We have developed a real-time arrhythmia detection system using four vaviables;heart rate, QS width, morphology and axis. Because of difficulties in real-time operation on the frequency domain, time domain process are carried out. The sampling rate of the ECG signal is 240/sec by using 12 bit A/D converter and we design digital comb filter to avoid 60Hz AC interference and DC drift. The band width of the digital comb filter is 1.79 Hz and Q is 64. To design a QRS detection logic, an 8 to 20 Hz bandpass filter is design on the basis of the power spectrum of the QRS complexes derived from the simulators and patients'data. By feeding the filter output into an adaptive threshold comparator, no detection of false QRS or T waves are found, and an accurate heart rate detection is obtained.
Animals ; Arrhythmias, Cardiac* ; Axis, Cervical Vertebra ; Comb and Wattles ; Electrocardiography ; Heart Rate ; Logic

We designed software system to detect intermittent arrhythmia from the patients automatically. To overcome the difficulties on real-time processing, we used four variavles; heart rate, QS width, morpholigy and axis. Templete generation routine was designed to produce patient's individual normal ECG pattern and store in the computer. The most important point of automatic detection is to discriminate the Q and J point. It is done by linear phase differentiation, the point that five point gradient is within a minimum value of 6Hz curve gradient is defined as Q and J points. The morphology calculation is simplified by simple addition and substraction, making real-time processing by modified cross correlation method. We find that both value of morphology and QS width will be used as a parameter of datermining the abnormalities of ECG signal automatically.
Arrhythmias, Cardiac* ; Axis, Cervical Vertebra ; Electrocardiography ; Heart Rate ; Humans

Adenosine deaminase(ADA) is an enzyme capable of catalysing the pathway from adenosine to inosine. Previous studies have shown that this enzyme may be useful in recognition of a tubeculous etiology of pleural, peritoneal, or meningeal effusions. ADA activity was studied in 42 patients with large amount of pericardial effusion. Patients were subdivided into the following four group : (A) 15 cases of tuberculous effusions : (B) 4 with pyogenic effusions : (C) 15 with idiopathic effusions : (D) 9 with malignant effusions. The results were as follows ; 1) The mean ADA activities assessed in pericardial effusions were 134.0+/-77.6U/L in group A : 93.8+/-43.8 in group B : 38.3+/-23.2 in group C : 27.3+/-20.8 in group D. Comparing the level achieved in group A with all others, the difference is significant at the P<0.001 level. 2) The mean ADA activities assessed in sera were 50.7+/-57.2 U/L in group A : 63.5+/-24.1 in group B : 25.9+/-12.0 in group C : 14.0+/-7.5 in group D. Comparing the level achieved in group A with all others, there is no significant difference. 3) Specificity(0.87) and sensitivity(0.93) of the test for the differential diagnosis of patients with tuberculous effusion from those with idiopathic effusion is high, when a value of more than 50 U/L is considered. In conclusion, the assessment of ADA in pericardial effusions is of great value in the diagnosis of tuberculous pericarditis.
Adenosine Deaminase* ; Adenosine* ; Diagnosis ; Diagnosis, Differential ; Humans ; Inosine ; Pericardial Effusion* ; Pericarditis, Tuberculous

Alterations in the expression of genes that control the cell cycle may be of critical importance in tumorigenesis and malignant transformation. The major regulatory events leading to cell proliferation occur in Gl phase of cell cycle, and the deregulated expression of Gl cyclins is related to oncogenesis. Cyclins Dl and E play important roles in the progression of cell through Gl phase of the cell cycle. Amplification and/or overexpression of the cyclin Dl gene and aberrant expression of cyclin E has been described in various forms of human cancer. However, the role of cyclins Dl and E in cervical cancer has been poorly defined. In this study, we examined the expression of cyclins Dl and E by Northern blot technique and the status of human papil- lomavirus(HPV) type 16 and 18 by polymerase chain reaction in 25 cases of cervical carcinoma to explore the relationship between cyclins Dl and E and cervical cancer. We found cyclin Dl expression showed down-regulated expression in cervical cancer but cyclin E expression was increased in cancer group. Other clinicopathological prognostic factors were not correlated with cyclins D1 and E expression. Further study based on larger numbers of cases with correlation of cyclins D1 and E status and survival data will be needed to elucidate the use of cyclin expressions as prognostic factor.
Blotting, Northern ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cyclin E ; Cyclins* ; Humans ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

Tamoxifen is a nonsteroidal triphenylethylene delivative that has been widely used in the treatment of breast cancer. tamoxifen is indicated for the adjuvant treatment of breast cancer in women following total mastectomy or segmental mastectomy, breast irradiation and chemotherapy. tamoxifen has been shown to have significant benificial effect in the treatment of breast cancer patient as hormonal therapy. However ,there is mounting evidence that tamoxifen may affect other hormon sensitive organs, including the uterus and ovaries. An increased risk of endometrial polyps, endometrial hyperplasia and adenocarcinoma has been reported in tamoxifen treated women. We have met cases of endometrial polyp and endocervical polyp which were associated with tamoxifen use, after modified radical mastectomy for infilterating ductal carcinoma of breast . So we report these cases with the brief review of literatures.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Drug Therapy ; Endometrial Hyperplasia ; Female ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Mastectomy, Simple ; Ovary ; Polyps* ; Tamoxifen* ; Uterus

We report a case of primary cardiac angiosarcoma in a 35 year-old woman. She presented with dyspnea, facial edema and neck vein distension during 1 month. The oval round large mass(8x4 cm) filling the right atrium infiltrated into the entire thickness of the lateral wall and extended to the vena cava and ventricle. The interatrial septum and pericardium seemed to be intact. Despite the surgical excision and adjuvant chemo-and radiotherapy, the patient died 8 months later due to tumor recurrence. The histologic findings of tumor varied from benign looking capillary proliferation mimicking granulation tissue to sarcoma composed of spindle cells. But anastomosing vascular channels lined by anaplastic polygonal cells and intracytoplasmic lumen containing red blood cells were characteristic findings. These tumor cells showed positive reaction to endothelial cell antigen and factor VIII-related antigen. The intercellular junctional complex and vascular channels formed by cytoplasmic process of tumor cells were identified by the ultrastructural study.
Female ; Humans

This article was conducted to understand the Buddhist doctrine of 'not-self' (anatta) in respect of psychotherapy. The author reviewed the earliest Buddhist canons (Nikayas) and extracted the thoughts of 'not-self'. The Buddhist self (or ego) is not equal to the recent psycological self (or ego). It is rather the systemic being than the single one, which is composed of 5 aggregates. 'Anatta' does not mean 'no self' but 'not-self'. Buddha regards that self or ego is not real but conceptual. The Buddhist doctrine of 'anatta' is based upon the theory of the dependent origination (paticcasamuppada). Buddhism and psychotherapy consent that one could be emancipated from sufferings not by belief, but by introspection. Just as the emotional insight may lead to the change of behavior and personality in psychotherapy, so the true insight to Enlightenment in Buddhism. The psychotherapeutic significance of 'not-self' implies both the recognition and extinction of the conscious and the unconscious adherence. Therefore psychotherapeutic analysis can be introduced into Buddhism and the meditative contemplation of 'paticcasamuppada' can be adopted by psychotherapy.
Buddhism ; Ego ; Psychotherapy

Bacterial endocarditis is a disease with protean manifestations whose presentation has recently changed greatly. Right-sided endocarditis associated with congenital heart lesions is now relatively less common. Patients with ventricular septal defect are at risk for right-sided endocarditis, but its incidence is low in children and adolescents. The organism is frequently a staphylococcus and the clinical course is dominated by septic pulmonary infarction and septicemia. We reported two cases of pulmonic vegetation and pulmonary infarction associated VSD with brief review of literature.
Adolescent ; Child ; Endocarditis ; Endocarditis, Bacterial ; Heart ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Pulmonary Infarction* ; Sepsis ; Staphylococcus

The myocardial infarction is usually associated with the coronary artery disease in adults. It is unusual in chilhood and young adult but occasionally associated with coronary vasculitis. Takayasu's arteritis produces a panaortits with thickening of the adventitia and narrowing of aorta. Narrowing of coronary arteries is due to extension into these arteries of the processes of inflammation that occur in aorta. We report here two cases of Takayasu's aortitis causing acute myocardial infarction. Case 1 is a 17-year-old girl presented with the inferior myocardial infarction and the cerebral infarction. Digital subtraction aortography showed a diffuse narrowing of the aorta and the obstruction of both subclavian arteritis, right carotid artery and both femoral arteries. Case 2 is a 19-year-old male patient with anterior myocardial infarction. Coronary cineangiogram showed the beak like appearance of the left main coronay artery.
Adolescent ; Adult ; Adventitia ; Animals ; Aorta ; Aortitis* ; Aortography ; Arteries ; Arteritis ; Beak ; Carotid Arteries ; Cerebral Infarction ; Coronary Artery Disease ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Inferior Wall Myocardial Infarction ; Inflammation ; Male ; Myocardial Infarction* ; Takayasu Arteritis ; Vasculitis ; Young Adult

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*