• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1411-1416
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• 2002

Purpose : Although the use of intravenous gamma-globulin(IVGG) in Kawasaki disease(KD) is effective in reducing clinical symptoms and coronary artery complications, 20-30% of patients have persistent or recrudescent fever and ongoing clinical symptoms. In these patients, the additional infusion of IVGG is considered. The authors studied the characteristics of patients who received IVGG retreatment, and compared them with the patients who did not need IVGG retreatment, for determination of IVGG retreatment. Methods : We reviewed the medical records of 117 KD patients who could be followed up at least six months. We studied the conventional laboratory findings, electrocardiogram(EKG), signal averaged ECG(SAECG) and echocardiogram. Results : Twenty three patients had early cardiac complications during the six months of follow-up. Four patients had late cardiac complications after six months. The early cardiac complication rate was higher in the IVGG retreatment group than the single infusion group(P<0.0001). The late complication rate was also higher in the retreatment group(P<0.0001). The patients who received methyl-prednisolone(m-PD) pulse therapy had much higher rates of early and late cardiac complications than those who received a single IVGG infusion. Among the clinical data and laboratory findings, only CRP increased significantly in patients who have had the cardiac complications. The IVGG retreatment group had increased CRP than the single infusion group. Conclusion : The patients with increased initial CRP may have an increased incidence of complications and an increased possibility of IVGG retreatment. We thought that retreated KD patients might have inflammations severe enough to need high dose IVGG as shown by high CRP levels, and IVGG retreatment could not prevent coronary artery lesions sufficiently.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.468-475
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• 2005

Transmyocardial revascularization (TMR) in end stage ischemic heart disease results in variable clinical responses. We investigated the acute effect of early reperfusion and the angiogenesis after formation of the transmyocardial channel in a transplanted rat heart model with acute myocardial infarction. Material and Method: In the 30 transplanted hearts we induced acute myocardial infarction by ligating the proximal left coronary artery and inserted a porous 22G intravenous cannula into the left ventricle. After ten minutes of reperfusion, we removed the cannula. At every stage, we recorded the heart rate, QRS size, and left coronary arterial blood flow using the electrocardiogram and Doppler. One week later the rats were sacrificed and evaluated for the patency of intramyocardial channels and the angiogenesis. Result: The heart rates after ligation and after cannula insertion were $239.1\pm61.7,\;235.8\pm58.0bpm$ respectively, and they were statistically significantly slower than that of before ligation, $277.6\pm40.3bpm\;(p=0.017,\;p=0.007\;respectively)$. QRS sizes before ligation, after ligation, and after cannula insertion were $3.6\pm3.3mm,\;2.8\pm3.3 mm,\;and\;2.4\pm2.2mm,$respectively, and there was no significant difference in the three groups. Doppler findings after ligation showed that average peak and mean values of coronary perfusion were significantly decreased from $2.11\pm0.17kHz,\;1.25\pm0.22kHz\;to\;0.83\pm0.15kHz,\;0.38\pm0.11kHz$(p<0.05 respectively). After insertion of the porous cannula, the average peak and mean values of coronary perfusion were $0.61\pm0.05kHz\;and\;0.33\pm0.05 kHz$ respectively, but there was no statistically significant change compared to values after ligation. In all cases except one, pathologic findings showed no patent channels in the acute stage, however, one case showed the angiogenesis. Conclusion: We confirmed that TMR in a rat heart transplant model did not show blood flow through the channel in the acute stage. However, reperfusion effect in some cases had a potential for angiogenesis.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.40-48
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• 1999

Purpose: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. Materials and Methods: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. Results: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. Conclusion: These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.

• Science of Emotion and Sensibility
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• v.8 no.1
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• pp.47-54
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• 2005

This study is aimed to inspect how the different sensitivities in Behavioral activation system(BAS) and behavioral inhibition system(BIS) modulate on the properties of physiological responses stimulated by positive or negative affective sound. We measured the electroencephalogram(EEG) and electrocardiogram (ECG) of 32 students, consisted of four groups depending on the BAS and BIS sensitivities, during listening to meditation music or noise. The EEG was recorded at Fpl and Fp2 sites and Power spectral density(PSD) of HRV was derived from the ECG, and the power of HRV was calculated for 3 major frequency ranges(low frequency[LF], medium frequency and high frequency[HF]). After listening to music or noise, subjects reported the affect induced by the sound. For EEG, the power in the alpha band at Fp2, especially in the alpha-2 band(9.0-11.0 Hz) increased during the subjects listening to music, while the power at Fpl increased during noise. During listening to meditation music, there is a tendency that the left-sided activation in prefrontal cortex(PFC) is positively correlated with the difference of BAS(Z)-BIS(Z). During listening to noise, there is a tendency that the right-sided activation in PFC is dominant in case any of the sensitivity of BAS or BIS is high. For HRV, we found that the index of MF/(LF+HF), during listening to music, was higher significantly in the individuals with a low BIS but high BAS than in the individuals with a low sensitivity both BIS and BAS individuals. With high BIS, regardless of the BAS sensitivity, the difference of this index values was not significant. From these results we suggest that the physiological responses of different individuals in BAS and BIS react differently under the same emotionally provocative challenge.

• Journal of Veterinary Clinics
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• v.14 no.2
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• pp.319-337
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• 1997

The electrocardiographic (ECG) parameters in the normal Korean black goat have been measured with a 3-channel Electrocardiograph and computed, analyzed. ECG in 243 black goats were made with the limb leads (I, II, III, aVR, aVL, aVF), that were recorded conduction parameters of wave and interval, and were analyzed as to shape and amplitude of the P and T waves and the components of the QRS complex. Heart rate were recorded by the ECG which were a mean of 106.1$\pm $21.8 beats/min. Average conduction times in the PR, the QRS complex and the QTc interval were recorded 103.9$\pm $34.9 msec., 58.3$\pm $23.2 msec. and 302.6$\pm $67.8 msec., in the P and T wave duration recorded 24.8$\pm $6.4 msec. and 51.7$\pm $10.8 msec. respectively. The shape of wave in each leads were observed various types, and any spacial wave type appeared the highest frequency in each lead that ware shown less than 60%, and these frequent rate and average amplitudes as fallow: 1. In P waver the frequent rate and average amplitudes of the positive type showed in leads I, II and aVL that were 54.8% (93.0$\pm $ 33.2 $\mu $V), 50.5% (90.1$\pm $30.5 $\mu $V) and 41.7% (58.5$\pm $ 31.1 $\mu $V). Average amplitude of the negative type showed the frequent rate of 49.8% in lead aVE which was -77.6$\pm$ 25.2 $\mu $V. Biphasic type in leads III and aVF were 46.1% (108.4 $\mu $V, -90.2 $\mu $V.) and 45.7% (137.4 $\mu $V, -105.4 $\mu $V.), and amplitudes between positive and negative of it were significant difference. 2. The highest amplitudes of the QRS complex in all leads were 534.8$\pm $ 232.3 $\mu $V of lead II. The frequent rate and amplitudes of the R wave type in the I, II, III and aVF were 30.2% (277.8 $\pm $131.3 $\mu $V), 45.1% (393.1$\pm $114.2 $\mu $V), 48.5% (349.3$\pm $178.3 $\mu $V) and 54.9% (334.4$\pm $129.7 $\mu $V), and QS ways type in the lead aVL was 49.5% (359.2$\pm $195.5$\mu $V), and RS and QS wave types in the lead a VR were 43.3% (312.4 $\mu $V, -212.7 $\mu $V.) and 41.1% (399.2$\pm $92.2 $\mu $V), respectively. 3. In T wave, the frequent rata and amplitudes of the positive type in the leads I, II, III and aVF were 44.6% (207.9$\pm $ 97.1 $\mu $V), 41.6% (245.1$\pm $92.1 $\mu $V), 46.9% (189.8$\pm $ 82.7 $\mu $V) and 53.0% (195.4197.8 $\mu $V), and the negative in the lead aVR was 41.2% (-230.7$\pm$ 103.1 $\mu $V), respectively. The positive and negative types in the lead aVe appeared with same frequent rate of 43.2%.4. Frontal plane vectors for P, QRS, and T were found to lie at 38.1$\pm $ 21.5, 142.0$\pm $ 57.2, and 117.2$\pm $ 63.9 degrees, respectively. These results in ECG of goats may be served to the limited purposes as to conduction parameters, arrhythmias except abnormal ECG because of waveforms, amplitudes and electrical axis of it were variability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.21 no.2
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• pp.63-71
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• 2010

Objectives : The aim of this study was to investigate the effect of the clinical and demographic variables such as body weight, dosage, family history of attention-deficit hyperactivity disorder (ADHD), and psychiatric co-morbidity on the side-effects of OROS-Methylphenidate (OROS-MPH), and to evaluate the relationship between drug response and side effect severity. Methods : A total of 144 children (ages 6-18) with diagnosed ADHD were treated with OROS-MPH. Children were examined at baseline and after 1, 3, 6, 9, and 12 weeks of each treatment condition. The stimulant drug side effect rating scale (SERS), pulse rate, systolic blood pressure, diastolic blood pressure, and electrocardiogram (ECG) were evaluated to assess side effect profiles. Changes in these parameters from baseline were examined and analyzed. Results : Anorexia (30.95%) and insomnia (13.10%) were the most commonly reported side effects during this study. Insomnia and loss of appetite score increased at one week follow-up, but was sustained or decreased as treatment progressed. Small but significant increases in pulse rate and diastolic blood pressure were observed during treatment ; however, no clinically meaningful changes in ECG parameters were noted during the study. Low body weight, high dosage of OROS-MPH, and family history of ADHD were associated with cardiovascular side effect. In contrast, there was no significant relationship between OROS-MPH treatment response and the severity of side effect and no difference resulted between the responder and non-responder groups with respect to OROS-MPH dosage in the 12 weeks of follow-up. Conclusion : To the best of our knowledge, this study is the first Korean study to investigate comprehensive side effect profiles and their correlates in OROS-MPH treatment for ADHD children. OROS-MPH was well tolerated with no clinically significant side effects during the treatment period. In conclusion, low body weight, high dosage of OROSMPH, and family history of ADHD could be used as predictive factors in increasing pulse rate and blood pressure.

• Korean Journal of Veterinary Research
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• v.33 no.4
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• pp.735-746
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• 1993

Electrocardiographic parameters of amplitude and the shape of waves on the unipolar precordial chest leads in the normal Korean native cattles have been measured with a 3 channel electrocardiograph built in a computed and analysis. The study was conducted on 98 heads of mean age of 17.6 months. The wave forms of P, T and QRS complex wave in all leads showed various types. The parameters of the amplitude in the wave types showed the most frequency in each lead that were analyzed as follow : 1. In P wave, amplitudes of positive type showed a frequency of 92.9% and 93.9% in leads $CV_6LU$ and $CV_6LL$ that were $83.8{\pm}31.0{\mu}V$ and $76.0{\pm}30.7{\mu}V$, and negative type showed a frequency of 97.9% in lead V 10 that were $-80.2{\pm}29.4{\mu}V$, respectively. But the plate type in leads $CV_6RU$ and $CV_6RL$ showed frequency of 48% and 58.3%, respectively. 2. Average amplitude of the QRS complex were in a range of $277.0{\pm}154.0{\mu}V$ to $648.2{\pm}146.2{\mu}V$(mean of $418.8{\pm}139.4{\mu}V$) in all leads that were manifested the Low-Voltage QRS complex(below 1 mV in unipolar precordial leads). Average amplitudes of each wave type in the QRS complex were $-250.0{\pm}139.8{\mu}V$ and $-399.2{\pm}226.8{\mu}V$ in the QS group types that showed a frequency of 50.0% and 82.5% in the leads $CV_6LU$ and $CV_6LL$, respectively. And average amplitudes of the R group types showed a frequency of 85.6%, 56.1% and 75.8% in the $CV_6RU$, $CV_6RL$ and $V_{10}$ that were $321.5{\pm}142.1{\mu}V$, $271.6{\pm}139.9{\mu}V$ and $552.4{\pm}132.7{\mu}V$, respectively. 3. In T waves, Amplitudes of the positive type showed a frequency of 60.2%, 46.9% and 83.7% in leads of $CV_6LL$, $CV_6RU$ and $CV_6RL$ that were respectively $184.7{\pm}93.7{\mu}V$ $103.7{\pm}64.43{\mu}V$ and $111.8{\pm}39.3{\mu}V$, the negative type showed a frequency of 62.2% and 93.7% in leads $CV_6LU$ and $V_{10}$ that were $142.2{\pm}82.1{\mu}V$ and $-280.3{\pm}107.2{\mu}V$, respectively. 4. Average amplitude of ST segment were $3.7{\pm}33.1{\mu}V$, $0.9{\pm}23.1{\mu}V$, $10.9{\pm}28.6{\mu}V$, $5.8{\pm}28.3{\mu}V$ and $-34.7{\pm}48.4{\mu}V$ in leads $CV_6LL$, $CV_6RU$, $CV_6RL$, $CV_6LU$ and $V_{10}$ respectively.

• Journal of the Korea Convergence Society
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• v.10 no.4
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• pp.99-106
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• 2019

The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.