• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.52-57
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• 2008

Even though the origin and nature of nocturnal paroxysmal dystonia (NPD) remains unclear, it has been considered as a manifestation of the nocturnal frontal lobe epilepsy. We report a 17-year-old man with abnormal stereotyped movement during sleep. Video-EEG monitoring, ictal SPECT and night polysomnography did not show any evidence of epilepsy. However, the partial response to large dose of carbamazepine and the scoring according to the frontal lobe epilepsy and parasomnias (FLEP) scale suggest his events could be classified as epilepsy. Therefore we think the FLEP scale might be a useful tool for differential diagnosis in a patient presenting NPD.

• Journal of Korean Neurosurgical Society
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• v.49 no.5
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• pp.284-286
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• 2011

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

• Membrane and Water Treatment
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• v.5 no.4
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• pp.235-250
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• 2014

The impacts of membrane degradation due to chlorine attack on the rejection of inorganic salts and trace organic contaminants by nanofiltration (NF) and reverse osmosis (RO) membranes were investigated in this study. The rejection of trace contaminants was examined at environmentally relevant concentrations. Changes in the membrane surface morphology were observed as a result of chlorine exposure. A small increase in rejection was consistently observed with all four membranes selected in this study after being exposed to a low concentration of hypochlorite (100 ppm). In contrast, a higher concentration of hypochlorite (i.e., 2000 ppm) could be detrimental to the membrane separation capacity. Membranes with severe chlorine impact showed a considerable decrease in rejection over filtration time, possibly due to rearrangement of the polyamide chains under the influence of chlorine degradation and filtration pressure. The reported results indicate that loose NF membranes are more sensitive to chlorine exposure than RO membranes. The impact of hypochlorite exposure (both positive and negative) on rejection is dependent on the strength of the hypochlorite solution and is more significant for the neutral carbamazepine compound than the negatively charged sulfamethoxazole.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.103-111
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• 2014

Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the nonsedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmitter (serotonin, norepinephrine, and dopamine) reuptake inhibitors and anticonvulsants. It has been used mainly as an analgesic drug for nociceptive pain, as well as a treatment for the prevention of postoperative shivering and hiccups. Based on NFP's mechanisms of analgesic action, it is more suitable for the treatment of neuropathic pain. Intravenous administration of NFP should be given in single doses of 20 mg slowly over 15-20 min or with continuous infusion of 60-120 mg/d to minimize adverse effects, such as nausea, cold sweating, dizziness, tachycardia, or drowsiness. The usual dose of oral administration is three to six times per day totaling 90-180 mg. The ceiling effect of its analgesia is uncertain depending on the mechanism of pain relief. In conclusion, the recently discovered dual analgesic mechanisms of action, namely, a) descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and b) inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain.

• Journal of Korean Society on Water Environment
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• v.35 no.6
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• pp.574-579
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• 2019

As interest in health issues increases, it is imperative to ensure good water quality from wastewater treatment plant effluent to preserve environmental health. In particular, currently there is a lack of water ecosystem risk assessment on pharmaceutical substances remaining in effluent. In this study, antidepressant escitalopram (ESC), antiepileptic carbamazepine (CBZ) and lead, which impact the behavior of aquatic organisms, were used to test their impact on the potential behavior of zebrafish. Zebrafish have been widely used in toxicological assessment studies due to the ease of handlinggenerically and genetically. It was possible to observe changes in the growth of organisms through monitoring the embryos' cognitive and behavior assessment. In this study, the embryo lethal dose test showed that the lethal concentration of ESC and CBZ was at 10 ppb, which is below the water quality criterion (100 ppb), increased by 32.5 % and 40 %, respectively. In the cognitive test, it was found that the cognitive ability function decreased by 22 % and 17% for ESC(500 ppb) and CBZ(1,000 ppb) respectively relative to control. Based on these results, it is necessary to initiate efforts to remove these trace pollutants from sewage treatment facilities to protect the health of aquatic organisms.

• Clinical and Experimental Pediatrics
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• v.59 no.3
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• pp.145-148
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• 2016

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature.

• Korean Journal of Biological Psychiatry
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• v.9 no.2
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• pp.129-139
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• 2002

Objective:This study was performed to investigate the prescribing patterns of antimanic agents in the treatment of acute bipolar disorder inpatients in Korea from 1990 through 2000. The results will serve as the basic data for the practice guideline for the pharmacotherapy of bipolar disorder patients in Korea. Method:Retrospective chart review of bipolar disorder inpatients of Soonchunhyang Medical Center in Seoul and Chun-An was conducted for each of the year 1990, 1995, and 2000. The following data are collected ; 1) demographic data, 2) history of bipolar disorder, 3) length of hospital stay, 4) detailed drug titration records of antimanic agents and antipsychotic agents. Results:During the last decade, the frequency of lithium monotherapy was decreased obviously. Instead, more than half of the patients in 2000 were on combination therapy of lithium and anticonvulsants. Lithiumvalproate combination was the preferred strategy and the use rate of carbamazepine has been decreased. In addition, most of the patients were given antipsychotic agents during the last 10 years. And recently, atypical antipsychotics were increasingly prescribed. These changes in the field of pharmacology of bipolar disorder have resulted neither in shorter hospital stays nor lower dosages of concurrent neuroleptics. Conclusions:The results indicate the trends in the prescribing of antimanic agents for the treatment of bipolar disorder in Korea across the past 10 years. Mostly, the change seems to correspond to the international practice guideline. More systematic research is needed to find out the clinical benefits of the anticonvulsants in the real practice of treatment of bipolar disorder.

• Korean Journal of Clinical Pharmacy
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• v.23 no.4
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• pp.344-364
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• 2013

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.154-163
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• 1988

In 1983, Sten H$\ddot{a}$kanson first reported the clinical safety and efficacy of retrogasserian glycerol injection as a treatment of typical trigeminal neuralgia in 96 of 100 patients during a follow-up period of 1~6 years. Since September 1987, we have injected sterile pure glycerol into the trigeminal cistern using an anterior percutaneous approach via the foramen ovale (H$\ddot{a}$rtel route) for treatment of tic douloureux in 12 patients who were suffering from attacks pain of following discontinuation of carbamazepine. The results were as follows; 1) Eight patients were completely free from pain attacks with a single dose of glycerol (0.4 ml). The remaining four patients needed a second dose (0.4 ml) several days later following the single dose. The degree of patient's subjective satisfaction by those injections was very good in 11 and fair in one. 2) During the follow-up period (1~13 months), persistent sensory deficit as determined by the pin prick test, appeared to be mild in 10 and moderate in one patient. There was no sensory deficit in one patient. further attacks of pain from those injections were still noted. 3) As a transient complication, there was headache in all patient, facial hematoma in 4, nausea and vomiting in two each, and vertigo and herpes simplex in one each. In conclusion, we confirmed that the above glycerol injections into the trigeminal cistern were clinically very effective as a treatment of tic douloureux even though the follow-up period was short.

• Journal of Korean Society of Water and Wastewater
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• v.33 no.6
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• pp.469-480
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• 2019

This study was conducted to evaluate the degradation and mineralization of PPCPs (Pharmaceuticals and Personal Care Products) using a CBD(Collimated Beam Device) of UV/H₂O₂ advanced oxidation process. The decomposition rate of each substance was regarded as the first reaction rate to the ultraviolet irradiation dose. The decomposition rate constants for PPCPs were determined by the concentration of hydrogen peroxide and ultraviolet irradiation intensity. If the decomposition rate constant is large, the PPCPs concentration decreases rapidly. According to the decomposition rate constant, chlortetracycline and sulfamethoxazole are expected to be sufficiently removed by UV irradiation only without the addition of hydrogen peroxide. In the case of carbamazepine, however, very high UV dose was required in the absence of hydrogen peroxide. Other PPCPs required an appropriate concentration of hydrogen peroxide and ultraviolet irradiation intensity. The UV dose required to remove 90% of each PPCPs using the degradation rate constant can be calculated according to the concentration of hydrogen peroxide in each sample. Using this reaction rate, the optimum UV dose and hydrogen peroxide concentration for achieving the target removal rate can be obtained by the target PPCPs and water properties. It can be a necessary data to establish design and operating conditions such as UV lamp type, quantity and hydrogen peroxide concentration depending on the residence time for the most economical operation.