Heart rate and blood pressure variability among hypertensive and normotensive patients with acute thrombotic stroke: clinical relevance and implications

This study was aimed to assess the circadian changes in the blood pressure, heart rate variability and the circadian changes of cortisol level in normotensive as well as hypertensive patients with acute thrombotic stroke to determine whether there is abnormality or not in their diurnal changes and their relation to stroke severity. The heart rate variability [time domain and frequency domain] from 24-hour ECG recordings were analyzed in 30 patients with first acute ischemic stroke [within 24 hours of onset]. Eighteen were known hypertensives and 12 were normotensives. Brain C-T scan and NIHSS were done after admission. Patients were monitored with a bedside monitor for 24 hours to assess blood pressure every 15 minutes and blood cortisol level was measured every 6 hours. The parasympathetic oscillation, the diastolic and mean blood pressure variability indices were reduced in hypertensive patients than normotensives. However, in the late night the parasympathetic oscillation increased in hypertensives but tend to be reduced in normotensives. Increasing in sympathetic daily variation and reduced systolic blood pressure variation were associated with increasing in the stroke severity in normotensives, but decreasing in parasympathetic daily changes were associated with increasing the stroke severity in both groups. Hypertension seemed to cause significant changes of the cardiovascular autonomic regulatory system manifested as abnormalities of heart rate and diastolic pressure variability [especially late night]. The stroke severity was increased with reduced diurnal changes of parasympathetic fluxes in both normotensives and hypertensives and excess sympathetic daily fluctuations in normotensives

Molecular analysis of transitional cell carcinoma of the upper urinary tract using CDNA microarray

To date, molecular evidence studies for transitional cell carcinoma [TCC], using the microarray technology, are focusing on TCC of the urinary bladder and no studies have been performed on TCC of the upper urinary tract [UUT]. This study was conducted to monitor the gene expression profiles between transitional cell carcinoma of the upper urinary tract [TCC-UUT] and normal urothelium of UUT. cDNA microarrays were prepared by spotting PCR products of 14.551 human genes onto specially treated glass slides to analyze gene expression among 9 eases of TCC-UUT and 8 cases of normal urothelium in order to study the molecular basis of TCC-UUT development. Quantitative real time polymerase chain reaction [QRT-PCR] was performed for selected genes to validate the results of mieroarray hybridization. After supervised analysis of the microarray data, there was at least a 2.5-fold difference in the expression between TCC-UUT and normal urothelium in 55 genes. Significant up-regulation of 27 genes was associated with cases of TCC-UUT, including matrix degradation-related genes, as well as genes related to growth factors, immunology, cell-cycling and angiogenesis. Conversely, significant down-regulation of 28 genes was associated with eases of TCC-UUT including genes involved in epithelial cell dedifferentiation and keratinization, as well as genes related to cell adhesion and apoptosis. Such gene profiling studies can identify new molecular markers for early diagnosis and disease follow-up, it also allows the classification of tumors into subclasses assisting in disease diagnosis and prognosis, as well as in treatment selection