• 한국위성정보통신학회논문지
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• 제9권1호
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• pp.85-89
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• 2014

심전도(electrocardiography, ECG)는 심장박동을 할 때, 발생하는 탈분극과 재분극으로 심장의 전위변화를 시간의 흐름에 따라 파형으로 표현한 것이다. 의료기관에서는 심전도신호를 이용하여 환자의 심장질환을 진단한다. 일반적으로 사람의 정상적인 심장박동수는 1분에 60-100회 이다. 만약 정상적인 심장박동 수보다 느리거나 빠르다면 부정맥이라고 한다. 본 논문에서는 심전도신호에서 R-peak를 검출하여, R-R 간격을 구하고 부정맥 중에 서맥(bradycardia)과 빈맥(tachycardia) 구간을 검출하는 알고리즘을 제안하고 모의실험을 하였다.

• Archives of Pharmacal Research
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• 제13권1호
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• pp.55-63
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• 1990

An attempt was made to investigate the effect of intracerebroventricular 5-hydroxytrypatamine (5-HT) on the cardiovascular system in urethane-anesthetized rabbit and to elucidate the mechanism of its action. 5-HT given into a lateral ventricle caused clearly a dose-dependent decrease inboth arterial blood pressure and in heart rate. The bradycardia and hypotension induced by 5-HT were significantly attenuated by the prior injection of ketanserin, cyproheptadine or clonidine. Pretreatment of atropine with bilateral vagotomy did not affect both bradycardia and hypotension. Propranolol weakened markedly the breadcardia of 5-HT but did not influence the depressor response of 5-HT. These experimental results suggest that intraventricular 5-HT cause the hypotension and bradyardia in rabbits through the stimulation of serotonergic receptors in brain, which is seemed to be associated to inhibition of sympathetic tone.

• 대한치과마취과학회지
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• 제13권4호
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• pp.161-166
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• 2013

Dexmedetomidine is a potent alpha-2-adrenergic agonist, more selective than clonidine, with widespread actions on the mammalian brain. A large body of recent work supports its analgesia and sympatholytic properties. Dexmedetomidine is a useful medication with many clinical applications. The medication has shown efficacy in decreasing the need for opioids, benzodiazepines, propofol, and other sedative medications. Dexmedetomidine has been used effectively for sedation during invasive procedures and in the ICU. Short-term sedation has been shown to be safe in studies, although hypotension and bradycardia are the most significant side effects. Dexmedetomidine is emerging as an effective therapeutic agent in the management of a wide range of clinical conditions with an efficacious, safe profile.

• 센서학회지
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• 제28권1호
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• pp.13-16
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• 2019

The analysis of electrocardiogram (ECG) signals facilitates the detection of various abnormal conditions of the human heart. The QRS complex is the most critical part of the ECG waveform. Further, different diseases can be identified based on the QRS complex. In this paper, a new algorithm based on the well-known Pan-Tompkins algorithm has been proposed. In the proposed scheme, the QRS complex is initially extracted by removing the background noise. Subsequently, the R-R interval and heart rate are calculated to detect whether the ECG is normal or has some abnormalities such as tachycardia and bradycardia. The accuracy of the proposed algorithm is found to be almost the same as the Pan-Tompkins algorithm and increases the R peak detection processing speed. For this work, samples are used from the MIT-BIH Arrhythmia Database, and the simulation is carried out using MATLAB 2016a.

• Neonatal Medicine
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• 제25권3호
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• pp.109-117
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• 2018

Purpose: Minimally invasive surfactant therapy (MIST) is currently used as a method of surfactant replacement therapy (SRT) for the treatment of respiratory distress syndrome (RDS) in preterm infants with a gestational age of less than 30 weeks. However, few studies have been conducted on MIST in neonates with a gestational age of 30 weeks or more. In this study, we compared MIST with endotracheal intubation as a rescue SRT for spontaneously breathing neonates with a gestational age of 30 weeks or more who were diagnosed with RDS. Methods: We investigated the clinical characteristics of spontaneously breathing neonates admitted to the neonatal intensive care unit of the Inje University Sanggye Paik Hospital from January 1, 2014 to December 31, 2016. These neonates were born at a gestational age of 30 weeks or more and were diagnosed with RDS. The neonates who were administered surfactant by MIST were categorized into the MIST group (n=16) and those who underwent endotracheal intubation were categorized into the control group (n=45). Thereafter, the clinical characteristics between the groups were compared. Results: Compared to the control group, the MIST group was less likely to require mechanical ventilation within 72 hours (P<0.001). The frequency of bradycardia during SRT was also low in the MIST group (P=0.033). Conclusion: MIST is considered relatively feasible and safe for treating RDS for reducing the need for mechanical ventilation and decreasing the occurrence of bradycardia during surfactant administration in neonates with a gestational age of 30 weeks or more.

• 대한임상독성학회지
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• 제4권1호
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• pp.78-81
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• 2006

Mad-honey poisoning is mainly brought about by the honey imported from Napal, Turkey, Brazil and other parts of Europe. This mad honey is extracted from Ericaceae plants of Rhododendron species and contains grayanotoxins that causes poisoning. These toxic compounds exert a specific stimulatory action on membrane permeability to Na+ions in various excitable tissues and cause depolarization of cell membranes. The toxic effects of grayanotoxins contained honey are mainly cardiovascular disturbances with bradycardia, cardiac arrhythmia, hypotension. There are Other symptoms like nausea, vomiting, salivation, dizziness, weakness and loss of consciousness. The precise amount for a toxic dose is not known. In general the severity of the honey poisoning depends on the amount ingested. Two cases of mad-honey poisoning are described here. Both patients showed bradycardia and arterial hypotension after ingestion of honey which was brought from Nepal. They were recovered fully within 24 hours after administration of fluids and atropine sulphate.

• 대한임상검사과학회지
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• 제44권3호
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• pp.136-141
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• 2012

The hearts of highly trained athletes show morphologic and electrocardiographic (ECG) changes that suggest the presence of cardiovascular disease, including sinus bradycardia, a striking increase in precordial R-wave or S-wave voltages, ST segment depression, and T-wave inversions. Despite a number of previous observational surveys, the determinants of abnormal ECG patterns in trained athletes remain largely unresolved. In this study, we compared the electrocardiographic characteristics of athletes to determine any sensitive indicators. Comparison between ECG patterns and cardiac physiology was performed in 21 junior athletes and 25 untrained subjects with no signs of cardiac disease. Sinus bradycardia was detected in a subset of athletes but not statistically significant between the athletes ($69.9{\pm}11.1bpm$) and the control ($72.7{\pm}9.9bpm$) group. The mean values of the PR and QTc intervals in the athletes' group were $149.2{\pm}15.4ms$ and $402.3{\pm}28.8ms$, respectively. Also, there were no significantly differences between control group and the athletes' group. In addition, the athletes demonstrated a spectrum of alterations in the 12-lead ECG pattern, including marked increase in precordial R-wave or S-wave voltages ($$SV_1+RV_5{\geq_-}35mm$$, 23.8%), QRS duration ($${\geq_-}90ms$$, 90.5%), suggestive of left ventricular hypertrophy. However, left axis deviation, ST segment depression, and T-wave changes in V5, V6 were not observed in either the athletes or control group. Our findings suggest that sinus bradycardia, precordial R-wave or S-wave voltages, and QRS duration seem to be more sensitively detected in athletes than in control group. Further researches on the electrocardiographic patterns of athletes should be carried out to improve the sensitivity and specificity of diagnostic criteria.

• 대한간호
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• 제33권4호
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• pp.62-85
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• 1994

The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease. The data were analyzed by using an S. P. S. S. computerized program for mean, standard deviation, percentage and paired t-test. The results of this study were as follows: 1. The increase in $PaO_2$ after hyperoxygenation and hyperinflation was highly statistically significant(p=0.041), and the increase in $PaO_2$ immediately after suctioning was not significant (p=0.752). The time of lowest $PaO_2$ was 30 seconds after the endotracheal suction. 2. The occurrance of cardiac arrhythmia after the endotracheal suction included sinus tachycardia, sinus arrhythmia, sinus bradycardia, premature atrial contraction (PAC), and premature ventricular contraction (PVC). The most frequent cardiac arrhythmia was sinus tachycardia (a subjects). Sinus arrhythmia was observed in 5 subjects and continued till 10 minutes after suctioning in two of these. Sinus bradycardia occurred in only 3 subjects and among them, 1 subjects shows sinus arrythmia till 10 minutes after suctioning along. PAC was observed in only one subject and continued till five minutes after suctining along with sinus arrhythmia. PVC was observed in three subjects: it lasted for only 30 seconds after suctioning in two subjects. but continued for 10 minutes after suctioning in the third. 6 subjects manifested two kinds of Cardiac arrhythmia Three of them showed sinus tachycardia with PVC, another 2 showed sinus bradycardia with sinus arrhythmia, and the other subject showed sinus arrhythmia with PAC. 3. The increases in heart rate during the endotracheal suction immediately after and at 30 seconds after suctioning were statistically significant (p=0.005). The increase in heart rate at one minute after suctioning was also significant (p=0.023). The increase in heart rate continued until 10 minutes after the endotracheal suction, but was not statistically significant In this study, endotracheal suctioning with hyperoxygenation and hyperinflation was effective in preventing a decrease in $PaO_2$ after suctioning, but not in preventing cardiac arrhythmias. Nurses should be aware of the complications of endotracheal suctioning and do effective hyperoxygenation and hyperinflation before and after suctioning. Further research is needed to develop a efficient endotracheal suction method which will minimize complications. This study needs to be replicated with different population of patients intubatted or having a tracheostomy, specifically, patients who cardiac or pulmonary desease.

• 대한약리학회지
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• 제30권3호
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• pp.313-319
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• 1994

$Na^+$ 이동에 관여하는 약물을 가토 측뇌실내로 투여하여 나타난 반응을 관찰함으로써 심혈관 조절 중추의 $Na^+$ channel과 뇌척수액내 $Na^+$ 농도의 상승에 의한 심혈관 반응과의 관계를 밝히고자 하였다. 1 M NaCl $200{\mu}l$을 urethane으로 마취된 가토의 측내실내로 투여시 승압과 서맥이 나타났고 이 서맥은 미주신경 절단으로 빈맥으로 역전되었다. $Na^+$ 이동억제제인 amiloride의 뇌실내 투여는 승압 및 서맥을 일으켰고 미주신경 절단으로 영향을 받지 않았으며 NaCl주입에 의한 심혈관계 반응에 영향을 미치지 않았다. Amiloride 유도체인 benzamil은 그 자체로도 심혈관계 반응에 아무런 영향을 미치지 않았을 뿐 아니라 NaCl의 효과에도 영향을 주지 않았다. 미주신경 절단 가토에서 amiloride는 NaCl에 의한 빈맥을 서맥으로 역전시켰으나, 그 서맥의 정도는 NaCl의 전처치로 영향받지 않았다. 이상의 성적으로 amiloiride와 benzamil이 심혈관계에 미치는 영향은 각기 다르나 그들 모두 NaCl에 의한 심혈관계 반응에는 아무런 영향을 미치지 않음을 알았다. 이로부터 심혈관 조절 중추내 amiloride나 benzamil에 민감한 $Na^+$ channel은 NaCl-유발 반응과는 관련이 없을 것이라 추론하였다.

• 한국임상수의학회지
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• 제33권4호
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• pp.234-236
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• 2016

A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosed by computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemic hypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heart valves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog was premedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone (2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heart rate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintained within normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). During subcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In no time at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done because mean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidal isoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardia after electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It is recommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.