• Title/Summary/Keyword: GCS

Search Result 396, Processing Time 0.023 seconds

Survival-related Factors in Patients with Traumatic Acute Subdural Hematoma (외상성 급성 경막하 혈종 환자의 생존 관련 요인)

  • Ha, Hey-Jin;Woo, Sang-Jun;Lee, Seung-Woo
    • Journal of the Korea Convergence Society
    • /
    • v.12 no.4
    • /
    • pp.285-291
    • /
    • 2021
  • This study is a retrospective study attempted to determine the factors that influence the survival of patients with traumatic acute subdural hematoma. The study subjects were 207 patients with traumatic subdural hematoma who visited the emergency room from January 2017 to February 2019 at C University Hospital in G Metropolitan City. Data analysis was using the SPSS 23.0 program, and χ2-test, t-test, and logistic regression analysis. As a result of the study, the factors affecting the survival of the subjects were under disease, complications, and initial GCS. Therefore, it is necessary to establish a medical system to check the subject's history and to train medical staff to prevent complications. In addition, it is necessary to improve the transfer system so that the GCS of the subject can be measured from the stage before transfer to a medical institution and transferred to a hospital that can be treated quickly.

Hypertensive Retinopathy and the Risk of Hemorrhagic Stroke

  • Thiagarajah, Ramani;Kandasamy, Regunath;Sellamuthu, Pulivendhan
    • Journal of Korean Neurosurgical Society
    • /
    • v.64 no.4
    • /
    • pp.543-551
    • /
    • 2021
  • Objective : Hemorrhagic stroke (HS) and hypertensive retinopathy are known end organ damage of the brain and eye respectively, with HS having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and HS in hypertensive disease. Methods : A control group of hypertensive patients only, and an investigated group of hypertensive HS patients. Fundoscopic examination to determine the grade of retinopathy was performed and then divided into low or high severity hypertensive retinopathy. Clinical and radiological parameter included are demography, vital signs, Glasgow coma scale (GCS) on admission, clot volume, site of clot, Intracerebral hemorrhage (ICH) score and Glasgow outcome scale (GOS). Data were correlated with the severity of hypertensive retinopathy. Results : Fifty patient in the control group and 51 patients in the investigated group were recruited. In the hypertensive HS group, 21 had low severity retinopathy (no or mild retinopathy) accounting for 41.2% and 30 patients had high severity (moderate or severe retinopathy). In the hypertensive patients 49 had low severity and one had high severity (p-value of 0.001). In HS group low severity showed better GCS score of 9-15 on admission (p-value of 0.003), clot volume less than 30 mL (p-value 0.001), and also a better 30 days mortality rate by using the ICH score (p-value 0.006), GOS score of 4 and 5 the low severity retinopathy fair better than the high severity retinopathy (p-value of 0.001), and the relative risk to develop HS in low severity and high severity retinopathy was 0.42 and 29.4, respectively. Conclusion : Hypertensive retinopathy screening could be used as an indicator in hypertensive patient, to evaluate the risk of developing hypertensive HS in the future.

Proposal of Network RTK-based Boundary Surveying Drone Using Mobile GCS (Mobile GCS를 이용한 Network RTK 기반 경계 복원 측량 드론)

  • Jeong, Eun-ji;Jang, Min-seok;Lee, Yon-sik
    • Journal of the Korea Institute of Information and Communication Engineering
    • /
    • v.25 no.12
    • /
    • pp.1942-1948
    • /
    • 2021
  • The cadastre in Korea was established with the outdated technology of the Japanese colonial period, and thus currently 15% of the Korea domestic land does not match the cadastral map. Accordingly, the government has been establishing the Korean cadastre under the name of 'Cadastral Re-investigation Project' and is changing the origin of the survey to the world geodetic system. Assuming that the project is completed, we propose a drone boundary survey method that can be used to easily survey using the exact digital cadastral information. The developed mobile GCS application can control the drone and acquire the boundary point coordinates recorded in the cadastre, and the drone automatically flies to mark the boundary points. The developed prototype of drone made a tour along the 6 boundary points in 2 minutes.

The Kernohan-Woltman Notch Phenomenon : A Systematic Review of Clinical and Radiologic Presentation, Surgical Management, and Functional Prognosis

  • Beucler, Nathan;Cungi, Pierre-Julien;Baucher, Guillaume;Coze, Stephanie;Dagain, Arnaud;Roche, Pierre-Hugues
    • Journal of Korean Neurosurgical Society
    • /
    • v.65 no.5
    • /
    • pp.652-664
    • /
    • 2022
  • The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

Development of Korean UCS Architecture and Service Design for GCS Standardization (GCS 공통화를 위한 한국형 UCS 개발 및 서비스 설계)

  • Yoorim Choi;Sangyun Park;Chulhwan Kim;Gyeongrae Nam;So-Yeong Jeong
    • Journal of Advanced Navigation Technology
    • /
    • v.27 no.3
    • /
    • pp.314-322
    • /
    • 2023
  • The use of unmanned aerial vehicles is rapidly increasing in order to effectively utilize limited manpower and minimize casualties on the battlefield. The requirements for ground control equipment vary depending on the operating concept and environment of the unmanned aerial system, but there are still common requirements. However, the lack of standardized system configurations to meet these common requirements makes it difficult to reuse common functions, leading to continuous acquisition costs. To solve this problem, this paper develops a Korean version of the UCS model using the UCS architecture. Furthermore, after designing elements related to service development not specified in the architecture (such as framework, communication middleware, service structure, etc.), we develop a Boilerplate to enhance developers' work efficiency based on this. The results of this study will serve as a foundation for effectively and economically carrying out the development of ground control equipment for unmanned aerial systems.

The Effect of Korean Medicine Treatment for Hemorrhagic Transformation after Interventional Reperfusion Therapy of an Anterior Circulation Infarction in a Patient with Hemiplegia and Conscious and Cognitive Disorders: A Case Report (전방순환 뇌경색의 중재적 재관류 치료 이후 출혈 변환으로 의식 및 인지장애를 동반한 편마비환자의 한방치험 1례)

  • Chae-eun Kim;Ji-hyeon Kang;Seo-hyun Kim;Jun-seok Kim;Kyung-min Baek
    • The Journal of Internal Korean Medicine
    • /
    • v.43 no.6
    • /
    • pp.1274-1288
    • /
    • 2022
  • Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

Comparison of Outcomes at Trauma Centers versus Non-Trauma Centers for Severe Traumatic Brain Injury

  • Tae Seok, Jeong;Dae Han, Choi;Woo Kyung, Kim;KNTDB Investigators
    • Journal of Korean Neurosurgical Society
    • /
    • v.66 no.1
    • /
    • pp.63-71
    • /
    • 2023
  • Objective : Traumatic brain injury (TBI) is one of the most common injuries in patients with multiple trauma, and it associates with high post-traumatic mortality and morbidity. A trauma center was established to provide optimal treatment for patients with severe trauma. This study aimed to compare the treatment outcomes of patients with severe TBI between non-trauma and trauma centers based on data from the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods : From January 2018 to June 2021, 1122 patients were enrolled in the KNTDBS study. Among them, 253 patients from non-traumatic centers and 253 from trauma centers were matched using propensity score analysis. We evaluated baseline characteristics, the time required from injury to hospital arrival, surgery-related factors, neuromonitoring, and outcomes. Results : The time from injury to hospital arrival was shorter in the non-trauma centers (110.2 vs. 176.1 minutes, p=0.012). The operation time was shorter in the trauma centers (156.7 vs. 128.1 minutes, p=0.003). Neuromonitoring was performed in nine patients (3.6%) in the non-trauma centers and 67 patients (26.5%) in the trauma centers (p<0.001). Mortality rates were lower in trauma centers than in non-trauma centers (58.5% vs. 47.0%, p=0.014). The average Glasgow coma scale (GCS) at discharge was higher in the trauma centers (4.3 vs. 5.7, p=0.011). For the Glasgow outcome scale-extended (GOSE) at discharge, the favorable outcome (GOSE 5-8) was 17.4% in the non-trauma centers and 27.3% in the trauma centers (p=0.014). Conclusion : This study showed lower mortality rates, higher GCS scores at discharge, and higher rates of favorable outcomes in trauma centers than in non-trauma centers. The regional trauma medical system seems to have a positive impact in treating patients with severe TBI.

Proper Indication of Decompressive Craniectomy for the Patients with Massive Brain Edema after Intra-arterial Thrombectomy

  • Sang-Hyuk Im;Do-Sung Yoo;Hae-Kwan Park
    • Journal of Korean Neurosurgical Society
    • /
    • v.67 no.2
    • /
    • pp.227-236
    • /
    • 2024
  • Objective : Numerous studies have indicated that early decompressive craniectomy (DC) for patients with major infarction can be life-saving and enhance neurological outcomes. However, most of these studies were conducted by neurologists before the advent of intra-arterial thrombectomy (IA-Tx). This study aims to determine whether neurological status significantly impacts the final clinical outcome of patients who underwent DC following IA-Tx in major infarction. Methods : This analysis included 67 patients with major anterior circulation major infarction who underwent DC after IA-Tx, with or without intravenous tissue plasminogen activator. We retrospectively reviewed the medical records, radiological findings, and compared the neurological outcomes based on the "surgical time window" and neurological status at the time of surgery. Results : For patients treated with DC following IA-Tx, a Glasgow coma scale (GCS) score of 7 was the lowest score correlated with a favorable outcome (p=0.013). Favorable outcomes were significantly associated with successful recanalization after IA-Tx (p=0.001) and perfusion/diffusion (P/D)-mismatch evident on magnetic resonance imaging performed immediately prior to IA-Tx (p=0.007). However, the surgical time window (within 36 hours, p=0.389; within 48 hours, p=0.283) did not correlate with neurological outcomes. Conclusion : To date, early DC surgery after major infarction is crucial for patient outcomes. However, this study suggests that the indication for DC following IA-Tx should include neurological status (GCS ≤7), as some patients treated with early DC without considering the neurological status may undergo unnecessary surgery. Recanalization of the occluded vessel and P/D-mismatch are important for long-term neurological outcomes.

Safe and time-saving treatment method for acute cerebellar infarction: Navigation-guided burr-hole aspiration - 6-years single center experience

  • Min-Woo Kim;Eun-Sung Park;Dae-Won Kim;Sung-Don Kang
    • Journal of Cerebrovascular and Endovascular Neurosurgery
    • /
    • v.25 no.4
    • /
    • pp.403-410
    • /
    • 2023
  • Objective: While patients with medically intractable acute cerebellar infarction typically undergo suboccipital craniectomy and removal of the infarcted tissue, this procedure is associated with long operating times and postoperative complications. This study aimed to investigate the effectiveness of minimally invasive navigation-guided burr hole aspiration surgery for the treatment of acute cerebellar infarction. Methods: Between January 2015 and December 2021, 14 patients with acute cerebellar infarction, who underwent navigation-guided burr hole aspiration surgery, were enrolled in this study. Results: The preoperative mean Glasgow Coma Scale (GCS) score was 12.7, and the postoperative mean GCS score was 14.3. The mean infarction volume was 34.3 cc at admission and 23.5 cc immediately following surgery. Seven days after surgery, the mean infarction volume was 15.6 cc. There were no surgery-related complications during the 6-month follow-up period and no evidence of clinical deterioration. The mean operation time from skin incision to catheter insertion was 28 min, with approximately an additional 13 min for extra-ventricular drainage. The mean Glasgow Outcome Scale score after 6 months was 4.8. Conclusions: Navigation-guided burr hole aspiration surgery is less time-consuming and invasive than conventional craniectomy, and is a safe and effective treatment option for acute cerebellar infarction in selected cases, with no surgery-related complication.

Effects of a Lipid Mixture on Glucocorticoid-induced Barrier Impairment and Epidermal Atrophy in the Canine Skin (글루코코티코이드에 의해서 유발된 개 피부의 장벽기능이상과 위축에 대한 지질 혼합물의 효과)

  • Jin, Yeo-Won;Ahn, Mi-Ji;Ku, Sae-Kwang;Park, Hyun-Jeong;Lee, Keun-Woo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
    • /
    • v.27 no.5
    • /
    • pp.522-532
    • /
    • 2010
  • The aims of the present study were to characterize the effect of glucocorticosteroids (GCs) on the normal canine skin and to evaluate the effect of a lipid mixture (LM), containing cholesterol, pseudoceramide, and free fatty acid, on the steroid-induced damaged skin of dogs. Five beagles were involved and the skin of the back of each dog was topically applied with four kinds of GCs twice daily for 28 days. LM was applied after that period of GCs application. Transepidermal water loss (TEWL), skin hydration, and skin pH were assessed during experimental periods and histopathological evaluation was performed. TEWL was significantly increased, with a maximum increase obtained on day 28 (p < 0.01). Skin pH was significantly decreased, with a maximum decrease obtained on day 28 (p < 0.01). Skin surface hydration was significantly increased on day 3, but values of skin hydration were progressively decreased and finally reached those of baseline. In histology, as results of steroid application, losses of keratin layers in the stratum corneum and edematous changes in the upper parts of dermis, and consequently, thickness of the epidermis and the stratum corneum were decreased. In addition, the numbers of hair follicles were markedly decreased in steroid control as compared to intact control. However, these skin atrophic changes were markedly inhibited by treatment of LM as compared with steroid control in the present study. Moreover, all biophysical parameters were reached to the baseline after LM treatment. These results showed that the topically applied GCs induced skin barrier impairment and a LM should be effective on repair of disturbed skin barrier function in dogs. Therefore, it is concluded that a LM tested in the present study is expected to treat the steroid-induced skin damages.