Polish Man Wakes From 19-Year Coma
WARSAW (June 2007) - A 65-year-old railwayman who fell into a coma following in an accident in communist Poland regained consciousness 19 years later to find democracy and a market economy, Polish media reported on Saturday.
Wheelchair-bound Jan Grzebski, whom doctors had given only two or three years to live following his 1988 accident, credited his caring wife Gertruda with his revival.
"It was Gertruda that saved me, and I'll never forget it" Grzebski told news channel TVN24.
"For 19 years Mrs Grzebska did the job of an experienced intensive care team, changing her comatose husband's position every hour to prevent bed-sore infections," Super Express reported Dr Boguslaw Poniatowski as saying.
A comatose patient is in a profound state of unconsciousness which renders them unaware of both self and the world around them, and from which they cannot be roused.
Although those in a coma do not respond to stimuli in a meaningful way, contrary to popular belief they do not always lie quiet and still - in some cases they can move, open their eyes and even talk.
"I cried a lot, and I prayed a lot," Mrs Grzebski said on Polsat television.
"Those who came to see us kept asking: ' When is he going to die? ' But he's not dead."
Last year, she noticed that he was trying to speak, Gazeta said. He returned to the hospital and came out of the coma some two months ago.
‘‘At the start, his speech was very unclear, now it is improving daily,’’ Pstragowski, a rehabilitation specialist, said. ‘‘If he continues to make such progress, he will soon be able to walk.’’
‘‘I am sure that without the dedication of his wife, the patient would not have reached us in the (good) shape that he did,’’ Pstragowski said.
"When I went into a coma there was only tea and vinegar in the shops, meat was rationed and huge petrol queues were everywhere," Grzebski told TVN24, describing his recollections of the communist system's economic collapse.
‘‘I could not talk or do anything, now it’s much better,’’ he said in a weak but clear voice, some two months emerging from his coma.
"Now I see people on the streets with cell phones and there are so many goods in the shops it makes my head spin."
"He remembers things that were going on around him," Mrs. Grzebski said. "He talks about it and remembers the weddings of our children. He had fever around the time of the weddings, so he knew something big was taking place."
Grzebski awoke to find his four children had all married and produced 11 grandchildren during his years in hospital.
"I've got nothing to complain about."
UAMS Researchers Identify Sleep-Wake Controls with Implications for Coma Patients and Those Under Anesthesia
LITTLE ROCK (July 2007) – How do we wake up? How do we shift from restful sleep to dreaming? Researchers at the University of Arkansas for Medical Sciences (UAMS) have discovered a new brain mechanism that just might explain how we do that. This new mechanism also may help us understand how certain anesthetics put us to sleep and how certain stimulants wake us up.
In their first published study on this topic, researchers in the UAMS Center for Translational Neuroscience found that some neurons in the reticular activating system, a region of the brain that controls sleep-wake states, are electrically coupled.
“By finding drugs for increasing the electrical coupling of these cells, we create a stronger pathway for potential sleep-wake control,” said study author Edgar Garcia-Rill, Ph.D., a professor of neurobiology and developmental sciences in the UAMS College of Medicine and director of the Center for Translational Neuroscience.
“The possible clinical applications range from the ability to wake people up from anesthesia more rapidly, to stimulating someone in a comatose state to awaken if there are enough of these cells left alive to couple them,” Garcia-Rill said.
The study, “Evidence for Electrical Coupling in the SubCoeruleus (SubC) Nucleus,” documenting this cellular new mechanism, was published in the April issue of the Journal of Neurophysiology. In June, the research team presented additional findings at the annual meeting of the Associated for Professional Sleep Societies in Minneapolis.
The researchers found that neurons in the SubCoeruleus nucleus, a part of the brain believed to control the phase of deep sleep known as rapid-eye-movement (REM) sleep, joined in a way that allowed them to transmit electrical activity across the cells. The activity occurred spontaneously or could be induced by chemical agents that induce REM sleep.
The research article was accompanied by an editorial that called the finding "seminal" in the field of sleep-wake research. The editorial was written by peers Matthew Ennis of the Department of Anatomy and Neurobiology at the University of Tennessee Health Center in Memphis and Subimal Datta of the Department of Psychiatry and Behavioral Neuroscience at the Boston University School of Medicine.
“The findings of [the researchers] provide novel and exciting avenues for understanding sleep-wake control as well as for the treatment of sleep and arousal disorders,” wrote Ennis and Datta in the editorial.
Lead author of the study was David S. Heister, a graduate student pursuing a combined medical and doctoral degree in the Department of Neurobiology and Developmental Sciences of the UAMS Graduate School and UAMS College of Medicine.
Joining Heister and Garcia-Rill are Abdallah Hayar, Ph.D., and Amanda Charlesworth, Ph.D., UAMS faculty members in the Department of Neurobiology and Developmental Sciences and researchers in the Center for Translational Neuroscience; Charlotte Yates, Ph.D., from the Department of Physical Therapy at the University of Central Arkansas; and former UAMS faculty member Yi-Hong Zhou, Ph.D., of the University of California-Irvine.
The researchers pointed to earlier work with animal models showing that stimulation of a specific region of the brain, the reticular activating system, produced electrical activity similar to that seen during waking and REM sleep. In studying the SubCoeruleus region of the brain, the researchers detected the presence of electrical coupling of cells, a mechanism that may help the brain switch between the sleep and waking states. The presence of electrical coupling between these cells offers a potential pathway for substances that could better regulate the sleep-wake control, Garcia-Rill said.
The electroencephalogram, or EEG, of the waking brain shows fast rhythms of 10-60 cycles per second, while the sleeping brain cycles at frequencies below 10 per second. Electrical coupling would allow many cells to fire together, generating a rhythm that is transmitted to other parts of the brain to induce changes in sleep-wake states. In collaboration with the chemical transmitters that control the firing rates in individual cells, the two mechanisms could generate any of the frequencies seen in the EEG. Some anesthetics are known to block gap junctions, the channels by which electrical coupling takes place, while some stimulants increase electrical coupling.
Garcia-Rill helped establish the UAMS Center for Translational Neuroscience in 2003 as a division of the Department of Neurobiology and Developmental Sciences supported by a Center of Biomedical Research Excellence award from the National Center for Research Resources at the National Institutes of Health. It is one of the few facilities in the nation devoted to quickly moving new treatments from basic scientific research to developing new treatments for patients in the clinic. The Center for Translational Neuroscience also has a Community Research and Education Core Facility that works to bring clinical treatments to the medical and lay community.
UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a medical center, six centers of excellence and a statewide network of regional centers. UAMS has 2,435 students and 714 medical residents. It is one of the state’s largest public employers with about 9,400 employees, including nearly 1,000 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. UAMS and its affiliates have an economic impact in Arkansas of $5 billion a year. For more information, visit www.uams.edu.