• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.61-69
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• 2021

Background: Inferior alveolar nerve block (IANB) using lidocaine 2% is commonly used for anesthetizing primary mandibular molars; however, this technique has the highest level of patient discomfort compared to other local anesthesia techniques. Therefore, alternative anesthesia techniques are necessary. The aim of this study was to evaluate the efficacy of a single buccal infiltration of 4% articaine with IANB using 2% lidocaine, for the bilateral extraction of primary mandibular molars. Methods: The present study was conducted on 30 patients aged between 6 and 9 years, who required the extraction of bilateral primary mandibular molars. The patients were randomly divided into two groups as follows: In the first session, Group A received IANB with lidocaine 2% and group B received infiltration with articaine 4%. In the second session, another injection method was performed on the opposite side. The Wong-Baker Facial Pain scale (WBFPS), Face Leg Activity Cry, and Consolability (FLACC), and physiologic parameters were used to assess pain perception. Results: The independent t-test showed no statistically significant difference in blood pressure and heart rate before and after extraction (P > 0.05). The mean FLACC index in the lidocaine and articaine groups was 0.89 and 1.36, respectively; there was no statistically significant difference between them (P > 0.05). According to the results of the chi-square test, there was no statistically significant difference between the groups for WBFPS (P > 0.05). Conclusion: The articaine infiltration technique may be an alternative to the IANB for the extraction of primary mandibular molars.

• Neonatal Medicine
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• v.18 no.2
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• pp.395-398
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• 2011

Sick sinus syndrome (SSS) is a disorder characterized by sinus node dysfunction. Although the condition is most common in the elderly, it can occur in children including neonates and its recognition and treatment are important. The diagnosis of SSS is based on the presence of sinus bradycardia, sinus arrest or exit block, combinations of sinoatrial and atrioventricular nodal conduction disturbances, and atrial tachyarrhythmias documented in the Holter recordings. In most children with SSS, previous history of congenital heart malformation or cardiac surgery is noted. SSS is also seen in the children including neonates without heart disease or other contributing factors, however SSS is most often idiopathic. The treatment of SSS depends on the basic rhythm problem, but generally involves the placement of a cardiac pacemaker. We report a case of SSS in extremely low birth weight infant without congenital heart disease and suggest that the treatment system is necessary for preterm infants with SSS.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.633-636
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• 2006

The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1180-1190
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• 1990

96 patients underwent cardiac valve replacement for valvular heart diseases consecutively between February 1986 to February 1990 in the Department of Thoracic and Cardiovascular Surgery of Yeungnam University Hospital. The follow up period was between 6 months and 4.5 years postoperatively[mean 23.4$\pm$13.1 months]. 75 cases got mitral valve replacement, 6 cases, aortic valve replacement, 15 cases, double valve replacement. 30[31.2%] patients were male and 66[68.8%] were female and the age ranged from 14 to 66 years old. Early hospital death within 30 days postoperation were 5 patients[5.2%], consisting of by low cardiac output in 2, infective endocarditis in 1, multiple organ failure with sepsis in 1 patient. There was no late postoperative death. Most common early postoperative complication was wound disruption [8.7%] and then low cardiac output, pneumothorax, pleural effusion in order. Most common late postoperative complications were minor bleeding episodes[8.7%] related to anticoagulant therapy which were consisted of frequent epistaxis in 3, gum bleeding in 2, hemorrhagic gastritis in 1, hypermenorrhea in 1, hematoma in right arm in 1 patient. Valve-related complications included valve thrombosis [1.6%/ patient-year], valve failure due to pannus formation[1.1% /patient-year], prosthetic valve endocarditis[1, 1%o/patient-year] and minor anticoagulant hemorrhage[4.4% /patient-year]. 5 cases of reoperations were performed in 4 patients due to valve failure and all of them were in the mitral positions[2.7% /patient-year]. Cardiothoracic ratios in the chest X-ray decreased at the 6th month and 1st year postoperation in all patients. But in New York Heart Association[NYHA] functional class IV, no change in cardiothoracic ratio was found between 6 months and 1 year postoperation. In the echocardiogram, the size of the cardiac chambers decreased, but ejection fraction increased postoperatively in each functional class. In the electrocardiogram, decreases were found in the incidence of atrial fibrillation, left atrial enlargement, left ventricular hypertrophy with right bundle branch block increasing postoperatively in each functional class. The actuarial survival rate was 98.4% for all patients, 98.7% for mitral valve replacement, 83.8% for aortic valve replacement, and 80% for double valve replacement at the end of a 4.5 year follow up period. Meanwhile the actuarial freedom rate was 91.5% for prosthetic valve endocarditis, 91.6% for thromboembolism, 89.0% for prosthetic valve failure and 83.7% for minor anticoagulant hemorrhage. Preoperative NYHA class III and IV were 75% of all patients, but 95% of all patients were up graded to NYHA class I and II postoperatively.

• Korean Journal of Acupuncture
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• v.30 no.3
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• pp.185-192
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• 2013

Objectives : Many studies have investigated the electric specificity of meridian and acupoint. However, the definition about the real substance of 'Ki(Qi)' that flows in the meridian has not been established yet. The authors hypothesized that the 'Ki(Qi)' may be the very 'bioelectricity' of western medicine, from two common features that they are not visible with naked eyes and that they function in the living body only. Methods : 20 healthy adults participated in this study. Heart rate was measured before and after exercise. Acupuncture was performed at PC6 immediately after exercise with counter balance in the first experiment. In the second experiment, acupuncture group was further divided to the three groups, i.e. glove acupuncture group, manual acupuncture group, and NaCl acupuncture group. In the glove group, acupuncturist put on the two folds of latex gloves to block bioelectric currents between the acupuncturist and subject. In the NaCl group, acupuncturist had his fingertips wet with NaCl solution. Results : Exercise increased Heart Rate and acupuncture at PC6 inhibited this increase. In the second experiment, the significant difference compared to the comtrol group was the most in NaCl acupuncture and the least in Glove acupuncture. However, there was no significant difference between three groups. Conclusions : The results of this study seem to be deficient as a conclusive evidence for the hypothesis that the 'Ki(Qi)' of Korean Medicine is the 'bioelectricity' of western medicine.

• Industrial Engineering and Management Systems
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• v.12 no.4
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• pp.380-388
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• 2013

Large variation in electrocardiogram (ECG) waveforms continues to present challenges in defining R-wave locations in ECG signals. This research presents a procedure to extract the R-wave locations by forward-backward (FB) algorithm and classify the arrhythmic beat conditions by using RR intervals. The FB algorithm shows forward and backward searching rules from QRS onset and eliminates lower-amplitude signals near the baseline using a statistical process control concept. The proposed algorithm was trained the optimal parameters by using MIT-BIH arrhythmia database (MITDB), and it was verified by actual Holter ECG signals from a local hospital. The signals are classified into normal (N) and three arrhythmia beat types including premature ventricular contraction (PVC), ventricular flutter/fibrillation (VF), and second-degree heart block (BII) beat. This work produces 98.54% accuracy in the detection of R-wave location; 98.68% for N beats; 91.17% for PVC beats; and 87.2% for VF beats in the collected Holter ECG signals, and the results are better than what are reported in literature.

• Clinical and Experimental Pediatrics
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• v.60 no.12
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• pp.390-394
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• 2017

Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ${\leq}18years$. Results: Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, $13.4{\pm}2.6years$) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure. Conclusion: RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

• Neonatal Medicine
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• v.18 no.2
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• pp.391-394
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• 2011

Neonatal lupus erythematosus (NLE) is a rare disease characterized by typical clinical features and the transplacental passage of maternal autoantibodies, particularly anti-SSA/Ro. The major clinical manifestations are cutaneous lupus lesions, congenital heart block, hematological disorders, and hepatobiliary diseases. We report a case of NLE presenting with multiple round and oval target-like erythematous skin lesions and abnormal liver function, born to a clinically asymptomatic mother whose diagnosis was made retrospectively only after her newborn's diagnosis. Both the infant and the mother were positive for the anti-SSA/Ro and anti-SSB/La antibodies.

• Journal of Korean Neurosurgical Society
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• v.49 no.1
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• pp.37-42
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• 2011

Objective: The author measured levels of fluoroscopic radiation exposure to the surgeon's body based on the different beam directions during kyphoplasty. Methods: This is an observational study. A series of 84 patients (96 vertebral bodies) were treated with kyphoplasty over one year. The patients were divided into four groups based on the horizontal and vertical directions of the X-Ray beams. We measured radiation exposure with the seven dosimetry badges which were worn by the surgeon in each group (total of 28 badges). Twenty-four procedures were measured in each group. Cumulative dose and dose rates were compared between groups. Results: Fluoroscopic radiation is received by the operator in real-time for approximately 50% (half) of the operation time. Thyroid protectors and lead aprons can block radiation almost completely. The largest dose was received in the chest irrespective of beam directions. The lowest level of radiation were received when X-ray tube was away from the surgeon and beneath the bed (dose rate of head, neck, chest, abdomen and knee: 0.2986, 0.2828, 0.9711, 0.8977, 0.8168 mSv, respectively). The radiation differences between each group were approximately 2.7-10 folds. Conclusion: When fluoroscopic guided-KP is performed, the X-Ray tube should be positioned on the opposite side of the operator and below the table, otherwise the received radiation to the surgeon's body would be 2.7-10 times higher than such condition.

• Journal of Veterinary Clinics
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• v.21 no.3
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• pp.291-297
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• 2004

Aminoglycosidic antibiotics have multiple effects on muscle. For example, they have been shown to block L-type $Ca^{2+}$ channels in vascular smooth muscle, cardiac muscle and skeletal muscle. Possibly as a consequence of this effect on $Ca^{2+}$ influx, they have been shown to decrease the contractility of cardiac muscle (gentamicin). The present study evaluated the effects of gentamicin on blood pressure, vasorelaxation and left ventricular pressure. Gentamicin(10, 20, 40mg/kg) produced dose-dependent blood pressure lowering in rat. The pretreatment of MgSO$_4$ and imipramine (Na$^{+}$-Mg$^{2+}$ exchange inhibitor) had no effect in gentamicin-induced hypotension. However, the gentamicin-induced hypotension was significantly potentiated in the preincubation of verapamil or nifedipine (L-type $Ca^{2+}$ channel blockers), and was significantly attenuated by CaCl$_2$ and was slightly attenuated by caffeine (phosphodiesterase inhibitor). Gentamicin (10, 30, 100$\mu$g/m1) did not have an effect on relaxation of phenylephrine-precontracted aortic rings but high concentration of gentamicin(100, 300$\mu$g/ml) relaxed KCl-precontracted aortic rings, which relaxation was potentiated by treatment of nifedipine. Whereas gentamicin markedly decreased left ventricular developed pressure (LVDP) in perfused heart. These data suggest that gentamicin has significant blood pressure lowering of the rat, which seems to be mediated by calcium channel-sensitive pathway and blood $Ca^{2+}$ level may be important role in this response.