• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.798-803
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• 2009

Purpose : We aimed to examine the effectiveness of the head-up tilt test (HUT) for the diagnosis of syncope or presyncope in children and adolescents. Methods : HUT results and clinical features of 160 children and adolescents with syncope or presyncope were studied from May 2003 through March 2008 at the Chonbuk National University Hospital. The children and adolescents were subjected to $70^{\circ}$ HUT for 45 minutes. The testees were divided into 2 groups: group I (children) comprising 39 children in the age range 7-12 years (mean, $10.59{\pm}1.60$ years) and group II (adolescents) comprising 121 adolescents in the age range 13-20 years (mean, $15.93{\pm}2.28$ years). Positive result rates of the HUT and types of hemodynamic response to the test in the 2 groups were compared. Results : Of the 160 testees, 92 (57.5%) showed positive HUT results; they showed 3 patterns of response to tilting. Twelve patients showed a predominantly vasodepressor response; 10 patients showed a cardioinhibitory response; and 70 patients showed a mixed response. The positive result rates were 43.6% (17/39) and 62.0% (75/121) in groups I and II, respectively. Mixed response was the predominant positive hemodynamic response in both the groups. Conclusion : The HUT is a useful diagnostic tool for evaluating the condition of pediatric patients, including adolescents, with syncope. Further, it may be considered as the first step for evaluating the condition of such patients.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.396-400
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• 2005

A 13-year old, female Maltese dog was presented due to a five-month history of episodic syncope. A diagnosis of sick sinus syndrome (SSS) with mitral valve endocardiosis (MVE) was made based on history takings, physical and cardiac examination, complete blood count (CBC), serum chemistry profiles, radiography, electrocardiography (ECG), atropine response test, hormonal assay, and echocardiography. In this case, SSS was definitely diagnosed by evaluation of ECG recording following atropine administration. Clinical signs were improved with medical management of theophylline (THEOLAN, KunWha Pharm, Seoul, Korea, 20 mg/kg, PO, BID). After 10 more month survival, the dog, died of respiratory distress and shock during the operation of abdominal mass removal in local animal hospital. Unfortunately, we were not able to perform necropsy after death due to owner's decline. This case demonstrates that theophylline can be used in management oF dog with SSS.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.248-252
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• 2010

Anomalous origins of coronary arteries are a rare type of disease among children. These anomalies can be categorized into 3 types according to the anatomical relationship of the aorta and pulmonary trunks. Among these types, the interarterial type, as observed in our case, needs early diagnosis and treatment, because it can increase the risk for the patient, causing sudden cardiac death in young individuals. Although there are controversies concerning the management of anomalous origins of the left coronary artery (LCA) in children, the result can be very beneficial, if treated accurately. Three well-known methods for correction of anomalous origins of LCA are re-implantation, coronary arterial bypass grafting (CABG), and unroofing. We report on the case of a 12-year-old girl who had chest discomfort and syncope with physical exercise and was later diagnosed with an anomalous origin of LCA by transthoracic echocardiography (TTE) and heart computed tomography (CT). She underwent a corrective operation by re-implantation, CABG, and unroofing.

• Journal of Sasang Constitutional Medicine
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• v.26 no.1
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• pp.55-63
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• 2014

Objectives This research was performed to establish the clinical practice guideline(CPG) for Lesser Yin Symptomatology of Soeumin disease. Methods Dongeui suse bowon(sinchuk edition), textbook for Sasang constitutional medicine, Clinical guidebook for Sasang constitutional medicine, and standardization reports on Sasang constitutional medicine and papers concerning symptomatology of Soeumin Disease, especially Lesser Yin Symptomatology was collected and classified. Additionally experts' conference was held to make agreement on the conflicting issues on a regular basis. Results & Conclusions There was no concerning paper on Lesser Yin Symptomatology. Experts' agreement was needed to establish the CPG. Lesser Yin pattern can be classified into 2 groups; Lesser Yin severe pattern and Lesser Yin critical pattern. There are Lesser Yin pattern accompanied abdominal pain and bowel irritability pattern and Lesser Yin pattern accompanied green tinged watery diarrhea pattern in Lesser Yin severe pattern. There are Visceral syncope pattern and Exuberant yin repelling yang pattern in Lesser Yin critical pattern. Lesser Yin symptomatology has several symptoms like abdominal pain and diarrhea, thirst, oral discomfort, chest discomfort, whole body pain, articular pain and coldness of hands and feet. Additionally there are abdominal pain and diarrhea in Lesser Yin symptomatology accompanied abdominal pain and bowel irritability pattern, there is green tinged watery diarrhea in Lesser Yin pattern accompanied green tinged watery diarrhea pattern and if this symptoms exacerbate, delirious speech and constipation can occur. There are restlessness and coldness on hands and feet in Visceral syncope pattern and severe restlessness and coldness on hands and feet and symptom which the patient cannot drink water in Exuberant yin repelling yang.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.63-67
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• 1993

The syndrome of carotid sinus hypersensitivity is cardovascular symptom complex including lightheadedness, transient loss of consciousness, perspiration, pallor, weakness of lower extremities, transient hypotension, bradycardia and seizure, which occurs from firing of hyperactive carotid sinus reflex. Most cases are idiopathic, but maliganant tumors involving parapharyngeal space have been occasionally implicated. We present a case of carotid sinus hypersensitivity due to nasopharyngeal carcinoma invading the parapharyngeal space with bilateral cervical lymphnode metastases(stage IV, $T_4N_2M_0$). The patient experienced several episodes of severe syncope proceeded by blurring of vision, dizziness and nausea, which were used to occur while he was working in erect position. The tumors were markedly regressed by external radiation therapy with successful resolution of syncope.

• The Journal of Internal Korean Medicine
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• v.34 no.4
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• pp.447-455
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• 2013

This clinical case reports the effect of Chilgi-tang, a kind of traditional Korean herbal medicine, on $3^{rd}$ degree AV block patients also known as complete heart block. Complete heart block caused by degeneration of electrical conduction system of heart may result in weakness, dizziness, syncope, etc. Two clinical cases reported herein are diagnosed as $3^{rd}$ degree AV block caused by psychological stress with chief complaints of syncope and dyspnea respectively. The chief complains of cases cured remarkably after Chilgi-tang medication. In one case, $3^{rd}$ degree AV block was disappeared. In conclusion, we suggest that Chilgi-tang can be a potential treatment for complete heart block due to psychological stress.

• Journal of Oriental Neuropsychiatry
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• v.11 no.2
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• pp.63-78
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• 2000

Headache is one of the most common medical complaints. It is not so easy to manage headache. especially if it is chronic although it seldom cause serious problem. There are many psychological factor known to induce, maintain an aggravate symptom in patients with chronic headache. The purpose of this study is to investigate clinical characteristics with ABR-2000 was carried out for 57 patients who had been suffered from headache for 6 months from march to August 2000.The results were as follows:1. According to the statics, on the whole woman's rate was higher than man's, and the mean duration of the headache was 8.06 years.2. Common associated symptoms were nausea. dyspepsia, dizziness, palpitation, fatigue, depression, etc.3. According to oriental medical differentiation of symptoms and signs, the rate of stagnation of the liver-qi's fire-transmission(肝變化火), deficiency of blood(血虛) and plegm syncope (痰厥), these three types were hghest.4. Result of analyzing ABR-2000 is that the rate of low response is higher than high response's on each item. But result of Graph A is that the rate of high response in higher than that of low response only in deficiency of Yin(陰虛) and the rate of high response in stagnation of the liver-qi's fire-transmission(肝變化火) and deficiency of blood (血虛) is comparatively high. Result of Graph R is that the rate of high response in wind-heat(風熱), deficiency of blood(血虛) and plegm syncope(痰厥) is comparatively higher than in others.

• Journal of Korean Medical classics
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• v.33 no.3
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• pp.21-36
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• 2020

Objectives : This paper aims to understand the meaning of '少陰人 心之範圍' and to determine its clinical implication. Methods : First, the meaning of the verb '範圍' was examined in 『IChing·XiCi(周易·繫辭傳)』 from where it originated. Based on the findings, the meaning of '心之範圍' in the context of the nature and emotion[性情] of So-eumin as explained in the 『DongUisusebowon(東醫壽世保元)』 was further investigated. Moreover, the clinical significance of the observation of '心之範圍' in relation to determining prognosis was discussed in regards to 'visceral syncope[藏厥]' and 'exuberating yin separating yang[陰盛隔陽]' which come under the severe symptoms[危證] category in the disease pattern of So-eumin. Results : '範圍' as mentioned in 『IChing·XiCi(周易·繫辭傳)』 refers to the process of creating a framework that takes after the tendencies of the patterns of change of the external world that influences mankind. The objective of this process is to prepare for the excessiveness and insufficiency of the change that happens in the external world so as to ultimately protect all existences. The workings of '範圍' could be assumed on a personal level as well. As the nature and emotion of So-eumin is closely related to the purpose and object of '範圍', Yi Jema suggested that through observing whether the So-eumin exhibits '心之範圍' or not, that it could be determined whether his/her innate nature is being properly exercised or not. Conclusions : Whether one's agitation calms down or not even for a moment is the criteria for determining prognosis of the entire disease, while its calming-down relies on proper functioning of '心之範圍'. The way to determine this is through observation of the manifest attitude of the So-eumin. If the So-eumin displays a poised and autonomous[綽綽卓卓] attitude even for a moment, it could be understood as the '心之範圍' process being properly functioning, indicating the overall direction to be heading towards relief of the sense of instability, allowing for a positive outlook on treatment.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.440-445
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• 2015

Purpose: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. Methods: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. Results: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. Conclusion: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.

• Journal of Veterinary Clinics
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• v.25 no.5
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• pp.391-395
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• 2008

An 8-year-old intact male Yorkshire cross dog (7.5 kg of body weight) was referred with the primary complaint of exercise intolerance and occasional syncope. Initial cardiological examination could not identify any abnormalities except mild mitral regurgitation. Exercise stress test revealed chronotrophic incompetence. Furthermore the 1 hr-digital event recording found the sudden onset of paroxysmal sinus tachycaridas (156-172 bpm) lasting few minutes and stopping abruptly. In addition, the tachycardia terminated by vagal maneuver and verapamil administration. Based on this finding, the case was diagnosed as sinoatrial reentrant tachycardia (SART). The dog was treated with diltiazem and enalapril. Although the dog still has exercise intolerance, no syncope has been observed after medication.