• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.205-213
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• 1997

The aim of this study is to find the relationship between interictal psychiatric symptoms and seizure-related variables such as structural changes, regional interictal perfusion changes, the number of interictal epileptic discharges and the presence of accompanying generalized tonic clonic seizure(GTC). The subjects were 75 patients (47 males : mean age $28.3{\pm}7.7$) with intractable epilepsy, Interictal psychiatric symptoms were rated by Symptom Checklist-90-R(SCL-90-R). Each of 4 seizure variables was measured by MRI, $^{99m}TC-HMPAO$ SPECT and the prolonged EEG monitoring. The mean SCL-90-R subscale T-scores and the ratio of the patients with definite psychiatric symptoms(T-score > 65 at any one subscale of SCL-90-R) were compared among the groups with different seizure variables. Demographic variables and clinical variables were not statistically different among the groups with different seizure variables. The patients with right mesial temporal sclerosis had higher mean SCL-90-R scores for obsessive compulsive symptom, interpersonal sensitivity, depression, hostility and psychotic symptoms than the patients with left mesial temporal sclerosis, and they also showed higher ratio of definite psychiatric symptoms. The presence of interictal epileptic discharges was related with higher T-scores of paranoid subscale. The areas of hypoperfusion, the presence of the GTC, and other clinical seizure variables showed no significant influences on the mean SCL-90-R subscale T-scores. from these results, the authors speculated that interictal subictal epileptic dischrages may be related with psychiatric symptoms of the intractable epileptic patients, especially with right mesial temporal sclerosis.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.138-142
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• 2014

Burning mouth syndrome is characterized by intra-oral burning sensation without any organic abnormalities. This syndrome is associated with various etiological factors such as neuropathy, malnutrition, menopause and depression. Several medications have been tried for the treatment. Those are analgesics, hormones, anticonvulsants and antidepressants. However, optimal effective pharmacologic treatment remains still unknown. The purpose of this case study is to report the clinical effectiveness of gabapentin in the treatment of burning mouth syndrome in postmenopausal women with comorbid depression. We report two menopausal women. Antidepressants were effective for improving depressive symptoms, but it had no effects on intra-oral burning sensation. Gabapentin reduced intra-oral burning sensation effectively for all two patients. One patient reported 55% reduction(a decrease from 9 to 4 on VAS), the other patient reported 35% reduction(from 8 to 5) of the intra-oral burning sensation during 16 weeks. The minimal effective daily dose of gabapentin was 300mg. This study suggests that gabapentin might be a useful, effective therapeutic option for treating burning mouth syndrome in postmenopausal women with comorbid depression. Further prospective clinical studies are needed to investigate the effectiveness of gabapentin in patients with burning mouth syndrome.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.2
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• pp.90-95
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• 2013

Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.1-5
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• 2015

Purpose: Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Materials and Methods: Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Results: Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. Conclusion: In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.311-313
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• 2005

Generally, many Asian women tend to dislike the square jaw, as they believe it makes the face look wider, giving a stubborn and strong impression. Contouring of the mandible is therefore a relatively common aesthetic procedure among Asians. These days, the use of botulinum toxin for contouring of the lower face offer simple alternative to surgery. Motor point, which is the site over a muscle where its contraction may be elicited by a minimal intensity short duration electrical stimulus, is the optimal injection point of botulinum toxin. Study was undertaken to identify the location of motor point of the masseter muscle and the skin surface landmark. First, the thickest point of the masseter muscle was inspected through palpation and inspection by 3 different individual plastic surgeons and then compound muscle action potentials(CMAPs) of masseter muscle in 15 health volunteers were recorded using EMG. For the localization of the measured points, line between lateral canthus to the mandibular angle was used. Location of motor points were mapped to skin surface from lateral canthus in a percentage of the distance along the landmark line and in distance in millimeters. The clinical injection point was located at 71.69 percentile and 7.3 mm of the landmark line. The motor point test was located at 72.54 percentile and 7.1 mm of the landmark line. The depth of motor point was 16mm. There was no statistically significant difference between the clinical injection point and the motor point. We conclude that surface mapping of motor point of the masseter muscle would increase accessibility and accuracy in botulinum toxin injection for contouring of the lower face.

• Korean Journal of Clinical Laboratory Science
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• v.44 no.3
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• pp.136-141
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• 2012

The hearts of highly trained athletes show morphologic and electrocardiographic (ECG) changes that suggest the presence of cardiovascular disease, including sinus bradycardia, a striking increase in precordial R-wave or S-wave voltages, ST segment depression, and T-wave inversions. Despite a number of previous observational surveys, the determinants of abnormal ECG patterns in trained athletes remain largely unresolved. In this study, we compared the electrocardiographic characteristics of athletes to determine any sensitive indicators. Comparison between ECG patterns and cardiac physiology was performed in 21 junior athletes and 25 untrained subjects with no signs of cardiac disease. Sinus bradycardia was detected in a subset of athletes but not statistically significant between the athletes ($69.9{\pm}11.1bpm$) and the control ($72.7{\pm}9.9bpm$) group. The mean values of the PR and QTc intervals in the athletes' group were $149.2{\pm}15.4ms$ and $402.3{\pm}28.8ms$, respectively. Also, there were no significantly differences between control group and the athletes' group. In addition, the athletes demonstrated a spectrum of alterations in the 12-lead ECG pattern, including marked increase in precordial R-wave or S-wave voltages ($$SV_1+RV_5{\geq_-}35mm$$, 23.8%), QRS duration ($${\geq_-}90ms$$, 90.5%), suggestive of left ventricular hypertrophy. However, left axis deviation, ST segment depression, and T-wave changes in V5, V6 were not observed in either the athletes or control group. Our findings suggest that sinus bradycardia, precordial R-wave or S-wave voltages, and QRS duration seem to be more sensitively detected in athletes than in control group. Further researches on the electrocardiographic patterns of athletes should be carried out to improve the sensitivity and specificity of diagnostic criteria.

• Journal of Korean Neurosurgical Society
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• v.50 no.1
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• pp.1-5
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• 2011

Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.289-294
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• 2014

Objective : The purpose of this study is to investigate the clinical characteristics of cerebral venous thrombosis (CVT) in a single center in Korea. Methods : A total of 36 patients were diagnosed with CVT from August 2005 to May 2013. The patient data regarding age, sex, disease stage, pathogenesis, location, laboratory findings, radiological findings, and treatment modalities were retrospectively collected. The results were compared with those of previous studies in other countries. Results : The patient group comprised 21 men and 15 women with a mean age of 46.9 years (ranging from three months to 77 years). The most common cause was a prothrombotic condition (8 patients, 22.2%). Within the patient group, 13 patients (36.1%) had a hemorrhagic infarction, whereas 23 (63.9%) had a venous infarction without hemorrhage. By location, the incidence of hemorrhagic infarction was the highest in the group with a transverse and/or sigmoid sinus thrombosis (n=9); however, the proportion of hemorrhagic infarction was higher in the cortical venous thrombosis group (75%) and the deep venous thrombosis group (100%). By pathogenesis, the incidence of hemorrhagic infarction was the highest in the prothrombotic group (n=6), which was statistically significant (p=0.016). Conclusion : According to this study, CVT was more prevalent in men, and the peak age group comprised patients in the sixth decade. The most common cause was a prothrombotic condition. This finding was comparable with reports from Europe or America, in which CVT was more common in younger women. Hemorrhagic infarction was more common in the prothrombotic group (p=0.016) than in the non-prothrombotic group in this study.

• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.1-4
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• 2002

Objective : Hyperhomocysteinemia has been proven to be an independent risk factor for stroke. The genetic mutation of methylenetetrahydrofolate reductase(MTHFR) elevates serum homocysteine level, but it still remains controversial whether the MTHFR gene mutation could be a predictor of ischemic stroke. Therefore, we studied if this genetic defect could cause ischemic stroke independently. Methods : We gathered ischemic stroke subjects and age, sex-matched controls. Age, gender, past medical history, smoking habit, serum homocysteine level, and the MTHFR genotype were recorded. General characteristics of ischemic stroke subjects were compared to the controls. We classified the stroke according to the related vessels(small and large artery infarction) and single lesion and multiple infraction. Relevant risk of the MTHFR genotype was evaluated in each stroke subtype with multiple logistic regression analysis. Results : When the controls were compared to the whole ischemic stroke, there was no specific difference except some medical histories. However, further analysis based on stroke subtypes showed important results. The small artery infarction group, multiple infraction group had significant odds ratio of the MTHFR TT genotype adjusted for age, gender, medical history and smoking habit. Conclusions : The MTHFR TT genotype is an independent risk factor for certain types of ischemic stroke, small artery infarction and multiple infarction.

• Journal of Oriental Neuropsychiatry
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• v.23 no.2
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• pp.13-32
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• 2012

Objectives : The purpose of this study was to obtain some knowledge concerning the scalp acupuncture treatment on patients with dementia for the future practice and research from clinical studies in China. Methods : The literatures were searched using the data base-China Academic Journals(CAJ) (2001-2011). Results : We found out 1 case study, and 17 randomized controlled trials(RCT) which met the inclusion criteria in most studies. There were 3 types of scalp acupuncture-applying method, cho-si scalp acupuncture(焦氏頭鍼法), combination of using ordinary acupoints(正經鍼) and extraordinary acupoints(經外寄穴), standard method of scalp acupuncture(標準頭鍼法). The often used acupoints are Yundongqu(運動區), Ganjuequ(感覺區), Yuntingqu(暈聽區), Zuyunganqu(足運感區), Sishencong (HN23), Baihui(GV20), Shenting(GV24), Fengchi(GB20), Dingnieqianxiexian(MS6), and Dingniehouxiexian(MS7). Conclusions : There were significant improvements on the scalp acupuncture-treated groups, compared to the control groups(western medication group or other acupuncture treatment group). Results of this study could be used for future studies concerning the scalp acupuncture for dementia.