• Journal of the Korea Institute of Military Science and Technology
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• v.16 no.2
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• pp.218-224
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• 2013

Organophosphorus compounds are irreversible inhibitors of cholinesterase enzyme. Exposure causes a progression of toxic signs, including hypersecretion, tremor, convulsion, respiratory distress, epileptiform seizure, brain injuries and death. To protect brain injuries, administration of diazepam as a neuroprotectant is now considered essential for severely exposed nerve agent casualties. However, studies have shown diazepam to provide less than total protection against the neuropathological consequences of nerve agent exposure. In this context, extensive studies have been carried out to find out effective alternative drugs to protect brain from epileptiform seizures induced by organophosphate compounds intoxication. It has been reported that a combination of carbamate and anticholinergic or antiglutamatergic can be a very effective medical countermeasure in dealing with the threat of organophosphorous poisoning. In this study, experimental animals including rats and guinea pigs were implanted with microelectrodes on their brain sculls, and treated with various centrally acting drugs such as physostigmine and procyclidine prior to soman challenge, and then its electroencephalography(ECoG) was monitored to see anticonvulsant effects of the drugs. It was found that seizure activities in ECoG were not always in proportion to clinical signs induced by soman intoxication, and that combinative pretreatment with physostigmine plus procyclidine effectively stopped the seizures induced by organophosphorous poisoning.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.359-365
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• 2005

Objective : The study investigates the extent of brain shift and its effect on the accuracy of the stereotaxic procedure. Methods : Thirty-five patients underwent 40stereotactic procedures between June 2002 and March 2004. There were 26 males, mean age 59years old. There were 34procedures for Parkinson's disease, 2 for essential tremor, 3 for cerebral palsy, 1 for dystonia. Patients were divided in four groups based on postoperative pneumocephalus : under 5cc [9 procedures], between $5{\sim}10cc$ [13procedures], between $10{\sim}15cc$ [11 procedures] and more than 15cc [7procedures]. The coordinates of the anterior commissure[AC], posterior commissure[PC], and target were defined in pre-and intraoperative magnetic resonance image scans and the amount of air volume was measured with @Target (BrainLab, Heimstetten, Germany]. Results : The mean AC-PC was 26.5mm for patients with less than 5cc, 26.9mm for $5{\sim}10cc$, 25.8mm for $10{\sim}15cc$ and 26.2mm for more than 15cc. The length of AC-PC line and coordinates of AC, PC was also not statistically different, Euclidean distance as well as ${\Delta}x$, ${\Delta}y$, ${\Delta}z$ of AC, PC, and target were also not statistically different among the groups [p>,1]. There was a variance in target of $0.7{\sim}7.6mm$, Euclidean distance of 2.5mm, related to electrophysiology but not to brain-shift. Conclusion : The amount of air accumulated in the intracranial space and compressing the cortical surface has no effect on the localization of subcortical stereotactic target and landmarks.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.655-661
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• 2004

Anorexia nervosa is a serious, often chronic, and life-threatening eating disorder defined by a refusal to maintain minimal body weight (within 15% of an individual s normal weight). Other essential features of this disorder include an intense fear of gaining weight, a distorted body image, and amenorrhea(absence of at least three consecutive menstrual cycles when they are otherwise expected to occur). With anorexia nervosa, the nails and hair become brittle, and the skin may become dry and yellow. In addition to depression, hypothermia, lanugo, nausea, vomiting, anxiety and dehydration from sweating can appear. Starvation, weight loss, and related medical complications are quite serious and can result in death. Recently one patient was admitted with anorexia nervosa-like symptoms. The patient is a 18-year-old girl with complaints of weight loss, amenorrhea, anorexia, nausea, vomiting, tremor, and sweating. After treatment through oriental medicine for 2 weeks, most of the symptoms improved. Therefore, this application of oriental medicine is reported with a plea for further investigation.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.272-279
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• 2007

Purpose: The aim of this study was to evaluate the discriminating nature of $^{123}I-FP-CIT$ SPECT in patients with parkinsonism. Methods: $^{123}I-FP-CIT$ SPECT images acquired from the 18 normal controls; NC ($60.4{\pm}10.0$ yr) and 237 patients with parkinsonism ($65.9{\pm}9.2$ yr) were analyzed. From spatialIy normalized images, regional counts of the caudate, putamen, and occipital lobe were obtained using region of interest method. Binding potential (BP) was calculated with the ratio of specific to nonspecific binding activity at equilibrium. Additionally, the BP ratio of putamen to caudate (PCR) and asymmetric Index (ASI) were measured. Results: BPs of NC $3.37{\pm}0.57,\; 3.10{\pm}0.41,\; 3.23{\pm}0.48$ for caudate, putamen, whole striatum, respectively) had no significant difference with those of essential tremor; ET ($3.31{\pm}0.64,\; 3.06{\pm}0.61,\; 3.14{\pm}0.63$) and Alzheimer's disease; AD (3.33 $\pm$0.60, 3.29$\pm$0.79, 3.31$\pm$0.70), but were higher than those of Parkinson's disease; PD (1.92$\pm$0.74, 1.39$\pm$0.68, 1.64$\pm$0.68), multiple system atrophy; MSA (2.36$\pm$1.07, 2.16$\pm$0.91, 2.26$\pm$0.96), and dementia with Lewy body; DLB (1.95$\pm$0.72, 1.64$\pm$0.65, 1.79$\pm$0.66)(p<0.005). PD had statisticalIy lower values of PER and higher values of ASI than those of NC (p<0.005). And PD had significantIy lower value of PCR, higher ASI and lower BP in the putamen and whole striatum than MSA (p<0.05). Conclusion: Dopamine transporter image of $^{123}I-FP-CIT$ SPECT was a good value in differential diagnosis of parkinsonism.

• The Korean Society of Law and Medicine
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• v.24 no.2
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• pp.147-196
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• 2023

Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.