• 제목/요약/키워드: coma

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Ivermectin투여가 고환에 미치는 영향에 관한 병리조직학적 관찰 (Histopathological changes on the testis by Ivermectin toxicity)

  • 손정훈;이차수
    • 대한수의학회지
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    • 제35권3호
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    • pp.563-573
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    • 1995
  • To know the effect of Ivermectin(IVM) toxicity in testis, histopathologic changes as well as clinical signs were observed in experimental animals including dogs by the subcutaneous injection with 3-50mg/kg of IVM. Clinically, it was observed to have depression and ataxia in all groups whereas tremor and coma in mice, rats and guinea pigs, coma in hamsters and rabbits, and tremor and salivation in dogs were shown. The clinical signs were different by the dosage of IVM, species and individuals in all animals. Susceptibility to IVM was most sensitive in dogs, especially in a Tosa dog and this was susceptible in mice, hamsters and rabbits, guinea pigs and rats in order. Microscopical observation revealed that the seminiferous tubules of testis had decreased thickness of germinal epithelium due to the necrosis and desquamation of the spermatids and spermatocytes. The progressive pattern by the times of administration showed vacuolar formation between the layer of spermatids and spermatogonia due to the marked necrosis of spermatocytes and the presence of multinucleated giant cells derived from spermatid throughout the seminiferous tubules of testis. Only a layer of spermatogonia, a few spermatogonia, and Sertoli cells wore observed with atrophied wavelike basement membrane in the seminiferous tubules of testis. Necrotic germinal cells, sloughed immature spermatids and spermatocytes were present in the lumen of epididymis and ductus deferens. Microscopical observation showed different susceptibility to IVM with clinical observation in which it was also most sensitive in dogs, especially in a Tosa dog and this was susceptible in rabbits and guinea pigs, hamsters, rats and mice in order. It was considered that IVM affects mainly spermatocyte or spermatid stage in the spermatogenesis and disturbs their developing beyond these stage.

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중환자실 의료기기 관련 욕창의 위험요인 (Risk Factors of Medical Device-Related Pressure Ulcer in Intensive Care Units)

  • 구미지;심영아;강인순
    • 대한간호학회지
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    • 제49권1호
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    • pp.36-45
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    • 2019
  • Purpose: The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units. Methods: A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, ${\chi}^2-test$, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program. Results: Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19). Conclusion: On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

Effects of Trauma Center Establishment on the Clinical Characteristics and Outcomes of Patients with Traumatic Brain Injury : A Retrospective Analysis from a Single Trauma Center in Korea

  • Kim, Jang Soo;Jeong, Sung Woo;Ahn, Hyo Jin;Hwang, Hyun Ju;Kyoung, Kyu-Hyouck;Kwon, Soon Chan;Kim, Min Soo
    • Journal of Korean Neurosurgical Society
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    • 제62권2호
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    • pp.232-242
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    • 2019
  • Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ${\leq}8$). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.

Could the Injury Severity Score be a new indicator for surgical treatment in patients with traumatic splenic injury?

  • Jeong, HyeJeong;Jung, SungWon;Heo, Tae Gil;Choi, Pyong Wha;Kim, Jae Il;Jung, Sung Min;Jun, Heungman;Shin, Yong Chan;Um, Eunhae
    • Journal of Trauma and Injury
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    • 제35권3호
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    • pp.189-194
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    • 2022
  • Purpose: The purpose of this study was to determine whether a higher Injury Severity Score (ISS) could serve as an indicator of splenectomy in patients with traumatic splenic lacerations. Methods: A total of 256 cases of splenic laceration were collected from January 1, 2005 to December 31, 2018. After the application of exclusion criteria, 105 were eligible for this study. Charts were reviewed for demographic characteristics, initial vital signs upon presentation to the emergency room, Glasgow Coma Scale, computed tomography findings, ISS, and treatment strategies. The cases were then divided into nonsplenectomy and splenectomy groups for analysis. Results: When analyzed with the chi-square test and t-test, splenectomy was associated with a systolic blood pressure lower than 90 mmHg, a Glasgow Coma Scale score lower than 13, active bleeding found on computed tomography, a splenic laceration grade greater than or equal to 4, and an ISS greater than 15 at presentation. However, in multivariate logistic regression analysis, only active bleeding on computed tomography showed a statistically significant relationship (P=0.014). Conclusions: Although ISS failed to show a statistically significant independent relationship with splenectomy, it may still play a supplementary role in traumatic splenic injury management.

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
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    • 제65권5호
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    • pp.652-664
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    • 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.

뇌혈관질환을 동반한 진행성 핵상마비 환자의 의식수준저하에 대한 한방복합치료 증례보고 1례 (A Case Report of Complex Korean Medicine Treatments of Decreased Mental Status in a Progressive Supranuclear Palsy Patient with a Cerebrovascular Accident)

  • 강지현;김서현;김준석;장우석
    • 대한한방내과학회지
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    • 제43권5호
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    • pp.881-890
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    • 2022
  • Objectives: This study investigated the effect of complex Korean medicine treatment on decreased mental status in a progressive supranuclear palsy patient with a cerebrovascular accident. Case presentation: The patient was treated with Korean medicine composed of herbal medicine (modified Guibi-tang), acupuncture, moxibustion, and cupping combined with Western medicine (a dopamine precursor and an anticholinergic) and physical therapy. The Glasgow Coma Scale, Mini-Mental State Examination, and Hoehn and Yahr Scale were used to evaluate the effects of the treatments. After treatment, Glasgow Coma Scores increased from 9-10 to 12-13, and Mini-Mental State Examination for dementia screen scores increased from 1 to 2. The Hoehn and Yahr score remained at 5. There were no side effects of the treatment. Conclusion: This study suggests that complex Korean medicine treatments may be effective for the decreased mental status of a progressive supranuclear palsy patient with a cerebrovascular accident, but further studies are needed.

전할(全蝎)에 대한 문헌적(文獻的) 고찰(考察) (The study on Buthus martensii Karsch)

  • 권기록;최성모;안창석
    • 대한약침학회지
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    • 제5권1호
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    • pp.181-188
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    • 2002
  • Objective: Through the literatures on the effects of Buthus martensii Karsch, we are finding out the clinical possibility and revealing the more effctive to intractable diseases. Method: We investigated the literatures of Oriental Medicine and experimental reports about Buthus martensii Karsch. Results: 1. The taste of Buthus martensii Karsch is salty, hot and toxic, and the effect of this is tetanus, headache, facial palsy and convulsion. 2. The venom of Buthus martensii Karsch is anaesthetic and toxic protein, composed of buthotoxin, lecithin, trimethylamine, betaine, taurine, cholesterol, stearic acid and palmitic acid and similar to the snake venom. 3. The pharmacological effects ofButhus martensii Karsch are anti-convulsion, depressor, anesthesia, anti-thrombosis and anti-cancer. 4. Symptoms of Buthotoxin poisoning are local pain, vomiting, fever, hypertension and palpitaion, and critical condition to Dyspnea, coma and death.

Cerebral Hemorrhage after Endovascular Treatment of Bilateral Traumatic Carotid Cavernous Fistulae with Covered Stents

  • Cho, Kwang-Chun;Seo, Dae-Hee;Choe, Il-Seung;Park, Sung-Choon
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.126-129
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    • 2011
  • Bilateral traumatic carotid-cavernous fistulae (TCCFs) is rarely encountered neurovascular disease. For treatment of TCCF, detachable balloons have been widely used. Nowadays, transarterial and/or transvenous coil embolization with placement of covered stents is adopted as another treatment method. We experienced a patient with a bilateral TCCFs who was successfully treated with covered stents. However, cerebral hemorrhage occurred in the bed of previous infarction one day after treatment. Hyperperfusion syndrome was considered as a possible cause of the hemorrhage, so that barbiturate coma therapy was started and progression of hemorrhage was stopped. We emphasize that cerebral hyperperfusion hemorrhage can occur even after successful endovascular treatment of TCCF.

A­-MiDAS 시스템의 MNAB 설계 및 구현 (Design and Implementation of MNAB for A-­MiDAS)

  • 김규형;류재홍;류원
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2003년도 가을 학술발표논문집 Vol.30 No.2 (3)
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    • pp.325-327
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    • 2003
  • 망 자원의 효율적인 사용, 관리 및 기존의 망을 흡수 통합하기 위해서 차세대통합네트워크(NGcN), ALL­IP 망으로 망 진화가 이루어지고 있으며, 이에 따라 동기식 CDMA2000 과 비동기식 WCDMA의 이동 통신망도 통합 및 연동에 대한 연구가 진행되고 있다. 그리고, 망 개방화에 대한 분위기도 고조되는 상황에서 CDMA2000, WCDMA등과 같은 서로 다른 무선 액세스 망에서 동일한 게이트웨이를 통하여 무선인터넷 서비스를 제공하려는 움직임도 있다. 본 논문에서는 망 진화에 따른 망통합 및 연동과 망 개방에 따른 COMA200 과 WCDMA 의 서로 다른 무선인터넷 액세스를 동시에 지원하기 위한 시스템인 A­MiDAS(Advanced Mobile internet Data Access System)에 대해서 소개하고, A­MiDAS 내의 CDMA2000 과 WCDMA 를 수용하기 위해서 설계 및 개발된 MNAB(Mobile Network Access Board)에 대해서 기술한다.

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