• 제목/요약/키워드: coma therapy

검색결과 51건 처리시간 0.027초

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.

加味升葛湯의 肛腸療法에 의한 急慢性 알레르기 反應 抑制效果 (Inhibitory Effects of Acute and Chronic Allergic Reaction by Anal Therapy of Gamiseunggal-tang)

  • 문영호;문석재;문구;원진희;김태균;배남규
    • 한방안이비인후피부과학회지
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    • 제14권1호
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    • pp.117-128
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    • 2001
  • Gamiseunggal-tang(G-tang) has long been used for the treatment of acute and chronic allergic diseases(especially, urticaria) in oriental medicine. But, It's mechanism of action is not well investigated. Anal therapy is another way of taking medicine, which is not used in common situation but available for the treatment of colon and anal diseases. It is also used in GI tract diseases, Gynecological diseases, and pediatric diseases and so on. It is especially benefitable for patients who are in such situations as coma, severe vomiting, and swallowing difficulty. In this study, the author investigated the effects of G-tang by anal therapy on acute and chronic allergic reactions in murine model. The results obtained are as follows: 1. G-tang(0.01, 0.1 g/kg) inhibited the compound 48/80-induced ear swelling response in mice. Inhibitory effects of G-tang was significant (P<0.05) at the dose of 0.01 g/kg. 2. G-tang(0.001-0.1 g/kg) inhibited the cutaneous allergic reaction activated by anti-dinitrophenyl(DNP) IgE in rats. Especially, G-tang 0.01, 0.1 g/kg inhibited the cutaneous allergic reaction significantly. 3. G-tang(0.01-1 g/L) dose-dependently inhibited the compound 48/80-induced histamine release from the peritoneal mast cells. 4. G-tang(0.001-0.1 g/L) had a inhibitory effect on anti-DNP IgE-induced tumor necrosis factor-${\alpha}$ production. Above results indicate that anal therapy of G-tang may be beneficial in the treatment of acute and chronic allergic diseases.

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CDMA-Based Ubiquitous $SaO_2$ Monitoring System for Oxygen Therapy Patients

  • Lee, Seung-Yup;Kang, Jae-Min;Shin, Il-Hyeung;Lee, Jae-Ho;Lee, Choon-Taek;Kim, Hee-Chan
    • 대한의용생체공학회:의공학회지
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    • 제27권5호
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    • pp.274-281
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    • 2006
  • In this paper, we propose a ubiquitous $SaO_2$ monitoring system for patients using oxygen therapy. For these patients, the ability to monitor oxygen saturation ubiquitously is very important fur accurate adjustment of ventilator's flow rate to match the patient's time-varying requirements with the shortest lag time possible. We have developed a portable device to measure $SaO_2$ and transmit it to hospital in real-time or in store-and-forward mode through the integration of $Bluetooth^{TM}$ technology and the code division multiple access (CDMA) cellular network. We also developed software for doctors to receive and manage the patients' $SaO_2$ information. Performance of the developed system was evaluated as acceptable by assessing the accuracy of the measured oxygen saturation value and the stability of communication network. Test results in real clinical setting demonstrate that our system is feasible for immediate use in home oxygen therapy.

전방순환 뇌경색의 중재적 재관류 치료 이후 출혈 변환으로 의식 및 인지장애를 동반한 편마비환자의 한방치험 1례 (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)

  • 김채은;강지현;김서현;김준석;백경민
    • 대한한방내과학회지
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    • 제43권6호
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    • pp.1274-1288
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    • 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.

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.

Effectiveness of Early Surgery in Children with Traumatic Subdural Hygroma

  • Kim, Byoung-Ook;Kim, Seok-Won;Lee, Seung-Myung
    • Journal of Korean Neurosurgical Society
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    • 제37권6호
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    • pp.432-435
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    • 2005
  • Objective: This study was performed to evaluate the usefulness of early operation in children with traumatic subdural hygroma. Methods: The subjects were nine patients (Glasgow coma scale (GCS) score was below 10 and age was below 10 years old) who developed subdural hygroma after trauma between January 2000 to December 2002. Subduroperitoneal shunt was performed in one group and not performed in the other group. We analyzed the GCS score on admission and at 1 year after operation. Overall clinical results were evaluated retrospectively. Results: Patients who underwent operation exhibited higher GCS scores at 1 year after trauma compared to those in the patients who were treated by conservative therapy(p<0.05). Conclusion: The early operation could be an effective treatment to children with subdural hygroma who showed delayed improvement of consciousness and to patients with hygroma that didn't decrease or was above moderate amount.

병원간호사회 중환자 중증도 분류도구 준거 타당도 검정: 뇌손상 환자를 대상으로 (Criterion-Related Validity of the Critical Patients' Severity Classification System Developed by the Hospital Nurses' Association)

  • 오현수;서화숙;박종숙;배은경;이수진;정윤예;최영은;최희정
    • 성인간호학회지
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    • 제21권5호
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    • pp.489-503
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    • 2009
  • Purpose: This study was conducted to test criterion-related validity of the Critical Patients' Severity Classification System (CPSCS) developed by the Hospital Nurses' Association by examining relationships with brain injury severity measured by Glasgow Coma Scale (GCS), recovery state measured by Glasgow Outcome Scale (GOS), and days of stay in ICU of brain injury patients. Methods: Prospective correlational research design was adopted by including 194 brain injury patients admitted to ICU of one university hospital. Results: The score of CPSCS appeared to significantly discriminate the severity of brain injury. Among nursing activities in CPSCS, Respiratory therapy, IV Infusion and Medication, Monitoring, Activities of Daily Living (ADL), Treatment and Procedure were significant to discriminate the severity of brain injury. Respiratory therapy, Vital Signs, and Monitoring appeared to significantly discriminate the recovery states of 1- and 3-months. Nursing activities significantly contributed to predict the days of ICU stay were Respiratory therapy, ADL, and Teaching and Emotional Support. Conclusion: CPSCS developed by the Hospital Nurses Association appeared to be valid to discriminate or predict brain injury severity, recovery states, and days of stay in ICU for brain injury patients.

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The Effects of Propofol and Thiopental Continuous Infusion on Serum Potassium Disturbances in Neurosurgical Patients

  • Kim, Tae Kyong;Lim, Young-Jin;Ju, Jae-Woo;Kim, Jin Wook;Park, Hee-Pyoung
    • Journal of Korean Neurosurgical Society
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    • 제57권3호
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    • pp.197-203
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    • 2015
  • Objective : The potassium disturbance associated with thiopental continuous infusion in neurosurgical patients is well known. However, the effect of propofol continuous infusion on serum potassium levels has not been investigated extensively. Methods : We reviewed the medical records of 60 consecutive patients who received coma therapy or deep sedation for intracranial pressure control using either thiopental or propofol between January 2010 and January 2012. Results : The overall incidence of hypokalemia (K<3.5 mmol/L) was comparable between thiopental and propofol groups (89.2% vs. 82.6%). But, the incidence of moderate to severe hypokalemia (K<3.0 mmol/L) was significantly higher in thiopental group (51.4% vs. 13.0%, p=0.003). The lowest potassium level (2.9 mmol/L vs. 3.2 mmol/L, p=0.020) was lower in thiopental group. The patients in the thiopental group required greater potassium replacement than the propofol group patients (0.08 mmol/kg/h vs. 0.02 mmol/kg/h, p<0.001). On multivariate analysis, thiopental [odds ratio, 95% confidence interval, 7.31 (1.78-27.81); p=0.005] was associated with moderate to severe hypokalemia during continuous infusion. The incidence of rebound hyperkalemia (K>5.0 mmol/L, 32.4% vs. 4.3%, p=0.010) and the peak potassium concentration (4.8 mmol/L vs. 4.2 mmol/L, p=0.037) after the cessation of therapy were higher in thiopental group. On multivariate analysis, thiopental [8.82 (1.00-77.81); p=0.049] and duration of continuous infusion [1.02 (1.00-1.04); p=0.016] were associated with rebound hyperkalemia once therapy was discontinued. Conclusion : Propofol was less frequently associated with moderate to severe hypokalemia after induction and rebound hyperkalemia following the cessation of continuous infusion than thiopental.

Parainfluenza virus 감염 후 발생한 횡문근융해증과 isovaleric acidemia로 인한 고암모니아혈증을 가진 소아에서의 지속적 신대체요법 (Continuous Renal Replacement Therapy in a 4-year-old Child with Rhabdomyolysis Following Parainfluenza Virus Infection and Hyperammonemia due to Isovaleric Acidemia)

  • 박세진;조수연;배기수;신재일
    • Childhood Kidney Diseases
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    • 제17권2호
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    • pp.132-136
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    • 2013
  • Parainfluenza virus 감염은 횡문근융해증의 하나의 원인이 될 수 있다. 횡문근융해증은 지속된 금식기간동안 미토콘드리아 지방산 ${\beta}$-oxidation 장애에 의해 악화될 수 있다. 또한 후기 발생 isovaleric 산증을 가진 환아들에게서 고암모니아혈증이 이화작용을 일으키는 상태 후 발생할 수 있다. 본 케이스는 parainfluenza virus 감염과 후기 발생 isovaleric 산증을 가진 4세 남아가 혼수, 경련 및 심호흡 부전으로 빠르게 진행했던 경우이다. 초기 암모니아와 creatinine kinase는 각각 $385{\mu}Mol/L$과 23,707 IU/L 이었으나 지속적 신대체요법 시행 후 암모니아와 creatinine kinase 수치는 정상으로 돌아왔다. 그러므로 생명을 위협하는 횡문근융해증과 고암모니아혈증을 가진 환아들의 치료에 있어서 즉각적인 지속적 신대체요법의 사용을 권하는 바이다.

중증 뇌손상 환자에서 고농도 산소치료법 (The High Concentration Oxygen Therapy in Severe Head Injury Patients)

  • 박성호;박한준;윤승환;조준;문창택;장상근
    • Journal of Korean Neurosurgical Society
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    • 제30권sup1호
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    • pp.37-43
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    • 2001
  • Object : The rapid and early oxygen delivery to brain tissue was a common therapeutic method in the treatment of severe head injury patients. The purpose of this study was to investigate the effect of increased fraction of inspired oxygen in early stage of severe head injury. Methods : The parameters of research were CSF(cerebral spinal fluid) oxygen pressure($PcsfO_2$), lactate, pH, temperature, and CSF carbon dioxide pressure($PcsfCO_2$). We selected 28 patients with head trauma whose the Glasgow Coma Scale(GCS) score was less than 8 point at admission. All patients were mechanically ventilated and monitored with the commercial ICP monitoring device. Each of parameters was compared as increased fraction of inspired oxygen. In experimental cohort of 14 patients, the mean $PcsfO_2$ level was increased to $314.93{\pm}259.15mmHg$ by raising the $FiO_2$ from 40% to 100% for nine hours(p<0.05). And the mean CSF lactate level was decreased to $2.96{\pm}1.98mmol/L$ on 100% $FiO_2$ as compared with $5.98{\pm}3.25mmol/L$ on 40% $FiO_2$ in control group(p<0.05). The only above two parameters were showed statistically meaningful outcome. Conclusions : Although this study was performed in small cohort and short period, these results supports that increased inspired oxygen therapy in severe head injuried patients was recommended as a modality of treatment in future through the continuous survey.

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