BACKGROUND: The relation between treadmill exercise testing and ambulatory ST segment monitoring in detection of ischemia in patients with coronary artery disease has not been well established, with pathophysiologic mechanisms underlying the development of ischemia in the ambulatory setting not being well elucidated. This study was performed to determine the relation between myocardial ischemic indexes on exercise testing and on Holter monitoring. METHODS: We analized 25 patients with stable angina and angiographically documented coronary artery disease, who exhibited ischemia both on a Bruce protocol exercise test and on 24-hr Holter monitoring while receiving routine antianginal medications. RESULTS: Mean heart rate at the onset of 1mm ST segment depression during exercise testing(74.4 VS 114.1 beats/min, p<0.01). Overall the correlations between ischemic indexes on both test were weak. But heart rate at the onset of ischemic episodes during Holter monitoring had a good correlation with heart rate at 1mm ST depression during exercise test. And the number of ischemic episodes on Holter monitoring revealed a weak negative correlation with duration of exercise during treadmill test. CONCLUSION: Ischemic indexes on exercise testing cannot accurately predict ischemic indexes on Holter monitoring in patients with coronary artery disease. In that regard, Holter monitoring may provide other clinical information in addition to that obtained by exercise testing in selected patients.
Angina, Stable ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Exercise Test* ; Heart Rate ; Humans ; Ischemia* ; Myocardial Ischemia

A fenestrated middle cerebral artery (MCA) is a rare congenital anomaly, and is related to interference in the normal embryonic development of the MCA. Fenestrated MCA has been regarded to have no clinical significance other than a rare event of hemorrhage from associated aneurysm. However, the fenestration within the arterial trunk can be an obstacle against thrombus migration and may be associated with a major cerebral infarction. Moreover, the presence of this anomaly can be hardly detected prior to thrombolytic procedures, and emergent treatments are proceeded without any information of anatomical configurations. Therefore, the recanalization procedures would carry a high risk of intraprocedural complications. We report a rare case of MCA territory infarction from occlusion of fenestrated M1 segment, and also introduce a safe method of mechanical thrombolysis using coil.
Aneurysm ; Cerebral Infarction ; Embryonic Development ; Female ; Hemorrhage ; Infarction ; Mechanical Thrombolysis ; Middle Cerebral Artery ; Pregnancy ; Thrombosis

No abstract available.
Humans ; Infertility* ; Luteinizing Hormone, beta Subunit*

BACKGROUND: The atrial repolarization waves might contribute to ST segment depression during the exercise loading test. As atrial repolarization waves are opposite in direction to P waves, they could shift the ST segment in the absence of myocardial ischemia. METHODS: The exercise test in 20 patients was seemed false positive because of normal coronary angiogram. Twenty-six patients with at least one coronary stenosis > or =50% served as a true positive group. The P waves, PR segments and ST segment were studied in leads II, III, aVF and V4 to V6 in those 46 patients whose exercise ECG suggested ischemia. RESULTS: The finding of steeply downsloping PR segment, particularly in the inferior ECG leads, in patients with longer exercise time and higher exercise heart rate might predict a false positive exercise test in those with a normal rest ECG and no apparent reason for a false positive test. The combination of downsloping PR segments in two of three inferior leads plus either exercise duration > or =5 min or peak heart rate > or =130 bests/min idenified false positive tests with a sesitivity of 75% and a specificity of 81% to 89%. CONCLUSIONS: Atrial repolarization waves might play a role in exercise induced ST segment depression.
Coronary Stenosis ; Depression ; Electrocardiography ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia ; Sensitivity and Specificity

In the case of brachial plexus block, mixtures of local anesthetics can combine better features of both components, rapid onset and long duration. Combining effects may influence the onset and duration of neural blockade. Our study was undertaken in order to compare the onset time (time of injection to time of loss of pain on pin prick) and duration of analgesia (time of return of sense of pain on pin prick minus time required for onset of analgesia) of a lidocaine and bupivacaine mixture with 5 minutes interval injection of lidocaine and bupivacaine. The patients admitted to our hospital for hand or forearm operations were divided into three groups. In Group 1, 9 patients were injected with 0.5% bupivacaine 150 mg only, in Group 2, 11 patients were injected with a mixture of 29: lidocaine 200 mg and 0.5% bupivacaine 100 mg, in Group 3, 10 patients were injected with 2% lidocaine 200 mg and 5 minutes later, 0.5% bupivacaine 100 mg was injected through the same needle. Group 3 had the shortest onset time (7.2+/-0.2 minutes) with moderately long duration (9.4+/-2.4hours). Group 2 had a moderately rapid onset time (9.4+/-2.3 mintes) with the shortest duration (8.6+/-1.6 hours). Group 1 had the slowest onset time (14.8+/-4.3 minutes) with the longest duration (11.3+/-2. 4 hours). The time for analgesia to reach the C7 dermatome was the slowest in group 1 and Group 2, but in Group 3, there was no difference in the time needed to achieve analgesia in all dermatomes.
Analgesia ; Anesthetics, Local* ; Brachial Plexus ; Bupivacaine ; Forearm ; Hand ; Humans ; Lidocaine ; Needles

Squamous cell carcinoma of the ovary is rare and usually arise from preexisting cystic teratomas, endometriosis or Brenner tumors which undergo carcinomatous degeneration in their epithelial elements. Some of squamous cell carcinoma of the ovary is known to be associated with cervical neoplasm, but the pathogenesis is still unknown. Recently we experienced one case of ovarian squamous cell carcinoma in patients with microinvasive squamous cell carcinoma of uterine cervix. We report this case with possible pathogenesis and brief review of literatures.
Brenner Tumor ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Endometriosis ; Female ; Humans ; Ovary ; Teratoma ; Uterine Cervical Neoplasms

No abstract available.
Cervix Uteri* ; Female ; Humans

No abstract available.
Animals ; Female ; Horns* ; Humans ; Uterus*

The dose-related effects of halothane, enflurane, and isoflurane on the rat EEG were evaluated qusntitstively by spectral analysis of the EEG recorded from the rat skull. The anesthetics were inhaled by animal ventilator into 10L glass bottle, in which the preparated rats were placed, at various concentrations, and then bipolar EEG was recorded from the rat skull and its spectrum was calculated by power speetral analysis. The density of each spectral bands (delta 1-3.25, theta 3.5-7.75, alpha 8-12.25, and beta 13-31.75Hz), total density, delta ratio, spectral edge frequency, and medisn power frequency were derived from the spectra. With inspection of conventional EEG, 1.5 MAC of hslothane revealed spindles, but higher dose decreased the amplitude. 1.5 MAC of enflurane revealed a lot of spike waves but 2.0 MAC revealed several spike waves and decreased the amplitude, and 1.5 MAC isoflurane revealed isolated spike waves but 2.0 MAC revealed cerebro- electrical silence. In quantitative spectral analysis of EEG, significant EEG changes were identified during inhalation of all anestheties. In halothane dominent frequencies in EEG were delta waves at 1.5 MAC and 2.0 MAC. In enflurane dominent waves in EEG were theta waves at 1.5 MAC and 2.0 MAC and in isoflurane those were theta waves. Taken together, these findings suggest that analysis for EEG parameters derived from power spectral analysis could be applied to determine the depth of halothane, enflurane, and isoflurane anesthesia.
Anesthesia ; Anesthetics ; Animals ; Electroencephalography* ; Enflurane* ; Glass ; Halothane* ; Inhalation* ; Isoflurane* ; Rats* ; Skull ; Spectrum Analysis ; Ventilators, Mechanical

To evaluate the depth of enflurane anesthesia, spectrum analysis of rat EEG was used. Bipolar EEG was recorded through one lead form rat scalp during inhalation with 1,2,3 and 4% of enflurane, and analysed to produce the spectrum from which the density of each band(delta 1-3.25Hz, theta 3.5-7.75Hz, alpha 8-12.75Hz, beta2 18-20.75Hz, and beta3 21-31.75Hz)and total density, and medican power frequency were calculated. Differences among the EEG patterns, which were represented by F values through discriminant analysis of those 8 variables, in each level of anesthesia were significant among all concentrations except between 1% and 2% enflurane administration. The results suggest that the discriminat anlysis for the EEG parameters derived from power spectrum analysis can apply to determine the level of enflurane anesthesia.
Anesthesia ; Anesthetics* ; Animals ; Electroencephalography* ; Enflurane* ; Inhalation ; Rats* ; Scalp ; Spectrum Analysis*