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        Update on Current Technologies for Deep Brain Stimulation in Parkinson’s Disease

        Michelle Paff,Aaron Loh,Can Sarica,Andres M. Lozano,Alfonso Fasano 대한파킨슨병및이상운동질환학회 2020 Journal Of Movement Disorders Vol.13 No.3

        Deep brain stimulation (DBS) is becoming increasingly central in the treatment of patients with Parkinson’s disease and other movement disorders. Recent developments in DBS lead and implantable pulse generator design provide increased flexibility for programming, potentially improving the therapeutic benefit of stimulation. Directional DBS leads may increase the therapeutic window of stimulation by providing a means of avoiding current spread to structures that might give rise to stimulation-related side effects. Similarly, control of current to individual contacts on a DBS lead allows for shaping of the electric field produced between multiple active contacts. The following review aims to describe the recent developments in DBS system technology and the features of each commercially available DBS system. The advantages of each system are reviewed, and general considerations for choosing the most appropriate system are discussed.

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        Efficacy of magnetic resonance imaging for diagnosis of penile fracture: A controlled study

        Erkin Saglam,Fatih Tarhan,Mustafa B. Hamarat,Utku Can,Alper Coskun,Emre Camur,Kemal Sarica 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.4

        Purpose: To evaluate the diagnostic value of magnetic resonance imaging (MRI) in patients with suspected penile fracture. Materials and Methods: A total of 122 patients admitted to our inpatient clinic with a suspicion of penile fracture following a recent history of penile trauma and who underwent surgical exploration were included this study. A thorough physical examination, a detailed medical history, description of the trauma, and preoperative International Index of Erectile Function (IIEF) scores were obtained for each patient prior to surgery. Thirty-eight of these patients were evaluated with MRI before the surgical exploration. Intraoperative findings were also recorded. Physical findings and IIEF scores were also recorded at postoperative 6 months. Results: The mean age of our patient group was 36.5±12.3 years. Penile fracture was detected in 105 of 122 patients in whom surgical exploration was performed owing to a suspected diagnosis. The mean time interval from penile trauma to hospital admittance was 9.9±15.1 hours. No cavernosal defect was detected in 9 of 84 patients (10.7%) who were not evaluated with MRI prior to surgery. Compared with surgical exploration, MRI findings showed 100% (30 of 30) sensitivity and 87.5% (7 of 8) specificity in the diagnosis of penile fracture. MRI had a high negative predictive value of 100% (7 of 7) and a positive predictive value of 96.7% (30 of 31) with just 1 misdiagnosed patient. Conclusions: MRI is a reliable diagnostic tool in the diagnosis of penile fractures. Compared to history and physical findings taken all together, the high sensitivity and specificity of this imaging technique can decrease the number of unnecessary surgical explorations.

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