• Title/Summary/Keyword: electrocardiography

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QT-interval prolongation due to medication found in the preoperative evaluation

  • Seto, Mika;Koga, Sayo;Kita, Ryosuke;Kikuta, Toshihiro
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.323-327
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    • 2017
  • QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively. These cases were considered to have drug-induced QT prolongation. We reaffirmed that even drugs administered for conditions unrelated to cardiac diseases can have adverse side effect of QT prolongation. In conclusion, our cases indicate that dental surgeons should be aware of the dangerous and even potentially lethal side effects of QT prolongation. For safe oral and maxillofacial surgery, cooperation with medical departments in various fields is important.

A Neonate Diagnosed with Wolff-Parkinson-White Syndrome Presenting with Cardiogenic Shock

  • Ha, Ji Eun;Lee, Sun Hyang;Park, Ga Young;Shin, Young-Lim;Kim, Sung Shin;Jang, Mi-Ae
    • Neonatal Medicine
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    • v.28 no.2
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    • pp.77-82
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    • 2021
  • We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.

2018 심방세동 카테터 절제술 대한민국 진료지침: PART III

  • Lee, Jeong-Myeong;Jeong, Dong-Seop;Yu, Hui-Tae;Park, Hyeong-Seop;Sim, Jae-Min;Kim, Ju-Yeon;Kim, Jun;Yun, Nam-Sik;O, Se-Il;No, Seung-Yeong;Jo, Yeong-Jin;Kim, Ki-Hun
    • International Journal of Arrhythmia
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    • v.19 no.3
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    • pp.285-339
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    • 2018
  • Catheter ablation of atrial fibrillation (AF) is one of the most complex interventional electrophysiological procedures. The success of AF ablation is based in large part on freedom from AF recurrence based on electrocardiography (ECG) monitoring. Arrhythmia monitoring can be performed with the use of noncontinuous or continuous ECG monitoring tools. AF ablation is an invasive procedure that entails risks, most of which are present during the acute procedural period. However, complications can also occur in the weeks or months following ablation. Recognizing common symptoms after AF ablation and distinguishing those that require urgent evaluation and referral to an electrophysiologist is an important part of follow-up after AF ablation. This section reviews the complications associated with catheter ablation procedures performed to treat AF. The types and incidence of complications are presented, their mechanisms are explored, and the optimal approach to prevention and treatment is discussed. Finally, surgical and hybrid AF ablation technology and the indications for concomitant open or closed surgical ablation of AF, stand-alone and hybrid surgical ablation of AF are covered in this section.

Sudden Intraoperative Hyperkalemia during Laparoscopic Radical Nephrectomy in a Patient with Underlying Renal Insufficiency

  • Jung, Sung Hoon;Han, Yun-Joung;Shin, Sang Ho;Lee, Hyo Seon;Lee, Ji Young
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.271-275
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    • 2018
  • We experienced a case of severe intraoperative hyperkalemia during laparoscopic radical nephrectomy in a 60-year-old male patient with renal insufficiency, whose hypertension had been managed by preoperative angiotensin II receptor blocker (ARB) and adrenergic beta-antagonist. After renal vessel ligation, his intraoperative potassium concentration suddenly increased to 7.0 mEq/L, but his electrocardiography (ECG) did not show any significant change. While preoperative ARB therapy has been regarded as a contributing factor for further aggravation of underlying renal insufficiency, we assumed that nephrectomy itself and rhabdomyolysis caused by surgical trauma also aggravated the underlying renal dysfunction and resulted in sudden hyperkalemia. Hyperkalemia was managed successfully with calcium gluconate, insulin, furosemide and crystalloid loading during the intraoperative and immediate postoperative periods, and potassium concentration decreased to 5.0 mEq/L at 8 hours after the operation. The patient's hospital course was uncomplicated, but his renal function deteriorated further.

Analysis of Clinical Research Trends for Acupotomy Treatment of Peripheral Facial Palsy

  • Jeon, Seok Hee;Choi, Ji Min;Yoo, Jae Hee;Shin, Jeong Cheol
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.276-283
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    • 2021
  • The purpose of this review was to investigate acupotomy treatment for peripheral facial palsy. By reviewing recent clinical trends, this may contribute to standardizing acupotomy treatment methods. There were 7 randomized controlled trials and 6 case series using acupotomy treatment for peripheral facial palsy published between January 01, 2014 and April 05, 2021, which were retrieved from 9 online databases. The number and characteristics of participants, main treatment sites, combination treatments, size of acupotomy needle, frequency and total period of treatment, evaluation indices, efficacy, and adverse events were analyzed. "Tender point or induration," "infraorbical foramen," and "buccal mucosa" were the most used treatment sites. The sizes of acupotomy needles varied from 20 mm to 80 mm in length, and 0.35 mm to 1.0 mm in diameter. One treatment cycle was performed every 3 to 5-7 days, and the number of treatments per treatment session ranged from 3 to 5-9 cycles. The results were evaluated using 1 to 4 evaluation indices and 9 different evaluation indices were used overall. The efficacy rate was the most used index, followed by the House-Brackmann grade, and electrocardiography. The "Risk of Bias 2," categorized most studies as having "some concerns." There were few adverse events reported.

Severe Case of Hypermagnesemia Caused by Ingesting Magnesium Containing Fertilizer (마그네슘 포함 비료 음독 후 발생한 중증의 고마그네슐혈증의 1례)

  • Lee, Ka-young;Yu, Jin-young;Cho, Nam-Jun;Park, Samel;Lee, Eun-young;Gil, Hyo-Wook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.141-144
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    • 2020
  • Hypermagnesemia is a rare condition that is usually iatrogenic in patients with elderly or renal failure. Severe hypermagnesemia is uncommon in patients with a normal renal function. Symptoms due to hypermagnesemia can range from mild symptoms, such as nausea, to severe symptoms, such as cardiac and respiratory arrest. This paper describes a case of a 49-year-old woman who ingested a magnesium-containing fertilizer with normal renal function. Cardiac arrest occurred eight hours after poisoning. Electrocardiography changed from a narrow QRS to a wide QRS and then to a complete atrioventricular block. Her hemodynamic state was unstable. Continuous renal replacement therapy was performed to remove magnesium from the blood, with the subsequent resolution of arrhythmia and hemodynamic stabilization. This paper reviews the pathophysiologic effects of magnesium on the cardiovascular system, clinical manifestation, and treatment of hypermagnesemia.

Iatrogenic Spark Burn Injury to the Chest From a Transcutaneous Pacing Patch (경피적 심장 충격 장치의 사용으로 발생한 의인성 전기 화상의 증례 보고)

  • Choi, Jong Yun;Cha, Won Jin;Jung, Ee Room;Seo, Bommie Florence;Jung, Sung-No
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.50-52
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    • 2021
  • Iatrogenic electrical burns that occur from the use of a defibrillator, a paddle-type cardiac shock device, have been reported in various forms. Electrical burns are usually conducted directly through the skin and are more damaging than scald burns or contact burns. A transcutaneous cardiac pacing device is a patch-type cardiac shock device that automatically delivers a shock when an abnormal heart rhythm is detected. We introduce a unique case of iatrogenic electrical burns caused by the transcutaneous pacing patch of a cardiac shock device. Electrical energy was converted into a spark due to foreign bodies deposited around the patch, resulting in damage to the peripheral area of the skin.

Abnormal Electrocardiogram Signal Detection Based on the BiLSTM Network

  • Asif, Husnain;Choe, Tae-Young
    • International Journal of Contents
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    • v.18 no.2
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    • pp.68-80
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    • 2022
  • The health of the human heart is commonly measured using ECG (Electrocardiography) signals. To identify any anomaly in the human heart, the time-sequence of ECG signals is examined manually by a cardiologist or cardiac electrophysiologist. Lightweight anomaly detection on ECG signals in an embedded system is expected to be popular in the near future, because of the increasing number of heart disease symptoms. Some previous research uses deep learning networks such as LSTM and BiLSTM to detect anomaly signals without any handcrafted feature. Unfortunately, lightweight LSTMs show low precision and heavy LSTMs require heavy computing powers and volumes of labeled dataset for symptom classification. This paper proposes an ECG anomaly detection system based on two level BiLSTM for acceptable precision with lightweight networks, which is lightweight and usable at home. Also, this paper presents a new threshold technique which considers statistics of the current ECG pattern. This paper's proposed model with BiLSTM detects ECG signal anomaly in 0.467 ~ 1.0 F1 score, compared to 0.426 ~ 0.978 F1 score of the similar model with LSTM except one highly noisy dataset.

Tightness Evaluation of Smart Sportswear Using 3D Virtual Clothing (3D 가상착의를 이용한 스마트 스포츠웨어의 밀착성 평가)

  • Soyoung Kim;Heeran Lee
    • Journal of the Korean Society of Clothing and Textiles
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    • v.47 no.1
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    • pp.123-136
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    • 2023
  • To develop smart sportswear capable of measuring biometric data, we created a close-fitting pattern using two- and three-dimensional (2D and 3D, respectively) methods. After 3D virtual fitting, the tightness of each pattern was evaluated using image processing of contact points, mesh deviation, and cross-sectional shapes. In contact-point analysis, the 3D pattern showed high rates of contact with the body (84.6% and 93.1% for shirts and pants, respectively). Compared with the 2D pattern, the 3D pattern demonstrated closer contact at the lower chest, upper arm, and thigh regions, where electrocardiography and electromyography were primarily carried out. The overall average gap was also lower in the 3D pattern (5.27 and 4.66 mm in shirts and pants, respectively). In the underbust, waist, thigh circumference, and mid-thigh circumference, the cross-section distance between clothing and body was showed a statistically significant difference and evenly distributed in the 3D pattern, exhibiting more closeness. The tightness and fit of the 3D smart sportswear sensor pattern were successfully evaluated. We believe that this study is critical, as it facilitates the comparison of different patterns through visualization and digitization through 3D virtual fitting.

A case of chronic licorice intoxication-induced apparent mineralocorticoid excess syndrome (만성 감초 중독으로 유발된 미네랄코르티코이드 과잉증후군 1예)

  • Young Jae Lim;Ji Eun Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.151-155
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    • 2023
  • Licorice is a perennial herb belonging to the legume family that mainly grows in northeastern China, Mongolia, Siberia, and other regions. It is used in traditional medicine in the form of dried roots in the East and the West. The main active component of licorice, glycyrrhizin, is known to produce mineralocorticoid effects when consumed chronically, which can lead to apparent mineralocorticoid excess syndrome. Herein, we present the case of a 72-year-old woman who was admitted to the emergency room with severe generalized weakness and difficulty keeping her neck upright, which had developed after daily consumption of licorice-infused water for the past 2 months. Blood tests revealed metabolic alkalosis and severe hypokalemia, and an electrocardiogram showed ventricular bigeminy. The patient was treated with daily potassium and spironolactone supplements, leading to a significant improvement in muscle strength after a week. One week later, the patient was discharged, showing rare ventricular premature contractions on electrocardiography, but with no specific complaints. Chronic licorice ingestion leading to hypokalemia and muscle weakness can be life-threatening, necessitating the discontinuation of the causative agent, close monitoring, and cautious supplementation of potassium and spironolactone as treatment.