PURPOSE: The aim of this study is to investigate the reproducibility of the quantitative assessment of segmental wall motion and systolic thickening provided by an automatic quantitation algorithm. MATERIALS AND METHODS: Tc-99m-MIBI gated myocardial SPECT with dipyridamole stress was performed in 31 patients with known or suspected coronary artery disease (4 with single, 6 with two, 11 with triple vessel disease; ejection fraction 51+/-14%) twice consecutively in the same position. Myocardium was divided into 20 segments. Segmental wall motion and systolic thickening were calculated and expressed in mm and % increase respectively, using AutoQUANTTM software. The reproducibility of this quantitative measurement of wall motion and thickening was tested. RESULTS: Correlations between repeated measurements on consecutive gated SPECT were excellent for wall motion (r=0.95) and systolic thickening (r=0.88). On Bland-Altman analysis, two standard deviation was 2 mm for repeated measurement of segmental wall motion, and 20% for that of systolic thickening. The weighted kappa values of repeated measurements were 0.807 for wall motion and 0.708 for systolic thickening. Sex, perfusion, or segmental location had no influence on reproducibility. CONCLUSION: Segmental wall motion and systolic thickening quantified using AutoQUANTTM software on gated myocardial SPECT offers good reproducibility and is significantly different when the change is more than 2 mm for wall motion and more than 20% for systolic thickening.
Coronary Artery Disease ; Dipyridamole ; Humans ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. MATERIALS AND METHODS: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM for Windows . RESULTS: Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV. 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. CONCLUSION: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.
Acupuncture Points* ; Acupuncture* ; Brain* ; Cerebellum ; Female ; Frontal Lobe ; Head ; Healthy Volunteers ; Humans ; Male ; Medicine, East Asian Traditional ; Needles ; Prefrontal Cortex ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: To determine whether cyclooxygenase (COX)-1 and COX-2 are expressed differentially during the whole gestational period in the pregnant human uterine cervix and if they are involved in the process of labor. METHODS: Nine patients were matched for obstetrical history and maternal age were divided into an abortion group who aborted between 13 and 16 weeks(n=3), a preterm group who delivered between 20 and 37 weeks(n=3), and a term group who delivered between 37 and 42 weeks of gestation(n=3). Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemically stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. RESULTS: Expression of COX-1 and COX-2 was found in epithelial and stromal cells of uterine cervical tissues of preterm and term group. The immunohistochemical expression of COX-1 and COX-2 was strongest in the term group compared to the preterm group in stromal cells(HSCORE : 2.0 vs. 4.0 ; 2.0 vs. 3.0), and in epithelial cells(HSCORE : 1.0 vs. 3.0 ; 1.0 vs. 3.0). CONCLUSION: Although small amount of the groups were investigated, in the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both shows the strongest expression in term cervical tissue. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and it is thought that the role of COX-1 and COX-2 is more important in parturition process with advancing gestational age.
Biopsy ; Cervix Uteri* ; Cyclooxygenase 1* ; Cyclooxygenase 2 ; Female ; Gestational Age ; Humans* ; Maternal Age ; Parturition ; Pregnancy ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Stromal Cells

In order to evaluate the hypotensive effect of the lisinopril, a long acting angiotensin converting enzyme inhibitor, 10 to 30mg of lisinopril were administered in 35 hypertensive Korean adults during six weeks after a week observation for washout with stepwise increments of the dose according to the response of the patients blood pressure in every two weeks. The results were ; 1) The supine blood pressures were decreased from 163.7+/-16.6/99.8+/-9.3mmHg to 140.7+/-15.5/87.4+/-9.9mmHg at the end of six weeks' drug therapy(p<0.001). The standing blood pressures were also decreased conferrably and to the some lower levels. 2) In 14 patients to whom the drug was administered longer period(12 to 28 weeks) the blood pressure lowering effects were maintained at the level of that of 6th week. 3) Hematologic examination and blood chemistry revealed no discernible abnormal findings before and after the treatment. 4) In those patients who showed no adequate blood pressure control with other classes of antihypertensive drugs the lisinopril was effective in lowering their blood pressures by adding small doses. 5) During the period of the study a few probably drug-related symptoms developed but not troublesome except dry cough and dry mouth shich forced to stop administering the drug after completion of six weeks' period in one patients. From above results we concluded that lisnopril is effective and safe for the treatment of hypertension in Korean adults.
Adult ; Antihypertensive Agents ; Blood Pressure ; Chemistry ; Cough ; Humans ; Hypertension ; Lisinopril* ; Mouth ; Peptidyl-Dipeptidase A

Pacemaker Runaway is a rare, but potentially lethal complication after pacemaker implantation. Pacemaker runaway was one of the common manifestations of malfunctioning pacemaker at the time of fixed rate pacemaker, but has been less common after the demand type pacemaker had replaced the fixed rate model. The early recognition of runaway pacemaker is very important because runaway pacemaker can cause bradyarrhythmia, ventricular tachycardia-fibrillation and asystole resulting in syncope or death. We report a clinical experience of runaway pacemaker in 68 year-old woman, who received permanent pacemaker implantation(fixed rate 72/min, VVI, Micropulse 22U, Edwards system) due to sick sinus syndrome eight years ago. She complained of sudden chest tightness and dyspnea 10 days prior to admission. On physical examination, increased jugular venous pressure, rapid heart beats, basal rales on both lung fields and three finger-breath tender hepatomegaly. Electrocardiogram showed a rapid pacemaker rhythm of 140 beats per minute. So, the malfunctioning pacemaker was removed and replaced with a new programmable demand type pacemaker(VVI, OPTIMA-MP, Telectronics) in the same pocket under the diagnosis of pacemaker runaway. Her subject symptoms were relieved and electrocardiogram showed a regular pacemaker rhythm of 71 BPM. She was discharged ten days after pacemaker replacement.
Aged ; Bradycardia ; Child ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Heart ; Heart Arrest ; Hepatomegaly ; Homeless Youth* ; Humans ; Lung ; Physical Examination ; Respiratory Sounds ; Sick Sinus Syndrome ; Syncope ; Thorax ; Venous Pressure

To evaluate the incidence and clinical course of AV conduction disturbances associated with acute myocardial infarction(MI) and coronary angiographic characteristics in acute inferior MI with AV blocks. We reviewed the medical records and serial ECG's in 89 patients with acute MI treated in CCU of Chonnam National University Hospital from january, 1987 through August, 1990. The subjects were 44 anterior MI's, 43 inferior MI's, and 2 anterior and inferior MI's. AV conduction disturbances were observed in 25.8% of all the patients with acute MI's, 48.8% of 43 inferior MI's and 4.5% of 44 anterior MI's. High degree AV block was observed in 20.0% of all the subjects, 39.3% of inferior MI patients, and none of anterior MI patients. The most severe AV blocks observed in each patients were 7(30.4%) first-degree, 5(21.7%) second-degree, and 11(47.8%) third-degree AV block. The initial AV conduction disturbances developed within 6 hours after onset of symptoms in 9(47.4%) and after 24-hours in 9(47.4%). Seven(30.4%) of 23 patients with AV block showed a transient progression in the degree of AV block, 5(29.4%) of 17 patients with first-or second-degree AV block progressed to third-degree AV block thereby constituting 45.5% of 11 third-degree AV blocks. Nine patients with early AV block less tended to progress in the degree of AV block than the patients with late AV block (1/9 vs 4.9). In early AV block the duration of high-degree AV block was shorter than late AV block(2.5 days vs 6.1 days). The duration of third-degree AV block was less than 2-hurs in 36.4~24 hours in 27.3%, and more than 24 hours in 36.4%. All third-degree AV blocks(90.9%) but one with the longest duration of 13 days returned to 1 : 1 AV conduction within 7 days. There was no significant difference in coronary angiographic findings including the incidence of stenotic lesion in proximal LAD and first septal perforator, number of involved vessel(s), and severity of RCA lesion between the patients with AV block and the patients without AV block in inferior MI.
Atrioventricular Block ; Humans ; Incidence ; Jeollanam-do ; Medical Records ; Myocardial Infarction*

BACKGROUND: The measurement of serum erythropoietin (EPO) is useful for the differential diagnosis of polycythemia and anemia and for treatment monitoring of recombinant human EPO. Radioimmunoassay (RIA) has been used in several clinical laboratories of Korea, and recently a few manufacturers developed fully automated chemiluminescence immunoassay (CLIA). We evaluated performance of Access EPO assay (Beckman Coulter, USA) using CLIA and established reference interval for Korean adults with this assay. METHODS: The precision, linearity, limit of detection, percent carryover, comparison of Access EPO CLIA and EPO-Trac RIA (DiaSorin Ltd, UK), and establishment of reference interval were determined according to the Clinical and Laboratory Standards Institute guidelines. The quality control materials were used in the determination of precision, limit of detection, and carryover. For the reference interval, serum specimens obtained from a total of 120 healthy adults were used. RESULTS: The linearity was good (R2=0.998) from 0.5 IU/L to 732.3 IU/L and within-run and total imprecision were 2.1-4.1% and 2.6-4.1%, respectively. The lower limit of detection was 0.259 IU/L and percent carryover was 0.18%. A comparison analysis with RIA assay showed good correlation, with a correlation coefficient (R) of 0.88. The reference interval was from 2.5 IU/L to 30.8 IU/L with nonparametric method. CONCLUSIONS: The Access EPO assay provided suitable performance for linearity, precision, and detection limits for clinical laboratory. As this assay does not need radioactive isotopes and afforded a short turnaround time (<1 hr), it is expected to be clinically useful especially for the outpatients.
Adult ; Anemia ; Diagnosis, Differential ; Erythropoietin ; Humans ; Immunoassay ; Korea ; Limit of Detection ; Luminescence ; Outpatients ; Polycythemia ; Quality Control ; Radioimmunoassay ; Radioisotopes

No abstract available.
Humans ; Leiomyoma* ; Pregnancy Rate* ; Pregnancy*