS AND METHOD: A retrospective analysis was performed on 43 N1-3 tonsillar cancer patients with contralateral negative necks who were treated between 1992 to 2002. All patients had a contralateral elective neck dissection. Surgical treatment was followed by postoperative radiotherapy in 33 patients. The follow-up period ranged from 2 to 120 months (mean, 38 months). The Kaplan-Meier method and log-rank test were used to calculate the disease-specific survival rates and prognostic significance of contralateral occult lymph node metastasis. RESULTS: Clinically occult, but pathologically positive contralateral lymph nodes were found in 16% (7 of 43). In cases of ipsilateral N (+) neck, contralateral occult lymph node metastases developed in 21% (7 of 33) and there was no incidence of that in the cases of ipsilateral N0 necks. Based on the clinical stages of the tumor, 5% (1 of 22) of the cases metastatically involved ymph nodes in the T2 tumors, 36% (5 of 14) in the T3, and 25% (1 of 4) in the T4. T1 tumors (3 cases) had no pathologically positive lymph nodes (T1+T2 vs T3+T4, p<.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific free survival rates over patients with any pathologically positive nodes (5 year disease specific survival rate, 92% vs 28%, p=<.05). CONCLUSION: The risk of contralateral occult neck involvement in above T3 staged tonsillar squamous cell carcinomas with unilateral metastases was high and patients who presented with contralateral metastatic neck have worse prognosis than those who are staged as N0. Therefore, we advocate a routine bilateral neck dissection in tonsillar squamous cell carcinoma patients with unilateral node metastases.

The Clinical Characteristics and Voice Analysis of Reinke's Edema / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Reinke's edema is characterized by the swelling of the vocal folds, which is bilateral, and is found superficial to the vocal ligament, Reinke's space. However, the etiology of Reinke's edema is not well understood, and voice characteristics are still controvertial. The aim of this study was to evaluate the clinical characteristics of Reinke's edema, and to assess the voice qualities in patients with Reinke's edema before and after a laryngomicrosurgery. Furthermore, this study also determined which parameters were most associated with the improvement of postoperative voice quality in Reinke's edema. SUBJECTS AND METHOD: The clinical records from 61 patients with Reinke's edema were reviewed and telephone questionnaires were carried out about smoking, laryngopharyngeal reflux, voice abuse, and allergy. All the patients were classified according to the stroboscopic findings (Yonekawa's classification). The voice analysis of 61 patients with Reinke's edema were performed and compared with 30 normal controls. Also, the voice analysis of 23 patients, who underwent laryngomicrosurgery, was carried out 2 months after surgery. RESULTS: Smoking, voice abuse and laryngopharyngeal reflux may play important roles in developing Reinke's edema. There were 26, 22, and 13 patients identified as Yonekawa types I, II, and III, respectively. The preoperative voice analysis of 61 patients showed decreased FxM (mean fundamental frequency), and increased subglottic pressure. Furthermore, FxSD (fundamental frequency standard deviation), QxM (mean closed quotient), and QxSD (closed quotient standard deviation) were all higher for the patients than the normal group. The postoperative results showed an increase in the FxM and an improvement in the MFR (mean flow rate), Psub (subglottic pressure), shimmer, and HNR (harmonics to noise ratio). The correlation analysis showed that jitter, HNR, QxM, and CFx (% irregularity of frequency) were the parameters, showing the best correlation with improvement in the postoperative voice quality. CONCLUSION: The fundamental frequency was approximated to normal ranges, and stabilizing of vocal fold vibration, and the improvement of vocal efficiency was also found 2 months after layngomicrosurgery. The parameters which represented voice quality by correlation analysis after surgery were jitter, HNR, QxM, and CFx.

Effect of Ginkgo Biloba Extract(EGb 761) on Apoptosis in Oral Cavity Cancer Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To examine the chemopreventive effects of Ginkgo biloba extract (EGb 761) on oral cavity cancer, we investigated the apoptosis of oral cavity cancer cells by EGb 761 and the apoptotic pathway involved. MATERIALS AND METHOD: SCC 1483 cancer cell line derived from a human retromolar trigone carcinoma was used. Inhibition of proliferation was examined by proliferation assay. Apoptosis was measured and confirmed by flow cytometry, DNA fragmentation assay and Western blotting with PARP antibodies. The involvement of the caspase cascade was investigated by co-treating with the caspase inhibitor, z-VAD-fmk. RESULTS: The inhibition of SCC 1483 cells was noted from 250 microgram/ml of EGb 761. Apoptosis was observed after 24 hours of incubation with 250 microgram/ml EGb 761 and it occurred in a time-dependent manner. Apoptosis was confirmed by DNA fragmentation and PARP cleavage. Co-treatment with z-VAD-fmk inhibited apoptosis and PARP cleavage by EGb 761. CONCLUSIONS: EGb 761 induces the apoptosis of SCC 1483 cells and the caspase cascade is involved in this apoptosis. Therefore, EGb 761 may be used as a chemopreventive agent in oral cavity cancer. Further studies are required on the clinical use of EGb 761.

Clinical Characteristics and Voice Analysis of Mutational Dysphonia: Diplophonia and Clinical Use of Electroglottographic Measures / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mutational dysphonia, also referred to as mutational falsetto, is defined as the dysphonia that continuously have high pitch after adolescence. The aims of this study were to investigate the acoustic and electroglottographic characteristics of mutational dysphonia before and after voice therapy and to identify the factors that may be of help in its treatment. SUBJECTS AND METHOD: The clinical records of 15 patients with mutational dysphonia were reviewed, and analyses of their voice records were carried out with the help of Lx Speech Studio studio (Laryngograph Ltd, London, UK) program. RESULTS: After voice therapy was combined with manual compression method, the voices of the subjects were lowered in pitch and also improved in voice quality. Furthermore, we were able to classify the mutational dysphonia into 4 categories according to diplophonia and closed quotients. The most common type among the categories was bimodal distribution of fundamental frequency, or so-called diplophonic, accompanied with low closed quotient-falsetto voice-at high frequency area. However, the results also showed that all cases of mutational dysphonia can not be generalized simply as falsetto voice. The effect of the therapy for each type was different, and we could assume that in the cases with diplophonia accompanied with non-trained falsetto voice, it is expected that it can be treated readily. CONCLUSION: The diplophonia and closed quotient, which were easily analyzed by using Lx Speech Studio program, are important factors which help to classify the mutational dysphonia, choose the treatment options, monitor the efficacy of therapy, and estimate the prognosis of diseases.

15-Lipoxygenase-1 Induced by Interleukin-4 Mediates Apoptosis in Oral Cavity Cancer Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In oral cavity cancer (OCC) cells, the effects of interleukin-4 (IL-4) are various according to the cell specificity. However, if IL-4 induces apoptosis on OCC cells, the mediator of this apoptosis is uncertain. Therefore, we investigated whether apoptosis of OCC cells occurs by IL-4 and whether 15-lipoxygenase-1 (15-LO-1) induced by IL-4 is the possible mediator of this apoptosis. MATERIALS AND METHODS: SCC 1483 cells were used. Flow cytometry and poly ADP-ribose polymerase cleavage were used to examine apoptosis. Western blot analysis and reverse transcription-polymerase chain reaction were used to measure 15-LO-1 protein and mRNA. RESULTS: The inhibition of cell proliferation by more than 50% was noted from 10 ng/ml of IL-4. At this dose, apoptosis was observed and this apoptosis was inhibited by 2.2 microM caffeic acid. 15-LO-1 expression was observed from the 8 hour treatment of IL-4 and apoptosis increased after the 24 hour treatment of IL-4. In this apoptosis, caspase cascade, cyclooxygenase-2, and non-steroidal anti-inflammatory drugs-activated gene-1 (NAG-1) were not involved. CONCLUSION: IL-4 induced apoptosis in SCC 1483 OCC cells and 15-LO-1 induced by IL-4 may mediate this apoptotic pathway.

The Effect of Cigarette Smoking on Bladder Cancer in Korean: A Prospective Cohort Study / 대한비뇨기과학회지

PURPOSE: To verify the association between cigarette smoking and bladder cancer in the Korean population, as smoking is well known as a risk factor on bladder cancer. The risk of bladder cancer was compared among never-smokers, ex-smokers and current-smokers using a multivariate adjusted incidence rate and the mortality rate of bladder cancer of Koreans. MATERIALS AND METHODS: A total of 348,010 participants were enrolled in this prospective study between 1993 (to 1994) and 2002. All participants completed a self administered questionnaire on cancer risk factors, including smoking habit. Follow up for incident bladder cancer was established. We classified all participants into three categories: current-smoker, ex-smoker and never-smoker, on the basis of their smoking habits. We confirmed bladder cancer from the data of the Korea National Cancer Registry and National Health Insurance Corporation up to (December?) 2002. The multivariate adjusted incidence and the mortality due to bladder cancer were used for both genders for a statistical analysis using a Cox proportional hazards model. RESULTS: The incidence rate of bladder cancer per 100,000 persons in male never-smokers, ex-smokers and current-smokers were 27, 41 and 48, respectively, and the multivariate adjusted relative risks (RR) were 1.3 (95% confidence interval (CI), 0.9-2.0) and 1.7 (95% CI, 1.2-2.3) in ex- and current smokers, respectively. The incidence rate of bladder cancer in women was 4.7, 8.4 and 13, respectively. There was no significant association between the risk of bladder cancer and the amount and duration of smoking. CONCLUSIONS: We concluded that current smokers have an increased incidence and mortality rate of bladder cancer in both genders in the Korean population, but there was no significant difference in relation to the amount and duration of smoking.

15-Lipoxygenase-1 Mediates Mucociliary Differentiation in Normal Human Nasal Epithelial Cells

BACKGROUND AND OBJECTIVES: 15-lipoxygenase-1 (15-LO-1) is involved in the differentiation of human tracheobronchial epithelial cells. Here we investigated the relation between 15-LO-1 expression and the differentiation of normal human nasal epithelial (NHNE) cells. MATERIALS AND METHODS: NHNE cells, RT-PCR, Western blot analysis, and scanning electron microscopy (SEM) were used. RESULTS: In retinoic acid (RA)-sufficient culture media, 15-LO-1 expression in NHNE cells increased time-dependently, but its expression was undetectable in RA-deficient culture media. Moreover, in RA-deficient culture media, IL-4 time-dependently induced 15-LO-1 expression at a concentration of 1 ng/mL. In addition, MUC8 gene expression, a marker of mucociliary differentiation, was up-regulated by 15-LO-1, which was itself induced by IL-4. In SEM, the ciliated epithelium was observed with the treatment of IL-4. CONCLUSION: Our findings suggest that 15-LO-1 may be related to the differentiation of human nasal epithelium, and that it may mediate the mucociliary differentiation of NHNE cells.

The Effect of Low-Dose Atropine on Hypertensive and Hypotensive Stimuli / 대한마취과학회지

BACKGROUND: Vagal cardiac function plays an important role in cardiovascular homeostasis. The purpose of this study was to investigate the association between vagal cardiac function and changes in blood pressure induced by phenylephrine and by thigh cuff deflation after low-dose atropine (LDA)(2microgram/kg) administration. METHODS: Beat-to-beat changes in R-R intervals (RRI) and systolic blood pressures (SBP) were measured in 33 healthy volunteers during spontaneous and controlled (15 min-1) breathing before and after LDA administration. The RMSSD (root mean square of successive differences of RRI), pNN50 (proportion of successive RRI > 50 ms in relation to the total RRI), standard deviation 1 (SD1) from Poincare plots, power spectral densities of heart rate variability (HRV) and SBP variability, and spontaneous baroreflex sensitivity (BRS) by transfer function analysis were assessed. Acute hypertension was induced by phenylephrine (2 microgram/kg), whereas acute hypotension was induced by thigh cuff deflation. RESULTS: RMSSD, pNN50, SD1 of Poincare plots, and the high frequency (HF) power of HRV increased after LDA administration as did spontaneous BRS. Moreover, acute hypertension induced by phenylephrine was significantly attenuated (15.9 +/- 1.9 to 10.8 +/- 3.1 mmHg, P = 0.004) after LDA administration. However, acute hypotension induced by thigh cuff deflation was not significantly changed (13.4 +/- 3.9 to 11.9 +/- 4.2 mmHg, P = 0.62) after LDA administration. Changes in SBP during acute hypertension induced by phenylephrine were significantly correlated with changes in the HF power of HRV (r = -0.60, P < 0.001). CONCLUSIONS: Increasing vagal cardiac function induced by LDA attenuated increased SBP during acute hypertension induced by phenylephrine, but not decreased SBP during acute hypotension induced by thigh cuff deflation in healthy awake subjects.