It has been suggested that epileptic seizures can be interrupted by deep brain stimulation (DBS) of various deep brain structures which may exert a therapeutic control on seizure generators or correspond to ictal onset zone themselves. Several groups have used DBS in drug-resistant epilepsy cases for which resective surgery cannot be applied. The promising subcortical brain structures are anterior and centromedian nucleus of the thalamus, subthalamic nucleus, and other nuclei to treat epilepsy in light of previous clinical and experimental data. Recently two randomized trials of neurostimulation for controlling refractory epilepsy employed the strategies to stimulate electrodes placed on both anterior thalamic nuclei or near seizure foci in response to electroencephalographically detected epileptiform activity. However, the more large-scale, long-term clinical trials which elucidates optimal stimulation parameters, ideal selection criteria for epilepsy DBS should be performed before long.
Anterior Thalamic Nuclei ; Brain ; Deep Brain Stimulation ; Electrodes ; Epilepsy ; Intralaminar Thalamic Nuclei ; Light ; Patient Selection ; Seizures ; Subthalamic Nucleus ; Thalamus

No abstract available in English.
Acetabulum ; Clinical Study

PURPOSE: This study was done to identify attitude and factors influencing attitudes to organ transplants. METHOD: Study participants were 165 people over the age of 18 and living in Seoul. The instrument used for this study was the descriptive questionnaire developed by Ju (1995). Analysis of the data was done with SPSS Win 10.0 with descriptive statistics, t-test, ANOVA and stepwise multiple regression. RESULTS: 1. The scores on attitude toward organ transplants ranged from 14 to 70, and had a mean score of 49.26. There were statistically significant differences in scores on attitude to organ transplants according to age (p=.03), marital status (p=.00), monthly income (p=.02) and experience of having education about organ transplants (p=.00). 2. The factors influencing attitudes to organ transplants were having the experience of education on transplants and marital status. These two variables explained 20.1% of the variance. 3. Reasons given for no written pledge to donate one's organs were 'fear on organ donation', 'not knowing the way or how to do', 'plan to give my organs to a family member when needed', 'physical condition' and 'religious belief'. CONCLUSION: Experience with education for organ transplant and marital status were identified as important variables in attitudes to organ transplants.
Education ; Humans ; Marital Status ; Organ Transplantation ; Surveys and Questionnaires ; Seoul ; Transplants*

PURPOSE: To examine the putative seizure-protective properties of ketamine in lithium-pilocarpine induced status epilepticus (LPSE). METHODS: Lithium chloride followed 24 h later by pilocarpine was administered for seizure induction. Ketamine (40 mg/kg) or phenytoin (50 mg/kg) was injected intraperitoneally 10 min or 60 min after the onset of continuous ictal discharge. Then the seizure behavior and EEG were observed and histological changes were compared through Nissl stain at 72 hours. RESULTS: The antiepileptic effect of ketamine, injected during the early stages of LPSE (10 min after the onset of continuous ictal discharge), was comparable to that of phenytoin. Ketamine was more effective than phenytoin in decreasing spike frequency, when administered on the plateau of LPSE (injection 60 min after onset of continuous ictal discharge electrographically). Anticonvulsant action of ketamine was confirmed by a less neuronal injury in hippocampus compared with control rats injected with phenytoin. CONCLUSIONS: In prolonged status epilepticus rat model, ketamine was effective as an antiepileptic, but phenytoin was not. Ketamine was also neuroprotective on the neuronal injury in the hippocampus. These results suggest that ketamine might be useful as an antiepileptic drug when standard antiepileptic drugs fail in the treatment of the refractory cases of status epilepticus.
Animals ; Anticonvulsants ; Electroencephalography ; Hippocampus ; Ketamine* ; Lithium Chloride ; Models, Animal* ; Neurons ; Neuroprotective Agents* ; Phenytoin ; Pilocarpine ; Rats* ; Seizures ; Status Epilepticus*

We report a family with autosomal dominant hereditary neuropathy having a liability to pressure palsy, which was confirmed by DNA analysis. A 5-year-old boy had been suffering from a left upper extremity weakness after falling sleeping with his head on his arm. Upon examination 2 months after the episode, the boy reported that he had a mild weakness on the left distal portion of his arm. Deep tendon reflexes on both the upper extremities were absent. He did not have any sensory disturbances. No definite family history of recurrent pressure palsy was taken. A nerve conduc-tion study and EMG demonstrated a widespread demyelinating sensorimotor polyneuropathy in all extremities. We analyzed DNA deletion, which revealed an abnormal deletion of the peripheral myelin protein 22 (PMP-22) gene in the chromosome 17p11.2. Of the patient and his mother.
Arm ; Child, Preschool ; DNA ; Extremities ; Head ; Humans ; Male ; Mothers ; Myelin Sheath ; Paralysis* ; Polyneuropathies ; Reflex, Stretch ; Upper Extremity

We report a family with autosomal dominant hereditary neuropathy having a liability to pressure palsy, which was confirmed by DNA analysis. A 5-year-old boy had been suffering from a left upper extremity weakness after falling sleeping with his head on his arm. Upon examination 2 months after the episode, the boy reported that he had a mild weakness on the left distal portion of his arm. Deep tendon reflexes on both the upper extremities were absent. He did not have any sensory disturbances. No definite family history of recurrent pressure palsy was taken. A nerve conduc-tion study and EMG demonstrated a widespread demyelinating sensorimotor polyneuropathy in all extremities. We analyzed DNA deletion, which revealed an abnormal deletion of the peripheral myelin protein 22 (PMP-22) gene in the chromosome 17p11.2. Of the patient and his mother.
Arm ; Child, Preschool ; DNA ; Extremities ; Head ; Humans ; Male ; Mothers ; Myelin Sheath ; Paralysis* ; Polyneuropathies ; Reflex, Stretch ; Upper Extremity

PURPOSE: The purpose of this study was to understand and describe the illness experience of married Korean women with epilepsy. METHODS: Data were collected during 2015~2016 through individual in-depth interviews with 12 married women with epilepsy. Verbatim transcripts were analyzed using Giorgi's phenomenological analysis to uncover the meaning of the illness experience of the participants. RESULTS: The study results showed that the illness experience of married Korean women with epilepsy was clustered into a specific description of situated structure and a general description of situated structure. Six themes from 20 meaning units were identified: 1) Undermined self-esteem with stigma of being epileptic; 2) Limited social interaction; 3) Suffering sorrow as a ‘disqualified being’; 4) Shuttling back and forth across the boundary between healthy and epileptic; 5) Desperate struggle to meet the expectation of given role; 6) Self-empowering through self-restriction and realization. CONCLUSION: The findings from this study show that both the enacted and felt stigma of epilepsy impact on the life of married Korean women with epilepsy. Although the participants face social and interpersonal restriction and prejudices, they try their best to fulfill their role rather than to be cared for as patients. As the stigma and hardships of the participants are related to lack of knowledge, health professionals should focus not just on clinical intervention but also on providing targeted educational programs and counseling for these women to dispel the stigma of the disease and to increase their quality of life.
Counseling ; Epilepsy* ; Female ; Health Occupations ; Humans ; Interpersonal Relations ; Marriage ; Prejudice ; Qualitative Research ; Quality of Life

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

Crossed cerebellar diaschisis has been described mostly in hemispheric stroke and supratentorial tumors with positron-emission tomography (PET) and single photon emission computed tomography (SPECT). Rarely it has been described with brain diffusion-weighted MRI of status epilepticus. We report a patient with status epilepticus, who developed MRI abnormalities in the cerebral cortex and contralateral cerebellum. EEG abnormalities correlated anatomically with the cerebral cortex of image change. An aggressive medication resulted in seizure control, reversal of neurologic deficit, and improvement or resolution of the MRI and EEG abnormalities in 3 weeks. We concluded that both localization and resolution of lesions may be explained by reversible excitotoxic cell damage due to seizure-related excessive synaptic activity.
Brain ; Cerebellum ; Cerebral Cortex ; Electroencephalography ; Humans ; Neurologic Manifestations ; Positron-Emission Tomography ; Seizures ; Status Epilepticus ; Stroke ; Supratentorial Neoplasms ; Tomography, Emission-Computed, Single-Photon

PURPOSE: Two types of chitosan oligosaccharides (COSs), COS I and COS II, were investigated for the effects on ascitic tumor and enzymes for cancer chemoprevention. MATERIALS AND METHODS: Chitosan oligosaccharides were administered once daily for 10 days after the tumor implantation. The change of body weight was observed for 20 days, and the survival rate of mice was determined after 21 days. Chitosan oligosaccharides were administered once daily for 10 days before the tumor implantation (1 106 cells). The number of ascitic tumor cells were measured at 6 days after tumor implantation. Chemopreventive potential of chitosan oligosaccharides was examined by the induction of quinone reductase and inhibition of cytochrome P450 1A1. RESULTS: Chitosan oligosaccharides exerted antitumor activity by inhibiting the growth of Ehrlich ascites tumor cells in vivo. Mice given Ehrlich cells and 10 or 100 mg/kg body weight of chitosan oligosaccharides had 33% survival after 21 days. Quinone reductase activity was increased with chitosan oligosaccharides. There were 26% and 33% inhibition in the activity of cytochrome P450 1A1 enzyme with the treatment of COS I and COS II, respectively. CONCLUSION: These results suggest that chitosan oligosaccharides has antitumor activity and cancer chemo preventive potential by inducing QR activity and inhibiting cytochrome P450 1A1.
Animals ; Body Weight ; Carcinoma, Ehrlich Tumor ; Chemoprevention* ; Chitosan* ; Cytochrome P-450 Enzyme System ; Mice ; NAD(P)H Dehydrogenase (Quinone) ; Oligosaccharides ; Survival Rate