• Clinical and Experimental Pediatrics
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• 제57권4호
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• pp.193-198
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• 2014

Purpose: This study aimed to evaluate the autonomic imbalance in syncope by comparing the baseline heart rate variability (HRV) between healthy children and those with vasovagal syncope. Methods: To characterize the autonomic profile in children experiencing vasovagal syncope, we evaluated the HRV of 23 patients aged 7-18 years and 20 healthy children. These children were divided into preadolescent (<12 years) and adolescent groups. The following time-domain indices were calculated: root mean square of the successive differences (RMSSD); standard deviation of all average R-R intervals (SDNN); and frequency domain indices including high frequency (HF), low frequency (LF), normalized high frequency, normalized low frequency, and low frequency to high frequency ratio (LF/HF). Results: HRV values were significantly different between healthy children and those with syncope. Student t test indicated significantly higher SNDD values (60.46 ms vs. 37.42 ms, P =0.003) and RMSSD (57.90 ms vs. 26.92 ms, P=0.000) in the patient group than in the control group. In the patient group, RMSSD (80.41 ms vs. 45.89 ms, P =0.015) and normalized HF (61.18 ms vs. 43.19 ms, P =0.022) were significantly higher in adolescents, whereas normalized LF (38.81 ms vs. 56.76 ms, P =0.022) and LF/HF ratio (0.76 vs. 1.89, P =0.041) were significantly lower in adolescents. In contrast, the control group did not have significant differences in HRV values between adolescents and preadolescents. Conclusion: The results of this study indicated that children with syncope had a decreased sympathetic tone and increased vagal tone compared to healthy children. Additionally, more severe autonomic imbalances possibly occur in adolescents than in preadolescents.

• 대한한방내과학회지
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• 제38권2호
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• pp.240-245
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• 2017

Objectives: The purpose of this clinical case report is to describe the efficacy of Korean medicine in the treatment of vasovagal syncope. Methods: The patient was treated with acupuncture, pharmacopuncture, and herbal medicine. The symptoms (headache, palpitation, sweating, flushing, weakness, coldness) of the patient were observed. Results: After the treatment, the patient's symptoms improved, but more treatments were required. Conclusion: This study can add to understanding of the effect of Korean medicine on vasovagal syncope.

• 대한치과마취과학회지
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• 제12권4호
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• pp.215-221
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• 2012

The loss of consciousness in the dental office have many causes, such as, vasodepressor syncope, drug administration, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, acute allergic reaction, acute myocardial infarction, cerebrovascular accident, hyperglycemic reaction and hyperventilation. Patients have fainted during all phases of dental care: during tooth extraction and other surgical procedures, during local anesthetic injections, or during procedures such as venipuncture, on being seated in the dental chair, and even on first entering the dental office. If an elderly patient with known cardiovascular or cerebrovascular problems experiences a syncopal episode, differentiation from cerebrovascular insufficiency of more serious etiology, such as cerebrovascular accident, must be considered. And anaphylactic shock is also suggested during intravenous drug administration. This is a case report of syncope care during venous injection of cephalosporin in patient with cerebrovascular accident.

• 대한치과마취과학회지
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• 제11권2호
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• pp.164-171
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• 2011

Altered consciousness may be the first clinical sign of a serious medical problem that requires immediate and intensive therapy to maintain life. There are many causes of the loss of consciousness in the dental office setting, such as, vasodepressor syncope, drug administration or ingestion, orthostatic hypotension, epilepsy, hypoglycemic reaction, acute adrenal insufficiency, cerebrovascular accident, hyperglycemic reaction, acute myocardial infarction, acute allergic reaction and hyperventilation. This is a case report of syncope and coma during endodontic treatment of a maxillary third molar under local infiltration anesthesia in multiple medically compromised patient. The main cause was thought to be hypoglycemic reaction. The patient was transferred to the medical emergency room and cared properly by the emergency medical physicians. The prognosis was good.

• Clinical and Experimental Pediatrics
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• 제59권11호
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• pp.451-455
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• 2016

Purpose: Neurocardiogenic syncope (NCS) is the most frequent cause of fainting during adolescence. Inappropriate cardiovascular autonomic control may be responsible for this clinical event. The head-up tilt test has been considered a diagnostic standard, but it is cumbersome and has a high false-positive rate. We performed a study to evaluate whether P-wave dispersion (PWD) could be a useful electrocardiographic parameter of cardiac autonomic dysfunction in children with NCS. Methods: Fifty-four patients with NCS (28 boys and 26 girls; mean age, $12.3{\pm}1.4$ years) and 55 age- and sex-matched healthy controls were enrolled. PWD was obtained as the difference between maximum and minimum durations of the P wave on standard 12-lead electrocardiography in all patients and controls Results: The value of PWD was significantly higher in the syncope group than in the control group ($69.7{\pm}19.6$ msec vs. $45.5{\pm}17.1$ msec, respectively; P<0.001). The minimum duration of P wave was shorter in the syncope group than in the control group ($43.8{\pm}16.8$ msec vs. $53.5{\pm}10.7$ msec, respectively; P<0.001). Left atrial volume was not different between the groups on transthoracic echocardiography. Conclusion: PWD on echocardiography could be used as a clinical parameter in patients with NCS.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2000년도 추계학술대회 논문집 학회본부 D
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• pp.854-856
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• 2000

In this paper, complex demodulation method to access the dynamic autonomic nervous system characteristic of patients with syncope is proposed. Assessment of heart rate variability using conventional power spectral analysis such as FFT or AR-modeling could not capture a split change occurrence. However, in this paper, these changes are seen and by using Complex Demodulation Method(CDM) autonomic nervous system function assessments of patients with vasovagal syncope were verified and suggested.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1999년도 추계학술대회 논문집 학회본부 B
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• pp.624-1-624-3
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• 1999

In this paper, complex demodulation method to access the dynamic autonomic nervous system characteristic of patients with syncope is proposed. Assessment of heart rate variability using conventional power spectral analysis such as FFT or AR-modeling could not capture a split change occurrence. However, in this paper, these changes are seen and by using Complex Demodulation Method(CDM) autonomic nervous system function assessments of patients with vasovagal syncope were verified and suggested.

• Clinical and Experimental Pediatrics
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• 제45권9호
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• pp.1114-1119
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• 2002

목 적 : 본 연구는 신경심장실신발작 환자의 일상생활에서의 심박수의 단기 및 장기 프랙탈 상관의 특성을 조사하고자 하였다. 방 법: 최소한 2회 이상의 실신이 있었던 25명의 환자(10-15세, 여 14명, 남 11명)를 대상으로 하였다. 24시간 홀터 테입을 정상재생속도의 230배 고속으로 재회전 시키면서 이를 460 kHz로 디지털 변환시켰다. 변환된 심전도를 1시간 단위로 자른 다음 RR간격을 측정하였다. 1시간의 RR interval(RRI) 자료 중 연속된 20,000개를 추출하여 분석하였다. 프랙털 상관을 정량화하기 위해서 detrended fluctuation analysis를 이용하여 단기간 프랙탈 상관지수($n{\leq}16$, ${\alpha}_1$)와 장기간 프랙탈 상관지수(n>16, ${\alpha}_2$)를 계산했다. 결 과: 대조군과 비교할 때, 실신환자에서 단기간 프랙탈 상관지수인 ${\alpha}_1$는 24시간 평균과 모든 6시간 대에 걸쳐 의미있게 증가되어 있었다. 반면 장기간 프랙탈 상관지수인 ${\alpha}_2$는 24시간 평균과 모든 6시간대에 감소되어 있었으나 통계적 의의는 24시간 평균과 0-6시에서만 있었다. 결 론 : 실신이 있는 소아의 심박수는 단기적 상관은 높고 이것은 일중 전체에 걸쳐 나타난다. 따라서 단기적으로 심박수는 정상소아보다 부드러운 거동을 보인다. 이것은 심박수가 일단 증가하거나 감소하면 단기간에서는 같은 방향으로 지속적 증가 또는 지속적 감소되는 경향이 있음을 나타낸다. 이것은 실신소아에서 실신발작 때 보이는 지속적인 심박수 감소가 일상생활에서의 지속적 심박수 감소와 관련됨을 시사한다.

• 동의생리병리학회지
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• 제24권5호
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• pp.737-747
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• 2010

In Neijing(內經) the theory of Reverse(厥) was explained syncope causes by disharmony of emotions irregularity, deficient or excessive Qi(氣虛, 氣實) and blood disorder, it was the causes of cold hypersensitivity of hands and feet except coldness itself, include impairment of Qi circulation and the deficiency of the kidney weakened essence and blood, weakness and damage in the kidney essence, deficiency of the lower part and deficiency of the lower Qi as the major causes. In Shanghanlun(傷寒論) the theory of Reverse(厥) was divided into by disharmony of heat or cold reversal symptom. In Jingyue quanshu(景岳全書), causes of Reverse(厥) was Qi and blood disorder, damps(痰飮), alcohol and sex include syncope. In Dongeuibogam(東醫寶鑑), causes of Reverse(厥) was deficient or excessive Qi, impairment of blood circulation which means the deficiency of blood, essence(精) and blood stasis (瘀血), and disorder of gastrointestinal system which means malfunction of gastrointestine, damps(痰飮) and toxicity of alcohol. The rest of the causes include San syndrome(疝症), sun stroke(暑病) and heat reversal(熱厥).

• 대한치과마취과학회:학술대회논문집
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• 대한치과마취과학회 2002년도 제2차 학술대회
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• pp.53-57
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• 2002