• Title/Summary/Keyword: heart attack

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Complete A-V Block 3 Months after Total Correction of Tetralogy of Fallot (활로 4징증의 근치수술후의 원격 방실전도 차단)

  • 송요준
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.326-332
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    • 1978
  • There appears some conduction defects frequently after total correction of Tetralogy of Fallot. Common defect is right bundle branch block due to surgical intervention. We experienced complete A-V block which occured 3 months later after total correction of Tetralogy of Fallot in a 8 year old boy. The patient was completely free of any A-V block after the operation for 3 months, and sudden onset of A-V block with coupled premature ventricular contractions resulted him in shock state during the attack of severe bronchopneumonia for 4 days prior to the second visit. Emergency implantation of Cordis demand type temporary pacemaker was necessary to control the complete heart block with bradyarrhythmia and frequent ventricular fibrillation. Permanent cardiac pacemaker was implanted two weeks later as indicated with Cordis Stanicor lambda demand pacemaker, and the patient was discharged uneventfully on the 8th post implantation day with the heart rate of 72/min. Another 3 months after the implantation, the patient was transported to this hospital as dead on arrival after an accidental fall from a 2 meter height, and all possible cardiopulmonary resuscitation was performed for 60 minutes at the emergency room in vain. Autopsy was done to find out the cause of sudden death and the etiology of complete heart block. Microscopic focal infarctions with scar formation were noted along the course of conduction system in the interventricular septum, which might be the main cause of complete heart block during the attack of severe bronchopneumonia complicated with acute bacterial endocarditis. The tip of the pacemaker wire was slipped from the granulation scar at the apex of the right ventricular cavity, and this might be the direct cause of pacing failure and death.

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The Safety Guidelines for use of Ma-huang in Obesity Treatment (비만처방에서의 안전한 마황사용 지침)

  • Song, Mi-Young;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine for Obesity Research
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    • v.6 no.2
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    • pp.17-27
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    • 2006
  • Objectives : Ma-huang (Ephedra sinica) is frequently prescribed for obesity management in oriental medicine. The main component is ephedrine alkaloids which can have serious adverse side effects such as heart attack, stroke, sudden death. There are no scientific guidelines for Ma-huang usage in the safe treatment of obesity in oriental medicine. We reviewed published studies on its safety to make evidence based guidelines. Methods : We searched electronic databases up to May 2006. We limited evidence to controlled trials for efficacy or safety, case reports for safety, and studies for Ma-huang contents analysis. Results and Conclusions : In clinical trials for weight loss, Ma-huang and ephedrine promote modest short-term weight loss but have no serious adverse effects, have only a few adverse effects associated with increased risk of psychiatric, autonomic, gastrointestinal symptoms and heart palpitations. In case reports, there have been serious adverse effects including stroke, heart attack, and death using typical doses of ephedrine or no associated illness. There are factors related to serious adverse effects, such as overuse, lack of standardization, individual sensitivity, and interactions with other drugs. Studies relating to these factors should be analyzed for safe use of Ma-huang and ephedrine. After analyzing related studies, we suggest guidelines for Ma-huang usage. We propose that the dosage should be within 4.5-7.5g per day for up to 6 months for generally healthy individual. It's use is contraindicated in individuals with heart disease, thyroid disease, diabetes mellitus, hypertension, psychiatric disorders, glaucoma, urination disorders, enlarged prostate, persons using MAOIs, methyldopa and sympathomimetic agents.

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A study of the destructive styles from Contemporary Paintings - Focused on distinguishing enmity-destruction and self-destruction - (현대회화에서 드러난 해체의 형식론에 관한 연구 -타의적 해체와 자의적 해체의 성격규정을 중심으로-)

  • Park Ki-Woong
    • Journal of Science of Art and Design
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    • v.7
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    • pp.5-63
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    • 2005
  • Generally, the meanings of destruction are related in the meaning of demolition, breakdown, into fragments ... and so on, and the similar meanings are twist, crush, demolish, split, cut, into pieces , break up ... etc. Further, it has related in the cruelty and destructive heart which are linked with orgy, Sadism, Necrophilia and so on. The meanings are also expressed by the initial , which are deprivation, deface, defame, deform, degrade, delegitimize, denounce , deride, destroy, devalue, as well as debase, debunk, declaim, declassify, decry, delete, denigrate, deprecate, despise or detract ...and so on. Dario Gamboni has discussed the meaning in his book as two categories Iconoclasm and Vandalism. And the similar meanings could be found in the words which has the initial of , like abase, abate, abhor, abjure, abolish, abridge, abuse ...and so on. Even though the distinct meanings of Iconoclasm and Vandalism, it is not easy to distinguish clearly between the differences when the results are accomplished in contemporary paintings because of the similarity of the results. In korean vocabulary there are no similar words to distinguish between the meanings of destruction and deconstruction, and the deconstruction is not recorded in the general dictionaries. However the meaning of is diminishing, separation, contrast and so on. So the unification of the word as do-construction is not construct, minus construction, reverse construction. And Vincent Ditch explained that there are the meaning of destroy the text. From Jacques Derrida, the deconstruction strategy is to criticise the world of traditional metaphysics and logocentrism, and not to reconstruire the philosophical meaning of texts but $d\'{e}construire$ them. And Saussure emphasized that the signifers could have more meaning that there can be more signified in traditional texts in the art. as a result, deconstruction is explained that there are many signified meanings in a signifer. In this thesis , from using the meanings of destruction and deconstruction, to distinguish the expressive skills in contemporary art works are arising. Therefore, special methods which are linked in the destruction styles are selected. As a result, the two different purposes of destruction is arising, one is enmity destruction and the other is self destruction another word, auto destruction or destruction to create The enmity destruction can be distinguished by the two category Iconoclasm and Vandalism. They come from the moment of different historical aspect is arising and want to attack the Icon or masterpiece this concept is from the study of John Philips and especially iconoclasm is linked with religious and artistic heart, but Vandalism is come from the political attack. Sometime, this distinguish is not clearly arising, because the two aspects are co-related in the attack. As a result, firstly, the Iconoclastic controversy had arisen in the methods of Dadaism which has developed by Man Ray, Francis Picabia and Marcel Duchamp. They want to attack the pre-established master-pieces and painting spaces, and they had 'non-artistic attitude' not to be art. Since 1980, the German artist Anselm Kiefer adapted the methods and made them his special skills so he had tried to paint tough brush strokes and draw with hugh pallette image line and fire and water images , they can be the image attack as the Iconoclasm. secondly, the model of vandalism is to be done by hammer, drill, canon and so on. the method is to attack the content of painting. Further, the object of destruction is bound by cords and iron lings to demolish or to declare the authority of pre-statues; it symbolize the pre-authority is gone already. Self-destruction based paintings are clearly different in the purpose of approaching the art work. First of all, they can be auto-destruction, creative destruction and metamorphosis destruction, which is linked with the skill the material aspect and basic stature, and sign destruction or signifier destruction, which is link with the inner meaning destruction that is considered as the Semiotical destruction in post-modern paintings. Since 1960, the auto destruction is based on the method of firing, melting, grinding and similar skills, which is linked with Neo-Dada and reverse-assemblage. Metamorphosis destruction is strongly linked with the basic inner heart price and quality, so it can be resulted in the changedness of expectation and recognition. Tony Cragg has developed the skills to metamorphose the wood as stone or iron as cloth and stone as sponge and rubber and so on. The researcher has developed the same style in the series of since 2003. The other self-destructive methods are found in the skill of sign destruction. In the methods the meaning of the art is not fixed as one or two, but is developed multi-meaning and differ from original starting situation, so Jacques Derrida called the difference meaning in deconstruction. It is the destruction of textes. These methods are accomplished by David Salle, Francesco Clemente, and recently Tracy Emin, who has developed the attacking heart in the spectators' emotion. Sometime in the method of self-destruction, it is based on horror and shock, the method is explored by Demian Hirst and Jakes and Dinos Chapman. Their destructive styles stimulate ambivalent heart and destroy original sign of girl and animals.

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Study on Establishment of criteria for Heart Disease in Oriental Medicine (심병증 진단요건의 표준 설정을 위한 연구)

  • Choi Sun Mi;Park Kyung Mo;Jeung Chan Gil;Sung Hyun Jea;Ahn Kyoo Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.4
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    • pp.845-851
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    • 2003
  • The objective is to establish the standard of criteria for differential diagnosis of signs and symptoms. This study selected signs and symptoms related to heart which stands for Fire(火) as a kind of five phase(五行). Eleven experts was asked to evaluate the adequateness of criteria which was developed by Korea Institute of Oriental Medicine(KIOM) and to suggest the amendment of them. To implement the study, we used the questionnaire which asks about the diagnosis criteria for an insufficiency of the heart-qi(心氣虛證), deficiency of the heart blood(心血氣證), deficiency of the heart-yin(心陰虛證), insufficiency of the heart-yang(心陽虛證), exuberant fire due to hyperactivity of the heart(心火亢盛證), stagnation of the heart blood(心血瘀阻證), heart disturbed by phlegm-fire(痰火擾心證), attack of the heart by retainedfluid(水氣凌心證). Every criteria consists of primary symptoms, secondary symptoms, tongue findings. and pulse findings. In perspectives of the classification of patterns for signs and symptoms and criteria for diagnosis, the result shows that the previous standard doesn't have so many problem. So many of experts were agree with the criteria which was suggested but the trend is that they use, in their actual practice, less than the criteria. Additionally, they pointed that every element in a criterion should have the different weight value, criteria for the overlapped pattern should be added, and, in future, criteria which are based on clinical investigation should be established.

Assessment of Double-blindness at the Conclusion of the $\beta-Blocker$ Heart Attack Trial

  • Byington Robert P.;Curb J. David;Mattson Margaret E.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.293-296
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    • 1994
  • At the conclusion of a double-blinded, randomized clinical trial of propranolol hydrochloride, but before un blinding, the patients and clinic personnel were asked to guess the treatment group assignment of each patient. While 79.9% of the patients receiving propranolol correctly Identified their treatment group assignment, 57.2% of the patients receiving placebo incorrectly guessed that they were aiso in the propranolol group. No specific mechanism was identified to explain why more patients receiving propranolol were better able to guess' their group assignment. Clinic physicians correctly identified the group assignment of 69.9% of the patients receiving propranolol and 68.8% of the patients receiving placebo. Clinic coordinators correctly identified the group assignment of 67.1% of the patients receiving propranolol and 70.6% of the patients receiving placebo. For clinic personnel, heart rate level and heart rate change seem to be the mechanisms employed to Identify their patients' treatment assignment.

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Rapidly Calcified Epidural Hematoma in a Neonate

  • Yu, Dong-Kun;Heo, Dong-Hwa;Cho, Sung-Min;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.98-100
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    • 2008
  • We report a very rare case of a rapidly calcified chronic epidural hematoma (EDH) in a neonate. A 26-day-old female infant was referred to us from a regional hospital because of drowsy mentality and a seizure attack. She was delivered through caesarian section because normal spontaneous vaginal delivery was prolonged and failed. At birth, mild scalp swelling was found on the right frontal area. Scalp swelling was spontaneously resolved and she was discharged without any problems. On the 25th day after her birth, the baby presented with drowsiness and hypotonia following a generalized tonic-clonic seizure. Magnetic resonance imaging (MRI) and a computed tomography (CT) scan revealed a chronic EDH that had a thick layer of calcification. A small burr-hole trephination was performed and a single silastic drainage catheter was inserted. After the operation, a total of 12 ml of liquefied hematoma was drained, and the patient's mentality improved from drowsiness to alertness. The patient was asymptomatic when discharged.

Development of the CPR training curriculum (심폐소생술 교육과정 표준화를 위한 연구)

  • Choi, Hea Kyung
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.29-42
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    • 2003
  • The purpose of this study was to development CPR training course to promote wide spread training. The course objectives was based on international Guidelines 2000. The course presents information about the AHA adult Chain of survival and signs of heart attack, cardiac arrest, stroke, and chocking in adult, and includes information about healty heart living and actions to reduce the risk of cardiovascular disease. The course also presents information about the AHA infant and chila Chain of survival, signs of breathing emergencies and chocking in infants and children, prevention of sudden infant death syndrome, and prevention of the most common fatal injuies in infants and children. Vedio-mediated instruction is the primary approach to teaching psycomotor skills.

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Short-term Coexisting Intracerebral Hemorrhage and Cerebral Infarctions

  • Song, Kwan-Su;Moon, Jae-Gon;Lee, Ho-Kook;Kim, Chang-Hyun;Hwang, Do-Yun
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.419-424
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    • 2005
  • Objective : Short-term coexisting intracerebral hemorrhage and cerebral infarctions defined as the recurrent stroke presented with different type within three weeks. Despite the high recurrence rate of stroke, little attention and insufficient clinical data had been given to short-term coexisting intracerebral hemorrhage and cerebral infarction's features. This study aims to estimate the risk factors and present the clinical features of short-term coexisting intracerebral hemorrhage and cerebral infarctions. Methods : We investigated 18 patients with short-term coexisting intracerebral hemorrhage and cerebral infarctions who were admitted to our hospital between January 1995 and January 2005. They were subdivided by the recurrence interval such as a group of within one week and another of between one and three weeks as hyperacute and acute respectively. Results : The mean interval between strokes was 6.64 days. Lesional analysis showed that short-term coexisting intracerebral hemorrhage and cerebral infarctions in this study occurred at the other side in 12 cases [66.7%]. The abnormality on the electrocardiographic feature [23.5%] and long-term history of hypertension [20.5%] were the most common risk factors. However, short-term history of diabetes was more common in hyperacute group than in acute group [P<0.05]. The mean number of risk factors was three in acute group. It is larger than that of hyperacute group [P<0.05]. Conclusion : If the patients who experienced cerebrovascular attack have many risk factors, they tend to be the cases of acute coexisting intracerebral hemorrhage and cerebral infarctions than hyperacute. Therefore, that cases are required to be vigilant to the change of patients' state up to three weeks in the treatment.

Clinical Study of Stroke Type (뇌졸중(腦卒中) 환자(患者) 형태(形態)에 관(關)한 임상연구(臨床硏究))

  • Youn, Hyoun-min;Ahn, Chang-beohm;Song, Choon-ho;Son, In-seok;Jang, Kyung-jeon
    • Journal of Acupuncture Research
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    • v.20 no.2
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    • pp.29-41
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    • 2003
  • Clinical observation was made on 52 cases of Stroke that were confined through brain CT, MRI scan. The Stroke cases wee classified into the following kinds cerebral infarction, cerebral hemorrhage, cerebellar or brain stem infarction, cerebellar or brain stem hemorrhage. And among the 52 cases of Stroke cerebral infarction was noticed in 75.00%, cerebral hemorrhage in 11.54%, cerebellar or brain stem infarction in 9.52%, cerebellar or brain stem hemorrhage in 3.85%. The ratio between males and females was 1.74:1 in the whole groups of Stroke and most cases were over 60 of age. As the time of hospitalization, most patients hospitalized from 1 day after stroke to 7 days after stroke. And as the course of hospitalization, most patients hospitalized first. Among the preceding disease at the onset of Stroke hypertention was noted in 32.69%, and deabetes mellitus or heart problem was noted frequently(15.39%). Electrocardiography findings were as follows: The normal was noted in 53.85%, the abnormal in 46.15%. And as the abnormal, left ventricular hypertrophy was noted in 17.54%. The predisposing factors or conditions at the onset of brain infarction were usually initiated during the time of sleeping and those of brain hemorrhage chiefly during the time of exercising like overwork or walking etc. It was noted that smoking a pack of cigarette showed highest disease rate(33.33%) among the average of smoking amount of one day in case of man. Prior to attack, the most chiefly complain was dyspnea or discomfort on chest region. And 30.70% of patients had no previous sign. There were a large number of recurrent cases. The first attack was noted in 71.15%, the 2nd attack in 23.08%, the 3rd attack in 5.77%.

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Factors Influencing the Changes of BAEPs in Vertebrobasilar Transient Ischemic Attacks (추골기저동맥 일과성 허혈발작에서 뇌간청각유발전위변화에 영향을 미치는 인자)

  • Park, Young Hyuk;Yoo, Bong Goo;Kim, Kwang Soo;Yoo, Kyung Moo
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.101-106
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    • 2000
  • Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

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