• Title/Summary/Keyword: Drowsy

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Hybrid Technique to Correct Cerebral Malperfusion Following Repair of a Type A Aortic Dissection

  • Kim, Seon Hee;Song, Seunghwan;Kim, Sang-Pil;Lee, Jonggeun;Lee, Han Cheol;Kim, Eun Soo
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.163-166
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    • 2014
  • A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

A Case Report of Acute Nicotine Poisoning from Subcutaneous Injection of Nicotine Solution for Electronic Cigarette (전자담배 용액의 피하 주사에 의한 급성 니코틴 중독 1례)

  • Choi, Jiun;Ko, Dong Ryul;You, Je Sung;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.60-64
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    • 2017
  • Nicotine-poisoning related to the electronic cigarettes (e-cigarette) is increasing worldwide. Moreover, the American Association of Poison Control Centers has advised the public to use caution with e-cigarette devices and highly concentrated liquid nicotine after a surge in related poisonings. We report here the first case of nicotine poisoning from self-injected e-cigarette fluid in Korea. A 17-year-old male patient subcutaneously injected himself with 0.5 ml of nicotine solution for an electronic cigarette via the dorsum of his hand, after which he complained of nausea, vomiting, dizziness and dyspnea. His vital signs were within the normal range, but his mental status was drowsy. He was admitted for observation and the symptoms disappeared the following day. Sinus bradycardia with a rate of 45/min was observed on the third hospital day, but improved after 6 hours. He was discharged without complications.

Efficient Brainwave Transmission VANET Routing Protocol at Cross Road in Urban Area (도심 사거리 교차로 지역의 효율적인 뇌파전송 VANET 라우팅 프로토콜)

  • Jo, Jun-Mo
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.3
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    • pp.329-334
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    • 2014
  • Recently, various electronic functions are developed for car drivers as the advent of electrical automobile. Especially, there are functions to examine for preventing drowsy or healthcare through monitoring brainwave(EEG) of drivers in real time. This function can be provided by transmitting driver's EEG, and the network function for transmission among cars or between car and road side infrastructure is a vital issue. Therefore, in this paper, to provide efficient routing protocol for transmitting EEG data at a cross road in an urban area, 5 different wireless communication network applied each routing protocol such as AODV, DSR, GRP, OLSR, and TORA is designed and simulated in the OPNet network simulator, then it is evaluated for the result.

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.

System for Detecting Driver's Drowsiness Robust Variations of External Illumination (외부조명 변화에 강인한 운전자 졸음 감지 시스템)

  • Choi, WonWoong;Pan, Sung Bum;Shin, Ju Hyun
    • Journal of Korea Multimedia Society
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    • v.19 no.6
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    • pp.1024-1033
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    • 2016
  • In this study, a system is proposed for analyzing whether driver's eyes are open or closed on the basis of images to determine driver's drowsiness. The proposed system converts eye areas detected by a camera to a color space area to effectively detect eyes in a dark situation, for example, tunnels, and a bright situation due to a backlight. In addition, the system used a thickness distribution of a detected eye area as a feature value to analyze whether eyes are open or closed through the Support Vector Machine(SVM), representing 90.09% of accuracy. In the experiment for the images of driver wearing glasses, 83.83% of accuracy was obtained. In addition, in a comparative experiment with the existing PCA method by using Eigen-eye and Pupil Measuring System the detection rate is shown improved. After the experiment, driver's drowsiness was identified accurately by using the method of summing up the state of driver's eyes open and closes over time and the method of detecting driver's eyes that continue to be closed to examine drowsy driving.

Acute Spontaneous Subdural Hematoma of Arterial Origin

  • Sung, Soon-Ki;Kim, Sung-Hoon;Son, Dong-Wuk;Lee, Sang-Weon
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.91-93
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    • 2012
  • Acute spontaneous subdural hematoma (SDH) of arterial origin is very rare. We report a case of acute spontaneous SDH that showed contrast media extravasation from cortical artery on angiograms. A 58-year-old male patient developed sudden onset headache and right hemiparesis. Brain CT scan demonstrated acute SDH at left convexity. The patient was drowsy mentality on admission. He had no history of head trauma. Cerebral angiography was performed and revealed a localized extravasation of the contrast media from distal cortical MCA branch. After angiography, the patient deteriorated to comatose mentality. Decompressive craniectomy for removal of SDH was performed. We verified the arterial origin of the bleeding and coagulated the bleeding focus. The histological diagnosis was aneurysmal artery. He recovered after surgery with mild disability. In a case of acute spontaneous SDH, the possibility of a cortical artery origin should be considered.

Endovascular Treatment of a Ruptured Posterior Inferior Cerebellar Artery Aneurysm during Pregnancy

  • Kim, Ki Dae;Chang, Chul Hoon;Choi, Byung Yon;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.273-276
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    • 2014
  • Aneurysmal subarachnoid hemorrhage (SAH) during pregnancy is quite rare, however it has a high maternal mortality rate. A pregnant woman in the 16th gestational week was admitted to our hospital with a drowsy level of consciousness. A brain magnetic resonance (MR) image showed hemorrhage on the prepontine cistern, and both sylvian fissures, and MR angiography and cerebral digital subtraction angiography demonstrated an aneurysm at the left posterior inferior cerebellar artery (PICA). We performed endovascular coil embolization attempting to minimize radiation exposure. She was discharged with no neurologic deficit and delivered a healthy baby by cesarean section at the 38th week of gestation. This case study reported the shortest gestational period and this is the first report on an aneurysmal rupture arising from PICA which was treated using an endovascular method. Using an appropriate technique for reduced radiation exposure to the fetus and limited alterations in maternal-fetal physiology, endovascular coil embolization could guarantee good results in treatment of aneurysmal SAH in pregnant women.

Anaphylactic Shock Following Nonionic Contrast Medium during Caudal Epidural Injection

  • Lee, Sang Hyun;Park, Jae Woo;Hwang, Byeong Mun
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.280-283
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    • 2015
  • Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

Glue Embolization of Ruptured Anterior Thalamoperforating Artery Aneurysm in Patient with Both Internal Carotid Arteries Occlusion

  • Lee, Jae-Il;Choi, Chang-Hwa;Ko, Jun-Kyeung;Lee, Tae-Hong
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.287-289
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    • 2011
  • Thalamoperforating artery aneurysms are rarely reported in the literature. We report an extremely rare case of ruptured distal anterior thalamoperforating artery aneurysm which was treated by endovascular obliteration in a patient with occlusion of both the internal carotid arteries (ICAs) : A 72-year-old woman presented with severe headache and loss of consciousness. Initial level of consciousness at the time of admission was drowsy and the Glasgow Coma Scale score was 14. Brain computed tomography (CT) scan was performed which revealed intracerebral hemorrhage in right basal ganglia, subarachnoid hemorrhage, and intraventricular hemorrhage. The location of the aneurysm was identified as within the globus pallidus on CT angiogram. Conventional cerebral angiogram demonstrated occlusion of both the ICAs just distal to the fetal type of posterior communicating artery and the aneurysm was arising from right anterior thalamoperforating artery (ATPA). A microcatheter was navigated into ATPA and the ATPA proximal to aneurysm was embolized with 20% glue. Post-procedural ICA angiogram demonstrated no contrast filling of the aneurysm sac. The patient was discharged without any neurologic deficit. Endovascular treatment of ATPA aneurysm is probably a more feasible and safe treatment modality than surgical clipping because of the deep seated location of aneurysm and the possibility of brain retraction injury during surgical operation.

Traumatic Brainstem Hemorrhage Presenting with Hemiparesis

  • Se, Young-Bem;Kim, Choong-Hyun;Bak, Koang-Hum;Kim, Jae-Min
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.176-178
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    • 2009
  • Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.