• Title/Summary/Keyword: electrocardiography

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Analysis of Patients with Acute Carbon Monoxide Poisoning in one Hospital (일개 병원에서의 일산화탄소 중독증으로 내원한 환자에 대한 분석)

  • Kim Kyung Hwan;Kim Ah Jin;Shin Dong Wun;Rho Jun Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.27-32
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    • 2005
  • Purpose: The frequency of carbon monoxide poisoning has been decreased in the interior of the Korea. But occasionally it is occurred and the risk of exposure is high in working place so far. Because of the characteristics of gas, the detection of exposure and poisoning could be delayed and fatality is high. We should apprehend of carbon monoxide poisoning. So we would report analysis of patients with carbon monoxide poisoning. Methods: A retrospective review of CO poisoned patients visited emergency department from January 2000 to December 2004 was conducted. Results: 24 patients were enrolled. Their average of age was $37.6\pm20.9$ years old and COHb was $19.4\pm13.32\%$. The blood level of initial COHb and mental status on arrival were not correlated each other. The blood level of initial COHb and loss of consciousness were not correlated, too. Initial electrocardiography (EKG) was not correlated with cardiac enzymes such as CK-MB and troponin I. But base excess was correlated with mental status on arrival and complication such as rhabdomyolysis. Hyperbaric oxygen therapy was correlated with base excess and mental status on arrival. Conclusion: The clinical features of carbon monoxide poisoning are nonspecific. For proper diagnosis, it is important that we should consider patient's environment and take patient's history carefully. The blood level of initial COHb does not reflect severity of poisoning accurately. So We should determine the treatment of choice depending on patient's status.

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The Risk Factors of Acute Cardiovascular and Neurological Toxicity in Acute CO Poisoning Patients and Epidemiologic Features of Exposure Routes (급성 일산화탄소 중독 환자에서 급성 심혈관계, 신경학적 독성의 위험요인과 노출 경로의 역학적 특성)

  • Park, Jinsoo;Shin, Seunglyul;Seo, Youngho;Jung, Hyunmin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.1
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    • pp.34-41
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    • 2020
  • Purpose: This study evaluated aggressive hyperbaric oxygen therapy (HBOT) by understanding various exposure routes of acute carbon monoxide (CO) poisoning, the risk factors causing acute cardiovascular, and neurological toxicity caused by poisoning. Methods: A retrospective study was conducted based on the medical records of 417 acute CO poisoning patients who visited the emergency care unit from March 2017 to August 2019. The exposure routes, HBOT performance, age, sex, medical history (hypertension, diabetes mellitus, ischemic heart disease, heart failure), intentionality, loss of consciousness (LOC), intake with alcohol or sedatives, and initial test results (carboxyhemoglobin (COHb), troponin-I, electrocardiography, echocardiography, brain MRI) were examined. Comparative analysis of the clinical information was conducted between the groups that showed acute cardiovascular toxicity and neurological toxicity, and groups that did not. Results: Among 417 patients diagnosed with acute CO poisoning, 201 cases (48.2%) were intentional, and charcoal briquette was the most common route (169 patients (40.5%)). Two hundred sixteen cases (51.8%) were accidental, and fire was the most common route (135 patients (32.4%)). The exposure route was more diverse with accidental poisoning. Three hundred ninety-nine patients were studied for acute cardiovascular toxicity, and 62 patients (15.5%) were confirmed to be positive. The result was statistically significant in intentionality, LOC, combined sedatives, initial COHb, HTN, and IHD. One hundred two patients were studied for acute neurological toxicity, which was observed in 26 patients (25.5%). The result was statistically significant in age and LOC. Conclusion: Active HBOT should be performed to minimize damage to the major organs by identifying the various exposure routes of CO poisoning, risk factors for acute cardiovascular toxicity (intentionality, LOC, combined sedatives, initial COHb, HTN, IHD), and the risk factors for acute neurological toxicity (age, LOC).

Clinical Observation for the 120 Cases of CVA (뇌전산화단층촬영(CT)상 확진된 120예의 뇌졸중환자에 대한 임상적 고찰)

  • Bae, Sung-Han;Nam, Chang-Gyu
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.168-184
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    • 1998
  • Clinical Observation was made on 120 Cases of CVA that were confirmed through brain CT of Oriental Medical hospital of Se-Myung University from July in 1997 to June in 1998. 1. The CVA cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), and the greatest in number among them were the cases of cerebral infarction. 2. The most cases were 50 of age in all cases, in cerebral infarction were over 70 of age. There is no significant difference in the frequency of strokes between the male and female. the ratio was 1.07 : 1. 3. The frequency of strokes seems to have no relation to month and season. 4. The course of entering hospital, most patients visited this hospital directly(not through any other hospital) within 24hours. 5. The first attack was noted in 80.8%, the recurrance attack in 19.2% and the cerebral infarction had high recurrance ratio compared with cerebral hemorrhage. 6. The average duration of hospitalization was 25.2 days. 7. The most ordinary preceding disease was hypertension. 8. The common symptoms were motor disturbance and dysphasia. 9. The most frequent location of the lesion in cerebral infarction was parietal lobe, in cerebral hemorrhage was basal ganglia. 10. According to electrocardiography findings, abnormality was noted in cerebral infarction more than cerebral hemorrhage, subarachnoid hemorrhage. 11. The hypercholesterolemia and hypertriglyceridemia were found more frequently in cerebral infarction than cerebral hemorrhage, subarachnoid hemorrhage. 12. The average time to start physical theraphy was 7.76 days after admission. 13. The most common complications were pneumonia and bed sore.

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Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis (양측성 신동맥 협착증에서 발생한 급성 비대상성 심부전과 급성 신손상)

  • Jung, Ho Jin;Choi, Won Suk;Kang, Hyun Jae;Jung, Byung Chun;Lee, Bong Ryeol;Lee, Jong Joo;Lee, Jun-Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.146-151
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    • 2015
  • Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

Postprandial Hypotension and Heart Rate Variability in Older Adults (노인의 식후 저혈압과 심박동변이)

  • Jang, Ae-Lee;Hwang, Sun-Kyung
    • Korean Journal of Adult Nursing
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    • v.24 no.2
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    • pp.139-148
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    • 2012
  • Purpose: A study was designed to compare heart rate variability (HVR) of older adults with postprandial hypotension (PPH) with older adults with no PPH. Methods: The samples were community-dwelling older adults (${\geq}$ 60 years old) with PPH (n=35) and without PPH (n=35). HRV was measured by 10 minutes of electrocardiography using Physiolab 400 and analyzed in time domain (SDNN) and with power spectral analysis in frequency domain (TP, LF, HF, LF/HF). Blood pressure was measured every 15 minutes before and until 120 minutes after the meal. Results: All HRV parameters were lower in the PPH group compared to those with no PPH. Specifically the measures of SDNN, TP, LF, and LF/HF of the PPH group were significantly lower (U=385.0, $p$=.008; U=361.0, $p$=.003; U=375.0, $p$=.005; U=368.0, $p$=.004, respectively). Further, the LF and LF/HF of SBP (${\geq}140$ mmHg) group and the LF/HF of DBP (${\geq}$ 90 mmHg) group were significantly lower ($x^2$=6.33, $p$=.042; $x^2$=33.10, $p$ <.001; $x^2$=11.03, $p$=.004, respectively). Conclusion: These findings indicate that the autonomic nervous functions in persons with PPH are less activated than those persons with no PPH. The findings contribute to an understanding of HRV and the association of autonomic nervous function with the mechanism of PPH.

Cardiac Troponin I Elevation in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jeon, Ik-Chan;Chang, Chul-Hoon;Choi, Byung-Yon;Kim, Min-Su;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.99-102
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    • 2009
  • Objective: Cardiac dysfunction after aneurysmal subarachnoid hemorrhage (SAH) is associated with elevation of serum cardiac troponin I (cTnl) levels. Elevation of cTnl predicts cardiopulmonary and neurological complications, and poor outcome. Methods: We retrospectively reviewed the medical and radiologic records of 114 (male: 30, female: 84) patients who developed aneurysmal SAH between January 2006 and June 2007 and had no history of previous cardiac problems. We evaluated their electrocardiography and cTnl level, which had been measured at admission. A cTnl level above 0.5 $\mu$g/L was defined as an indicator of cardiac injury following SAH. We examined various clinical factors for their association with cTnl elevation and analyzed data using chi-square test, t-test and logistic regression test with SPSS version 12.0. The results were considered significant at p< 0.05. Results: The following parameters shows a correlation with cTnl elevation: higher Hunt-Hess (H-H) grade (p = 0.000), poor Glasgow Outcome Scale (GOS) score (p = 0.000), profound pulmonary complication (p = 0.043), higher heart rate during initial three days following SAH (p = 0.029), ruptured aneurysm on communicating segment of internal carotid artery (p = 0.025), incidence of vasospasm (p = 0.421), and duration of hyperdynamic therapy for vasospasm (p = 0.292). A significant determinants for outcome were cTnl elevation (p = 0.046) and H-H grade (p = 0.000) in a multivariate study. Conclusion: A cTnl is a good indicator for cardiopulmonary and neurologic complications and outcome following SAH. Consideration of variable clinical factors that related with cTnl elevation may be useful tactics for treatment of SAH and concomitant complications.

The implementation of modular respiratory system for patient monitoring (환자감시를 위한 모듈형 호흡 시스템의 구현)

  • 박종억;김영길
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2001.05a
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    • pp.503-506
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    • 2001
  • There are four factors for patient monitoring : electrocardiography, blood pressure, temperature and respiration. While there are a lot of studies of E.C.C (electro-cardiography) monitoring system in the world, the studies of Respiratory system are not enough and leave much to be desired in the country. In this paper, we developed a respiratory system with the electrical impedance change of the lungs depending on the breath. Using the same electrode, we can monitor E.C.C and Respiration simultaneously, so we can monitor a patient's no-breathing state due to the central nerve paralysis in the emergency room easily. In this monitoring system, the analog part was made separated from the digital part for reducing power source noise and protecting patient from electric shock. The analog part consists of the several parts a high-frequency sine-wave generator, all amplifier for amplifying any impedance change signal, an analog processing part for rectifying and filtering. And the digital parts consists of three parts an AD convertor for converting analog signal to digital signal, digital filter, and a digital part for digital signal processing. This system's merits are using the same electrode with E.C.C and developing the multiple patient monitoring system easily.

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Assessment of covariate-effect of sleeping behavior on heart rate variability during a clinical trial (임상시험 중 수면행위가 심박변이도에 미치는 영향 분석)

  • Lee, Jeon;Oh, Dal-Seok;Lee, Hae-Jung;Choi, Sun-Mi;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.13 no.3
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    • pp.97-103
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    • 2007
  • The object of this study is to evaluate confounding effect of sleeping behavior on heart rate variability (HRV) in healthy volunteers during a randomized clinical trial. From 6 healthy volunteer, we acquired circadian electrocardiography(ECG) with a Holter monitoring device(DigiTrak Plus, Philips). The compatible analytical program, Zymed, was used for calculation of RR intervals of 24h ECG signal. Then, we generated HRV signals and calculated 9 HRV parameters in time domain and frequency domain for every 30 minute with Matlab 6.x software. We also encoded participants' activities as follows; stable condition(1), sleeping behavior(2), eating behavior(3), and undefined condition(4). Using SPSS 12.0, we tested if there was any difference between HRV parameters of day-time and night-time and between those of a subject in stable condition and in sleeping behavior. As a result, one of the most important parameter-LF/HF ratio, which indicates the autonomic balance between sympathetic and parasympathetic nervous systems, as same the other parameters, showed large inter-individual variations in circadian profiles. And, the mean LF/HF ratio of each participant was different between in stable condition and in sleeping behavior (p<.05). Consequently, the effect of sleeping behavior must be considered when one or more of HRV parameters, especially LF/HF ratio, are used as assessment index in clinical studies.

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The Efficacy and Safety of Beef Tallow Extract Including Cis-9-cetylmyristoleate in Patients with Osteoarthritis - As an Adjuvant Pharmacological Treatment -

  • Lee, Sang-Hoon;Kim, June-Hyuk;Cho, Whan-Seong;Seo, Sung-Wook;Kim, Sung-Kyu;Oh, Joo-Han
    • Preventive Nutrition and Food Science
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    • v.10 no.3
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    • pp.285-289
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    • 2005
  • In this double-blind, placebo-controlled trial, we assessed the efficacy and safety of beef tallow extract (BTE) including Cis-9-cetylmyristoleate in patients with arthritis. Between May and December 2003, we selected 80 patients (n=80) who showed/manifested arthritic symptoms and whose radiological findings were suggestive of arthritis, and randomly assigned them to placebo-controlled (n=40) and treatment group (n=40). The placebo (corn starch 350 mg) and BTE (208 mg) were orally administered to placebo-controlled and treatment group three times a day, respectively. We assessed the efficacy and safety based on the visual analogue scale (V AS) and modified knee society knee scores (MKSKS) at baseline and endpoint, respectively. To assess the safety, we monitored the adverse effects noted in liver, kidney, cardiovascular and gastrointestinal system for 3 weeks. Then, we performed not only a questionnaire study but also laboratory tests (e.g., liver function test, kidney function test, urinalysis, electrocardiography [EKG], complete blood cell counts [CBC] and chest X-ray). For statistical analysis, Student (-test and paired (-test were done using SPSS■ Version 11.0. Statistical significance was set at p < 0.05. The scores between V AS and MKSKS showed statistical significance (p < 0.05) with an improvement of $69.2\%$ (27/39) and $3.8\%$ (21/39) of treatment-group patients, respectively. Abnormal laboratory findings were noted in neither placebo-controlled nor treatment group. In conclusion, our results indicate that the administration of BTE was a safe and effective treatment regimen for patients with arthritis. In addition, the efficacy of BTE was more remarkable in alleviating the symptoms rather than improving the function.

Analysis of Data Transmission Rate and Power Consumption in Zigbee Based Electrocardiography (지그비 기반 심전계의 데이터 전송률과 소비 전력 분석)

  • Kim, Nam-Jin;Hong, Joo-Hyun;Lee, Tae-Soo
    • The Journal of the Korea Contents Association
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    • v.6 no.12
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    • pp.96-104
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    • 2006
  • In this study, data transmission ratio and power consumption issues of Zigbee based sensor module and personal digital assistant(PDA) were addressed to develop ECG telemetry device. PDA processes the data transmitted through serial port using non-blocking method. The transmission rate was dependent on the packet structure. It was 300 ECG samples/sec, when each packet was composed of 2 ECG data and 3-axial acceleration vector. Using two AAA batteries in series, operating time of the wireless sensor module was above 28 hours in average. Power consumption of PDA was dependent on screen ON/OFF condition and serial port usage. In this application, operating time of PDA was 5 hours in average. In conclusion, there was no problem in the power consumption of wireless sensor module and transmission rate, when the developed device was used as 24 hour Holter device. But, PDA has the problem of power consumption, which should be solved.

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