• Title/Summary/Keyword: GCS

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Metabolic Changes in Pericontusional Edematous Areas in Mild Head Injury Evaluated by Proton MRS (경도 두부외상 환자에서 뇌좌상주위 부종영역에서의 자기공명분광법을 이용한 대사변화)

  • Hong, Sang-Su;Son, Byung-Chul;Cho, Byung Gil;Kim, Euy-Nyeng;Kim, Bum-Soo;Park, Chun-Kum;Choe, Bo-Young;Kim, Moon-Chan;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1233-1237
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    • 2000
  • Objectives : In order to evaluate the metabolic changes associated with pericontusional edematous area in mild head injury, proton magnetic resonance spectroscopy(1H-MRS) was performed in mild head injury patients (initial GCS score 13-15) with focal brain contusion. Methods : Seven head injury patients with initial GCS 13-15(3 males and 4 females : age range 15-65 years, mean age 33 years) have underwent 1H-MRS evaluations. The patients were examined within 7 days after injury(n=7) and 2 months after injury(n=5). The region of interest(ROI) was selected in the edematous area adjacent to traumatic brain contusion upon T2-weighted MR images and a corresponding region of the contralateral hemisphere (ROC, region of contralateral corresponding hemisphere) was examined as well. The metabolic ratios of NAA/Cr and lactate/Cr were compared between ROIs, ROCs and control values. Results : In initial NAA/Cr ratios, the values of ROIs were significantly lower than those of the controls(p=0.009), but there was no difference either between ROIs and ROCs(p=0.410) or between ROCs of patients and the control (p=0.199). In lactate/Cr ratios, the ROIs in all seven patients and the ROCs in two showed increased lactate signals. The lactate/Cr ratios of the ROIs were significantly elevated as compared to those of the ROCs(p=0.02) and the control(p=0.015). In two months follow-up, lactate signals were absent or significantly reduced(p=0.015). In no patients, clinical or radiological deterioration has been observed. Conclusion : Our 1H-MRS results demonstrate that there are significant ischemic changes in pericontusional edematous areas as indicated by elevated lactate signals in the patients with mild head injury. But there were no consistent neural loss or dysfunction in these area. There findings suggest that pericontusional edematous areas can be vulnerable to secondary brain insults even in the patients with mild head injury.

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A Development of Fluxgate Sensor-based Drone Magnetic Exploration System (플럭스게이트 센서 기반 드론 자력탐사 시스템 개발)

  • Noh, Myounggun;Lee, Seulki;Lee, Heuisoon;Ahn, Taegyu
    • Geophysics and Geophysical Exploration
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    • v.23 no.3
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    • pp.208-214
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    • 2020
  • In this study, we have developed a drone magnetic exploration system (proto-type) using a fluxgate magnetic sensor. Hardware of the system consists of a fluxgate magnetometer, an inertial measurement unit (IMU), a GPS, and a communication module. And we have developed monitoring software, which enables it to transmit the measured data to the ground control system (GCS) in real time. The measured magnetic data are finally saved as 1 Hz data after passing through a notch filter and a band-pass filter. For verification of this system, a preliminary test was conducted to check the magnetic responses of a magnetic object first, then the field test was carried out in two iron mines. We tested the developed system on the field test in Pocheon, Gyeonggi and Jeongseon, Gangwon. The magnetic data from the developed drone system was very similar to those from unmanned airship system developed by Korea Institute of Geoscience and Mineral Resources (KIGAM). As a result, preliminary experiment and field test have demonstrated that this system is applicable for outdoor aeromagnetic exploration. It requires more studies to improve filter function and instrument performance to minimize noise in the future.

The Study on the Interest of Professional Physical Therapy (The undergraduate students of dept. of physical therapy in Busan, Ulsan and Kyungnam) (부산.울산.경남 지역 졸업반 물리치료(학)과 학생들의 전문물리치료 영역에 대한 인식 및 관심도 조사)

  • Kim, Chi-Hyok;Lee, Geon-Chul;Kwon, Hyuk-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.10 no.1
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    • pp.129-145
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    • 2004
  • Many physical therapy who graduate department of physical therapy interested in physical therapy specialist. The boundary of physical therapy specialist is consist of 7 parts; CCS(Cardiopulmonary Certified Specialist), ECS(Clinical Electrophysiologic Certified Specialist), GCS(Geriatric Certified Specialist), NCS(Neurologic Certified Specialist), NCS(Neurologic Certified Specialist), OCS(Orthopaedic Certified Specialist), PCS(Pediatric Certified Specialist), SCS(Sports Certified Specialist). So the purpose of this study was to investigate of undergraduate student's interest about the area of special physical therapy and its academy. The data were collected from May 17 to 24, 2004 and 158 valid questionnaires were obtained and analyzed. It was for undergraduate students who major in physical therapy in college and university which are located in Busan, Ulsan and Kyoungnam province. The result is follows: 1. The research about the study of physical therapy after graduation was that 45.5% of female thought that they going to study as possible as they can was the best. In the case of men, 54.3% of male thought that they going to study was the best. 2. The result about recognition of special physical therapy was that 62.0% of people answered CCS, 69.6% of people answered GCS. The most familiar part of special physical therapy at course of school curriculum was that 88.0% of people answered OCS, and 84.2% of people answered NCS. 3. The result about the most interesting part of special physical therapy was that 68.6% of male and 36.1% of female answered OCS. On the other hand, the least part that people doesn't care was that 41.2% of male answered PCS, and 41.0% of female answered CCS. 4. About educational matters of special physical therapy and its academy was that 60% of answered 'Not enough'. An answer to question of special physical therapy and its academy's educational necessity. At the a course of faculty and clinical practice was that 58.9% of answered 'somewhat necessary'. After graduation, study a plan of special physical therapy was that 59.5% of answered 'immediate academy'. 5. Recognize scale in alternation physical therapy, think of extend physical therapy's territory is 'necessary of extend territory' was 78% the highest answer. 57.6% of answered was concerned about alternating physical therapy, and want to study.

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The effect of LH Receptor in the Pregnancy of Poor Responders (황체호르몬 수용체의 발현이 저반응 환자군의 임신에 미치는 영향)

  • Lee, Jung-Bok;Do, Byung-Rok;Kim, Eun-Soo;Kim, Myung-Hee;Chun, Eun-Kyung;Jeong, Hyeon-Jeong;Roh, Sung-Il;Kim, Moon-Kyoo;Yoon, Hyun-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.2
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    • pp.111-117
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    • 2004
  • Objectives: To investigate the effect of LH receptor in folliculogenesis, we confirm the expression level of LH receptor (LH-R) mRNA in human granulosa cells (GCs) and its expression levels were analyzed by comparison to embryo developmental rate and pregnancy rate. Materials and Methods: GCs were obtained at the time of oocyte retrieval from the patients undergoing IVF-ET program. The patients were divided into two groups: Group I (n=20) is poor responder (retrieved oocyte(s)$\leq$3ea), Group II (n=80) is normal responder (retrieved oocytes>3ea). After the extraction of total RNA, semiquantitative RT-PCR was performed and the expression level of LH-R mRNA was normalized by $\beta$-actin. Statistical analysis was performed by using $X^2$ test, Student's t-test and Pearson correlation. Results: In Group II, the relative values of LH-R mRNA (0.680 vs. 0.463, p<0.005) and pregnancy rate (54.7% vs. 23.1%, p<0.05) were significantly higher than in Group I. Number of retrieved oocyte(s) was gradually increased when the expression of LH-R mRNA was increased (p<0.05). But the quality of retrieved oocyte and transferred embryo were not related with the expression of LH-R mRNA. When the pregnancy rate was compared with FSH only group and FSH combined with hMG group in the ovarian stimulation protocol, FSH combined with hMG group was significantly higher than FSH only group in Group I (37.5% vs. 0%), and the expression of LH-R mRNA was significantly higher in hMG combined group than FSH only group (p<0.05). Conclusion: Expression level of LH-R mRNA has important role in ovarian function related with the response to gonadotrophin in human folliculogenesis. Furthermore these data might provide the evidence that additional use of hMG is helpful to poor responders.

A Study on Organophosphate Poisoning Patients: Comparison of the Survivor Group and Dead Group (생존군과 사망군의 비교 분석을 통한 유기인계 살충제 중독환자에 대한 연구)

  • Choi, Youn-Gyu;Lee, Dong-Hyeon;Kim, Woo-Hyung;Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.1
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    • pp.16-23
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    • 2010
  • Purpose: Organophosphate insecticide poisoning is common in Korea, but there is no definitive guideline for determining the severity of the poisoning and the predictive factors. Therefore, we evaluated the organophosphate poisoned patients and we divided them into two groups, the survivors and the dead, and the results might be useful for treating organophosphate poisoning patients. Methods: We performed a retrospective analysis of 68 organophosphate poisoned patients who visited the Chosun University Hospital Emergency Medical Center during a 24-month period from January, 2007 to December, 2008. We made a work sheet of the patients' characteristics and the collected data was analyzed and we compared this data between the survivor group and the dead patient group. Results: There were significant differences between the survivor group and the dead patient group for the mean age, the alcohol intake state and the typically expressed signs. The dead patients had lower blood pressure, tachycardia and a lower Glasgo Coma Score (GCS) score than the survivor group. On the arterial blood gas analysis, the dead patients had more severe acidemia and they had lower saturations. Increased serum amylase levels were found in the dead patients. The survivors'initial and follow up serum pseudocholinesterase activity (after 6~8 days) was significantly higher than that of the dead group. The total amount of atropine injected to patient was less in the survivors than that in the dead patients. Conclusion: Old age and expressing the typical intoxication signs, a lower GCS score and blood pressure, showing acidosis on the gas analysis and low serum cholinesterase activity may be useful as poor prognostic indicators for patients with organophosphate poisoning. We suggest that physicians must pay careful attention to the signs and prognostic factors of organophosphate insecticide poisoned patients.

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Prognostic Value of Blood Lactate for Mortality of Acutely Poisoned Patients in Emergency Department (응급실내 급성 중독 환자들의 예후 예측에 대한 혈액 젖산 수치의 유용성)

  • Kim, Hye Ran;Kang, Mun Ju;Kim, Yong Hwan;Lee, Jun Ho;Cho, Kwang Won;Hwang, Seong Youn;Lee, Dong Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.1
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    • pp.16-25
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    • 2016
  • Purpose: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients' condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. Methods: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. Results: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89-8.64), respectively. Conclusion: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.

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Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury

  • Lim, Tae Kyoo;Yu, Byug Chul;Ma, Dae Sung;Lee, Gil Jae;Lee, Min A;Hyun, Sung Yeol;Jeon, Yang Bin;Choi, Kang Kook
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.140-144
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    • 2017
  • Purpose: The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI). Methods: A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP). Results: The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were $24.2{\pm}6.1$ and $5.4{\pm}0.8$, respectively. The mean ONSD of the TBI group ($5.5{\pm}1.0mm$) was higher than that of the non-TBI group ($4.7{\pm}0.6mm$). Some significant differences in age ($55.3{\pm}18.1$ vs. $49.0{\pm}14.8$, p<0.001), GCS ($11.7{\pm}4.1$ versus $13.3{\pm}3.0$, p<0.001), and ONSD ($5.5{\pm}1.0$ vs. $4.7{\pm}0.6$, p<0.001) were observed between the TBI and the non-TBI group. An ROC analysis was used to assess the correlation between TBI and ONSD. Results showed an area under the ROC curve (AUC) value of 0.752. The same analysis was used in the TBI with midline shift group, which showed an AUC of 0.912. Conclusions: An ONSD of >5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.

Correlation of Changes of Intracranial Pressure and Clinical Manifestations in Spontaneous Intracerebral Hemorrhage (자발성 뇌실질내혈종 환자에서의 뇌압변화와 임상증상과의 관계)

  • Chung, Eul-Soo;Ko, Sam-Kyu;Kim, Oh-Lyong;Chi, Yung-Chul;Choi, Byung-Yearn;Cho, Soo-Ho
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.35-44
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    • 1991
  • Recently many authors have reported about the relationship of the volumes of hemorrhage in the brain parenchyme, hemorrhagic sites, optimal operation time, and the effects of mannitol and steroid on control of ICP to clinical manifestations. Many attempts to measue ICP in hydrocephalus, brain tumor, and head injury have been reported. But the measurements of intracranial pressure in spontaneous intracerebral hemorrhage are rare. Intracranial pressure was monitored prospectively in 30 patients who had stereotaxic surgery for spontaneous intracerebral hemorrhage. The results are as follows. 1. Intracranial pressure was increased in high $PaCO_2$. 2. There were no correlation in ICP, rebleeding and ADL at discharge(P > 0.05). 3. ICP was the most high level in 72 hours after operation. 4. There was 63.2% decrease in ICP after litigation with 6000 IU urokinase in the site of hemorrhage. 5. There was no correlation between the numbers of natural drainage and ADL at discharge(P > 0.05). 6. The higher the initial GCS, the higher the Postoperative GCS.

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Effectiveness of Simple Trauma Team Activation Criteria on Prognosis of Severe Trauma Patients (단순 외상팀 활성화 조건이 중증 외상 환자의 치료 결과에 미치는 영향)

  • Lee, Dong Keon;Lee, Kang Hyun;Cha, Kyoung Chul;Park, Kyoung Hye;Choi, Han Joo;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.71-76
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    • 2009
  • Purpose: The goal of this study was to compare the outcome of the after trauma team (AfterTT) group to the before trauma team (BeforeTT) group. Methods: All trauma patients who visited to emergency room (ER) between July 1, 2006 and February 29,2008 based on trauma registry, with systolic blood pressure (SBP) < 90 mmHg or GCS < 9 were included in this study. We compared the amount of packed RBC transfusion, the ER stay time, the ER visit to CT evaluation time, the ER visit to operation time, the length of ICU stay, the length of hospital admission and the survival discharge rate between the AfterTT group and the BeforeTT group. Patients with brain injuries had little chance of survival. Burn patients, who visited the ER 24 hours after injury and patients who were dead on arrival (DOA) were excluded from this study. Results: Total of 93 patients were included in this study: 42 in the AfterTT group and 51 in the BeforeTT group. The AfterTT group and the Before TT group showed no differences in Revised Trauma Score (RTS) and mean age. The amount of packed RBC transfusion was lower in the AfterTT group, but no statistically significant difference was noted (AfterTT 11${\pm}$11units, BeforeTT 16${\pm}$15units, p=0.136). The ER visit to operation time was shorter in the AfterTT group, but there were no statistically significant difference between the groups (AfterTT 251${\pm}$223 minutes, BeforeTT 486${\pm}$460 minutes, p=0.082). The length of ICU stay was shorter in the AfterTT group, but the difference was not statistically significant (AfterTT 11${\pm}$12 days, Before TT 15${\pm}$30 days, p=0.438). The length of Hospital admission was shorter in the AfterTT group (AfterTT 43${\pm}$37 days, BeforeTT 68${\pm}$70 days, p=0.032), but this difference was not statistically significant. Conclusion: Simple Trauma team activation criteria decreased the amount of packed RBC transfusion and the hospital admission duration. Hemodynamic instability (SBP < 90 mmHg) and decreased mental state (GCS<9) are good indices for activating the trauma team.

Clinical Observation for Endotracheal intubation Patients in ICU (중환자실(重患者室)에서 기관내(氣管內) 삽관후(揷管後) 퇴원(退院)한 환자(患者)의 임상통계(臨床統計) 고찰(考察))

  • Nam, Chang-Gyu;Moon, Byung-Soon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.407-432
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    • 1996
  • Clinical Observation was made on 37 cases of Endotracheal intubation patients in the ICU of Oriental Medical Hosptal of Tae- Jon University from January in 1992 to June in 1995. 1. There were many cases of Endotracheal intubation in ischemic attack hemorragic in order. 2. Cerebral embolism mostly occured in the MCA territory and cerebral thrombosis, ICH, in the pons, generally. 3. On admission the consciousness of the most patients was 3 to 7 point by GCS. 4. The ordinary preceeding disease was hypertension. 5. Most patients were discharged from ICU after 2 days. 5. Most patients were discharged from ICU after 2 days. 6. Endotracheal intubation was done most frequently from 1 p.m. to 3 p.m. and intubated time was less than 2 hours. 7. Endotracheal intubation was done in case of heart arrest than dyspnea cases. 8. The main complication of patients of C.V.A. in ICU were urinary tract infection, pneumonia in order. 9. There were no side effects after and by Endotracheal intubation.

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