Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.
Hypertension is not only a well-established cardiovascular risk factor but also increase the risk of atherosclerosis. Most studies conducted to investigate the effectiveness of treatment for cardiovascular disease such as hypertension have focused primarily on conventional drug and physiotherapeutic treatments. BanhabackchulChunma-tang(半夏白朮天麻湯:BCT) is popular herbal medicine used in clinic for the treatment of various symptoms of drulatory disorders and weakness of digestive system, including anorexa and nausea with vertigo, severe headache, vomiting and so on. However, the mechanisms underlying its efficacy are unknown. This study investigated the effects of BCT as an alternative medication on the contraction induced by phenylephrine and KCI in rat thoratic aorta. BCT revealed siginificant relaxation on phenylephrine-induced arterial contraction, but revealed noncompetitive effect on concentration responses of phenylephrine-induced contraction. Treatment of N-L/sup ω/ -argine methyl ester(L-NAME) and methylene blue(MB)(10/sup -5/M) reduced the relaxation of BCT. BCT also increased in vitro NO production. It suggest that the relaxation effect of BBT is related with NO pathway, becausse the effect of L-NAME and MB are due to inhibition of NO synthesis from endothelial cells. These results indicate that BCT would be effective in hypertension treatment and its mechanism of relaxtion on arterial contraction is likely to be related with NO production, blocking of α-receptor and signal transduction after receptor activation.
Calcitonin exerts a positive effects on bone pain. The relief of bone pain has been well known in Paget's disease and malignancy patients with bone metastasis who were treated with salmon calcitonin. We carried out a clinical study evaluating efficacy of salmon calcitonin in reducing bone pain and improving mobility of the postmenopausal osteoporosis women. Fifty women suffering pain from postmenopausal osteoporosis diagnosed by evidence of radiology and/or dual photon absorptiometry were treated with salmon calcitonin 50 MRC three times per week for 4 weeks. The severity of pain estimated by visual analogue scale(VAS) was reduced significantly in treated patients from $8.6{\pm}0.7$ on day 0 to $2.7{\pm}1.7$ on day 28. The mobility of the patients was improved in 2 weeks after salmon calcitonin treatment. Mild adverse effects were seen in 8(16%) patients; headache in 4(8%), sweating and dizziness in 2(4%), pain at the injection site in 1(2%), nausea and vomiting in 1(2%) patient. The treatment was stopped in 3 patients by their request. Salmon calcitonin was effective in 39(83%) of 47 patients above moderate degree. In conclusion, salmon calcitonin is useful in the treatment of patients with pain from postmenopausal osteoporosis.
Objectives : We tried to investigate the effects of Panax Ginseng Radix pharmacopuncture and Zizyphi Spinosi Semen pharmacopuncture on human body with the Heart Rate Variability (HRV) in adult man. As well as we tried to investigate how safe Panax Ginseng Radix and Zizyphi Spinosi Semen pharmacopuncture on the the human being. Methods : We investigated on 44 healthy volunteers consisted of 16 subjects in Panax Ginseng Radix pharmacopuncture group, 13 subjects in Zizyphi Spinosi Semen pharmacopuncture group and 15 subjects in Normal Saline. We ruled out subjects who wasn't stable by rest, with in the limit of normal heart beat(60-120cycle/min). Study form was a randomized, clinical trial. Each group was injected Panax Ginseng Radix pharmacopuncture, Zizyphi Spinosi Semen pharmacopuncture and Normal Saline $0.2m{\ell}$ at $GB_{21}$(Kyonjong). We measured HRV on 7 times : before and after injection per 5 minutes during 30 minutes. The SPSS 13.0 for windows was used to analyze the data by the paired t-test(in the group) and Anova test(among the groups) were used to verify the result. Results : 1. After Panax Ginseng Radix pharmacopuncture injection, SDNN was significantly high, pNN50 was significantly low, Ln(TP) was significantly high, Ln(VLF) was significantly high, Ln(LF) was significantly high at 30 minutes. 2. After Zizyphi Spinosi Semen pharmacopuncture injection, Complexity was significantly low, Ln(VLF) was significantly high at 30 minutes. 3. HRV-index made a significant difference between the Zizyphi Spinosi Semen pharmacopuncture and normal saline at 5 minutes(p=0.02). 4. There wasn's any pain the injected region and whole body, rubefaction, uredo, nausea, vomiting, colic, headache, dizziness within 24 hours. Measured data and mean value of Mean-HRV was within normal range. Conclusions : The results suggested that and Panax Ginseng Radix pharmacopuncture in healthy adult man tended to activate the vagus nervous system within normal range.
The objective of this study was to determine the perception of monosodium glutamate (MSG) contents in eating out menu and MSG symptom complex. Respondents in the Seoul area were surveyed from Feb. 10 to 20, 2014. The results are summarized as follows. The 51.3% of respondents were male and 48.7% of them were female. As for age, 73.5% of respondents were 20~24 years old. Favorite menu of respondents' eating out were Korean food (57.8%), Western food (17.6%), Fast food (9.5%), Japanese food (6.2%), Chinese food (5.2%). Male respondents favored Korean food (62.4%), Fast food (10.2%) and Western food (9.6%), but female respondents favored Korean food (53.0%), Western food (26.2%) and Fast food (8.7%). The 48.7% of respondents considered Chinese food containing high amount of MSG. A few respondents (18.6%) recognized to usage amount of MSG as consideration factor to select eating out menu. However, most respondents (55.2%) perceived harmful to take excessive amount of MSG contained food. The 37.9% of respondents had experience of MSG symptom complex after eating out. Respondents' self recognized MSG symptom complex were thirstiness (84.5%), drowsiness (55.7%), weakness (34.5%), nausea (30.2%), tightness (20.7%) and headache (14.7%). The 19.9% of respondents like MSG contained food. The reason for disliking MSG contained food were 'bad for health' (66.3%) and 'MSG symptom' (33.2%). The reason for liking MSG contained food were 'good taste (83.6%) and 'habitual eating' (14.8%). The result of this study showed that some sensitive people have unpleasant reaction after eating out. Therefore, it is suggested that natural flavor enhancer may develop to replace the use of MSG.
The World Health Organization (WHO) declared the outbreak of H1N1 pandemic in 2009. South Korea also had outbreaks of H1N1 virus and used oseltamivir in large volume with increased reports of adverse drug reaction(ADR). The present study was aimed to investigate the ADR frequency, the factors related to ADR, and characteristics of oseltamivir's ADR. Participants for the study were patients randomly drawn from those who were prescribed oseltamivir for treatment from CHA Bundang Medical Center during October 1 and October 30. The information examined as factors related to ADR were collected by a subsequent cross-sectional telephone survey. The factors are the following; a) age; b) gender; c) patient medical history; d) diagnosis of H1N1 virus; e) adherence; f) whether taking other medication with oseltamivir or not; and g) the number of combined medications. We also asked ADR after taking oseltamivir. Total subjects were 86 patients. The average age is $22.6{\pm}18.48$ years old. The gender was 45.3% women and 54.7% men. Half (50%) of all respondents showed one or more ADR, 67.4% were positively diagnosed for H1N1 virus, and 54.7% were completed the full course of oseltamivir (i.e. twice daily x 5days). The most frequently reported ADR symptoms were: dizziness (15.1%), nausea (11.6%), lethargy (10.4%), diarrhea (10.4%), abdominal pain (8.1%), headache and vomiting (6.9%). ADR classifications by categories are gastro intestinal (44.2%), neuropsychiatric events (22.1%), systemic symptom (20.9%), skin events (5.8%), eye events (4.7%), and other cases (2.3%). The onset of ADR 'after taking 1~3 doses' was 69.7%. No increase in neuropsychiatric events was detected in children and adolescents. No factors examined for the study do have significant influence on the presence of ADR. This study showed that ADR of oseltamivir have occurred in half of the patients. The use of oseltamivir is essential for treatment and prophylaxis of influenza A(H1N1). But mass treatment should be properly monitored for ADR.
Objectives: This study aimed to report the effectiveness and outcome on the prognosis of pregnancy of traditional Korean medicine treatment for inpatients who had a traffic accident during pregnancy. Methods: The study is conducted by analyzing the medical records of hospitalized patients in a Korean medicine hospital. Seventy-six pregnant patients who got into car accidents from March 2015 to February 2020 were included. We performed statistical analysis by using Statistical Package for the Social Sciences(SPSS) ver. 25.0. To verify the effect of traditional Korean medicine treatment for traffic accidents during pregnancy, we analyzed improvement of symptoms. Also, we analyzed the prognosis of pregnancy and signs of premature birth or miscarriage during treatment to verify the applicability of traditional Korean medicine treatment for traffic accidents during pregnancy. Results: Among the symptoms of pain, there was a statistically significant decrease in lower back pain, post neck pain, headache, pelvic pain, knee pain, lower limb pain, wrist pain, and upper limb pain. Other systemic symptoms showed statistically significant improvement in nausea, abdominal pain, dizziness, and lower limb numbness. All confirmed cases reported normal pregnancy maintenance and delivery, and no miscarriage was reported. Two cases that showed signs of premature birth or miscarriage during treatment were unrelated or unclear with traditional Korean medicine treatment. Conclusions: Traditional Korean medicine treatment is effective and applicable for pregnant women injured by traffic accidents. Further studies are needed to identify the effectiveness and safety of traditional Korean medicine treatment for the sequelae of traffic accidents during pregnancy.
Livio Pereira de Macedo;Delson Culembe Baptista-Andre;rlindo Ugulino-Netto;Kaue Franke;Pierre Vansant Oliveira Eugenio;Auricelio Batista Cezar-Junior;Igor Vilela Faquini;Eduardo Vieira de Carvalho-Junior;Nivaldo S. Almeida;Hildo Rocha Cirne Azevedo-Filho
Journal of Cerebrovascular and Endovascular Neurosurgery
/
제26권2호
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pp.216-222
/
2024
Dissecting posterior inferior cerebellar artery (PICA) aneurysms are uncommon lesions. Their anatomy and the location of the dissection are variable, however, they usually occurs at the origin of the PICA. Dissecting PICA aneurysms generally have non-vascular morphology involving an entire segment of the artery and cannot be cut. Nevertheless, the detection of these vascular lesions has increased latterly, so it is necessary to recognize it and take the appropriate management modalities for these injuries. In this report, we describe a case of a 73-year-old male patient, who presented a history of severe headache, associated with neck stiffness, nausea, vomiting, dizziness, hypoactivity, mental confusion, and walking difficulty. Radiographic investigation with brain computed tomography (CT) showed mild bleeding in a pre-medullary and pre-pontine cistern, and cerebral angiogram showed a dissecting PICA aneurysm. Despite being a challenging treatment, microsurgery management was the chosen modality. It was performed an end-to-end anastomosis between the p2/p3 segments, showing to be effective with good clinical and radiographic outcomes. We discussed an unusual case, reviewing the current literature on clinical presentations, the angiographic characteristics of the dissecting aneurysms of PICA, and evaluating the clinical and angiographic results of patients undergoing microsurgical treatment.
This study was designed to verify the effect of aromatherapy on menstrual cramps and dysmenorrhea by a quasi experiment (nonequivalent control group pretest-posttest design), from March to October, 2000. The subjects of this experiment consisted of 45 college women with menstrual cramps and dysmenorrhea. They were randomized by 25 for the experimental group and 20 for the control group. Their mean age was 20.6 years, mean menstrual period 28.7 days, mean menstrual cramps(VAS) 7.25, mean dysmenorrhea (Dysmenorrhea Scale) was 27.34. As treatment, aromatherapy was to give effleurrage of the abdomen with lavender, clary sage and rose as aroma oil, almond oil as carrier oil. For the control group, abdominal massage was given with only almond oil. Data collection included menstrual cramps, dysmenorrhea, the change of symptoms(low abdominal pain, lumbago, headache, nausea, fatigue, edema). Menstrual cramps, dysmenorrhea and general, menstrual characteristics of subjects were measured the first day of the pre menstrual period before treatment (pre-test), menstrual cramps, dysmenorrhea, the change of symptoms were measured the first and second day of post menstrual period after treatment (posttest). Data were analyzed by t-test, $\chi^2$- test, repeated measures ANOVA, Cronbach's ${\alpha}$ with SAS Program. The results of this study was as follows; 1. Menstrual cramps was significantly lower in the experimental group(p = .001). 2. Dysmenorrhea was significantly lower in the experimental group(p = .027). 3. Less women in the experimental group complained about the six symptoms than women in the control group after treatment on the first day of the menstrual period(p < 0.05, p < 0.01) In conclusion, these findings indicate that aromatherapy with lavender, clary sage, and rose could be effective to decrease menstrual cramps, and dysmenorrhea. So, aromatherapy could be applied to women suffering with menstrual cramps, dysmenorrhea periodically as an nursing intervention.
Objectives : The aim of the present study was to examine whether anxiety and depression of children and mothers were associated with the children's medically unexplained somatic symptoms in attention-deficit/hyperactivity disorder(ADHD). Methods : 83 clinic-referred boys with ADHD and 52 boys without ADHD were included in this study. The frequency of the medically unexplained somatic symptoms, such as general-ache, headache, nausea, eye problems, skin problems, abdominal pain, vomiting was evaluated using the somatic symptom domain of the Child Behavior Checklist(CBCL). Children's anxiety and depression were evaluated using Kovacs Children's Depression Inventory(CDI) and Spielberger's State-Trait Anxiety Inventory(STAI) for children. Maternal anxiety and depression were measured by Spielberger's State-Trait Anxiety Inventory(STAI) and Beck's Depression Inventory(BDI). Stepwise linear regression analysis was used to examine the hypothesis. Results : Score of maternal state anxiety affects the T score of the somatic symptom domain in CBCL significantly(adjusted $R^2$=0.057 ; p=0.026). Conclusion : The frequency of medically unexplained somatic symptom of children perceived by mothers was associated with the high level of maternal state anxiety in ADHD. Frequent maternal report of the children's somatic symptom may be a warrant for the evaluation and management of the maternal state anxiety in ADHD.
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