• 제목/요약/키워드: Corrected QT

검색결과 20건 처리시간 0.029초

글리포세이트 제초제 중독 후 심전도에서 QRS파 확장을 보여 치료한 1례 (A Case of Treatment with QRS Widening in Electrocardiogram after Glyphosate Herbicide Poisoning)

  • 이주환
    • 대한임상독성학회지
    • /
    • 제17권1호
    • /
    • pp.28-31
    • /
    • 2019
  • Glyphosate herbicides, which are widely used worldwide, are known to have low toxicity. However, excessive intake may cause serious life-threatening complications; therefore, caution is needed when using them. A 51-year-old man visited the hospital after ingesting glyphosate herbicide. At the time of admission, his vital signs were 80/60 mmHg-115/min-20/min-$37.3^{\circ}C$. Electrocardiogram (ECG) showed QRS widening and corrected QT (QTc) prolongation, and blood tests showed metabolic acidosis. Treatment with gastric lavage, activated charcoal, sodium bicarbonate and intravenous lipid emulsion therapy was performed. After 2 hours, his blood pressure increased to 130/90 mg, and no QRS widening was observed on ECG.

Validation of Non-invasive Method for Electrocardiogram Recording in Mouse using Lead II

  • Kim, Myung Jun;Lim, Ji Eun;Oh, Bermseok
    • 대한의생명과학회지
    • /
    • 제21권3호
    • /
    • pp.135-143
    • /
    • 2015
  • Electrocardiogram measures the electric impulses generated by the heart during its cycle. Recently genome-wide association studies on electrocardiogram traits revealed many relevant genetic loci. Therefore, these findings need to be validated and investigated to determine the underlying mechanisms using mouse models. Invasive radiotelemetry has been widely used to record the electrocardiogram in mice because it has several advantages over non-invasive measurements. However, radiotelemetry is expensive and requires complicated surgery. On the other hand, a non-invasive method using 3 electrodes (one for earth) for lead II is easy to establish and allows for rapid measurement. In this study, eleven mice were measured with this non-invasive method and no statistical difference among them was found in any ECG measurements. In addition, repeat measurement in the same mouse was performed in 9 sets of experiment and the results indicated that non-invasive method was reliable for reproducibility. Further it was shown that measurements for 1, 5, 10, and 15 minutes were not different so that a short recording such as 5 minutes was enough to estimate the ECG values including heart rate. Further this method was validated by measuring the ECG of Balb/c and FVB that were previously shown to differ in ECG values by radiotelemetry. Significant differences were found in heart rate, PR interval and corrected QT interval between these mouse strains. This study partially proved that non-invasive method also could provide the accuracy and reproducibility. Based on these results, the non-invasive ECG recordings of lead II is recommended as a useful method for quick test in mouse model.

저소성 실트지반의 비배수 전단강도 특성을 고려한 CPTU 콘계수 평가 (Evaluation of CPTU Cone Factor of Silty Soil with Low Plasticity Focusing on Undrained Shear Strength Characteristics)

  • 김주현
    • 한국지반신소재학회논문집
    • /
    • 제16권1호
    • /
    • pp.73-83
    • /
    • 2017
  • 모래 및 실트 함유량이 우세한 서해안 저소성 지반(인천, 화성, 군산)에서 실시된 실내 및 현장시험으로부터 얻어진 비배수전단 강도를 이용하여 피에조콘계수(Nkt)를 분석한 후, 이에 대한 적용성을 평가하였다. 인천, 화성 및 군산지역에서 얻어진 일축압축 강도에 의한 콘계수(Nkt)는 19~23, 간이 CU 강도에 의한 값은 13~13.8, 현장베인강도에 의한 값은 11.6~13.1로 평가되었다. 이는 저소성 실트 지반조건에서 일축압축강도가 과소평가되는 원인에 의한 것으로 간이 CU 강도 적용조건과 비교했을 때 콘계수(Nkt)가 약 1.8배 전후로 커지며 분산되는 경향을 나타냈다. 저소성 실트 지반에서 수행된 CPTU 데이터를 이용하여 콘계수(Nkt)를 평가할 때에는 지반의 입도분포, 액소성한계 등의 물리적 특성, 지층 내의 sandseam 분포 등으로 인한 콘선단저항(qt) 및 주면마찰력(fs)의 불규칙한 분포, 간극수압계수(Bq)를 종합적으로 분석하여 수행하는 것이 바람직할 것으로 판단된다.

Effects of heme oxygenase-1 upregulation on isoproterenol-induced myocardial infarction

  • Eltobshy, Somaia A.G.;Hussein, Abdelaziz M.;Elmileegy, Asaad A.;Askar, Mona H.;Khater, Yomna;Metias, Emile F.;Helal, Ghada M.
    • The Korean Journal of Physiology and Pharmacology
    • /
    • 제23권3호
    • /
    • pp.203-217
    • /
    • 2019
  • The present study was designed to examine the effect of heme oxygenase-1 (HO-1) induction by cobalt protoporphyrin (CoPP) on the cardiac functions and morphology, electrocardiogram (ECG) changes, myocardial antioxidants (superoxide dismutase [SOD] and glutathione [GSH]), and expression of heat shock protein (Hsp) 70 and connexin 43 (Cx-43) in myocardial muscles in isoproterenol (ISO) induced myocardial infarction (MI). Thirty two adult male Sprague Dawely rats were divided into 4 groups (each 8 rats): normal control (NC) group, ISO group: received ISO at dose of 150 mg/kg body weight intraperitoneally (i.p.) for 2 successive days; ISO + Trizma group: received (ISO) and Trizma (solvent of CoPP) at dose of 5 mg/kg i.p. injection 2 days before injection of ISO, with ISO at day 0 and at day 2 after ISO injections; and ISO + CoPP group: received ISO and CoPP at a dose of 5 mg/kg dissolved in Trizma i.p. injection as Trizma. We found that, administration of ISO caused significant increase in heart rate, corrected QT interval, ST segment, cardiac enzymes (lactate dehydrogenase, creatine kinase-muscle/brain), cardiac HO-1, Hsp70 with significant attenuation in myocardial GSH, SOD, and Cx-43. On the other hand, administration of CoPP caused significant improvement in ECG parameters, cardiac enzymes, cardiac morphology; antioxidants induced by ISO with significant increase in HO-1, Cx-43, and Hsp70 expression in myocardium. In conclusions, we concluded that induction of HO-1 by CoPP ameliorates ISO-induced myocardial injury, which might be due to up-regulation of Hsp70 and gap junction protein (Cx-43).

응급실 초기에 다량의 글라이포세이트 중독과 관련된 예측인자: QTc 간격 연장 (Predicting Factors Associated with Large Amounts of Glyphosate Intoxication in the Early-Stage Emergency Department: QTc Interval Prolongation)

  • 경동수;전재천;최우익;이상훈
    • 대한임상독성학회지
    • /
    • 제18권2호
    • /
    • pp.130-135
    • /
    • 2020
  • Purpose: Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. Methods: This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. Results: Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. Conclusion: The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

A case of syncope in a villager with hypertrophic cardiomyopathy after hydrogen sulfide exposure by an unauthorized discharge of wastewater

  • Hyeonjun Kim;Seunghyeon Cho;Inho Jung;Sunjin Jung;Won-Ju Park
    • Annals of Occupational and Environmental Medicine
    • /
    • 제35권
    • /
    • pp.34.1-34.8
    • /
    • 2023
  • Background: Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident. Case presentation: In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge. Conclusions: We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

건강한 너구리(Nyctereutes procyonoides)들의 심전계 지표에 대한 평가 (Evaluation of Electrocardiographic Index in Healthy Raccoon Dogs (Nyctereutes procyonoides))

  • 홍원우;김종택;양동근;남효승;현창백
    • 한국임상수의학회지
    • /
    • 제30권6호
    • /
    • pp.456-458
    • /
    • 2013
  • 포획된 건강한 너구리들의 심전도의 기준값을 평가하는 것이 본 논문의 주된 목적이다. 41마리의 방목되고 있는 다 자란 너구리들이 강원대학교 야생동물구조센터에 의해 구조되었으며 본 논문에 이용되었다. 어떠한 화학적 보정도 사용하지 않고 6-유도 심전도를 측정하였다. 평균 심박수는 $146.10{\pm}43.31$ 박동수/분 이었다(95% 신뢰구간 132.84~159.36 박동수/분). 평균 호흡수는 $35.73{\pm}11.56$ 호흡수/분 이었다(95% 신뢰구간 32.19~39.27 호흡수/분). 평균 수축기 압력은 $136{\pm}29.26mmHg$ 이었다(95% 신뢰구간 127.99~145.91 mmHg). 모든 너구리들의 심전계의 특징들을 또한 평가하였다. P-파의 평균 너비와 높이는 $38.2{\pm}4.0ms$ (범위 28-40 ms) 와 $0.128{\pm}0.039mV$ (범위 0.09~0.20)이었다. QRS파의 평균 너비와 높이는 $48.5{\pm}7.2ms$ (범위 36-60 ms) 와 $1.330{\pm}0.650mV$ (범위 0.15~2.30)이었다. 평균전기축 (QRS)은 $-91^{\circ}{\sim}+96^{\circ}$ ($10^{\circ}{\sim}60^{\circ}$; 95% 신뢰구간)이었다. 평균 교정 QT 간격(QTc)은 $273.7{\pm}32.7ms$ (범위 212-333 ms)이었고, PR간격은 $76.1{\pm}10.0ms$ (범위 50-82 ms)이었다. 본 논문은 포획된 건강한 너구리들의 심전도(ECG)의 기준값을 제공하는 최초의 논문이다.

Brugada 심전도 양상을 포함한 이미프라민에 의한 독성 부작용 1예 (A case of imipramine induced toxicity with Brugada electrocardiographic pattern in a toddler)

  • 최우연;박수민;한의정;김영남;조영국;마재숙
    • Clinical and Experimental Pediatrics
    • /
    • 제51권11호
    • /
    • pp.1232-1235
    • /
    • 2008
  • 삼환계 항우울제의 하나인 이미프라민은 우울장애와 야뇨증, 불안장애, 신경성 통증에 쓰인다. 그러나 이미프라민을 포함한 삼환계 항우울제는 많은 부작용이 관찰되는 데, 항콜린성 작용으로 초기에 입이 마르고 동공산대, 소변 정체, 동성빈맥을 보인다. 또한 중추신경계에 작용하여 섬망, 불안, 초조, 환각, 경련, 혼수를 야기할 수 있다. 그러나 앞에서 말한 부작용 보다도 치명적인 것인 삼환계 항우울제에 의해 소디움 채널 차단으로 인한 부정맥이다. QRS파의 연장과 QTc 연장, 넓은 QRS파 빈맥, Brugada 심전도 양상이 나타나며 이런 현상은 중탄산 나트륨을 통해 나트륨을 대량으로 공급하여 회복시킬 수 있다. 이미프라민을 포함한 삼환계 항우울제에는 아직도 널리 쓰이고 있지만 지금까지 소아에서 부정맥이 부작용으로 나타난 증례에 대한 보고가 없었다. 따라서 저자들은 이미프라민 과량복용 후 경련, 넓은 QRS파를 보이는 빈맥, Brugada 심전도 양상, 무뇨를 보인 환아를 경험, 치료하여 이를 보고한다.

글라이포세이트 중독 환자에서 포함된 염의 종류에 따른 예후의 차이 (The Prognosis of Glyphosate herbicide intoxicated patients according to their salt types)

  • 정민규;금경탁;안성준;김용환;이준호;조광원;황성연;이동우
    • 대한임상독성학회지
    • /
    • 제19권2호
    • /
    • pp.83-92
    • /
    • 2021
  • Purpose: Glyphosate herbicide (GH) is a widely used herbicide and has been associated with significant mortality as poisoned cases increases. One of the reasons for high toxicity is thought to be toxic effect of its ingredient with glyphosate. This study was designed to determine differences in the clinical course with the salt-type contained in GH. Methods: This was a retrospective study conducted at a single hospital between January 2013 and December 2017. We enrolled GH-poisoned patients visited the emergency department. According to salt-type, patients were divided into 4 groups: isopropylamine (IPA), ammonium (Am), potassium (Po), and mixed salts (Mi) groups. The demographics, laboratory variables, complications, and their mortality were analyzed to determine clinical differences associated with each salt-type. Addtionally, we subdivided patients into survivor and non-survivor groups for investigating predictive factors for the mortality. Results: Total of 348 GH-poisoned patients were divided as follows: IPA 248, Am 41, Po 10, and Mi 49 patients. There was no difference in demographic or underlying disease history, but systolic blood pressure (SBP) was low in Po group. The ratio of intentional ingestion was higher in Po and Mi groups. Metabolic acidosis and relatively high lactate level were presented in Po group. As the primary outcome, the mortality rates were as follows: IPA, 26 (10.5%); Am, 2 (4.9%); Po, 1 (10%); and Mi, 1 (2%). There was no statistically significant difference in the mortality and the incidence of complications. Additionally, age, low SBP, low pH, corrected QT (QTc) prolongation, and respiratory failure requiring mechanical ventilation were analyzed as independent predictors for mortality in a regression analysis. Conclusion: There was no statistical difference in their complications and the mortality across the GH-salt groups in this study.

수면 무호흡 증후군 환자에서 자율 신경 장애의 평가 (Evaluation of Autonomic Neuropathy in Patients with Sleep Apnea Syndrome)

  • 이학준;박혜정;신창진;김기범;정진흥;이관호;이현우
    • Tuberculosis and Respiratory Diseases
    • /
    • 제45권2호
    • /
    • pp.404-415
    • /
    • 1998
  • 연구배경: 수면 무호흡 증후군에서 고혈압, 허혈성 심질환, 심부정맥등과 같은 심혈관 합병증과 주간 과다 졸음증은 주간 사고와 사망율의 증가와 관계가 있다. 수면 무호흡 증후군 환자에서의 심혈관 합병증의 원인으로는 수면중의 저산소혈증과 자율 신경 장애가 중요한 역할을 한다. 현재까지 수면 무호흡 증후군 환자에서 자율 신경 장애 유무에 대해서는 상반된 결과가 발표되고 있으며 발생기전도 잘 밝혀져 있지 않다. 저자들은 수면 무호흡 증후군 환자에서 자율 신경 장애 검사로 심혈관 자율 신경 장애 검사법이 유용한 검사가 될 수 있을지를 알아보았고 자율 신경 장애의 유무를 확인하였으며 이들 장애가 의미있는 상관 관계가 있는 인자를 알아보았다. 방 법: 수면 다원 검사에서 수면 무호흡 증후군으로 진단된 환자와 건강한 대조군에서 심혈관 자율 신경 장애 검사를 실시하여 환자군에서 자율 신경 장애 유무를 관찰하였으며 또한 수면 무호흡 증후군에서 심혈관 자율 신경 장애 검사가 유효한 검사법이 될 수 있을지를 알아 보았다. 또한 심혈관 자율 신경 장애 검사 결과와 수면 다원 검사 결과를 비교 분석하여 자율 신경 장애와 관계있는 인자를 알아보았다. 결 과: 수면 무호흡 증후군 환자에서 심혈관 자율 신경 장애 검사법의 결과 환자군에서 대조군보다 Valsalva maneuver 에서 유의한 차이를 보이면서 낮게 측정되었으며 나머지 항목에서는 유의한 차이가 없었다. 자율 신경 장애의 정도를 나타내는 자율 신경 장애 접수는 환자군이 $1.10{\pm}0.55$점으로 대조군의 $0.30{\pm}0.36$ 점보다 의의있게 높았으며, 교정한 QTc 간격도 환자군이 $423.93{\pm}18.44msec$, 대조군이 $396.93{\pm}19.85msec$로 두 군간에 유의한 차이를 보였다 (p<0.001). 그러나 자율 신경 장애 접수와 교정한 QTc 간격사이에는 상관 관계가 없었다 (r=0.410, p=0.073). 자율 신경 장애 점수와 수면 다원 검사에서 측정된 항목사이에는 유의한 상관 관계를 가지는 항목을 관찰할 수 없었다. 자율 신경 장애 정도를 유형에 따라 5가지로 분류하고 환자의 분포를 당뇨병 환자와 비교해 본 결과 두 질환은 서로 다른 분포를 보였다. 결 론: 수면 무호흡 증후군 환자에서 심혈관 자율 신경 장애 검사법을 적용하여 자율 신경계의 장애가 있음을 확인할 수 있었으며 심혈관자율 신경 장애 검사법이 수면무호흡 환자의 자율 신경 장애를 평가할 수 있는 유용한 검사법이었다. 앞으로 자율 신경 장애의 발생에 관여하는 인자를 밝히기 위한 더 많은 연구가 시행되어야 할 것으로 생각된다.

  • PDF