• Journal of Chest Surgery
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• 제16권4호
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• pp.547-554
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• 1983

Implantation of Dual Chamber Pacemakers Which sense in the Atrium and the Ventricle, and sequentially or synchronously trigger impulses in the both chambers, has led us to the near realization of the ideal "Physiologic Pacing". We have experienced two cases of implantation of Dual chamber pacemaker in September and October, 1983. One patient was a 21-year-old male who had postoperative complete heart block since he was taken Total correction of TOF in May, 1983 . We implanted transvenously a dual chamber pacemaker, VDD type, through the left subclavian vein. In the other patient who came to the emergency room for partial obstruction of small bowels with severe abdominal pain, nausea and vomiting, in whom heart block was found, we implanted a DDD type pacemaker through the left subclavian puncture. The pacemakers have been functioning well postoperatively for more than two months, and the conditions of patient were uneventful.

• 한국임상수의학회지
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• 제40권1호
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• pp.50-55
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• 2023

A 10-year-old spayed female Cocker spaniel weighing 6.64 kg was presented with a sign of syncope. Electrocardiographic findings revealed pathologic atrioventricular (AV) block alternating 3rd degree AV block, non-responsive to atropine. Before pacemaker implantation, several anti-hypertensive medications were administered, but there was no improvement. After pacemaker implantation, the heart rate and systemic arterial systolic blood pressure were immediately improved. This is the first report on the resolution of an AV block and malignant systemic hypertension after a pacemaker implant in veterinary medicine.

• Journal of Chest Surgery
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• 제17권3호
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• pp.356-361
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• 1984

During the period from January 1982 to June 1984 we implanted permanent pacemakers in 18 patients who received open heart surgery at Yonsei University Hospital. 1.In 11 patients, open heart surgery was performed at Yonsei University Hospital and new surgical induced heart blocks were developed and implantations of permanent pacemaker were done. 2.Total 1035 open heart surgeries were done and implantations of pacemaker were performed in 11 cases. [1.06%]. After total correction of TOF [215 cases] implantations of pacemaker were done in 3 cases. [1.4%] Implantations of pacemaker were 0.37% after VSD repair, 0.78% after ASD repair, 5.9% after ECD repair, 0.48% after MVR and 2.0% after AVR. 3.Causes were complete A-V block, sick sinus syndrome and A-V dissociation. 4.Heart blocks were developed immediately after bypass stop in 8 patients. 5.Implantations of pacemaker were done at more than 2 weeks after open heart surgery. 6.Local anesthesia was done in adult and general anesthesia in infants. Locations of pulse generator were subxiphoid, subcostal & subclavian. Position of pulse generator was between subcutaneous fat layer and muscle layer. 7.Types of pulse generator were VVI, VDD and AAI. 8.The postoperative complications included infection, pacing failure, sensing failure and lead dislodgment.

• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.181-185
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• 1994

저자들은 완전방실블록 환자에서 쌍극의 영구심장박동기를 이식후에도 계속되는 실신발작을 보여 단극의 영구심장박동기로 바꾼 후 그 증상이 소실된 예를 경험하였기에 이를 보고하는 바이다.

• 대한약침학회지
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• 제16권4호
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• pp.36-42
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• 2013

Objectives: Shengmaisan (SMS) is a traditional Chinese medicine prescription widely used for the treatment of diverse organs in Korea. The interstitial cells of Cajal (ICCs) are pacemaker cells that play an important role in the generation of coordinated gastrointestinal (GI) motility. We have aimed to investigate the effects of SMS in the ICCs in the mouse small intestine. Methods: To dissociate the ICCs, we used enzymatic digestions from the small intestine in a mouse. After that, the ICCs were identified immunologically by using the anti-c-kit antibody. In the ICCs, the electrophysiological whole-cell patch-clamp configuration was used to record pacemaker potentials in the cultured ICCs. Results: The ICCs generated pacemaker potentials in the mouse small intestine. SMS produced membrane depolarization with concentration-dependent manners in the current clamp mode. Pretreatment with a $Ca^{2+}$ free solution and thapsigargin, a $Ca^{2+}$-ATPase inhibitor in the endoplasmic reticulum, stopped the generation of the pacemaker potentials. In the case of $Ca^{2+}$-free solutions, SMS induced membrane depolarizations. However, when thapsigargin in a bath solution was applied, the membrane depolarization was not produced by SMS. The membrane depolarizations produced by SMS were inhibited by U-73122, an active phospholipase C (PLC) inhibitors. Furthermore, chelerythrine and calphostin C, a protein kinase C (PKC) inhibitors had no effects on SMS-induced membrane depolarizations. Conclusions: These results suggest that SMS might affect GI motility by modulating the pacemaker activity through an internal $Ca^{2+}$- and PLC-dependent and PKC-independent pathway in the ICCs.

• Journal of Chest Surgery
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• 제37권6호
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• pp.499-503
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• 2004

배경: 본 연구에서는 소아연령군에서 과거 13년 동안 시행한 심외막 인공 심박 조율 수술의 임상경험을 바탕으로 인공 심박동기의 평균 수명, 역치, 재수술의 원인 등을 알아보고자 하였다. 대상 및 방법: 1989년 1월부터 2002년 7월까지 영구 심박 조율기 또는 전극의 이식을 시행한 83명의 환아에게 시행한 121예의 수술을 대상으로 하였다. 후향적으로 환자의무기록을 조사하여 심박 조율기의 수명, 자극 역치, 저항, R파, P파, 감지 역치 등을 조사하였다. 결과: 수술 당시 측정한 평균 심실 자극역치는 1.2$\pm$0.l (0.1∼5) mV, 평균 저항은 519.1$\pm$18.1 (319∼778) ohm, 평균 심실 R파 감지역치는 8.9$\pm$0.7 (4∼20) mV, 평균 P파 감지역치는 2.5$\pm$0.7 (0.4∼12) mV 이었다. 심박 조율기의 평균 수명은 64.7$\pm$3.7 (2∼196)개월이었다. 심박 조율기 무재수술률은 1년 94.6%, 2년 93.6%, 5년 80.8%, 7년 63.7%, 10년 45.4%였다. 재수술의 원인은 전지 고갈이 26예, 전극 이상이 9예 등이었다. 심박 조율기 삽입 후 이의 오작동과 관련된 수술 후 조기 사망은 없었다. 결론: 소아연령군에서 심외막 심박 조율기 삽입 후 재수술 없이 이를 사용할 수 있는 비율은 비교적 만족할 만한 수준으로 19.1%의 환자만이 5년 내에 재삽입이 필요했다. 스테로이드 용출 전극의 재수술률은 6.7%로 이는 심외막 심박 조율기의 수명을 늘리는 데 도움이 될 것으로 생각된다.

• The Korean Journal of Physiology and Pharmacology
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• 제8권3호
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• pp.153-159
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• 2004

The interstitial cells of Cajal (ICCs) are the pacemaker cells in gastrointestinal tract and generate electrical rhythmicity in gastrointestinal muscles. Therefore, ICC may be modulated by endogenous agents such as neurotransmitter, hormones, and prostaglandins (PGs). In the present study, we investigated the effects of prostaglandins, especially $PGE_2$, on pacemaker currents in cultured ICCs from murine small intestine by using whole-cell patch clamp techniques. ICCs generated spontaneous slow waves under voltage-clamp conditions and showed a mean amplitude of $-452{\pm}39\;pA$ and frequency of $18{\pm}2$ cycles/min (n=6). Treatments of the cells with $PGE_2$ $(1\;{\mu}M)$ decreased both the frequency and amplitude of the pacemaker currents and increased the resting currents in the outward direction. $PGE_2$ had only inhibitory effects on pacemaker currents and this inhibitory effect was dose-dependent. For characterization of specific membrane EP receptor subtypes, involved in the effects of $PGE_2$ on pacemaker currents in ICCs, EP receptor agonists were used: Butaprost $(1\;{\mu}M)$, $EP_2$ receptor agonist, reduced the spontaneous inward current frequency and amplitude in cultured ICCs (n=5). However sulprostone $(1\;{\mu}M)$, a mixed $EP_1$ and $EP_3$ agonist, had no effects on the frequency, amplitude and resting currents of pacemaker currents (n=5). SQ-22536 (an inhibitor of adenylate cyclase; $100\;{\mu}M$) and ODQ (an inhibitor of guanylate cyclase; $100\;{\mu}M$) had no effects on $PGE_2$ actions of pacemaker currents. These observations indicate that $PGE_2$ alter directly the pacemaker currents in ICCs, and that the $PGE_2$ receptor subtypes involved are the $EP_2$ receptor, independent of cyclic AMP- and GMP-dependent pathway.

• The Korean Journal of Physiology and Pharmacology
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• 제12권3호
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• pp.111-115
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• 2008

The effects of (-)-epigallocatechin gallate (EGCG) on pacemaker activities of cultured interstitial cells of Cajal (ICC) from murine small intestine were investigated using whole-cell patch-clamp technique at $30^{\circ}C$ and $Ca^{2+}$ image analysis. ICC generated spontaneous pacemaker currents at a holding potential of -70 mV. The treatment of ICC with EGCG resulted in a dose-dependent decrease in the frequency and amplitude of pacemaker currents. SQ-22536, an adenylate cyclase inhibitor, and ODQ, a guanylate cyclase inhibitor, did not inhibit the effects of EGCG. EGCG-induced effects on pacemaker currents were not inhibited by glibenclamide, an ATP-sensitive $K^+$ channel blocker and TEA, a $Ca^{2+}$-activated $K^+$ channel blocker. Also, we found that EGCG inhibited the spontaneous $[Ca^{2+}]_i$ oscillations in cultured ICC. In conclusion, EGCG inhibited the pacemaker activity of ICC and reduced $[Ca^{2+}]_i$ oscillations by cAMP-, cGMP-, ATP-sensitive $K^+$ channel-independent manner.

• The Korean Journal of Physiology and Pharmacology
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• 제14권2호
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• pp.83-89
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• 2010

In this study, we studied whether hydrogen sulfide ($H_2S$) has an effect on the pacemaker activity of interstitial cells of Cajal (ICC), in the small intestine of mice. The actions of $H_2S$ on pacemaker activity were investigated using whole-cell patch-clamp technique, intracellular $Ca^{2+}$ analysis at $30^{\circ}C$ and RT-PCR in cultured mouse intestinal ICC. Exogenously applied sodium hydrogen sulfide (NaHS), a donor of hydrogen sulfide, caused a slight tonic inward current on pacemaker activity in ICC at low concentrations (50 and $100{\mu}m$), but at high concentration ($500{\mu}m$ and 1 mM) it seemed to cause light tonic inward currents and then inhibited pacemaker amplitude and pacemaker frequency, and also an increase in the resting currents in the outward direction. Glibenclamide or other potassium channel blockers (TEA, $BaCl_2$, apamin or 4-aminopydirine) did not have an effect on NaHS-induced action in ICC. The exogenous application of carbonilcyanide p-triflouromethoxyphenylhydrazone (FCCP) and thapsigargin also inhibited the pacemaker activity of ICC as NaHS. Also, we found NaHS inhibited the spontaneous intracellular $Ca^{2+}$ ($[Ca^{2+}]_i$) oscillations in cultured ICC. In doing an RT-PCR experiment, we found that ICC enriched population lacked mRNA for both CSE and CBS, but was prominently detected in unsorted muscle. In conclusion, $H_2S$ inhibited the pacemaker activity of ICC by modulating intracellular $Ca^{2+}$. These results can serve as evidence of the physiological action of $H_2S$ as acting on the ICC in gastrointestinal (GI) motility.

• 대한기계학회논문집B
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• 제35권11호
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• pp.1205-1211
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• 2011

본 논문은 말기 심질환 환자의 생존율과 치료효과를 증대시키기 위한 심실보조장치용 심박조율기의 개발에 대한 내용이다. 심실보조장치만을 이식 받은 환자는 부정맥이 발생할 가능성을 항상 갖고 있으며 심박조율기를 동시에 적용함으로써 혈류의 체순환량을 유지하고 부정맥으로 인한 장기의 손상을 예방한다. 심박조율기의 전극과 도선은 심실보조장치의 도관을 이용하여 제작되었으며, 전극은 심실보조장치의 도관이 삽관되는 좌심실의 심첨부에 도관과 함께 이식된다. 심박조율기는 0 bpm에서부터 191.4 bpm까지 자극 빈도를 조절할 수 있으며, 60 bpm의 빈도로 자극이 가하여 질 때 0.25 J 의 에너지가 심장으로 인가된다. 심실보조장치용 심박조율기의 성능과 안정성을 검증하기 위하여 돼지를 이용한 동물실험을 수행하였다. 실험동물의 심장에 86.4 bpm, 100.2 bpm, 126.6 bpm의 자극을 순차적으로 가하였고 ECG 및 대동맥혈압의 변화 대동맥 혈류를 관찰하였다.