BACKGROUND: The heart rate adjusted ST segment criteria(Delta ST/HR index and rate-recovery loop or R-R loop) compared to standard ST segment criteria may improve the ability of the exercise electrocardiogram for the prediction of severe coronary artery disease and future cardiac events in patients with chronic angina pectoris, but the predictive value of these criteria for predicting these issues has not been studied in patients with acute myocardial infarction. METHODS: 64 patients with first uncomplicated myocardial infarction were studied. All patients performed predischarge(mean 8+/-4 days) symptom-limited exercise test and coronary angiography(mean 11+/-15 days). During the follow-up period(mean 449+/-273 days), the occurrence of the major cardiac events(death, reinfarction, coronary artery bypass surgery) and minor cardiac event(angina, heart failure) were recorded, and then univariate and multivariate analysis of several clinical and exercise variables known to be as prognostic markers were performed. RESULTS: The results are as follows : 1) The sensitivities of Delta ST/HR index and R-R loop(92%, 83% respectively) for predicting multivessel disease showed no significant difference compared to that of standard ST segment criteria(83%). 2) Major cardiac events occurred in 12(20%) of 64 patients and only single independent predictive factor for its prediction was multivessel coronary artery disease(p=0.0001), whereas total cardiac event occurred in 32(50%), multivessel disease(p=0.003), and maximal workload <5mets(p=0.038). 3) For the prediction of total cardiac event, DeltaST/HR index and R-R loop(all 97%) were significantly more sensitive(p<0.05) than standard ST segment criteria(78%), and there was a tendency to increase in specificity in R-R loop(84%) compared to DeltaST/HR index(59%) or standard ST segment criteria(66%). 4) The negative predictive value of all negative test of three ST segment criteria for predicting total cardiac event was 100%. CONCLUSION: Although the heart rate-adjusted ST segment criteria have no advantage over standand ST segment criteria for the prediction of severe coronary artery disease, they can be more useful prognostic markers by enhancing the accuracy of the predischarge exercise electrocardiogram for the prediction of subsequent cardiac events after a first acute myocardial infarction.
Angina Pectoris ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Exercise Test* ; Follow-Up Studies ; Heart ; Heart Rate ; Humans ; Multivariate Analysis ; Myocardial Infarction* ; Prognosis ; Sensitivity and Specificity

INTRODUCTION: Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Sleep deprivation can have significant effects on athletic performance. However, there are few published data related to the amount of sleep obtained by elite athletes. We investigated sleep patterns of Korean women golfers using sleep-related questionnaires. METHODS: For this study, 98 Korean university women golfers and 46 age- and sex-matched controls were recruited. All subjects were asked to complete the self-administered sleep questionnaire consisting of questions about habitual sleep patterns (sleep onset time, sleep latency, awakening time in the morning, day time napping time), exercise habits, Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Pittsburgh Sleep Quality Index (PSQI), validation of the Perceived Stress Scale (PSS), and Beck Anxiety Inventory (BAI). RESULTS: The sleep onset time was significantly earlier (pm 23 : 05 +/- 00 : 52 and 00 : 14 +/- 00 : 51 ; t = 5.287, p < 0.001), the waking time was later (am 07 : 21 +/- 01 : 09 and 6 : 35 +/- 00 : 32; t = -2.715, p = 0.008), the weekday total sleep time was greater (417.77 +/- 78.18 minute and 351.52 +/- 77.83 minute ; t = 4.406, p = 0.001), and the daytime nap time was greater (77.73 +/- 41.28 minute and 20.22 +/- 33.03 minute ; t = 7.623, p < 0.001) in the golf athletes compared to the controls. The PSQI scores were significantly lower, but estimated sleep latency and ESS, ISS, PSS, and BAI scores were not different among the two groups. CONCLUSION: This study suggests that Korean university women golfers have good sleep patterns resulting in no difference in sleep-related stress compared to age- and sex-matched control students.
Anxiety ; Athletes ; Athletic Performance ; Female ; Golf ; Humans ; Surveys and Questionnaires ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders

Heterogeneity in clinical features and pathogenesis of non-steroidal anti-inflammatory agent (NSAIDs) hypersensitivity have been reported. NSAIDs can cause bronchial constriction in asthmatics or hives and angioedema in patients with chronic urticaria, in which case causative drugs show cross-reactivity with other NSAIDs. Normal subjects without allergic diseases may develop urticaria angioedema or anaphylaxis after ingestion of a specific NSAID. In this type of reaction, cross-reactivity between causative drugs and other NSAIDs does not occur. We experienced a case of acetaminophen anaphylaxis without aspirin sensitivity in a 38-year-old male, which was confirmed by oral provocation test. An oral challenge with 150mg of acetaminophen induced urticaria in lower legs, and erythema, with febrile sensation in ears. With a dose of 600mg acetaminophen, urticaria developed in trunk and extremities with facial angioedema. An oral provocation test with 650mg of aspirin was well tolerated without any adverse reactions. We report acase of acetaminophen anaphylaxis, which occurred in a normal individual at a small dose(150mg) without cross-reactivity with aspirin. This type of reaction supports heterogenei~ty of NSAIDs hypersensitivity and it may be caused by an other mechanism, not by cyclooxygenase inhibition.
Acetaminophen* ; Adult ; Anaphylaxis* ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin* ; Bronchoconstriction ; Ear ; Eating ; Erythema ; Extremities ; Humans ; Hypersensitivity ; Leg ; Male ; Population Characteristics ; Prostaglandin-Endoperoxide Synthases ; Sensation ; Urticaria

OBJECTIVE: The aim of this study was to investigate the usefulness of serum ECP as a marker of the severity of asthma and extent of airway inflammation. METHOD: We investigated 108 patients suffering from bronchial asthma, who were classified as mild intermittent(n=19), mild persistent(n=27), moderate persistent(n=42), and severe persistent(n=20) and 10 healthy controls. Atopy was defined as those who showed >2+ responses on skin prick test. Serum ECP, peripheral blood eosinophil, sputum eosinophil, and PEFR were measured on the same date and meth~acholine PC20 were determined within 2 weeks. RESULTS: Serum ECP levels were 10.1+- 2.0 ug/L in controls, and 29.1+- 23.6 ug/L in asthmatic patients. According to symptom severity, serum ECP levels were 22.9 +- 15.6 ug/L, 28. 6 +- 24.1 ug/L, 29.5 +- 22.2 ug/L, and 34.6 +- 31.2 ug/L in mild intermittent, mild persistent, moderate persistent and severe persistent asthmatic patients, respectively and there were no significant differences among four groups(p>0.05). Serum ECP levels correlated with peripheral blood eosinophil counts(r=0.48, p<0.01), but not with sputum eosinophil, PEFR, and methacholine PC20 levels. There was no significant difference in serum ECP level between atopic and non-atopic asthma(p>0.05). CONCLUSION: Single measurevment of ECP level at clinic could not represent the severity of asthma.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Skin ; Sputum

For evaluation of the response and toxicity of the combination chemotherapy, forty six patients with malignant ovarian tumors who had prior surgery were treated with combination chemotherapy from January 1985 to March 1991 at the Department of Obstetrics and Gynecology, Kyung-pook National University Hospital. The results were as follows : 1. The responses were in complete 20 cases(43.5%), in partial 9 cases(19,6%), in stable 6 cases(13.0%), in progressive 11 cases(23.9%) among 46 patients. 2. By the response rates of various combination chemotherapy regimens, the response rate of CAP was 64%(16/25), CP 57.1%(8/14), VAC 100%(3/3), VBP 50%(1/2), FAM 0%(0/1), and Melphalan 100%(1/1) respectively. 3. As the chemotoxicities of combination chemotherapy, leukopenia 20 cases(46.5%), thrombocytopenia 2 cases(4.7%), anemia 20 cases(46.5%), nephrotoxity 6 cases(14.6%), hepatotoxicity 7 cases(18.4%) were observed.
Anemia ; Drug Therapy* ; Drug Therapy, Combination ; Gynecology ; Humans ; Leukopenia ; Melphalan ; Obstetrics ; Thrombocytopenia

No abstract available.

We analysed the thirty three cases of the free vascularized bone graft performed in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from February 1982 to December 1989 and would like to report the results as follows. 1. There were 27 cases in men and 6 cases in women and the mean age was 27.3 years. 2. We have performed the procedure for the reconstruction of the large bony defects developed after massive trauma in 13 cases, core decompression of the avascular necrosis of the femoral head in 8 cases, tumoral resection in 6 cases, treatment of congenital pseudoarthrosis in 3 cases, and bone infection in 3 cases. 3. The most common recipient site was tibial shaft (18 cases, 54%) and the most common donor site was fibular shaft (23 cases, 69%). 4. The average length of bone defect (or grafted bone) in 23 cases of vascularized fibular graft was 9.8 cm and in 9 cases of vascularized osteocutaneous iliac bone graft, it was 5.8 cm. 5. The follow-up period was ranged from 13 months to 5 years 8 months (mean, 2 years 2 months). 6. All patients were evaluated clinically and roentgenographycally on the basis of fuctional recovery and bony union. Of the 33 cases, 31 cases (93%) showed satisfactory functional recovery with sound bony union. 7. It is highly expected that the vascularized bone graft is a one of the better alternatives for the reconstruction of the large bone defect and prevention of the early state of the avascular necrosis of the femoral head from progession.
Decompression ; Extremities ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Necrosis ; Pseudarthrosis ; Spine ; Tissue Donors ; Transplants

Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

OBJECTIVE: To evaluate the basophil histamine releasability in response to IgE- and non- IgE-mediated stimuli in children with atopic asthma. Met: Basophil histamine releasability was measured in Dermatophagoides farinae (D. farinae)-sensitive atopic asthmatics, D.farinae-sensitive healthy atopics, non-atopic asthmatics, and healthy non-atopics. Basophils were stimulated with D.farinae, goat antihuman IgE antibody, formyl-Met-Leu-Phe(fMLP), and Calcium ionophore A23187. Histamine was measured by automated fluorometric technique. RESULTS: Sponianeous histamine release was higher in atopic asthmatics compared to healthy non-atopics. Histamine release by D.farinae and by anti-IgE antibody was higher in atopic asthmatics compared to the other groups. There was no difference in histamine release by fMLP among all groups. Histamine release by Calcium ionophore was higher in healthy atopics and non-atopic asthmatics compared to healthy non-atopics. The atopics showed correlation between histamine release by D.farinae, by anti-IgE antibody and total serum IgE levels. CONCLUSIONS: Spontaneous and IgE-mediated histamine release were related to the presence of both atopy and asthma, whereas non-IgE mediated histamine release was different depending on the stimuli.
Asthma* ; Basophils* ; Calcimycin ; Calcium ; Child* ; Dermatophagoides farinae ; Goats ; Histamine Release ; Histamine* ; Humans ; Immunoglobulin E

No abstract available.
Leiomyoma*