• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.166-169
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• 2006

Poisonings caused by 'mad honey' are known to occur in response to grayanotoxins, which bind to sodium channels in the cell membrane, increasing membrane sodium permeability and preventing inactivation. Mild symptoms of mad honey intoxication are dizziness, weakness, hypersalivation, nausea, vomiting, and paresthesia. Severe intoxication, however, leads to serious cardiac manifestations such as atrioventricular block, dose-dependent hypotension, bradycardia, and respiratory depression. Atropine and vasoactive drugs improve symptoms of both bradycardia and respiratory rate depression. We report an unusual case of saliva-type hyperamylasemia in a mad honey poisoning patient who developed clinically significant bradycardia. She recovered fully within 3 days following atropine administration and medical treatment.

• The Korean Journal of Emergency Medical Services
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• v.21 no.2
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• pp.71-78
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• 2017

Purpose: The purpose of the study was to investigate the satisfaction of paramedic students with simulation-based learning in an emergency intervention for bradycardia patients. Methods: Study participants were 72 paramedic students who experienced simulation-based learning. Data on satisfaction with the intervention were collected and analyzed using SPSS 18.0. Results: The mean satisfaction score for the simulation-based learning intervention was 4.28 by Likert 5 point scale. Conclusion: Simulation-based learning can facilitate adaptation to the scene of an emergency among paramedic students.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.2
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• pp.114-118
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• 2005

Ingestion of plant material rarely manifest in clinical intoxication. This is due to the relatively low toxicity of most plants in Korea. But, veratrum is an important plant on account of its highly toxic alkaloids. Five cases of Veratrum grandiflonum mass poisoning are described. Clinical symptoms occurred quickly, within 30 min. Vomiting, a fall in blood pressure and bradycardia was observed. Treatments in the emergency department included gastric lavage, activated charcoal, and administration of atropine and dopamine for bradycardia and hypotension. Although one of them experienced profound hypotension, bradycardia and mental change, the outcomes were favorable in all cases, producing a complete cure without any sequellae at discharge.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.335-336
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• 2021

The oculocardiac reflex is a trigeminal-vagal reflex that manifests as cardiac arrythmias, most often bradycardia. The reflex can be triggered by manipulation of periorbital structures and unintended pressure on the bulbus oculi maxillofacial procedures. In this brief communication, we describe an unusual trigger of the oculocardiac reflex during maxillofacial surgery that resulted in severe bradycardia. This case highlights the need for careful securement of medical devices and attention to surgical technique to avoid undue pressure on draped fascial structures.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.1
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• pp.41-44
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• 2004

With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.

• Proceedings of the Korean Society of Fisheries Technology Conference
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• 2001.10a
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• pp.265-266
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• 2001

Cardiovascular and respiratory responses of fish exposed to environmental hypoxia have on the subject of a number of investigations. Although relatively few species have been examined, generalized responses to ambient hypoxia include an elevation of blood pressure, increased systemic vascular resistance and bradycardia (Fritsche and Nilsson, 1990; Bushnell and Brill, 1991). The degree of bradycardia experienced by fish during hypoxia is highly variable and may depend upon the severity of the hypoxia and the rapidity with which it is imposed. (omitted)

• The Journal of Internal Korean Medicine
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• v.39 no.4
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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.

• Korean Journal of Veterinary Research
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• v.41 no.4
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• pp.497-503
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• 2001

Evidence from the last 10 years have been suggested that melatonin mainly produce a depressant effect on the cardiac system, but we found an activating effect of melatonin on heart rate in this research. To determine the hypothesis that melatonin has dual effects on physiological behaviour of cardiac system, we investigated the effects of melatonin on heart rate in isolated rat atria and anesthetized rats. Regardless of concentration, melatonin produced bradycardia in the 84 cases of 148 experiments (57 %) and tachycardia in the 64 cases of 148 experiments (43 %). And in atrium, melatonin produced a decrease automaticity in 52 cases of 86 experiments (60 %) and increase automaticity in 40 % (34/86 cases). Also, these effects are not significnat relationship with concetration of melatonin. The melatonin-induced bradycardia in vivo was inhibited by pretreatment of atropine or bilateral cervical vagotomy. Also, in isolated atrium the melatonin-induced decrease in automaticity was inhibited by pretreatment of atropine. These melatonin-induced responses were potenitated by pretreatment of propranolol. The melatonin-induced tachycardia in vivo was inhibited by pretreatment of propranolol, nifedipine or bilateral cervical vagotomy, but not by pretreatment of atropine. The melatonin-induced incease in automaticity in isolated atrium was converted to decrease in automaticity by pretreatment of propranolol. In addition, the change in heart rate caused by adrenoceptor agonists was inhibited by pretreatment of melatonin. These results indicate that melatonin-induced bradycardia may be related to a muscarinic receptor activation and melatonin-induced tachycardia may be related to a $\beta$-adrenoceptor stimulation.

• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.345-349
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• 2007

The objective of this study was to investigate the efficacy of needle-acupuncture (needle-AP) at PC06 and BL15 on xylazine induced bradycardia in dogs. Total 12 dogs were divided into control (4 dogs), PC06 (4 dogs) and BL15 (4 dogs) groups, respectively. As for the treatments in each group, control group was injected with xylazine only. PC06 and BL15 groups were treated by needle-AP during 20 minutes at the same time of xylazine injection. The changes of heart rates, R-R intervals and respiratory rates were investigated on pre, 10, 20, 30, 40, 50 and 60 minutes after xylazine injection. The change of heart rates in experimental PC06 and BL15 groups revealed significant increase on 10 (p<0.05) and 20 minutes (p<0.05) after xylazine injection, compared with those of control group. In addition, heart rates in PC06 group showed increased value on 30 minutes (p<0.05) after xylazine injection, comparing with those of BL15 group. The changes of respiratory rates in experimental PC06 and BL15 groups revealed significant increase on 20 minutes (p<0.05) after xylazine injection, compared with those of control group, however, significance was not found between experimental groups. In conclusion, needle-AP at PC06 and BL15 were effective for improvement of xylazine induced canine bradycardia and needle-AP at PC06 was more effective than that at BL15.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.133-138
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• 2021

Glufosinate-containing herbicides is a non-selective herbicide commonly used worldwide. As the use of them increased gradually since paraquat was banned in 2012, the number of suicides by their ingestion is also increasing continuously. Complications of glufosinate-containing herbicide poisoning include various central nervous system (CNS) toxicities such as convulsions, loss of consciousness, memory impairment, and respiratory depression, which may be accompanied by hemodynamic changes such as bradycardia and hypotension. However, it is very rare that arrhythmias other than bradycardia occurred and Takotsubo cardiomyopathy was combined due to cardiotoxicity. A 71-year-old female patient was transferred to our hospital after ingesting 500 mL of glufosinate-containing herbicide and receiving 5 L of gastric lavage at a local hospital. A few hours later, she presented stuporous mentality, respiratory depression, and convulsions, and was accompanied by hypotension and bradycardia. On the second day of admission, electrocardiogram (ECG) showed bradycardia and QTc prolongation with hemodynamic Instability. Accordingly, we conducted the early treatment with continuous renal replacement therapy (CRRT) and the application of temporary cardiac pacemaker. An echocardiogram demonstrated decreased ejection fraction (EF) and Takotsubo cardiomyopathy on the third day of admission. Then, she was discharged safely with conservative treatment. At the follow-up after 1 year, Takotsubo cardiomyopathy, EF and QTc prolongation were recovered on echocardiogram and ECG. Because cardiac toxicity after glufosinate-containing herbicide poisoning may cause life-threatening consequences, caution is required while treating the patient. Therefore, if electrocardiogram changes are seen in the elderly with a large amount of glufosinate herbicide ingestion, additional cardiac function test through echocardiography should be concerned, and early treatment through CRRT or artificial cardiac pacing should be considered.