Assessment of Disparity in the Blood Pressure of Both Arms

PURPOSE: Inter-arm blood pressure differences of more than 10 mmHg are measured not only in patients who have vascular diseases, such as aortic dissections, and aortic aneurysms, but also in heathy patients. We investigated the degree of and the factors for normal inter-arm blood pressure variations in our country. METHODS: We prospectively studied the cases of 351 patients who visited the Emergency Department of Korea University Hospital between May 1 and July 31, 2001. we collected clinical and demographic data, including age, sex, right/left handedness, and bilateral blood pressure. After we divided the cases into a Normal blood pressure group and a High blood pressure group, we compared the inter-arm blood pressure difference and influencing factors between the two group. RESULTS: The variation in the inter-arm blood pressure was unrelated to age, sex, right/left handedness, and right/left arm in both groups. In the Normal blood pressure group (n=180), the systolic inter-arm blood pressure difference was 3.9+/-0.4 mmHg, and the diastolic inter-arm blood pressure difference was 3.6+/-0.4 mmHg. In the High blood pressure group (n=171), the systolic inter-arm blood pressure difference was 5.2+/-0.5 mmHg, and the diastolic interarm blood pressure difference was 4.8+/-0.5 mmHg. CONCLUSION: The variation in the inter-arm blood pressure was unrelated to age, sex, right/left handedness, and right/left arm. But inter-arm blood pressure difference was significant among subjects without exclusion criteria and was measured as about 5 mmHg in two groups.

Acute Encephalitis following Rubella

We experienced 5 cases of acute rubella encephalitis, a serious complication of rubella. The patients presented with convulsions and a deteriorated mental state, both of which occurred with a vanishing maculopapular rash and a low grade fever. The cerebrospinal fluid analysis showed pleocytosis and increased protein and normal glucose levels. We diagnosed the rubella encephalitis by detection of IgM in the serum. Rubella encephalitis is known to be a serious complication of rubella, and with poor prognosis. The mortality rate may reached as high 20%. Our cases recovered without any sequelae.

Anti-inflammatory effects of IL-4 and IL-10 on Human Polymorphonuclear Leukocytes

Inflammatory responses are strictly regulated by coordination of pro-inflammatory and anti-inflammatory mediators. Interleukin-4 (IL-4) and interleukin-10 (IL-10) have typically the biologic anti-inflammatory effects on monocytes, but uncertain effects on polymorphonuclear leukocytes (PMNs). The PMNs are the first line of cellular response for host defense during acute inflammation. To modify hyper-inflammatory reaction with biologic anti-inflammatory mediators, we have determined the biologic anti-inflammatory activities of IL-4 and IL-10 on human PMNs. Human PMNs were pretreated with IL-4 or IL-10 and then stimulated with formyl methionyl leucyl phenylalanine (fMLP) for times indicated. The level of H2O2, interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) were determined in the each cell free supernatants. fMLP plays the role of a typical pro-inflammatory agent and, at least in determined conditions, down-regulated TNF release. IL-4 acts as an anti-inflammatory mediator but IL-10 did not show its anti-inflammatory activities on fMLP-stimulated human PMNs. IL-4 and IL-10 have different anti-inflammatory mechanisms. Perhaps, IL-10 needs co-factors to act as an anti-inflammatory mediator.