• 제목/요약/키워드: Heart Sound

검색결과 146건 처리시간 0.028초

임상실습 전 간호학생에게 적용한 OSCE 프로그램 효과 (The Effects of OSCE Application Before Clinical Practice for Nursing Students)

  • 윤진;김금자;최미숙
    • 한국간호교육학회지
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    • 제19권2호
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    • pp.273-284
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    • 2013
  • Purpose: The study was done to identify the effects of OSCE program prior to clinical practice for nursing students and to find out the weakest area of fundamental nursing skills. Methods: Study design was methodological triangulation. Qualitative analysis was done to derive nursing students' OSCE experiences using OSCE reflection note. Level of basic nursing skill acquirement was identified by quantitative method. Results: Four themes and 10 sub-categories emerged: (a) confidence and interests in nursing being increased, (b) being encouraged by mentor and evaluator, (c) requiring much effort to learn nursing skill, (d) being aware of themselves and understanding others in their shoes. Results of analysis of OSCE application score record showed as followings ; Intravenous injection(92.6%), Intramuscular injection(89.5%), Foley catheterization(85.2%), Vital sign(81.5%): BP check(63.0%) Respiration check(50.0%), Health assessment: respiration sound auscultation(33.3%) heart sound auscultation(44.4%). Conclusion: OSCE program application before frist clinical nursing practice was effective in terms of fundamental nursing skills learning. It is necessary to reinforce nursing skills based on the study results.

심정지 감지를 위한 다생체 신호 측정 웨어러블 디바이스 개발 (Multi-modal Wearable Device for Cardiac Arrest Detection)

  • 안현준;유승민;조경원;박훈기;김인영
    • 대한의용생체공학회:의공학회지
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    • 제38권6호
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    • pp.330-335
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    • 2017
  • Cardiac arrest is owing to the failure of the heart that makes the blood circulation stop. Arrested blood circulation prevents the supply of the oxygen and the glucose and it results the loss of consciousness and, finally, brain death. Many public institution installed the AED for emergency treatment, but, it is not efficient when the patient is alone. In this paper, we made multiplexed wearable device for cardiac arrest detection. With this device, we measure the individual's electrocardiography, heart sound and motion. If the cardiac arrest is detected, the device make a warning horn and transmit the signal for defibrillation. We obtain 98.33% of ECG data, 94.5% of PCG data and 98.38% of IMU data accuracy for each evaluation and 93.33% accuracy for integrated evaluation.

우심방에 발생한 원발성 섬유성 육종: 1례 치험 보고 (Primary Fibrosarcoma of Right Atrium: A Case Report)

  • 이성행
    • Journal of Chest Surgery
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    • 제10권1호
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    • pp.173-178
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    • 1977
  • A 51 year old man was admitted to the Thoracic and Cardiovascular Department of Kyungpook University Hospital on April 7, 1976, with chief complaints of orthopnea and the chest pain for about 3 months. Physical examination showed narrow pulse pressure, puffy face, engorged neck veins at sitting position, distant heart sound, enlarged liver and edematous upper extremities. The chest roentgenogram demonstrated markedly enlarged cardiac silhouette. Low voltage and the low to diphagic T`s were noted on the electrocardiogram. Paroxysmal ventricular tachycardia was developed intermittently and was subsided spontaneously. Repeated pericardiocentesis were performed each of which yielded from 100 to 300ml. but intractable cardiac failure was progressed. The bacteriology and cytology of the pericardial fluid were not revealed any specific findings. The pericardiectomy was performed to release the intractable cardiac tamponade. Pericardium was found to be thickened and cardiac constriction was noted. The thickened pericardium was easily removed. A large hen`s egg sized dark blue tumor mass occupied the anterior wall of the right atrium and two thumb tip sized pearl gray tumors were placed at the just below portion of the main pulmonary artery. The biopsy report revealed primary fibrosarcoma of the heart. The patient was improved from the symptoms of the cardiac failure during the postoperative course.

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흉총창에 의한 심방파열 치험 2례

  • 이두연;곽상룡
    • Journal of Chest Surgery
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    • 제13권1호
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    • pp.60-65
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    • 1980
  • We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

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신디사이저와 퍼커션의 독자적인 리듬기법 연구 - Sting의 "Nothing Like The Sun" 앨범을 중심으로 - (A Study on Independent Rhythm Technique of Synthesizer & Percussions - Focusing on the Sting's "Nothing Like The Sun" Album -)

  • 엄수한
    • 한국산학기술학회논문지
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    • 제17권12호
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    • pp.327-332
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    • 2016
  • 스팅은 1985년 첫 솔로앨범인 를 필두로 세련된 감각과 폭넓은 음악적 스펙트럼을 선보이며 1억 장 이상의 앨범 판매고를 올린 영국을 대표하는 아티스트다. 본 논문에서는 스팅이 솔로 아티스트로서 폴리스 해체 이 후 30년이 넘도록 다양하고 폭넓은 자신만의 음악적 색채를 인정받는데 큰 발판이 되었던 음반에 수록되어 있는 곡들 중 'Straight To My Heart'와 'Be Still My Beating Heart'의 리듬 편곡에 대해 중점적으로 분석 할 것이다. 음반에 있는 곡들은 전체적으로 드럼파트는 기본적인 연주를 벗어나지 않고 전체적인 리듬분할의 역할을 여러 가지 퍼커션을 통해 하거나 신디사이저를 코드악기로서의 역할보다는 리듬악기로서의 역할에 더 비중을 둔 곡들이 많은 것을 볼 수 있다. 솔로 초기 스팅 만의 독특한 악기별 리듬구성과 역할배분은 다른 뮤지션들의 음반과는 사뭇 다른 그 만의 독특한 사운드를 창출해낸다. 이에 본 논문에서는 이 시기의 음반에 두드러지게 나타난 편곡적인 특징과 리듬적 특성, 즉 드럼비트를 쪼개서 리듬을 분할하는 통상적인 방식에서 벗어나 퍼커션을 포함한 다른 악기들의 리듬분할을 통해 곡의 기본적인 흐름을 이끌어가는 방법에 대해 설명 하고자 한다.

제주 연안에서 어획된 두툽상어의 청각 특성 (Auditory Characteristics of Tiger shark Scyliorhinus torazame caught in the Coast of jeju Island)

  • 안장영;최찬문;이창헌
    • 수산해양기술연구
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    • 제47권3호
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    • pp.234-240
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    • 2011
  • In order to obtain the fundamental data about the behavior of sharks by underwater audible sound, this experiment was carried out to investigate the auditory characteristics of tiger shark Scyliorhinus torazame which was caught in the coast of Jeju Island by heart rate conditioning method using pure tones coupled with a delayed electric shock. The audible range of tiger shark extended from 80Hz to 300Hz with a peak sensitivity at 80Hz including less sensitivity at 300Hz. The mean auditory thresholds of tiger shark at the frequencies of 80Hz, 100Hz, 200Hz and 300Hz were 90dB, 103dB, 94dB and 115dB, respectively. The positive response of tiger shark was not evident after the sound projection of over 300Hz. At the results, the sensitive frequency range of tiger shark is narrower than that of fish that has swim bladder. In addition, it is assumed that the most sensitive frequency in auditory thresholds of Chondrichthyes is lower than that of Osteichthyes. Critical ratios of tiger shark measured in the presence of masking noise in the spectrum level range of about 60-70dB (0dB re $1{\mu}Pa/\sqrt{Hz}$) increased from minimum 27dB to maximum 39dB at test frequencies of 80-200Hz. The noise spectrum level at the start of masking was distributed at the range of about 65dB within 80-200Hz.

음향 자극에 의한 인체 경락의 반응분석 (Analysis of Meridian Response by Sound Stimulus in Body)

  • 김용진;정동명
    • 전자공학회논문지SC
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    • 제38권3호
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    • pp.47-54
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    • 2001
  • 본 논문에서는 경락의 실체를 객관화하기 위한 방법으로서, 경락과 비경락을 음향 자극하고 인체의 임피던스 변화를 분석하였으며, 인체 에너지에 대한 고전 동양의학 이론인 경락순행통로 학설의 타당성을 입증하기 위하여 경락지하수 학설을 제안하였다. 현대의학의 주장과 같이 경락은 그 존재를 증명할 만한 채널이나 파이프 형태의 해부학적 실체를 가지고 있지 않다. 그러나 생체에너지는 인체 안에서 관상구조없이 지하를 흐르는 지하수 흐름과 유사하게 경락을 따라 흐른다. 이러한 모델의 반응특성을 확인하기 위하여, 인체의 경락을 지하수가 흐르는 관로로 보고 지하수를 탐지하는 산업용 음향탐사기법을 적용하기 위하여, 피부와 청각을 구분하여 음향자극하고 경혈과 대조적인 비경혈에서의 인체 임피던스 반응을 분석하였다. 특히 자극 음향과 12경락과의 주파수 상관성을 추출하기 위하여, 5개의 특정 음으로 자극하고 측정전류의 평균치와 변화율을 처리하였다. 분석결과 전류 변화율은 족궐음간경(宮), 수소음심경(商) 30.6%, 족소음신경(角) 33.1%, 족태음비경(徵) 33.9%, 수태음폐경(羽) 30.7%로 대조점과 구별되는 특성을 가지고 있어서, 경락은 비경락과 구별되는 채널 특성을 나타내고 있으며 5개 경락은 5개의 특정 음과 상관성이 있음을 확인하였다.

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음향감성에 의한 전전두엽의 비대칭성과 심박동변이도 (Asymmetric Activation in the Prefrontal Cortex and Heart Rate Variability by Sound-induced Affects)

  • 장은혜;이지혜;이상태;김원식
    • 감성과학
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    • 제8권1호
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    • pp.47-54
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    • 2005
  • 본 연구에서는 행동활성화체계(behavioral activation system : BAS)와 행동억제체계(behavioral inhibition system BIS)의 개인차가 음향감성에 의한 전전두엽의 비대칭성과 심박동변이도(heart rate variability : HRV)에 미치는 영향을 밝히고자 하였다. 이를 위하여 피험자들을 BAS와 BIS 민감성의 고저에 따라 네 집단으로 분류하고 명상음악과 소음이 제시되는 동안 전전두엽의 비대칭성과 심박동변이도를 측정하였다. 전전두엽의 비대칭성을 측정한 결과, 명상음악에서는 BAS가 BIS에 비하여 민감도가 상대적으로 높을수록 전전두엽 편측치(asymmetry score)가 증가하였고, 소음조건에서는 BAS와 BIS 중 어느 하나라도 민감도가 높으면 소음과 같은 부정감성을 유발시키는 음 환경에서는 전전두엽의 편측치가 감소하는 것으로 나타났다. 또한 부정감성이 상대적으로 우측 전전두엽의 활성화를 증가시키는 반면, 긍정감성은 좌측 전전두엽의 활성화를 증가시킴을 알 수 있었다. 심박동변이도를 각 주파수 대역별로 전력을 분석한 결과, 명상음악에서는 BAS가 높고 BIS는 낮은 집단이 BAS와 BIS가 모두 낮은 집단에 비하여 심박동변이조의 감성평가지표로 알려진 MF/(LF+HF)가 유의하게 높았다. 또한 BAS가 높고 BIS는 낮은 집단은 명상음악 청취시가 소음 청취시에 비하여 MF/(LF+HF)가 더 높은 경향을 보였는데, 이는 BAS가 높고 BIS는 낮은 집단이 다른 집단에 비하여 긍정감성에 더 민감함을 의미한다. 본 연구결과는 전전두엽 비대칭성과 심박동변이도, 특히 MF/(LF+HF)가 긍정 및 부정감성을 평가할 수 있는 지표로 사용될 수 있음을 시사한다.

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단심실 -III C Solitus 형의 수술치험- (Surgical Repair of Single Ventricle (Type III C solitus))

  • naf
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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Ebstein 기형의 수술 -2례 보고- (Surgical Repair for Ebstein's Anomaly)

  • naf
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.289-296
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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