Search PubMed⌕ Search

Biomedical subjects

S H Chan

Publications and source records attributed to S H Chan.

At least 73 records · Page 4Linked to original sources
PubMed1998

Elevated Fos expression in the nucleus tractus solitarii is associated with reduced baroreflex response in spontaneously hypertensive rats.

We delineated the functional role of Fos protein at the nucleus tractus solitarii in the manifestation of reduced baroreceptor reflex control of heart rate during hypertension, using spontaneously hypertensive rats (SHR), stroke-prone SHR, Wistar-Kyoto rats, or Sprague-Dawley rats. Microinjection into the bilateral nucleus tractus solitarii of an antisense oligonucleotide that targets against the initiation codon of c-fos mRNA significantly potentiated the baroreceptor reflex in response to 30 minutes of sustained increase in blood pressure. Of particular note was the restoration of both the impaired sensitivity and capacity of baroreceptor reflex in SHR and stroke-prone SHR to levels comparable to those in normotensive rats. Likewise, the number of Fos-immunoreactive nuclei evoked by the sustained increase in blood pressure in the caudal nucleus tractus solitarii of SHR and stroke-prone SHR was reduced, after this antisense c-fos treatment, to the basal level exhibited by the normotensive animals. Control treatment with the corresponding sense oligonucleotide, an antisense oligonucleotide that targets against a different portion of the coding sequence of the c-fos mRNA or artificial cerebrospinal fluid, on the other hand, elicited no discernible effect on either the baroreceptor reflex response or the induced expression of Fos protein in the nucleus tractus solitarii by baroreceptor activation. We also found that the basal level of Fos expression in the caudal nucleus tractus solitarii was significantly elevated in the SHR and stroke-prone SHR. Together, these novel findings suggest that an elevated expression of basal Fos protein in the NTS during hypertension may be associated with the dysfunction in baroreceptor reflex control of heart rate.

Animals↗
PubMed1998

Epstein Barr virus (EBV) antibodies in the diagnosis of NPC--comparison between IFA and two commercial ELISA kits.

BACKGROUND: Antibodies to Epstein Barr Virus (EBV) antigens have been used for the diagnosis of nasopharyngeal carcinoma (NPC). While immunofluorescence assays (IFA) of IgA antiviral capsid and early antigens have been the mainstay of this diagnosis, enzyme immunoassays (ELISA) of various EBV antigens are now available. However in almost all of these assays, the sensitivities and specificities have been calculated using blood donors and normal hospital staff as controls, who may not be the most appropriate controls. We wanted to evaluate the usefulness of IFA and ELISA of various EBV antigens in a clinical setting to distinguish between patients with NPC and those suspected of NPC but being biopsy negative. METHODS: Between January 1987 and June 1988, 322 consecutive patients suspected of NPC and who had a post-nasal biopsy were studied. Blood was taken for EBV tests before diagnosis. Tests included IFA and ELISA IgA anti-VCA and anti-EA and ELISA IgA and IgG anti-ribonucleotide reductase, a cloned EA antigen. RESULTS: IFA IgA anti-VCA together with IFA IgA anti-EA both at a cut-off of 1:10 gave the best discrimination between patients with NPC and those suspected of NPC but were biopsy negative. CONCLUSION: The ELISA IgG anti-ribonucleotide reductase test is convenient to perform and looks very promising. An ELISA using a cocktail of cloned EA peptides may be even better.

Antibodies, Viral↗
PubMed1998

Power spectral analysis of arterial blood pressure after spinal anesthesia.

BACKGROUND: The continuous, on-line and real-time analysis of the power spectrum (CORAPS) of systemic arterial pressure (SAP) and heart rate (HR) signals is one of the current progresses in the development of non-invasive indexes for autonomic nervous system. It might be a useful clinical tool to monitor the progress of preganglionic block of sympathetic nervous system and the homeostatsis of cardiac neuroregulation after spinal anesthesia. The purpose of this study is to examine the relationship between the hypotensive response and the changes of components in CORAPS throughout the course of spinal anesthesia. METHODS: In 10 ASA class I-II patients (aged from 17 to 75 years) scheduled for elective surgery, we analyzed the changes of spectrum of systemic arterial blood pressure signals during spinal anesthesia. Spinal anesthesia was performed with 0.5% bupivacaine (dosage at 13-15 mg). For CORAPS, SAP signals were simultaneously relayed to an analog-digital converter connected to a computer. Power spectral density of the data was computed using a fast Fourier transform. The areas of the spectral peaks within each measurement were calculated as the follows: very low (BVLF, 0.01-0.08 Hz), low (BLF, 0.09-0.15 Hz), and high (BHF, 0.16-0.25 Hz). RESULTS: During the time interval (S2 period) when spinal anesthesia was initiated and 15 min thereafter the power density of low frequency (BLF), (1.2 vs. 2.3), and very low frequency (BVLF) components decreased, (3.4 vs. 7.8), in comparison with that at the baseline level (S1 period). We also found the shift of dominance between low frequency (BLF) and high frequency (BHF) in S2 period. The effects of intrathoracic pressure on the venous return may contribute to the increase of power density of BHF components (1.7 vs. 1.1). We also found that even in patients with stable hemodynamic variability, the decrease of BLF and BVLF components, and the shift of dominance were the same as in patients with unstable hemodynamic variability. CONCLUSIONS: It might prove that the cephalic spread of spinal block abolished the sympathetic tone of the autonomic nervous system. These results validated previous speculations of a sympathetic block during spinal anesthesia. More importantly, patients with stable hemodynamic variability still have profoundly sympathetic block with decreased power density of BLF and BVLF. The CORAPS is a good clinical monitoring tool to evaluate the homeostatsis of cardiac neuroregulation after spinal anesthesia.

Adolescent↗
PubMed1997

Interchangeable discharge patterns of neurons in caudal nucleus tractus solitarii in rat slices: role of GABA and NMDA.

1. We characterized in rat brain slices the discharge patterns of spontaneously active neurons in the caudal region of the nucleus tractus solitarii (cNTS) and the neuromodulatory role of GABA and glutamate, via GABAA and NMDA receptors. 2. Spontaneous action potentials recorded intracellularly from cNTS neurons manifested either a regular or an irregular discharge pattern, alongside characteristic waveforms of the action potentials. These discharge patterns were interchangeable, and were highly sensitive to fluctuations in membrane potentials. In addition, the repolarizing rate of the after-hyperpolarization (AHP) in cNTS neurons that exhibited a regular discharge pattern was significantly higher than that of neurons that displayed irregular discharges. 3. cNTS neurons that manifested a regular discharge pattern were converted to irregular discharges upon superfusion with GABA (200 microM). This was accompanied by a reduction in the repolarizing rate of the AHP of both spontaneous and evoked action potentials. Conversion of discharge patterns in the opposite direction was elicited by superfusion with NMDA (6.8 microM). 4. The irregular discharges of spontaneous or evoked cNTS neurons were converted to a regular discharge pattern by bicuculline (200 microM). Subsequent application of D(-)-2-amino-5-phosphonopentanoic acid (250 microM) essentially led the neuronal discharges to revert to an irregular pattern. 5. Our results support the presence of two interchangeable modes of electrophysiological manifestations from the same cNTS neuronal population. They also showed that GABA and glutamate, via GABAA and NMDA receptors, may provide a novel form of neuromodulation at the cNTS by switching the patterns of neuronal discharges.

Animals↗
PubMed1997

Association between microsatellites within the human MHC and nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) has been known to be associated with specific HLA haplotypes, in particular HLA A2, B46 and A33, B58 haplotypes. A linkage study based on this observation suggested that HLA antigens are not the cause of NPC but that there exists a gene that lies close to if not within the major histocompatibility complex locus and confers a greatly increased relative risk of NPC. Since then, no further work has elucidated the presence of this gene. One of the difficulties faced by researchers has been the size of the region of chromosome implicated. The MHC locus alone is almost 4 Mb in length, and the number of genes encoded within it is numerous. The purpose of our study was thus to reduce the region of DNA in which the NPC susceptibility gene is likely to be. We report that the NPC susceptibility gene may be within the centromeric end of the class-1 and the telomeric end of the class-III regions of the MHC, near the D6S1624 microsatellite locus, where the presence of allele 4 of the microsatellite conferred a 3 1/2-fold increase in the risk of NPC, the highest reported for a single locus, and the presence of allele 1 of the same microsatellite conferred a highly significant protective effect against NPC.

Centromere↗
PubMed1997

Expression patterns of erbB receptor family in normal urothelium and transitional cell carcinoma. An immunohistochemical study.

The class I tyrosine kinase growth-factor receptors include epidermal growth factor receptor (EGFR), ErbB2 (c-erbB-2, HER-2/neu), ErbB3 and ErbB4. To elucidate their role in the regulation of homeostasis and carcinogenesis, we examined the expression of the receptors in normal urothelium and in urothelial carcinoma by immunohistochemistry. EGFR was expressed in the basal cells of normal urothelium, while ErbB2, ErbB3 and ErbB4 were present mainly in the superficial layer. A distinct reciprocal distribution was observed between the EGFR and the remaining members of the subclass (P = 0.0001). Both BCL-2 protein and Ki-67 antigen (MIB-1) showed a strong positive association with EGFR (P = 0.002) and an inverse correlation with ErbB2, ErbB3 or ErbB4 (P = 0.0004, 0.0000, and 0.001, respectively). With regard to carcinoma, there was no important relationship between receptor overexpression and tumour grading (P > 0.1), while only EGFR overexpression was correlated with muscular invasion (P = 0.02). Coexpression of EGFR-ErbB3 and ErbB3-ErbB4 was more often detected in high-grade tumours and correlated with the extent of tumour invasion. Our data indicate that class I receptors are differentially expressed in normal urothelium in vivo, but an orchestrated expression pattern does not exist during tumorigenesis.

Carcinoma, Transitional Cell↗
PubMed1997

Expression of vascular endothelial growth factor in normal liver and hepatocellular carcinoma: an immunohistochemical study.

Angiogenesis is of vital importance during the development and progression of solid tumors. To examine the role of vascular endothelial growth factor (VEGF) in hepatocarcinogenesis, we evaluated the expression of peptide in normal human liver (n = 6) and in 36 cases of hepatocellular carcinoma (HCC). Immunoreactivity for VEGF was present in the extracellular matrix of the portal tracts in the normal and nontumor part of liver, but not in hepatocytes and bile duct epithelium. For HCC, variable amounts of VEGF were expressed in 13 cases (36.1%) of tumor cells. Using a logistic regression model, expression of VEGF was significantly associated with a higher proliferative index (P = .01) and sonographic portal vein thrombosis (P = .05). However, VEGF expression did not correlate with a biochemical liver profile, alpha-fetoprotein levels, histological grading, gender, or clinical stage of cirrhosis (P > 0.1, respectively). Log-rank test showed that evaluation of VEGF did not provide more prognostic information (P > .5) than that from tumor volume and portal vein thrombosis (P < .01, respectively). In addition, VEGF was always present in the fibrovascular stroma or pericellular matrix of HCC, although no strong relationship was observed with the expression of VEGF in tumor cells (P > .5). Our data suggested that expression of VEGF may characterize a progression toward higher proliferation in hepatocarcinogenesis in vivo. The relevance of VEGF existing in the extracellular matrix of the normal liver and HCC remains to be clarified.

Adolescent↗
PubMed1997

Quantification of hepatitis B virus DNA using competitive PCR and a scintillation proximity assay.

A rapid assay for the quantification of hepatitis B virus DNA in human serum was developed. The principle of the method combines competitive polymerase chain reaction (cPCR) (for the controlled amplification of hepatitis B virus DNA) and scintillation proximity assay (SPA) technology (for rapid detection and quantitation of PCR products). It also incorporates a reproducible and simple method for the preparation of serum DNA suitable for PCR amplification. The assay has a better linear dynamic range than traditional methods that use 32P to detect PCR products. It was applied to a range of hepatitis B virus (HBV) surface antigen positive (HBsAg + ) sera, and shown to be more sensitive than a commercially available HBV DNA kit.

DNA, Viral↗
PubMed1997

Functional characterization of caudal hypoglossal neurons by spectral patterns of neuronal discharges in the rat.

This study evaluated the spectral characteristics of neuronal discharges in the caudal hypoglossal nucleus and their physiological relevance in adult, male Sprague Dawley rats which were anaesthetized and maintained with pentobarbital sodium. Based on auto-spectral analysis of extracellular single-neuron activity, three spectral patterns were identified in the spontaneous discharges of hypoglossal neurons. Neurons that exhibited a rhythmic pattern manifested a concentrated peak in the auto-spectrogram that corresponded to the mean discharge rate. A majority of hypoglossal neurons displayed the modulated pattern, which was manifested either as scattered power densities (wide-band modulated pattern) or with a peak frequency component that was different from the mean discharge rate (narrow-band modulated pattern). Neurons that exhibited a mixed pattern displayed both rhythmic and modulated spectral patterns. Cross-spectral analysis further revealed that respiratory modulation constituted a major physiological influence on caudal hypoglossal neurons. The respiratory modulated pattern, however, could be converted to a mixed pattern in the presence of a central dipsogen, angiotensin III. The results suggest that the spectral patterns of neuronal discharges in caudal hypoglossal neurons represent manifestations of multiple physiological information, including that regarding respiration and dipsogenesis, which is encoded in these neurons. It was also shown that this information may only be revealed by auto-spectral and cross-spectral analysis of neuronal discharge signals.

Angiotensin III↗
PubMed1997

Involvement of cerulospinal glutamatergic neurotransmission in fentanyl-induced muscular rigidity in the rat.

BACKGROUND: Investigators in the authors' laboratory previously established the critical participation of the cerulospinal noradrenergic pathway in muscular rigidity elicited by fentanyl. The identification of colocalization of glutamate with tyrosine hydroxylase in most locus ceruleus neurons suggests a role for cerulospinal glutamatergic neurotransmission in fentanyl-induced muscular rigidity. This suggestion and the subtype(s) of glutamate receptors involved were investigated here. METHODS: Electromyographic signals activated by bilateral microinjection of 2.5 microg fentanyl into the locus ceruleus were recorded differentially from the left sacrococcygeus dorsi lateralis muscle of adult male Sprague-Dawley rats. The effect of intrathecal administration at the lower lumbar spinal cord of various N-methyl-D-aspartate (NMDA) and non-NMDA receptor antagonists or agonists on this index of muscular rigidity was studied. Rats were under mechanical ventilation, and intravenous infusion of ketamine (30 mg x kg(-1) x h(-1)) was maintained until 10 min before fentanyl was administered. RESULTS: Microinjection of fentanyl bilaterally into the locus ceruleus increased the root mean square and decreased the mean power frequency values of electromyographic signals. The efficacy of fentanyl to elicit muscular rigidity in this manner was significantly reduced by previous intrathecal administration of either 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine maleate (MK-801), D-(-)-2-amino-5-phosphonovaleric acid (AP5), or (+/-)-3-(2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP). Intrathecal administration of kainic acid or NMDA also resulted in significant electromyographic activation. CONCLUSIONS: In addition to the cerulospinal noradrenergic mechanism, the cerulospinal glutamatergic pathway and both NMDA and non-NMDA receptors in the spinal cord may mediate fentanyl-induced muscular rigidity in the rat.

Analgesics, Opioid↗
PubMed1997

Spectral analysis of systemic arterial pressure and heart rate signals as a prognostic tool for the prediction of patient outcome in the intensive care unit.

OBJECTIVES: To evaluate the applicability of changes in spectra of systemic arterial pressure and heart rate signals in the prediction of patient outcome in an adult intensive care unit (ICU). To compare the prognostic predictability of this method with the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system. DESIGN: Prospective data collection from 52 ICU patients. SETTING: Adult ICU at a large, university-affiliated, medical center. PATIENTS: Consecutive patients who were admitted to the adult ICU due to noncardiac emergencies, and who remained for at least 2 days. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The demographic data, diagnosis, and survival data were recorded for each patient enrolled in this study. For the period between admission and 24 hrs before discharge, the APACHE II score was tabulated daily. Likewise, continuous, on-line, and real-time spectral analysis of systemic arterial pressure and heart rate signals was carried out every day for at least 30 mins at 2200 to 2400 hrs. The averaged power density values during this 30-min recording period of the high-frequency (0.15 to 0.4 Hz), low-frequency (0.08 to 0.15 Hz), and very low-frequency (0.016 to 0.08 Hz) components of systemic arterial pressure and heart rate signals were subsequently computed. Systemic vascular resistance index and cardiac index were also determined daily. We observed a trend of changes in the spectral components of systemic arterial pressure and heart rate signals in patients who eventually survived (n = 25) or died (n = 27). Progressive increases in the power density values of both the low-frequency and very low-frequency components of systemic arterial pressure and heart rate signals appeared to be related to recovery. Conversely, progressive decreases in the power density values of these spectral components was indicative of deterioration and fatality. The predicted outcome based on the trend of changes in the low-frequency and very low-frequency components of systemic arterial pressure and heart rate signals correlated positively with daily APACHE II scores. No direct correlation, however, was indicated by mean systemic arterial pressure, heart rate, systemic vascular resistance index, and cardiac index. We also confirmed that the differential trend of spectral changes in patients who survived or died was not due to circadian rhythm, nor alterations in the responsiveness of the blood vessels to intravenous infusion of dopamine. CONCLUSION: Power spectral analysis of systemic arterial pressure and heart rate signals offers a reasonable means of monitoring acute, critically ill patients, and may be used as an alternative prognostic tool for the prediction of patient outcome in the ICU.

APACHE↗
PubMed1997

Participation of paraventricular nucleus of hypothalamus in central regulation of penile erection in the rat.

PURPOSE: To investigate the possible participation of the paraventricular nucleus of hypothalamus in central regulation of penile erection. MATERIALS AND METHODS: Male adult Sprague-Dawley rats were anesthetized and maintained with pentobarbital sodium. The intracavernous pressure (ICP) was used as an experimental index for penile erection, and was recorded alongside systemic arterial pressure and heart rate. The effect on ICP of electrical (30-s train of 30-120 microA, 40-160 Hz, 1-ms rectangular pulses) or chemical (L-glutamate, 0.5 nmol/50 nl.) activation of the paraventricular nucleus of hypothalamus (PVN) or hippocampal formation was evaluated. RESULTS: Electrical activation of the PVN elicited both multiple and single episodes of elevation in ICP, along with visible erection and ejaculation. The former pattern exhibited an increase in ICP that was more sustained, with higher peak amplitude and longer latency. Chemical stimulation of neuronal perikarya in the PVN also resulted in similar patterns of rise in ICP and visible erection. These effects were, nonetheless, not accompanied by significant alterations in systemic arterial pressure and heart rate. Activation of the hippocampal formation, as we reported previously, similarly elicited multiple and single episodes of increase in ICP. These erectile responses, however, were substantially reduced or eliminated upon electrolytic lesion of the ipsilateral PVN. CONCLUSION: These observations suggest that the PVN may be an important nucleus that participates in central neural regulation of penile erection in the rat. Furthermore, an efferent pathway(s) from the hippocampal formation to PVN may constitute part of the neural circuitry in the forebrain in the regulation of erectile functions.

Animals↗
PubMed1997

Comparative usefulness of PCR in the detection of Mycobacterium tuberculosis in different clinical specimens.

The role of the polymerase chain reaction (PCR) in the diagnosis of tuberculosis in clinical practice remains to be defined; most results have been based on sputum samples. This study systematically compared the relative sensitivity and specificity of a single simplified method for different clinical samples. A wide range of clinical samples, including sputum, bronchoalveolar lavage fluid, cerebrospinal fluid, pleural fluid, gastric aspirate, pus and tissues (both fresh and paraffin-embedded) was tested. This method did not require routine DNA extraction before PCR, and consisted of an optimised single tube PCR amplification designed with different sets of time and temperature profiles. A total of 398 samples from 293 patients was studied. The sensitivity was 100% for all types of specimens, while the specificity ranged from 95% for sputum to 88% for bronchoalveolar lavage fluid and pleural fluid and to 85% for non-pulmonary specimens. This study showed that it was possible to employ a single simplified method with minor modifications for a wide range of specimens in clinical practice without loss of sensitivity and specificity.

Blotting, Southern↗
PubMed1997

Possible protective role of HLA-B*2706 for ankylosing spondylitis.

HLA-B27 is strongly associated with ankylosing spondylitis (AS) but the role of the HLA molecule itself is still unclear. In this study on Singapore Chinese, we have subtyped 50 B27 positive AS patients and 45 B27 positive normals and found that the B*2706 allele has a significant negative association with disease (p = 0.047). Together with recent data indicating the existence of AS "protective" B27 alleles, our data shows that the HLA molecule itself plays a crucial role in disease development.

Alleles↗
PubMed1997

Selective activation of vasomotor component of SAP spectrum by nucleus reticularis ventrolateralis in rats.

We evaluated the contribution of the rostral nucleus reticularis ventrolateralis (NRVL) to the vasomotor component in the spectrum of systemic arterial pressure (SAP) signals by quantifying the transfer function between electrical stimulation of this medullary nucleus and the SAP response. Sprague-Dawley rats anesthetized with pentobarbital sodium, paralyzed with pancuronium, and mechanically ventilated were used. Broad-band stimulation of the NRVL with computer-generated rectangular current pulses (10-50 microA, 1 ms), at a mean spike rate of 50 pulses/s and randomized modulation frequency of 0-3 Hz, elicited a site-specific and intensity-related pressor response. Intriguingly, the corresponding autospectrum of SAP signals exhibited prevailing power density only in the lower frequency range (0-0.8 Hz). This low-pass response characteristic was confirmed by the observation that 90% of the total magnitude of transfer function between NRVL stimulation and SAP response concentrated between 0 and 0.6 Hz. The magnitude of NRVL-SAP transfer function was significantly reduced by phentolamine or prazosin but appreciably enhanced by yohimbine. We conclude that the NRVL may contribute to the very-low (0-0.25 Hz)- and low (0.25-0.8 Hz)-frequency components of the SAP spectrum, which are belived to reflect sympathetic modulation on vasomotor activity via alpha-adrenergic neurotransmission.

Adrenergic alpha-Antagonists↗
PubMed1997

Involvement of AT2 receptors at NRVL in tonic baroreflex suppression by endogenous angiotensins.

We evaluated the role of endogenous angiotensin II and III (ANG II and ANG III) at the rostral nucleus reticularis ventrolateralis (NRVL) in the modulation of baroreceptor reflex (BRR) response and the subtype of angiotensin receptors involved in this process. Adult male Sprague-Dawley rats anesthetized and maintained with pentobarbital sodium were used. Exogenous application of ANG II or ANG III (10, 20, or 40 pmol) by bilateral microinjection into the NRVL significantly suppressed the BRR response to transient hypertension induced by phenylephrine (5 micrograms/kg i.v.). The suppressive effect of ANG II (20 pmol) was reversed by an equimolar dose (1.6 nmol) of its peptide antagonist, [Sar1, Ile8]ANG II, and the nonpeptide antagonists for AT1 and AT2 receptors, losartan and PD-123319, respectively. On the other hand, the inhibitory action of ANG III (20 pmol) was blunted by its peptide antagonist. [Ile7]ANG III or PD-123319, but not by losartan. Blocking the endogenous activity of the angiotensins by microinjection into the bilateral NRVL of [Sar1, Ile8]ANG II, [Ile7]ANG III, or PD-123319 elicited an appreciable enhancement of the BRR response, whereas losartan produced minimal effect. These results suggest that, under physiological conditions, both endogenous ANG II and ANG III may exert a tonic inhibitory modulation on the BRR response by acting selectively on the AT2 receptors at the NRVL.

Angiotensin II↗
PubMed1997

Diminished vasomotor component of systemic arterial pressure signals and baroreflex in brain death.

We compared the cardiovascular autonomic regulatory mechanisms between patients with brain death or under a persistent vegetative state and healthy volunteers, based on auto- and cross-spectral analysis of systolic blood pressure (SBP) and interpulse interval (PPI) signals. Brain-dead patients exhibited a significant reduction in the absolute and relative power of the low-frequency (LF; 0.04-0.15 Hz) component in both SBP and PPI spectra, along with appreciable decrease in the very low frequency (VLF; 0.004-0.04 Hz), LF, and high-frequency (HF; 0.15-0.4 Hz) power of the PPI signals. Patients in a persistent vegetative state exhibited a power of the VLF and LF component in the SBP spectrum that was comparable to that in healthy subjects, although a discernible reduction in the VLF, LF, and HF power of the PPI spectrum was manifested by the former group. Assessments with the magnitude of SBP-PPI transfer function and linear regression analysis of beat-to-beat fluctuations in SBP and PPI revealed a progressive decline in spontaneous baroreflex sensitivity from healthy subjects to patients in a persistent vegetative state or with brain death. We conclude that the vasomotor component of systemic arterial pressure signals and spontaneous baroreflex are highly correlated with the functional integrity of the brain stem.

Adult↗