PURPOSE: To investigate the correlations of keratometry and corneal high order aberrations (HOAs) between the Keratron Scout videokeratoscope and the Pentacam HR Scheimpflug camera. METHODS: From December 2012 to February 2013, keratometry and corneal HOAs were determined using the Keratron Scout videokeratoscope and Pentacam HR Scheimpflug camera in 23 healthy individuals (46 eyes). RESULTS: Average keratometry showed high correlation with 95% confidence interval -0.155 +/- 0.37 between the Keratron Scout and Pentacam HR. When comparing HOAs of the Keratron Scout and total corneal HOAs of Pentacam HR, total root-mean-square (RMS), and spherical aberration were positively correlated between the 2 devices (r = 0.67, p < 0.001 and r = 0.74, p < 0.001, respectively). When comparing HOAs of Keratron Scout and anterior corneal HOAs of Pentacam HR, total RMS, spherical aberration and coma were positively correlated between the 2 devices (r = 0.62, p < 0.001, r = 0.81, p < 0.001, and r = 0.52, p = 0.047, respectively). CONCLUSIONS: Although the 2 devices are based upon different principles, the Keratron Scout videokeratoscope and Pentacam HR Scheimpflug camera showed positive correlations in keratometry, total RMS, spherical aberration, and coma. Both devices may be useful for clinical applications.
Coma

PURPOSE: To investigate the correlations of keratometry and corneal high order aberrations (HOAs) between the Keratron Scout videokeratoscope and the Pentacam HR Scheimpflug camera. METHODS: From December 2012 to February 2013, keratometry and corneal HOAs were determined using the Keratron Scout videokeratoscope and Pentacam HR Scheimpflug camera in 23 healthy individuals (46 eyes). RESULTS: Average keratometry showed high correlation with 95% confidence interval -0.155 +/- 0.37 between the Keratron Scout and Pentacam HR. When comparing HOAs of the Keratron Scout and total corneal HOAs of Pentacam HR, total root-mean-square (RMS), and spherical aberration were positively correlated between the 2 devices (r = 0.67, p < 0.001 and r = 0.74, p < 0.001, respectively). When comparing HOAs of Keratron Scout and anterior corneal HOAs of Pentacam HR, total RMS, spherical aberration and coma were positively correlated between the 2 devices (r = 0.62, p < 0.001, r = 0.81, p < 0.001, and r = 0.52, p = 0.047, respectively). CONCLUSIONS: Although the 2 devices are based upon different principles, the Keratron Scout videokeratoscope and Pentacam HR Scheimpflug camera showed positive correlations in keratometry, total RMS, spherical aberration, and coma. Both devices may be useful for clinical applications.
Coma

Thirty four patients with diffuse axonal injury, defined as post-traumatic coma for over 24 hours with Glasgow Coma Scale(GCS) score of 8 or less following nonsurgical resuscitation, admitted to Inha Hospital from January to December 1991, were studied in order to identify clinical analysis. The aim of this study was to find out the effects of barbiturates or other intensive therapy or head elevation on the intracranial pressure(ICP), arteriovenous oxygen difference(AVDO2) and outcome. The results were as follows; The ratio of male to female was about 6 to 1. 2) In clinical signs at the emergency room, abnormal pupil size was shown 17 cases(61%) under 8-5 on the GCS, but all cases under 5 on the GCS showed abnormal pupil size. 3) Ventricular compression was shown in 29 cases(85%), 17 cases(50%) was showed the ventricular compression & cisternal obliteration. 4) Post-traumatic cerebral infarction was developed 59% of DAI and occurred in 88% of ventricular compression and cisternal obliteration. 5) On admission, above 5 ml/100 ml in AVDO2 was developed in 32 cases(94%) under 8 on the GCS, but in all cases under 5 on the GCS. Recording of ICP showed above 20 mmHg in 15 cases(44%). On coagulopathy, our cases showed that decrease of platelet was involved in 5 cases(15%), prothrombin time(PT) prolongation in 11 cases(32%), activated partial thromboplastin time(APTT) in 4 cases, fibrinogen in 5 cases. 6) The mean ICP was slightly lower when the patient's head was elevated at 30 degree than at 0 degree. The mean ICP was moderately lower when the patients were taken barbiturates therapy. ICP tends to increase from the 1st to 3rd day after injury. 7) The mean AVDO2 was significantly lower when the patients were taken barbiturates therapy, especially at the 1st day. 8) On the relation between Glasgow Outcome Scale(GOS) and Neurological grading(NG), GOS IV was developed in 8 cases(NG score 3-6), GOS III in 5 cases(NG score 7-9), GOS II in 2 cases(NG score 10). Total mortality rate was 56%.
Axons* ; Barbiturates ; Blood Platelets ; Cerebral Infarction ; Coma ; Coma, Post-Head Injury ; Diffuse Axonal Injury ; Emergency Service, Hospital ; Female ; Fibrinogen ; Head ; Humans ; Male ; Mortality ; Oxygen ; Prothrombin ; Pupil ; Resuscitation ; Thromboplastin

Sixty-seven patients with moderate to severe cerebral diffused sxonal injuries(that is, in post-traumatic coma for over 24 hours without mass lesions or ischemic insults) were admitted during past four years and four months period ending April 30, 1991. A retrospective study of these patients was done for identification of prognostic factor. The ratio of male to female was 2.7 to 1 and the peak incidence was at the second decade. The most common cause of trauma was traffic accident and pedestrian trauma was the most common event among that. Forty-nine patients(73%) recovered from coma, nine(13%) remained in vegetative state and another nine(13%) died. The median duration of coma was 13 days. The age, initial Glasgow Coma scale(GCS), prolonged duration of coma, initial motor reactivities, signs of hypothalamic damage, corpus callosum and brain stem lesions on brain MRI were proved as adverse factors for prognosis.
Accidents, Traffic ; Brain Stem ; Brain* ; Coma ; Coma, Post-Head Injury ; Corpus Callosum ; Diffuse Axonal Injury* ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Persistent Vegetative State ; Prognosis ; Retrospective Studies

OBJECTIVETo determine the effect of arousal methods for prolonged coma of 175 patients with severe traumatic brain injury and related factors.

METHODSThere were 175 cases with persistent coma longer than 1 month after severe traumatic brain injury. Coma lasted 1-12 months. Arousal procedures included hyperbaric oxygen, physical therapy and arousal drugs.

RESULTSIn the 175 prolonged coma patients 110 got recovery of consciousness; in 118 cases with coma of 1-3 months, 86 cases recovered consciousness (72.9%); in 42 cases with coma of 4-6 months, 20 cases recovered consciousness (47.6); and in 15 cases with coma of longer than 6 months, only 4 cases recovered consciousness (26.7%). The recovery of consciousness depended on patient's primary brain stem damage, cerebral hernia, GCS score, and age.

CONCLUSIONSApplication of appropriate arousal procedures improves recovery of consciousness in patients with prolonged coma.

Adolescent ; Adult ; Aged ; Brain Injuries ; therapy ; Child ; Child, Preschool ; Coma, Post-Head Injury ; therapy ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Recovery of Function ; Treatment Outcome

We investigated neurobehavioural sequelae after head injury in consecutive 104 patients who were evaluated by psychometric examinations from 1990 to 1994. Organic brain syndrome(OBS), posttraumatic stress disorder(PTSD), and others were observed in 55 patients(52.9%), 37 patients(35.6%), and 12 patients(11.5%), respectively. OBS was more common when the initial Glasgow Coma Score was low or when there was an intradural demage(p<0.025). OBS and PTSD did not differ significantly in age, sex, cause of injury, interval from injury to psychometric examination, skull fracture, cranial operation, or the Injury Severity Score. In OBS, the mean verbal Intellegence Quotient(IQ) was 91.3, performance IQ 77.8, total IQ 84.9 and memory quotient 70.7. In PTSD, it was 101.4, 100.1, 100.9 and 77.8, respectively. Performance IQ and total IQ of OBS and PTSD differed significantly, but verbal and memory quotient did not. In OBS, the mean verbal IQ of patients with right hemispheric damage was generally higher than that of patients with the left hemispheric damage, except in vocabulary and comprehension. But that of performance IQ was the reverse. In OBS, simplification, distortion, rotation, omit, impaired judgement, labile affect, impulsivity, depression, flatness, apathy, and bluntedness were commonly observed. While somatization, hostility, frustration, faking bad, and retarded manner were more frequently found in PTSD. The burden imposed on the family is primarily attributable to neurobehavioral sequelae rather than motor or sensory deficits. We should concerned about the adequate management of neurobehavioral sequelae as much as the proper treatment of head injury during the acute period.
Apathy ; Brain ; Coma ; Comprehension ; Craniocerebral Trauma* ; Depression ; Frustration ; Head* ; Hostility ; Humans ; Impulsive Behavior ; Injury Severity Score ; Memory ; Psychometrics* ; Skull Fractures ; Stress Disorders, Post-Traumatic ; Vocabulary

In oder to evaluate the effect of hyperglycemic control and potential complications of the recommended protocol using small doses of inssulin in treating the non- ketotic hyperosmolar diabetics. 22 studies partients were used Regular insulin with an initial dose of 0.1 IU/kg/h by continuous intravenous infusion. The dose of insulin was reduced to 0.05 IU/kg/h when the patient’s glycemia dropped to a level of 16 mmol/l. Results: 17 non ketotic hyperosmolar coma patients (77%) were successfully treated and discharged. No severe complications concerned with the inssulin therapy (such as hypoglycemia; hypokalemia) were noticed in this study. 5 patients died. The mean total dose of insulin in these patients during the first 24 h was not significantly different from that of the other survivals. Conclusions: the proposed small doses of insulin by continuous intravenous infusion showed a high and safe effect in treatment of non- ketotic hyperosmolar diabetics.
Hyperglycemic Hyperosmolar Nonketotic Coma ; Insulin ; Diabetes Mellitus

PURPOSE: To compare ocular aberrations measured with a laser ray tracing aberrometer (iTrace(R), Tracey technology) or a Shack-Hartmann aberrometer (Zywave(TM), Bausch & Lomb). METHODS: A total of 68 eyes were included in this study. After manifest refraction (MR) and pupil dilation, aberrations and phoroptor predicted refraction (PPR) were measured with the Zywave(TM) and iTrace(R) devices. The study group was subdivided into a more myopic group (<-4.33 Diopter (D)) and a less myopic group (>-4.33 D). The root mean square (RMS) errors of the total high order, spherical, coma and 3rd~5th order aberrations were compared. RESULTS: The mean and SE of MR was -4.33+/-2.03 diopter (D), and that of the PPR was -4.20+/-2.13 D in iTrace(R) and -4.42+/-2.23 D in Zywave(TM). A paired-t test of the PPR and MR indicated that they were not statistically different. Zernike coefficients were expressed in the opposite sign in the 2nd and 4th order. The coma and spherical aberrations were larger in Zywave(TM). In a scattergram of each Zernike coefficient, the coefficient of determination (R2) was very low with higher order aberrations, with an exception for coma and spherical aberrations. The correlation of RMS error was greater in the less myopic group. CONCLUSIONS: Taking PPR values as a good reference of MR was a reliable method. For the HOA, only coma and spherical aberrations showed good correlations between Zywave(TM) and iTrace(R), and the correlations for HOA were decreased for the high myopic eyes.
Coma ; Pupil

Study on 22 nonketonic hyperosmolar coma patients (13 males and 9 females) at the B¹ch Mai hospital during the period from 6/98 to 5/99. Patients were followed a volume replacement protocol using a normal saline during 3 first hours and a half - strength saline solution after that until the plasma osmolatty restores a preset value ((320 mOsmol/kg). Results shown that 17 patients (77%) were treated successfully and discharged. 5 deaths (23%) were seen in study: 1 patient died within the first 12 hours, when he had been presenting an uncontrolled hyperosmolar condition; 4 others died from different causes (such as septic shock, cerebral infarction...). Conclusion: fluid challenge with normal saline and half - strength saline solutions in our study shown a high efficiency in management of nonketotic hyperosmolar coma of NIDDM and did not evoke any serious complications
Coma ; therapeutics

Myxedema coma is associated with decreased mental status and hyponatremia among patients with diagnosed or undiagnosed hypothyroidism. The diagnosis is challenging in the absence of universally accepted diagnostic criteria, but should be considered as a differential even in cases with competing established diagnoses. All patients should receive intensive care level treatment. Even with optimal treatment, mortality is very high.
Myxedema ; Coma