• 제목/요약/키워드: Heart block

검색결과 198건 처리시간 0.026초

Prognostic Significance of Left Axis Deviation in Acute Heart Failure Patients with Left Bundle branch block: an Analysis from the Korean Acute Heart Failure (KorAHF) Registry

  • Choi, Ki Hong;Han, Seongwook;Lee, Ga Yeon;Choi, Jin-Oh;Jeon, Eun-Seok;Lee, Hae-Young;Lee, Sang Eun;Kim, Jae-Joong;Chae, Shung Chull;Baek, Sang Hong;Kang, Seok-Min;Choi, Dong-Ju;Yoo, Byung-Su;Kim, Kye Hun;Cho, Myeong-Chan;Park, Hyun-Young;Oh, Byung-Hee
    • Korean Circulation Journal
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    • 제48권11호
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    • pp.1002-1011
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    • 2018
  • Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <-30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, -3.25; 95% confidence interval, -5.82, -0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

개심술후 영구적 인공심박조정기 장 (Implantation of permanent pacemaker after open heart surgery)

  • 조범구;박영식;이종국
    • Journal of Chest Surgery
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    • 제17권3호
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    • pp.356-361
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    • 1984
  • During the period from January 1982 to June 1984 we implanted permanent pacemakers in 18 patients who received open heart surgery at Yonsei University Hospital. 1.In 11 patients, open heart surgery was performed at Yonsei University Hospital and new surgical induced heart blocks were developed and implantations of permanent pacemaker were done. 2.Total 1035 open heart surgeries were done and implantations of pacemaker were performed in 11 cases. [1.06%]. After total correction of TOF [215 cases] implantations of pacemaker were done in 3 cases. [1.4%] Implantations of pacemaker were 0.37% after VSD repair, 0.78% after ASD repair, 5.9% after ECD repair, 0.48% after MVR and 2.0% after AVR. 3.Causes were complete A-V block, sick sinus syndrome and A-V dissociation. 4.Heart blocks were developed immediately after bypass stop in 8 patients. 5.Implantations of pacemaker were done at more than 2 weeks after open heart surgery. 6.Local anesthesia was done in adult and general anesthesia in infants. Locations of pulse generator were subxiphoid, subcostal & subclavian. Position of pulse generator was between subcutaneous fat layer and muscle layer. 7.Types of pulse generator were VVI, VDD and AAI. 8.The postoperative complications included infection, pacing failure, sensing failure and lead dislodgment.

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Motor Weakness after Caudal Epidural Injection Using the Air-acceptance Test

  • Lee, Mi Hyeon;Han, Cheol Sig;Lee, Sang Hoon;Lee, Jeong Hyun;Choi, Eun Mi;Choi, Young Ryong;Chung, Mi Hwa
    • The Korean Journal of Pain
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    • 제26권3호
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    • pp.286-290
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    • 2013
  • Air injected into the epidural space may spread along the nerves of the paravertebral space. Depending on the location of the air, neurologic complications such as multiradicular syndrome, lumbar root compression, and even paraplegia may occur. However, cases of motor weakness caused by air bubbles after caudal epidural injection are rare. A 44-year-old female patient received a caudal epidural injection after an air-acceptance test. Four hours later, she complained of motor weakness in the right lower extremity and numbness of the S1 dermatome. Magnetic resonance imaging showed no anomalies other than an air bubble measuring 13 mm in length and 0.337 ml in volume positioned near the right S1 root. Her symptoms completely regressed within 48 hours.

방실차단에 의한 서맥을 보이는 환자 한방 치험 1례 (A Case of Bradycardia with Atrioventricular Block Treated with Korean Medicine)

  • 이형민;김정화;이상화;정혜선;양승보;조승연;박성욱;박정미;고창남
    • 대한한방내과학회지
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    • 제39권4호
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    • pp.839-845
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    • 2018
  • This is a case report of a 57-year-old patient diagnosed with bradycardia and atrioventricular (AV) block. The chief complaint of the patient was palpitation and dizziness. An electrocardiogram (ECG) showed a second degree AV block with 2:1 AV conduction. The patient was treated with Korean medicine, including herbal medicine, for 35 days. After 2 weeks of treatment, the heart rate increased from 33 to 56 and the follow-up electrocardiogram showed normal findings. The symptoms of palpitation and dizziness were also improved. The effect on heart rate, ECG, and symptoms lasted until the end of the treatment. This case report demonstrated that Korean medicine could be effective for treatment of symptomatic bradycardia with AV block.

경피적 접근을 이용한 영구 박동조절기(pacemaker) 장착을 통한 3도 방실 차단이 있는 비글종 개의 치료 (Permanent Transvenous Cardiac Pacing in a Beagle Dog With a Third Degree Atrioventricular Block)

  • 이승곤;문형선;이무현;현창백
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.414-418
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    • 2007
  • 2.8살 된 암컷 비글종 개 (체중 11kg)가 운동 불내성과 간헐적인 실신증상을 보여 내원하였다. 청진상 불규칙하게 불규칙한 심장박동과 지속적인 맥박결손이 청진되었다. 심전도상에 3도 방실차단 소견이 관찰되었다. 환자는 임상증상 개선을 위하여 경정맥을 통한 영구적인 박동조절기(pacemaker)를 장착하였다. 그 결과 환자는 더 이상 실신증상을 보이지 않았고 주인과 함께 산책을 나갈 수 있을 만큼 임상증상이 개선되었다. 현재까지 박동조절기 장착과 관련된 합병증 없이 잘 생존하고 있다.

상악결절골을 이용한 상악동점막거상술에 관한 연구 (A SINUS FLOOR ELEVATION METHOD USING MAXILLARY TUBEROSITY BONE)

  • 이용찬
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권2호
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    • pp.236-244
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    • 1996
  • The maxillary sinus elevation for simultaneous placement of dental implants and combination grafts of autogenous bone harvested from the maxillary tuberosity and demineralized freeze dried bone and HA is relatively easy and safely done under local anesthesia in out patients clinic. This article is to introduce the sinus floor elevation method which has been performed to 5 patients in the department of Dentistry/Oral & Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym University, from 1993.

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구간적분과 통계변수 분석에 의한 심음 인식 (Heart Sound Recognition by Analysis of Block Integration and Statistical Variables)

  • 이상민;김인영;홍승홍
    • 대한의용생체공학회:의공학회지
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    • 제20권6호
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    • pp.573-581
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    • 1999
  • 청진에 의한 심음도법은 오래 전부터 진단에 이용되어 왔지만 심음 인식분야에서는 제 1심음, 제 2심음, 특정 판막의 운동과 같이 부분적 기능이나 동작 분석을 목적으로 심음의 일부 구간에 대한 인식 연구가 행하여졌을 뿐 심음 한 주기 전체를 대상으로 하는 심음 특징 인식에 대한 연구성과는 매우 미약하였다. 본 논문에서는 한 주기 동안의 전체 심음을 분석하여 파라메터를 추출하고 이를 이용하여 한 주기 심음 특성에 대한 인식방법을 제안하였다. 제안된 알고리즘은 시간영역에서 제 1심음과 제 2심 검출을 기반으로 한다. 알고리즘은 주요 구간을 추출하고 정점 위치, 구간 적분, 통계변수에 대한 분석을 통하여 심음을 분류한다. 심음을 정상, 수축초기 심잡음, 수축말기 심잡음, 이완 초기 심잡음, 이완 말기 심잡음, 연속적 심잡음으로 구분하였다. 시험 결과 평균 88% 의 평균 인식률을 얻어 제안된 알고리즘의 유용성을 확인하였다. 비정상 심음의 분류에 대한 오인식은 주로 수축초기의 심잡음인 경우로 나타났다.

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십자형심장에 동반된 양대혈관우심실기시증 -수술치험 1례 (Double Outlet of Right Ventricle in Criss-Cross Heart -Surgical Experience of One Case)

  • 김대연;조성래;박성달;정현기
    • Journal of Chest Surgery
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    • 제30권12호
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    • pp.1242-1246
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    • 1997
  • Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in priss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solidus, concordant atrioventricular connection and double outlet of rig t ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 314 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.

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Characterization of Linear Polymer-Dendrimer Block Copolymer/Plasmid DNA Complexes: Formation of Core-shell Type Nanoparticles with DNA and Application to Gene Delivery in Vitro

  • Choi, Joon-Sig;Choi, Young-Hun;Park, Jong-Sang
    • Bulletin of the Korean Chemical Society
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    • 제25권7호
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    • pp.1025-1030
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    • 2004
  • A hybrid linear polymer-dendrimer block copolymer, poly(ethylene glycol)-block-poly(L-lysine) dendrimer, was synthesized and introduced to form polyionic complexes with DNA. The copolymer formed core-shell type nanoparticles with plasmid DNA. From dynamic light scattering experiments, the mean diameter of the polyplexes was observed to be 154.4 nm. The complex showed much increased water solubility compared to poly(L-lysine). The plasmid DNA in polyplexes was efficiently protected from the enzymatic digestion of DNase I. The cytotoxicity and transfection efficiency for 293 cells was measured in comparison with poly(Llysine).

상복부 암성통증 환자관리에 있어서 내장신경통 차단술의 임상적 고찰 (Neurolytic Splanchnic Nerve Block for the Treatment of Upper Abdominal Pain)

  • 윤영준;진상호
    • The Korean Journal of Pain
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    • 제2권2호
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    • pp.181-188
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    • 1989
  • Neurolytic splanchnic nerve block is an effective method for the relief of pain of upper abdominal cancer. Nine cases of intractable upper abdominal cancer pain were treated by splanchnic nerve block with absolute alcohol (25 ml) at the pain clinic of Kangdong Sacred Heart Hospital, Hallym University, during a 19 month period from March, 1988 to September, 1989. The group included six patients with stomach cancer, two patients with pancreatic cancer, and one patient with hepatobiliary cancer. We used fluoroscopy in all cases of alcohol spianchnic nerve block to determine both, the position of the needle tip, and the spread of the neurolytic solution. Of the 9 patients, 6 patients had excellent pain relief, and 3 patients who had combined upper abdominal and lower back pain had relieved upper abdominal pain only, but remaining lower back pain. Of the 9 patients', 5 patients had excellent pain relief through the patients remaining life (1-2 months) in which follow up was possible.

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