• Title/Summary/Keyword: heart sound

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Does the Layman Understand "the Whistling Sounds when Breathing out" as Real Wheezing? (일반인들은 숨쉴 때 "쌕쌕하는 소리"를 천명음으로 이해하는가?)

  • Jang, Seung-Hun;Jung, Seung-Hyun;Eom, Kwang-Seok;Shin, Taerim;Kim, Chul-Hong;Bahn, Joon-Woo;Kim, Dong-Gyu;Park, Myung-Jae;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.378-385
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    • 2003
  • Background : Wheezing is an important clue in the diagnosis of asthma. Previously, a Korean National asthma survey used a written questionnaire, containing the question, "Have you ever experienced a breathing sound-like 'sack-sack' or a flute sound (the Korean description for wheezing) during the last 12 months?" The response to this question showed a large discrepancy between the prevalence of wheezing and physician diagnosed asthma. This might have resulted partly from a misunderstanding of the question, due to an inadequate description for wheezing. This study was aimed at finding how well the layman understands the term "wheezing" when described as a breathing sound-like 'sack-sack', a whistle or a flute. Subjects and method : Sixty subjects, without experience of wheezing(group I), and 45 subjects, with chronic cough alleging wheezing(group II), were recruited from the Hallym University's Sacred Heart Hospital, in Anyang, Korea. Four different breathing sounds; vesicular, wheezing, tracheobronchial and crackle, were played for the subjects, without any experience with wheezing, and they were asked "which sound is most like that you would imagine when asked about a breathing sound-like 'sack-sack', a whistle or a flute?" This was followed by replaying the true wheezing sound, and then a global assessment was requested for the concordance between the real wheezing sound and the imagined wheezing sound. The wheezing sound was played for those subjects alleging wheezing, and they were asked, "have you really experienced that sound". Results : Only 46.7% of group I answered correctly, with 13.3% choosing the vesicular sound, 16.7% the tracheobronchial sound, 5.0% the crackle and 18.3% failed to answer. The concordance between their imagined wheezing and the real sound was $69.3{\pm}22.4%(mean{\pm}S.D.)$. 77.8% of group II recognized the correct sound as the one they had experienced. Conclusions : Language is not sufficient to the layman for describing natural sounds, such as wheezing.

The Effects of OSCE Application Before Clinical Practice for Nursing Students (임상실습 전 간호학생에게 적용한 OSCE 프로그램 효과)

  • Yoon, Jin;Kim, Keum Ja;Choi, Mi Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.2
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    • pp.273-284
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    • 2013
  • Purpose: The study was done to identify the effects of OSCE program prior to clinical practice for nursing students and to find out the weakest area of fundamental nursing skills. Methods: Study design was methodological triangulation. Qualitative analysis was done to derive nursing students' OSCE experiences using OSCE reflection note. Level of basic nursing skill acquirement was identified by quantitative method. Results: Four themes and 10 sub-categories emerged: (a) confidence and interests in nursing being increased, (b) being encouraged by mentor and evaluator, (c) requiring much effort to learn nursing skill, (d) being aware of themselves and understanding others in their shoes. Results of analysis of OSCE application score record showed as followings ; Intravenous injection(92.6%), Intramuscular injection(89.5%), Foley catheterization(85.2%), Vital sign(81.5%): BP check(63.0%) Respiration check(50.0%), Health assessment: respiration sound auscultation(33.3%) heart sound auscultation(44.4%). Conclusion: OSCE program application before frist clinical nursing practice was effective in terms of fundamental nursing skills learning. It is necessary to reinforce nursing skills based on the study results.

흉총창에 의한 심방파열 치험 2례

  • Lee, Doo-Yun;Kwack, Sang-Ryong
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.60-65
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    • 1980
  • We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

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Multi-modal Wearable Device for Cardiac Arrest Detection (심정지 감지를 위한 다생체 신호 측정 웨어러블 디바이스 개발)

  • Ahn, Hyun Jun;You, Sung Min;Cho, Kyeongwon;Park, Hoon Ki;Kim, In Young
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.330-335
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    • 2017
  • Cardiac arrest is owing to the failure of the heart that makes the blood circulation stop. Arrested blood circulation prevents the supply of the oxygen and the glucose and it results the loss of consciousness and, finally, brain death. Many public institution installed the AED for emergency treatment, but, it is not efficient when the patient is alone. In this paper, we made multiplexed wearable device for cardiac arrest detection. With this device, we measure the individual's electrocardiography, heart sound and motion. If the cardiac arrest is detected, the device make a warning horn and transmit the signal for defibrillation. We obtain 98.33% of ECG data, 94.5% of PCG data and 98.38% of IMU data accuracy for each evaluation and 93.33% accuracy for integrated evaluation.

Primary Fibrosarcoma of Right Atrium: A Case Report (우심방에 발생한 원발성 섬유성 육종: 1례 치험 보고)

  • 이성행
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.173-178
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    • 1977
  • A 51 year old man was admitted to the Thoracic and Cardiovascular Department of Kyungpook University Hospital on April 7, 1976, with chief complaints of orthopnea and the chest pain for about 3 months. Physical examination showed narrow pulse pressure, puffy face, engorged neck veins at sitting position, distant heart sound, enlarged liver and edematous upper extremities. The chest roentgenogram demonstrated markedly enlarged cardiac silhouette. Low voltage and the low to diphagic T`s were noted on the electrocardiogram. Paroxysmal ventricular tachycardia was developed intermittently and was subsided spontaneously. Repeated pericardiocentesis were performed each of which yielded from 100 to 300ml. but intractable cardiac failure was progressed. The bacteriology and cytology of the pericardial fluid were not revealed any specific findings. The pericardiectomy was performed to release the intractable cardiac tamponade. Pericardium was found to be thickened and cardiac constriction was noted. The thickened pericardium was easily removed. A large hen`s egg sized dark blue tumor mass occupied the anterior wall of the right atrium and two thumb tip sized pearl gray tumors were placed at the just below portion of the main pulmonary artery. The biopsy report revealed primary fibrosarcoma of the heart. The patient was improved from the symptoms of the cardiac failure during the postoperative course.

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A Study on Independent Rhythm Technique of Synthesizer & Percussions - Focusing on the Sting's "Nothing Like The Sun" Album - (신디사이저와 퍼커션의 독자적인 리듬기법 연구 - Sting의 "Nothing Like The Sun" 앨범을 중심으로 -)

  • Ohm, Soo-Han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.327-332
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    • 2016
  • Sting (Gordon Sumner) is a British musician and singer-songwriter. He was the principal songwriter, lead singer, and bassist for the new wave rock band 'The Police' from 1977 to 1984, before launching a solo career in 1985. With his stylish and sophisticated sensibility and musical spectra, he achieved 100 million album sales. In this thesis, after he disbanded the group THE POLICE, his career as a solo artist with his wide variety of musical colors has been acknowledged for his reputation over more than 30 years. Therefore, I analyze 'Sting' of music included in 'Straight To My Heart' and 'Be Still My Beating Heart' in. Songs in indicate that the drum part the tunes that there is in a record doesn't break away from the basic way of music. The role of the whole rhythm division through the various percussions or can see a synthesizer than the role as the cord musical instrument that there are lots of tunes placing a great deal of weight on the role as the rhythmic musical instrument more. The unique instrument-based rhythm of the early Sting and role dispensation create a unique sound that is quite different from what the musician subsequently recorded. The feature and rhythmic characteristic, which is the arrangement that appeared outstandingly in this record, I am trying to explain about the way in which I lead the basic flow of the tune through the rhythm division of the other musical instruments which I split that is, the drum beat and break away from a rhythm from the divided general way and include a percussion.

Auditory Characteristics of Tiger shark Scyliorhinus torazame caught in the Coast of jeju Island (제주 연안에서 어획된 두툽상어의 청각 특성)

  • Ahn, Jang-Young;Choi, Chan-Moon;Lee, Chang-Heon
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.47 no.3
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    • pp.234-240
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    • 2011
  • In order to obtain the fundamental data about the behavior of sharks by underwater audible sound, this experiment was carried out to investigate the auditory characteristics of tiger shark Scyliorhinus torazame which was caught in the coast of Jeju Island by heart rate conditioning method using pure tones coupled with a delayed electric shock. The audible range of tiger shark extended from 80Hz to 300Hz with a peak sensitivity at 80Hz including less sensitivity at 300Hz. The mean auditory thresholds of tiger shark at the frequencies of 80Hz, 100Hz, 200Hz and 300Hz were 90dB, 103dB, 94dB and 115dB, respectively. The positive response of tiger shark was not evident after the sound projection of over 300Hz. At the results, the sensitive frequency range of tiger shark is narrower than that of fish that has swim bladder. In addition, it is assumed that the most sensitive frequency in auditory thresholds of Chondrichthyes is lower than that of Osteichthyes. Critical ratios of tiger shark measured in the presence of masking noise in the spectrum level range of about 60-70dB (0dB re $1{\mu}Pa/\sqrt{Hz}$) increased from minimum 27dB to maximum 39dB at test frequencies of 80-200Hz. The noise spectrum level at the start of masking was distributed at the range of about 65dB within 80-200Hz.

Analysis of Meridian Response by Sound Stimulus in Body (음향 자극에 의한 인체 경락의 반응분석)

  • Kim, Yong-Chin;Jeong, Dong-Myong
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.38 no.3
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    • pp.47-54
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    • 2001
  • This study is to analyze the impedance response in human body by acoustic stimulation on acupoints and contrast parte; for objectification of the meridian substance. It is to verify meridian pathway and channel theory or bio-energy in body. This paper proposes to make an hypothesis about the underground water theory. The meridian has not tube or pipe line type channel but bio-energy flow along the channel similar to flowing pattern of underground water in body. It was analyzed the current characteristic or impedance response after acoustic stimulation by sound wave of 5 specific tones. The response characteristics of current stimulation are measured by the average current magnitude and variation ratio or meridian. The current variation ratio or Live Meridian(gung) 33.2%, Heart Meridian(sang) 30.7% Kidney Meridian (gak) 33.1%, Spleen Meridian(chi) 33.9%, Lung Meridian (wo) 30.7% are to be compared to contrast parts (non-acupoint and meridian). In experimental results, meridian is discrimination to non-meridian, and 5 vital meridians have a reciprocal relationship with sound wave of 5 specific tones.

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Asymmetric Activation in the Prefrontal Cortex and Heart Rate Variability by Sound-induced Affects (음향감성에 의한 전전두엽의 비대칭성과 심박동변이도)

  • Jang Eun-Hye;Lee Ji-Hye;Lee Sang-Tae;Kim Wuon-Shik
    • Science of Emotion and Sensibility
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    • v.8 no.1
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    • pp.47-54
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    • 2005
  • This study is aimed to inspect how the different sensitivities in Behavioral activation system(BAS) and behavioral inhibition system(BIS) modulate on the properties of physiological responses stimulated by positive or negative affective sound. We measured the electroencephalogram(EEG) and electrocardiogram (ECG) of 32 students, consisted of four groups depending on the BAS and BIS sensitivities, during listening to meditation music or noise. The EEG was recorded at Fpl and Fp2 sites and Power spectral density(PSD) of HRV was derived from the ECG, and the power of HRV was calculated for 3 major frequency ranges(low frequency[LF], medium frequency and high frequency[HF]). After listening to music or noise, subjects reported the affect induced by the sound. For EEG, the power in the alpha band at Fp2, especially in the alpha-2 band(9.0-11.0 Hz) increased during the subjects listening to music, while the power at Fpl increased during noise. During listening to meditation music, there is a tendency that the left-sided activation in prefrontal cortex(PFC) is positively correlated with the difference of BAS(Z)-BIS(Z). During listening to noise, there is a tendency that the right-sided activation in PFC is dominant in case any of the sensitivity of BAS or BIS is high. For HRV, we found that the index of MF/(LF+HF), during listening to music, was higher significantly in the individuals with a low BIS but high BAS than in the individuals with a low sensitivity both BIS and BAS individuals. With high BIS, regardless of the BAS sensitivity, the difference of this index values was not significant. From these results we suggest that the physiological responses of different individuals in BAS and BIS react differently under the same emotionally provocative challenge.

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Surgical Repair of Single Ventricle (Type III C solitus) (단심실 -III C Solitus 형의 수술치험-)

  • naf
    • Journal of Chest Surgery
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    • v.12 no.3
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    • pp.281-288
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    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

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