When Your Patients are Suffering From Depression Parkinson s disease Multiple sclerosis Anxiety Obsessive compulsive disorder Tinnitus Hallucination P

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1 TMS Transcranial Magnetic Stimulation The True Specialist in TMS Therapy Excellence in Brain Stimulation & Rehabilitation Technology

When Your Patients are Suffering From Depression Parkinson s disease Multiple sclerosis Anxiety Obsessive compulsive

in researching and developing world class products for brain stimulation as a true solution of depression.

is expanding its product portfolio to meet the diverse needs from the field.

Experience the powerful values of ALTMS providing strong magnetic filed of 3 Tesla for deeper brain stimulation.

2 When Your Patients are Suffering From Depression Parkinson s disease Multiple sclerosis Anxiety Obsessive compulsive disorder Tinnitus Hallucination Panic REMED Stroke Facial stroke Since its foundation in 2003, REMED has been specialized in researching and developing world class products for brain stimulation as a true solution of depression. Epilepsy As a result, REMED has successfully introduced state-of-the-art TMS device, ALTMS first in its kind in Korea, and is expanding its product portfolio to meet the diverse needs from the field. REMED Provides True Solution for Them as Genuine Specialist of TMS Therapy. Experience the powerful values of ALTMS providing strong magnetic filed of 3 Tesla for deeper brain stimulation. REMED is the name of true specialist of TMS therapy. All rights reserved. All products and their specifications contained in the catalogue may differ from country to country where they are sold. Specification change may occur without prior notice

TECHNICALLY PROVEN MECHANISM OF TMS TMS therapy is an outpatient procedure and does not require anesthesia or sedation, so the patient can go back to daily life

Time-varying electrical current in a coil is produced. Why TMS Therapy?

improvement from prior antidepressant medication.

mental processes related to memory, speech, perception and functional connection More focused magnetic field from figure of 8 shaped transducer passes unimpeded

3 TECHNICALLY PROVEN MECHANISM OF TMS TMS therapy is an outpatient procedure and does not require anesthesia or sedation, so the patient can go back to daily life right after treatment. Unlike other treatments, such as electro-convulsive therapy(ect), TMS does not cause cognitive side effects or memory problems. Time-varying electrical current in a coil is produced. Why TMS Therapy? (Transcranial Magnetic Stimulation) Transcranial Magnetic Stimulation(TMS) is a safe, non-invasive therapy method that uses rapidly changing magnetic field to stimulate the neurons in the brain. It is indicated for the treatment of Major Depressive Disorder(MDD), and other certain conditions, for adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication. Also, TMS is widely accepted as a unique research tool for the investigation of broad variety of issues in different fields: Cognitive Neuroscience- in studying mental processes related to memory, speech, perception and functional connection More focused magnetic field from figure of 8 shaped transducer passes unimpeded through skull. MRI images for patients with Depression and ADHD after TMS treatment 20 Hz 1 Hz Neurons in the cortex of brain (PFC) is stimulated to lead to behavioral changes. Psychiatry- to influence specific brain function within the dorsolateral prefrontal cortex Neurophysiology- used in the stimulation of the peripheral and central nerve pathways Rehabilitation- used in the promotion of muscle recovery and the relief of nerve spasticity Patient with Depression Patient with ADHD

The 1st TMS device approved by KFDA in Korea Features & Benefits ALTMS

ALTMS providing strong magnetic filed of 3 Tesla for deeper brain

Convenient & easy operation by touch screen color display Unique design

circulating transducer for intensive & non-tiring treatment 4

and Pair modes Technical Specifications Peak Magnetic Energy 0.5~3.

1Hz Train Duration User selectable in 0.

350μs Weight 60Kg Power Supply 200~240 Vac 50/60 Hz Integrated color

TBS(Theta Burst Stimulation), Pair Stimulation) Clinical Indications

4 The 1st TMS device approved by KFDA in Korea Features & Benefits ALTMS Most reliable & powerful TMS Device Experience the powerful values of ALTMS providing strong magnetic filed of 3 Tesla for deeper brain stimulation. Convenient & easy operation by touch screen color display Unique design of 8 shaped transducer for focused brain stimulation Patented oil circulating transducer for intensive & non-tiring treatment 4 stimulation modes for diverse applications : Single, Repetitive, TBS and Pair modes Technical Specifications Peak Magnetic Energy 0.5~ % output Frequency Maximum 100Hz Minimum 0.1Hz Train Duration User selectable in 0.1 sec increment Output waveform Symmetric biphasic pulse Pulse width 350μs Weight 60Kg Power Supply 200~240 Vac 50/60 Hz Integrated color touch screen display Software 4 stimulation mode (single, repetitive, TBS(Theta Burst Stimulation), Pair Stimulation) Clinical Indications Depression Hallucination Stroke Obsessive Compulsive Disorder Insomnia Parkinson s Disease Anxiety Headache Facial Palsy Bipolar Disorder Panic Multiple Sclerosis Schizophrenia Tinnitus Epilepsy ALTMS Economic Premium

Features & Benefits Compact yet powerful TMS device for optimized treatment effect Far

for 8 kinds of treatment modes Easy MEP (Motor Evoked Potential) location by individual

gear) In house treatment available for patients who are not available for frequent visit

5 Tesla @ 100% output Repetition rate 100Hz Timer Set 60 minutes, 1 min increment Preset

Phase Dimension (W*H*D) 412*316*97mm Clinical Indications BRAIN STIM A A compact TMS

Compulsive Disorder Insomnia Parkinson s Disease Anxiety Headache Facial Palsy Bipolar

5 Features & Benefits Compact yet powerful TMS device for optimized treatment effect Far less space occupation due to compact size Easy and minimized operation by touch buttons for 8 kinds of treatment modes Easy MEP (Motor Evoked Potential) location by individual patient's head gear ( No need to make 2nd MEP for the same patient due to marked head gear) In house treatment available for patients who are not available for frequent visit to clinics Technical Specifications Magnetic Energy 0.5~ % output Repetition rate 100Hz Timer Set 60 minutes, 1 min increment Preset Mode Mode 1~8 Weight Device : 5Kg, Transducer : 2Kg Power Supply 200~240Vac 60Hz, Single Phase Dimension (W*H*D) 412*316*97mm Clinical Indications BRAIN STIM A A compact TMS device that brings big satisfaction to patients Depression Hallucination Stroke Obsessive Compulsive Disorder Insomnia Parkinson s Disease Anxiety Headache Facial Palsy Bipolar Disorder Panic Multiple Sclerosis Schizophrenia Tinnitus Epilepsy BRAIN STIM A World's 1 st Compact TMS Device with Customized MEP location 07 08

Side effects for patients with Drug therapy Insomnia, Fatigue Nausea, Weight Gain, Sexual Dysfunction Clinically Proven TMS Therapy 인지행동 - 대인관계치료도해볼만 이미치료효과가입증돼정신과에서사용되고있는비약물치료요법도있다.

최근엔 16단계문답항목이갖춰진단기정신역동적지지정신치료 (SPSP) 도도입단계에있다. 초기우울증에효과적이다. 뇌에직접자극을주는 ECT( 전기경련요법 ), TMS( 경두개자기자극치료법 ) 도있다. ECT는약물치료를거부하거나, 약물반응이없는환자에게많이쓰인다. 머리에번개를맞는듯한전기자극을준다. 효과가좋지만자극정도가심해마취를해야하는부담이있다.

< 의학 > 자폐증, 경두개자기자극치료실험 ( 서울 = 연합뉴스 ) 한성간기자 = 자폐스펙트럼장애 ( 자폐증 ) 을두피가까이에자기코일을갖다대는이른바경두개자기자극 (TMS : transcranial magnetic stimulation) 으로치료하는실험이미국루이빌대학 (Louisville University) 에서시작된다고 UPI 통신등이 24 일보도했다.

1007/s00737-009-0058-5 LETTER TO THE EDITOR RTMS may be a good choice for pregnant women with depression Dongjun Zhang & Zeqing Hu 미국립보건원 (NIH) 으로부터 88 만 8 천달러를지원받아실시되는이실험에서는자폐아들에게 12-15

6 Side effects for patients with Drug therapy Insomnia, Fatigue Nausea, Weight Gain, Sexual Dysfunction Clinically Proven TMS Therapy 인지행동 - 대인관계치료도해볼만 이미치료효과가입증돼정신과에서사용되고있는비약물치료요법도있다. 인지행동치료와대인관계치료가그것이다. 인지행동치료는일종의상담치료다. 환자가의사에게자신의모든상황을설명한다음의사가문제점을지적한다. 환자가자신의생각에매몰될수있다는사실을다른방식으로생각하도록깨우쳐주는것이다. 대인관계치료는주변사람때문에힘들어하는사람에게적합하다. 환자와문제의발단이되는사람과의관계설정을새롭게해우울증을해소시킨다. 최근엔 16단계문답항목이갖춰진단기정신역동적지지정신치료 (SPSP) 도도입단계에있다. 초기우울증에효과적이다. 뇌에직접자극을주는 ECT( 전기경련요법 ), TMS( 경두개자기자극치료법 ) 도있다. ECT는약물치료를거부하거나, 약물반응이없는환자에게많이쓰인다. 머리에번개를맞는듯한전기자극을준다. 효과가좋지만자극정도가심해마취를해야하는부담이있다. TMS는자기장을뇌에쏘여뇌신경전달물질분비를바로잡아준다. ECT보다자극정도가낮아마취가필요없지만, 효과는좀더약할수있다. < 의학 > 자폐증, 경두개자기자극치료실험 ( 서울 = 연합뉴스 ) 한성간기자 = 자폐스펙트럼장애 ( 자폐증 ) 을두피가까이에자기코일을갖다대는이른바경두개자기자극 (TMS : transcranial magnetic stimulation) 으로치료하는실험이미국루이빌대학 (Louisville University) 에서시작된다고 UPI 통신등이 24 일보도했다. Arch Womens Ment Health (2009) 12: DOI /s LETTER TO THE EDITOR RTMS may be a good choice for pregnant women with depression Dongjun Zhang & Zeqing Hu 미국립보건원 (NIH) 으로부터 88 만 8 천달러를지원받아실시되는이실험에서는자폐아들에게 회에걸쳐다소높은주파수의자기자극이가해지게된다. For the patients with TMS therapy 배지영 jybae@joongang.co.kr 도움말박용천한양대구리병원정신과교수전홍진삼성서울병원정신과교수안정훈한국보건의료연구원실장 Accelerated Transcranial Magnetic Stimulation (TMS) for Depression Summary The purpose of this study is to determinate if accelerated rtms treatment over 1.5 days is effective for ameliorating depression in Parkinson s disease. Description Objective : The goal of this study is to investigate a new approach to administering repetitive transcranial magnetic stimulation(rtms) in patients with refractory depression. (Please Note : The original requirement for comorbid Parkinson s disease has been dropped from this study). Research Plan : This inpatient study will provide an initial test for the hypothesis that accelerated rtms is an effective treatment for depression. Followup testing will help delineate the time course of response. Methods : The rtms treatment site over left dorsolateral prefrontal cortex will be 5.5cm 지금까지예비실험에서는 30 명의자폐아들에게모두 6 차례에걸쳐매회 15 분씩낮은주파수의자기자극을가하는실험이실시되었으며반복행동, 사회성결핍등전형적인자폐증상이호전되는효과가나타났다. 의료치매환자, 자기장자극으로 뇌기능 호전강력한전류파흘려보내 " 자기장 " 을뇌에쏘이는방법 알츠하이머환자 TMS 치료전 ( 좌 ), 후 ( 우 ) SPECT 결과 혈류량개선 메디컬투데이허지혜기자 알츠하이머병 ( 치매 ) 을앓고있는환자의뇌부위를자기장으로자극해뇌기능을호전시키는임상연구결과가나왔다. 가톨릭대학교서울성모병원신경과양동원교수팀은알츠하이머환자 16명을대상으로실험군 (8명), 대조군 (8명) 으로나눠경두개자기자극술 ( 이하 TMS) 을실시한결과, 실험군의인지기능이향상되고, 뇌혈류량이증가한것을확인했다고 15일밝혔다. Received: 17 December 2008 /Accepted: 9 February 2009 /Published online: 24 February 2009 # Springer-Verlag 2009 Abstract Due to the possible adverse effects on fetus, the treatment of pregnant women with depression is a difficult problem in the field of psychiatry. Repetitive transcranial magnetic stimulation (rtms) was used to treat three pregnant women with depression in the early pregnancy. After systemic treatments, the patient's depressive symptoms significantly relieved, and each of them smoothly provided a healthy baby. Up to now, we have not found that rtms can be harmful to fetuses. RTMS may be a good choice for pregnant women with depression. Keywords Repetitive transcranial magnetic stimulation (rtms). Pregnant women. Depression. Treatment Dear Sir: As the symptoms of depression have adverse impacts on pregnant women and fetuses, many experts have been The letter has not been presented at any meeting. The work was done at the Department of Forensic Psychiatry, Sichuan University, Sichuan, Chengdu, China. We acknowledge that the author s of the manuscript do not have conflicting interests. D. Zhang : Z. Hu Department of Forensic Psychiatry, Sichuan University, No.17, 3-th Section of South People Road, Sichuan, Chengdu , People s Republic of China Z. Hu (*) Mental Health Center of West China Hospital, Sichuan University, Sichuan, Chengdu , People s Republic of China huzeqing@126.com studying the treatment of pregnant women with depression. However, we have not found an appropriate treatment until now. In the US, the Food and Drug Administration has not approved any kind of the antidepressant drugs which could be used for pregnant women. Adrienne Einarson et al. (2008) concluded that paroxetine did not appear to be associated with an increasing risk of fetal defects following use in early pregnancy. But Barbara Mintzes and Jureidini (2008) questioned the former conclusion. As we know, due to the possibility of adverse effects on the fetus, there are still a lot of controversies in the area of applying antidepressant to pregnant women. The treatment of depression in pregnant women also is a difficulty in the field of psychiatry, but repetitive transcranial magnetic stimulation (rtms) may be a good choice for pregnant women with depression. RTMS is a new neuro-electrophysiological technique, which is developed on the basis of transcranial magnetic stimulation (TMS). With its unique characteristics of noninvasion, simplicity, and security, rtms has been widely applied in the areas of research and therapies for neuropsychiatric diseases, especially for treating depression. RTMS can enhance the excitement of the brain through adjusting the biological activities of the cerebral cortex and then has wide biological effects, which is one basic mechanism of therapy for depression (Wassermann and Lisanby 2001). Many researchers (Shajahan et al. 2002) found that rtms was effective in treating depression and the by-effects were not obvious. However, few scholars tried to use rtms to treat pregnant women with depression for its uncertain effects. In our hospital, three pregnant women with depression received the therapy of rtms in the early pregnancy. After systemic treatments, the patient's depressive symptoms 09 10

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