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Background: The aim was to investigate which of two different b values (b 500 s/mm² and b 800 s/mm²) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI)., Materials and Methods: Patients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm² and b 800 s/mm²), and the results were compared with histopathological findings., Results: Out of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 ± 328.13) compared to benign nodules (19037.48 ± 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 ± 200.23) compared to benign nodules (1610.44 ± 418.06). When a cut-off value of 1.1 × 10 - 3 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%., Conclusion: DW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules., Competing Interests: Declarations Ethical approval Before the study commenced; ethical approval was obtained from the Ethics Committee of Celal Bayar University Faculty of Medicine. Consent for publication Written informed consent was signed by patients. Competing of interest We declare that we have no conflict of interest., (© 2024. The Author(s).)

Background/aims: Anorectal diseases, including fecal incontinence, are prevalent and have an enormous impact on the quality of life. Therefore, investigating their etiological factors may help to reduce the incidence and/or the severity of the underlying diseases., Materials and Methods: Referral complaints (constipation, strained defecation, and incontinence) and medical and anorectal manometry records of 883 (562 female/321 male, ages 45.17±1.00 and 48.41±0.63 years, respectively) patients were evaluated retrospectively. Maximal resting pressure (MRP) and maximal squeeze pressure (MSP) measured by stationary pull-through technique, volume of rectoanal inhibitory reflex, and sensory threshold to rectal balloon distention (ST) were obtained by water perfusion system. Data were compared according to referral complaints, age, gender, parity, and underlying diseases., Results: Incontinence was the most frequent referral complaint in 61.2% of females and 67.6% of males. MRP and MSP were significantly lower in incontinent females than in the other groups. In incontinent males, MSP was lower than the strained defecation group, and ST was higher than the constipation group. Age was negatively correlated with MRP for both of the genders and in all groups. Obstetric trauma (85%) and number of parity (3.40±2.59) were significantly higher in incontinent females. Moreover, the most prevalent underlying disease was diabetes in incontinent females (13.7%) and neurological diseases, including traumas, in incontinent males (41.5%)., Conclusion: Increasing awareness of labor safety, controlling diabetes mellitus, and preventing obstetric traumas may reduce the prevalence of fecal incontinence.

Alkan F, Düzgün F, Yüksel H, Tarhan S, Coşkun Ş. Percutaneous embolization of congenital portosystemic venous shunt in an infant with respiratory distress. Turk J Pediatr 2018; 60: 456-459. A 5-month-old boy with progressive respiratory distress was admitted to our hospital. Physical examination revealed mild tachypnea and retraction. The left main bronchus was found as severely collapsed between the right pulmonary artery and the descending aorta, on the bronchoscopic evaluation. Further evaluation revealed persistent ductus venosus (PDV). As in the fetal period the ductus venosus arises from the posterior aspect of the left portal vein, a PDV is considered another type of intrahepatic portosystemic shunt. Therefore, he was diagnosed with congenital portosystemic venous shunt, leading to persistent respiratory distress. The PDV was closed with Amplatzer vascular plug II, and then he had immediate clinical improvement. Congenital portosystemic venous shunts (CPSS) are rare vascular malformations associated with severe complications. Here we presented a case with progressive respiratory distress as a result of CPSS and rapid improvement after embolization.

Objective: To determine the attitude and knowledge of type-2 diabetics related to insulin therapy., Methods: The descriptive cross-sectional study was conducted from January to March 2014 at the Dr. Burhan Nalbantoglu Public Hospital, Nicosia in the Turkish Republic of Northern Cyprus, and comprised patients with type-2 diabetes. The Likert scale was used to score participants' response to questions using the following scoring system: 0 (disagree), 1 (neutral) and 2 (agree). The minimum scoring value for all the questions combined was 0 whereas the maximum scoring value was 50. Patients' attitudes were classified as either high, medium or low based on scores between 0-16, 17-33 and 34-50, respectively. SPSS 16 was used for data analysis., Results: Of the 271 participants, 165(60.9%) were female and 106(39.1%) male. The overall mean age was 60.3±32.4 years. Moreover, 136(50.3%) participants had a medium attitude and knowledge score towards insulin therapy. men scored significantly better than females (p<0.05). Only 25(9.2%) participants had a high score towards insulin therapy., Conclusions: The participants were found to have an inadequate attitude and knowledge response to insulin therapy.

Congenital intrahepatic portosystemic shunts are rare in children. Portosystemic venous malformations are characterized by extreme clinical variability. We report a full-term 33-day-old male infant presenting with neonatal jaundice. On physical examination, he had generalized icterus and the liver was palpable 3.5 cm below the right costal margin. He had no other symptoms. Laboratory tests showed AST 632 U/L, ALT 198 U/L, total bilirubin 12.1 mg/dL, conjugated bilirubin 10.2 mg/dL, alkaline phosphatase 753 U/L, GGT 47 U/L and glucose 67 U/L. Colour Doppler ultrasonography showed the left portal vein was more dilated than the right portal branch and communication with dilated left hepatic vein. There was no evidence of portal hypertension, heart failure, hepatopulmonary syndrome and encephalopathy during his hospital stay, so he was discharged from the pediatric department and his parents advised to attend monthly follow-up. Congenital portosystemic shunts are rarely observed in the childhood period. 1 Depending on anatomic characteristics they may be intrahepatic or extrahepatic. 2 Intrahepatic portosystemic shunts (PSS) are observed between the portal vein and hepatic vein or vena cava inferior.3, 4 Small shunts may close themselves before the age of 2 years. 5 With the increase in use of imaging methods, diagnosing PSS has become easier, with an increase in the number of cases reported. 6 Neonatal cholestatis is a frequent complication of PSS. 1 We present a case presenting with neonatal cholestasis diagnosed with congenital intrahepatic PSS.

The objective of this study is to examine the direct effects of low doses and high doses of ε-viniferin, a substance known to be an antioxidant, and vincristine sulphate, a chemotherapeutic agent, alone and in combination [ε-viniferin + vincristine] on HepG2 cell strain, as well as evaluate oxidative stress after incubation periods of 3, 6, and 24 h. Direct effect was determined right after the incubation period; however, for protective effect, antioxidant protection response was determined after the treatment for 1 h with 500 μM H2O2, which is an oxidative stressor. For this purpose, superoxide dismutase was determined for enzyme activity, and lipid hydroperoxide (LPO) and reduced glutathione concentrations were studied as indicators of oxidative stress. Results show that low [3.63 µM vincristine + 3.75 µM ε-viniferin] and high [11.25 µM vincristine + 15.8 µM ε-viniferin] doses of combination groups showed similar direct antioxidant effect on LPO levels as protective when compared to the H2O2 control group (p < 0.05). Superoxide dismutase enzyme showed a direct antioxidant effect in low and high dose combination groups. In addition, when the incubation period was increased to 24 h, a protective effect was observed in both dose groups (p < 0.05). Reduced glutathione activities showed a direct effect in the low dose combination group, and a protective effect in both the low and high doses in the 24 h. These results show that combined usage of drugs in HepG2 cell strain possesses a protective effect against exogenically produced oxidative stress conditions.

Sinonasal-type hemangiopericytomas, which comprise less than 0.5% of all sinonasal neoplasms, arise unilaterally in the nasal cavity as polypoid masses with a mean diameter of about 3 cm. A 34-year-old female patient was admitted due to nasal obstruction and epistaxis. A polypoid mass covered with intact mucosa that originated both from the right inferior concha and lateral nasal wall was detected by nasal endoscopy. The tumor, extending from the oropharynx to the nasopharynx, was measured as 3,5x3x2 cm. Although exhibiting characteristic histopathological features and typical clinical symptoms, this case with unexpected immunohistochemical findings can provide a viewpoint on the nature of this kind of tumors.

Background: To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renal tumors in patients with excessive anesthetic and surgical risk., Materials and Methods: Data for RFA performed in in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anesthetic and/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) and retroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia. Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications., Results: The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA (simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFA and 1 (8.3%) R-LRFA. The mean age was 65.3 ± 8.5 (52-76) years. The mean tumor size was 29.6 ± 6.08 (15-40) mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) was determined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and 6th months follow-up data revealed no residua and recurrence., Conclusions: RFA application appears to be safe as a less invasive and effective treatment modality in selected cases of small renal tumors in individuals with excessive anesthetic and also surgical risk.

We report a case of a 32-year-old female patient who presented with decreased vision on both eyes and headache. In fundus examination, both eyes had elevation of the optic disc and star shaped hard exudates in the macula. Magnetic resonance imaging was completely normal except the saccular dilatation of bilateral optic nerve sheath. The patient was treated with oral steroids following high-dose intravenous methylprednisolone. She displayed good anatomical and functional results during the follow-up. This case raises the possibility that optic nerve sheath enlargement, probably induced by an idiopathic inflammatory optic neuritis, may simulate dural ectasia of the optic nerve sheath.

Congenital high airway obstruction syndrome (CHAOS) is the obstruction of the fetal upper airways, which may be partial or complete. It is usually incompatible with life. Prenatal recognition of the disease is quite important due to the recently described management options. We report here two cases of CHAOS due to tracheal atresia diagnosed by antenatal ultrasonography and fetal MRI. We also briefly review the relevant literature with the associated management options.

We aimed to investigate the long-term effect of microsurgical inguinal varicocelectomy on testicular blood flow using color Doppler sonography (CDS) in this observational study. A total of 30 patients clinically diagnosed with left varicocele who underwent a microsurgical inguinal varicocelectomy were examined 3 times with CDS for testicular blood flow parameters, first before, then 3 months after, and finally 6 months after the operation. CDS values of testicular blood flow (peak systolic velocity, end diastolic velocity, resistive index, and pulsatility index) were measured from testicular, capsular, and intratesticular arteries. We also evaluated preoperative and postoperative semen parameters. The mean values of blood flow velocities in the left testicular artery (peak systolic and end diastolic) increased and resistance indices (resistive and pulsatility) in the left capsular and intratesticular arteries decreased significantly after surgery (P < .05). No significant difference was detected between the preoperative and postoperative blood flow parameters in the right testicular, capsular, or intratesticular arteries (P < .05). In the semen analysis run 3 months after the operations, statistically significant increases were found in sperm concentration (P < .001), morphology percentage (P < .001), and total motile sperm concentration (P = .009). The increase in blood flow velocity in the testicular artery and the decrease in resistive and pulsatility indices in the capsular and intratesticular branches of the artery may be strong indicators of an increase in testicular arterial blood flow into the testicular tissue. Our data show that a significant improvement occurs in testicular blood supply and sperm parameters after microsurgical inguinal varicocelectomy.

Purpose: Most intracranial dissecting aneurysms involve the posterior circulation, and the intradural segment of the vertebral artery is affected in majority of these. The aim of this report is to summarize the results of endovascular treatment in patients with ruptured dissecting aneurysms of the non-vertebral posterior circulation., Materials and Methods: During the past six years, the medical records of 23 patients with subarachnoid hemorrhage related to dissecting aneurysm arising from non-vertebral arteries of the posterior circulation were reviewed retrospectively., Results: The locations of the aneurysms were as follows: seven in the posterior cerebral artery, five in the superior cerebellar artery, six in the basilar artery trunk, and five in the posterior inferior cerebellar artery. Two basilar artery aneurysms were treated in the chronic stage with stent-assisted coil embolization. In the remaining patients, the aneurysm was coiled with or without parent vessel occlusion in the acute stage. One patient re-bled and died 20 days after initial treatment. At follow-up, recanalization had occurred in two patients, whose aneurysms were re-embolized successfully. Overall, three patients had permanent neurological sequelae, two had transient neurological sequelae, and one patient died., Conclusion: Embolization with or without parent artery occlusion is feasible with an acceptable morbidity and mortality rate in the treatment of dissecting aneurysms confined to non-vertebral arteries of the posterior circulation.

The aim of the study was to define a simple system for the identification of unknown bodies by using CT images of frontal sinus and to discuss whether it was worth to add measurements to the system or not. The system was including simple features as F (presence or absence of frontal sinus), S (intersinus and intrasinus septum) and S (scalloping), and named as FSS system. Measurements selected for the study were width, height, anteroposterior length, total width of two sinuses, the distance between the highest points of the two sinuses and the distance of each sinus to its maximum lateral limit. The study was conducted retrospectively on the paranasal CT scans of 100 cases (38 male and 62 female) who had no apparent sinonasal pathology. All the features and measurements were coded according to the system defined by the authors for each case and coded formulas were compared. At least 93% of the formulas could be eliminated for a case by using FSS system. The rate of success was increased to 98% by adding measurements. Contrary to objective criteria of FSS system, measurements were prone to bias. Therefore, in practice success rate would be expected to be lower than calculated. In the study population, instead of making 100 measurements, eliminating the most of the cases with FSS system and later discriminating the rest by pattern matching was seen logical.

The aim of the study was to ascertain whether spiking of the tibial tubercle is associated with cartilage defects detected by magnetic resonance imaging (MRI) in patients with osteoarthritis (OA) of the knee joint. Angulation of the tip of the medial and lateral tubercles, and the height of the tubercles above the tibial plateau were measured on a standard anteroposterior radiograph of the knee joint. Cartilage defects in the tibiofemoral joint (TFJ) were determined by MRI examination. The lengthening and sharpening of the angles of the tubercles were significantly more prominent in the patients than controls. A strong association was found between angulation (if less than 70 degrees) and especially the height (if more than 0.16) of the medial tibial spike and MRI-detected cartilage defects in the medial tibiofemoral compartment. The predictive value of the spiking of tibial tubercles for MRI-detected cartilage defects in TFJ is related to the degree and size of the spiking. The presence of tibial spiking itself may not be a reliable sign of early OA.

Gastric stromal tumors are rare neoplasms of the stomach. In this report we present a gastric stromal tumor with an exophytic growth pattern, and describe magnetic resonance imaging and endoscopic ultrasonography findings.

Background: Intravenous somatostatin decreases acid secretion, splanchnic blood flow, and portal pressure, but the evidence for its efficacy in the treatment of non-variceal upper gastrointestinal bleeding has been mixed. We aimed to evaluate the vasoactive effect and possible mechanisms of somatostatin infusion in the cessation of non-variceal upper gastrointestinal bleeding., Material/methods: Patients with non-variceal upper gastrointestinal bleeding without portal hypertension were enrolled in the study. They were given somatostatin infusion in a dose of 250 microgr/hour for 72 hours. Superior mesenteric arterial average flow velocity (SMA-V), SMA pulsatility index (SMA-PI), portal venous volume flow (PV-F), and renal artery resistance index (RA-RI) were measured two times for each patient by Doppler ultrasound; once on the first day of infusion therapy and again 6 hours or more after stopping the infusion., Results: 21 patients (12 male, mean age 44.1 +/- 9.9) with bleeding peptic ulcer were enrolled. During somatostatin infusion, PV-F was 33.7 +/- 12.7 cm3/sec. After stopping infusion, it increased to 56.3 +/- 16.0 cm3/sec (p=0.001). SMA-V was 39.7 +/- 13.1 cm/sec and 64.4 +/- 15.1 cm/sec during somatostatin infusion and after cessation of somatostatin respectively (p=0.01). SMA-PI was 2.0 +/- 0.8 during somatostatin infusion but 2.8 +/- 0.8 without somatostatin infusion (p=0.02). However, RA-RI showed no difference between states with or without somatostatin infusion (p>0.05)., Conclusions: Somatostatin infusion causes a decrease in arterial blood flow to the stomach and duodenum in patients with non-variceal upper gastrointestinal bleeding without portal hypertension. Somatostatin therapy also decreases portal blood flow while not altering renal blood.

Recent studies suggest that thoracal high resolution computed tomography (HRCT) of the thorax can detect the irreversible structural changes in chronic asthma cases. This study is aimed to evaluate these possible changes and their relation with asthma severity. Twenty-eight stable asthmatic patients with normal conventional radiography and 10 healthy controls were included. Twenty of the patients were female (71.4%) and the mean age of the group was 43 +/- 10.5 (30-61). The groups were divided into 2; as group 1 included mild intermittent and mild persistent cases, and group 2 included moderate and severe persistent cases. Asthma and control group, and group 1 and 2 were compared according to the thickness of airwall (T), thickness to outer diameter (T/D), wall area (WA), the percentage wall area (WA%). HRCT showed that air trapping, bronchiectasis, fibrotic lesions and airwall thickening were significantly more common in asthma group (p< 0.05). Emphysema, acinar pattern, collapse and mucoid impact were common in asthma group (p> 0.05). The incidence of T and WA was higher in asthma group but also did not reach statistical significance and the thickening of airwall in small airways was significantly more in asthma group. Any correlation between HRCT findings and asthma severity was not found. So reversible and irreversible bronchial and parenchymal changes, detected by HRCT but not by plain chest radiograms, may be present in asthma cases. The early detection of these changes may lead more aggressive asthma management.

Objective: Stylohyoid apparatus might be an anatomic region in the cervical spine involved by enthesopathy. The aim of this study was to assess the elongation and/or ossification at the stylohyoid apparatus in the degenerative or inflammatory diseases such as ankylosing spondylitis (AS), psoriatic arthropathy (PsA) and cervical spondyloarthrosis (CS) in which cervical spine involvement can be seen., Methods: Twenty-eight patients with AS, 25 patients with PsA, 31 patients with CS and 50 controls who did not have any complaints or symptoms related with elongated styloid process (SP) were included in the study. On the lateral cervical radiographs, the anterior and posterior aspects of each vertebral body and intervertebral disk were carefully evaluated for the presence and severity of syndesmophytes, osteophytes or ossification of the adjacent longitudinal ligaments in the patient group. The entire osseous length of the SP was measured on the lateral and lateral oblique mandibular or cervical views or the anteroposterior views radiographs in the patients and controls., Results: There were statistically significant differences between the patients with AS and control group and between the patients with PsA and control group with respect to the length of SP. The dimension of syndesmophytes or ligamentous ossification of the cervical spine involving C5-6 intervertebral disk level were significantly correlated with length of SP in the patients with AS., Conclusion: Elongated SP might be another manifestation of enthesopaty in cervical spine of the spondyloarthropathies.

Despite the high prevalence of lumbosacral transitional vertebra (LSTV), little is known about the biomechanics of this condition. In addition, as previous studies have focused solely on symptomatic and elderly LSTV patients, the relationship between LSTV and congenital or developmental spinal stenosis remains uncertain. In the present study, the spinal canal diameters were measured in young subjects in whom degenerative changes have not yet become significant. Seventeen young adults with LSTV and 24 normal controls were included in this study. The spinal canal sagittal diameter, interpedicular distance, interfacet distance and lateral recess diameter were measured using CT scans. There was no significant difference in the measured values between the two groups. In conclusion, the results indicate that there is no relationship between LSTV and a congenitally narrower canal.

Between 1964 and 1978, aortocoronary bypass graft procedures were performed in more than 300,000 patients, and the number seems to increase every year. Nevertheless, the procedure itself can result in perioperative myocardial infarction leading to death. Greater understanding of and constant attention to the myocardial oxygen (O2) supply and demand may reduce the incidence of perioperative myocardial infarction. Some of the factors influencing supply and demand can be controlled pharmacologically. Drugs such as nitroglycerin, nitroprusside, and propranolol can reduce the myocardial O2 demand. Unfortunately, there are few data to elucidate the relationship between myocardial O2 demand and supply as influenced by anesthetic drugs, especially in patients with myocardial ischemia. However, enthusiasm for aortocoronary bypass graft operations has given enormous impetus to laboratory and clinical studies of this subject. Recent developments in anesthetic management afford better means for protection of the ischemic myocardium during and after operation.

During 1967 and 1968, a total of 32,877 patients had general anesthesia at the Mayo Clinic; 422 had previous myocardial infarction. Of these 6.6% experienced another infarction during the first postoperative week. There was no relationship between incidence of postoperative reinfarction and type or duration of anesthesia. However, operations on the thorax and upper abdomen were followed by three times as many reinfarctions as operations at other sites. Patients who were operated on within three months of infarction had a 37% reinfarction rate. This rate decreased to 16% in patients at three to six months after infarction, and remained at 4% to 5% when infarction had occurred more than six months previously. A significantly higher number of myocardial infarctions occurred during the third postoperative day.

Dobutamine, a recently introduced derivative of dopamine, is reported to retain inotropic properties with less pronounced chronotropic and arrhythmogenic effects than isoproterenol. The drug was evaluated in two doses, 5 mug/kg/min and 10 mug/kg/min, in two groups of ten patients each, during emergence from cardiopulmonary bypass. A third group of five patients was studied similarly with isoproterenol, 0.02 mug/kg/min. Cardiac index increased 16 and 28 per cent eith the two doses of dobutamine, respectively, and 9 per cent with isoproterenol. Heart rate, in contrast, increased 6 and 15 per cent with dobutamine (not significant) and 44 per cent with isoproterenol (significant). Dobutamine seemed to associated with fewer arrhythmias than isoproterenol. It is concluded that dobutamine, 5-10 mug/kg/min, is suitable for use during emergence from cardiopulmonary bypass and may possess advantages over isoproterenol.

Although transfusion of autologous blood by the method described would seem to be a safe and proctical means of reducing banked-blood requirements for open-heart operations, our experience indicates that the amount of blood needed to be added to the pump oxygenator more than negates the value in reducing intraoperative blood requirements. In fact, autologously transfused patients used more blood than did control subjects. Platelet and fresh-frozen plasma administration was not significantly different for the autologous transfusion or control group.

Hemodynamics and blood gases were measured before and 15 minutes after small (10 mg/70 kg) doses of intravenously administered morphine in two groups of patients having open heart surgery. In one group, the study was undertaken after median sternotomy but before perfusion. The other group had been in the intensive care unit for approximately 1 hour. No changes were found in either group in cardiac index, atrial pressures, arterial pressure, or blood gas variables. However, mean systemic vascular resistance decreased from 41.5 to 35.4 after morphine was given postoperatively. Hence, hemodynamically, morphine is a safe drug if given in small doses for pain relief and sedation early after open heart surgery.

Almost three decades have passed since the establishment of open-heart surgery, and in such a short life span the specialty has established itself scientifically and reached a certain maturity. New techniques, better understanding of the pathophysiology of cardiac problems, and the effective use of new drugs constantly improve the results of operation. Greater experience in anesthetic management and improved postoperative care will contribute much to the success of this youngest surgical specialty. This review outlines the current principles of anesthesia and postoperative care of patients undergoing cardiac operations. Preanesthetic evaluation provides guidance for anesthetic management, supportive techniques, and postoperative care. During operations, light anesthesia is usually sufficient for patients with cardiac disease and minimizes myocardial depression. Monitoring must provide data on the physiological changes that are taking place from moment to moment during and after operations. Perfusion produces a highly abnormal state, and the severity of complications varies with its duration. Introduction of new drugs has also facilitated hemodynamic management during and after operations. Postoperative care is based on careful observation of the patient and early detection of trends, both of which lead to preventive rather than curative treatment wheneven possible.

In 12 patients undergoing saphenous vein coronary artery bypass operations, cardiovascular hemodynamics were studied in the awake state (control) and during anesthesia with isoflurane (inspired concentration, 1.24%, 7 patients) or with halothane (inspired concentration, 0.77%, 5 patients). Isoflurane anesthesia was accompanied by decreases of 19% in the cardiac index (Q), 19% in mean arterial pressure (AP), and 16% in heart rate (HR). Only the change in AP was statistically significant. Halothane anesthesia was accompanied by decreases in Q (28%), AP (22%), and HR (10%). The changes in Q and AP were significant. HR did not change significantly following the induction of anesthesia with either agent. The decrease in AP was similar with both agents, and, in this regard, neither agent was clearly superior for patients with occlusive coronary artery disease.