• The Korean Journal of Physiology and Pharmacology
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• 제20권1호
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• pp.119-127
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• 2016

Dihydropyridine (DHP) calcium channel blockers (CCBs) have been widely used to treat of several cardiovascular diseases. An excessive shortening of action potential duration (APD) due to the reduction of $Ca^{2+}$ channel current ($I_{Ca}$) might increase the risk of arrhythmia. In this study we investigated the electrophysiological effects of nicardipine (NIC), isradipine (ISR), and amlodipine (AML) on the cardiac APD in rabbit Purkinje fibers, voltage-gated $K^+$ channel currents ($I_{Kr}$, $I_{Ks}$) and voltage-gated $Na^+$ channel current ($I_{Na}$). The concentration-dependent inhibition of $Ca^{2+}$ channel currents ($I_{Ca}$) was examined in rat cardiomyocytes; these CCBs have similar potency on $I_{Ca}$ channel blocking with $IC_{50}$ (the half-maximum inhibiting concentration) values of 0.142, 0.229, and 0.227 nM on NIC, ISR, and AML, respectively. However, ISR shortened both $APD_{50}$ and $APD_{90}$ already at $1{\mu}M$ whereas NIC and AML shortened $APD_{50}$ but not $APD_{90}$ up to $30{\mu}M$. According to ion channel studies, NIC and AML concentration-dependently inhibited $I_{Kr}$ and $I_{Ks}$ while ISR had only partial inhibitory effects (<50% at $30{\mu}M$). Inhibition of $I_{Na}$ was similarly observed in the three CCBs. Since the $I_{Kr}$ and $I_{Ks}$ mainly contribute to cardiac repolarization, their inhibition by NIC and AML could compensate for the AP shortening effects due to the block of $I_{Ca}$.

• Journal of Chest Surgery
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• 제49권5호
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• pp.356-360
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• 2016

Background: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. Methods: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy. Results: No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence. Conclusion: The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period.

• 중환자간호학회지
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• 제15권3호
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• pp.88-100
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• 2022

Purpose : This study aimed to identify risk factors for unplanned reintubation after planned extubation and to analyze the clinical outcomes in patients admitted to the intensive care unit after cardiac surgery. Methods : The study examined patients who underwent intubation and planned extubation admitted to the intensive care unit after cardiac surgery between January 1, 2017, and December 31, 2021. The reintubation group comprised 58 patients underwent unplanned reintubation within 7 days of planned extubation. The maintenance group comprised 116 patients who did not undergo reintubation and were matched with the reintubation group using the rational for matching criteria. Data were collected retrospectively from electronic medical records. We used the independent t-test, Mann-Whitney U test, 𝑥²-test, Fisher's exact test, and logistic regression analysis with SPSS/WIN 27.0. Results : The multivariate logistic regression analysis demonstrated that albumin (odds ratio [OR]=0.38, 95% confidence interval [CI]=0.20-0.72), surgery time (OR=1.54, 95% CI=1.20-1.97), PaO₂ before extubation (OR=0.85 per 10 mmHg, 95% CI=0.75-0.97), postoperative arrhythmia (OR=2.82, 95% CI=1.22-6.51), reoperation due to bleeding (OR=4.65, 95% CI=1.27-17.07), and postoperative acute renal failure (OR=2.97, 95% CI=1.09-8.04) were risk factors for unplanned reintubation. The reintubation group had a higher in-hospital mortality rate (𝑥²=33.74, p<.001), longer intensive care unit stay (Z=-7.81, p<.001), and longer hospital stay than the maintenance group (Z=-8.29, p<.001). Conclusion : These results identified risk factors and clinical outcomes of unplanned reintubation after planned extubation after cardiac surgery. These findings should be considered when developing and managing an intervention program to prevent and reduce the incidence of unplanned reintubation.

• Journal of Chest Surgery
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• 제57권2호
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• pp.205-212
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• 2024

Background: Postoperative atrial fibrillation (A-fib) is a serious complication of cardiac surgery that is associated with increased mortality and morbidity. Traditional 24-hour Holter monitors have limitations, which have prompted the development of innovative wearable electrocardiogram (ECG) monitoring devices. This study assessed a patch-type wearable ECG device (MobiCARE-MC100) for monitoring A-fib in patients undergoing cardiac surgery and compared it with 24-hour Holter ECG monitoring. Methods: This was a single-center, prospective, investigator-initiated cohort study that included 39 patients who underwent cardiac surgery between July 2021 and June 2022. Patients underwent simultaneous monitoring with both conventional Holter and patchtype ECG devices for 24 hours. The Holter device was then removed, and patch-type monitoring continued for an additional 48 hours, to determine whether extended monitoring provided benefits in the detection of A-fib. Results: This 72-hour ECG monitoring study included 39 patients, with an average age of 62.2 years, comprising 29 men (74.4%) and 10 women (25.6%). In the initial 24 hours, both monitoring techniques identified the same number of paroxysmal A-fib in 7 out of 39 patients. After 24 hours of monitoring, during the additional 48-hour assessment using the patch-type ECG device, an increase in A-fib burden (9%→38%) was observed in 1 patient. Most patients reported no significant discomfort while using the MobiCARE device. Conclusion: In patients who underwent cardiac surgery, the mobiCARE device demonstrated diagnostic accuracy comparable to that of the conventional Holter monitoring system.

• Clinical and Experimental Pediatrics
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• 제45권7호
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• pp.928-932
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• 2002

저자들은 재태 연령 $38^{+6}$주에 태아 심초음파 검사에 의해 태아 심방 조동이 발견되어 산모에게 digoxin을 투여하였으나 효과가 없어 제왕 절개술을 통해 분만한 후, digoxin, 전기적 심율동 전환에 의해서도 치료되지 않아 propafenone을 복용하여 정상 동율동으로 회복된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한한방내과학회지
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• 제27권3호
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• pp.751-761
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• 2006

Atrial fibrillation (AF) is a common arrhythmia that is a potent independent risk factor for stroke. The incidence of AF increases with age and most affected people have underlying cardiac disease. An aging society increases the incidence of AF patients. The case was designed to evaluate the improving effect of Chengsim Yeunja-tang (CYT) for atrial fibrillation (AF) with Cb-infarction patients. This patient was treated with CYT and had significant improvement in symptoms and change of EKG. -Heart rate decreased in patients with higher than normal heart rate -RV5+SV1 voltage decreased (LVH improved) -Arrhythmia remained steady. -Palpitation. chest discomfort, dyspnea, headache, dizziness diminished. Results suggest that CYT is an effective treatment for Taeumin AF patients.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.323-327
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• 2017

QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively. These cases were considered to have drug-induced QT prolongation. We reaffirmed that even drugs administered for conditions unrelated to cardiac diseases can have adverse side effect of QT prolongation. In conclusion, our cases indicate that dental surgeons should be aware of the dangerous and even potentially lethal side effects of QT prolongation. For safe oral and maxillofacial surgery, cooperation with medical departments in various fields is important.

• 한국정보통신학회논문지
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• 제21권2호
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• pp.450-460
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• 2017

T파는 심장의 심실의 재분극을 나타내는 파라미터로써 부정맥 진단에 있어 매우 중요하다. T 파를 검출하기 위한 기존 연구방법으로는 주파수 분석과 비선형 접근방법 등이 제안되어 왔지만 검출 정확도가 낮다는 문제점이 있다. 이는 T파의 경우 P파와 중복되는 경우가 발생하기 때문이다. 본 연구에서는 QRS 구간을 제거한 후, 이동평균을 통한 P파와 T파의 대상 영역을 추출하여 정확히 T파를 검출하는 알고리즘을 제안한다. 이를 위해 전처리를 통해 잡음이 제거된 심전도 신호에서 Q, R, S를 검출한다. 이후 검출된 QRS 구간을 제거, 이동평균을 통해 4개의 PAC 패턴과 기타부정맥에 대한 판단규칙을 적용하여 P, T파의 대상 영역을 추출하고, 이를 대상으로 RR 간격과 RT 간격의 문턱치를 적용하여 T파를 검출하였다. 제안한 방법의 우수성을 입증하기 위해 MIT-BIH 부정맥 데이터베이스 48개의 레코드를 대상으로 한 T파의 평균 검출율은 95.32%의 성능을 나타내었다.

• Genomics & Informatics
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• 제20권4호
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• pp.44.1-44.13
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• 2022

Brugada syndrome (BS) is an autosomal dominant inheritance cardiac arrhythmia disorder associated with sudden death in young adults. Thailand has the highest prevalence of BS worldwide, and over 60% of patients with BS still have unclear disease etiology. Here, we performed a new viral metagenome analysis pipeline called VIRIN and validated it with whole genome sequencing (WGS) data of HeLa cell lines and hepatocellular carcinoma. Then the VIRIN pipeline was applied to identify viral integration positions from unmapped WGS data of Thai males, including 100 BS patients (case) and 100 controls. Even though the sample preparation had no viral enrichment step, we can identify several virus genes from our analysis pipeline. The predominance of human endogenous retrovirus K (HERV-K) viruses was found in both cases and controls by blastn and blastx analysis. This study is the first report on the full-length HERV-K assembled genomes in the Thai population. Furthermore, the HERV-K integration breakpoint positions were validated and compared between the case and control datasets. Interestingly, Brugada cases contained HERV-K integration breakpoints at promoters five times more often than controls. Overall, the highlight of this study is the BS-specific HERV-K breakpoint positions that were found at the gene coding region "NBPF11" (n = 9), "NBPF12" (n = 8) and long non-coding RNA (lncRNA) "PCAT14" (n = 4) region. The genes and the lncRNA have been reported to be associated with congenital heart and arterial diseases. These findings provide another aspect of the BS etiology associated with viral genome integrations within the human genome.

• 한국방사선학회논문지
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• 제5권5호
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• pp.289-294
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• 2011

본 연구의 목적은 cardiac MRI를 이용하여 확장기와 수축기의 정량적 측정을 통해 각 단면의 심박출률의 차이를 알아보고자 하였다. 총 12명(정상 7명, 심근교 1명, 부정맥 4명)을 대상으로 심첨에서부터 대동맥궁 쪽으로 단면을 얻었다. 수축기와 확장기 영상을 확대하여 경계를 정하였고, 이 면적을 바탕으로 1, 3, 5, 6-7단면의 심박출률을 구하였다. 정상인의 평균 박출률은 각각 1, 3, 5, 6-7단면에서 67.14%, 66.24%, 65.63%, 그리고 65.29% 로 나타났다. 반면, 환자들의 평균 박출률은 각각 1, 3, 5, 6-7단면에서 61.74%, 60.92%, 60.89%, 그리고 61.89%로 나타났다. 본 연구를 통해 cardiac MRI를 이용한 특정단면의 심박출률은 각 단면마다 큰 차이가 없음을 알 수 있었고 따라서 cardic MRI를 이용한 심박출계수의 평가는 대표 단면만으로 가능함을 알 수 있었다.