PURPOSE: In many other countries, based on research, recombinant tissue plasminogen activator (r-tPA) has been approved for the treatment of acute ischemic strokes. However, in Korea, little research has been done till now, in spite of using r-tPA widely. We sought to assess the feasibility and the efficacy of treatment and to evaluate the prognosis and complications at the violation of using r-tPA. Our study was compared with other previous studies. METHODS: A retrospective review is presented of 25 the cases of patients with acute ischemic stroke treated with rtPA according to the National Institutes of Neurological Disorders and Strokes (NINDS) protocol. We classified the groups by protocol violation (time, blood pressure, and computed tomography). We then analyzed neurologic outcomes by using the National Institutes of Health Strokes Scale (NIHSS) and complications based on whether or not intracerebral hemorrhage (ICH) had occurred. RESULTS: Of the 25 patients (mean age: 57 males: 19), 6 had time violation (onset time > 180 min), 4 had blood-pressure violation (systolic BP > 185 mmHg), 5 had CT violation (low density at initial CT). The NIHSS score improved in 64% of all patients after 24 hours. However, improvement was lower in the case of deviation present than it was in the case of deviation absent (time, blood pressure, and CT, respectively, 20%, 50%, and 40%; p-value respectively 0.0274, 0.8350, and 0.4125). ICH occurred in 6 cases, but in cases of deviation present, ICH occurred at a greater frequency. CONCLUSION: Our safety and feasibility of outcome compared favorably with NINDS and other previous studies. In addition, we confirmed that the presence of protocol deviation was associated a poor outcome.
Academies and Institutes ; Blood Pressure ; Cerebral Hemorrhage ; Humans ; Korea ; Male ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Nervous System Diseases ; Prognosis* ; Retrospective Studies ; Stroke* ; Thrombolytic Therapy ; Tissue Plasminogen Activator

OBJECTIVE: We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke.METHODS: We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them.RESULTS: The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p<0.01) and distal thrombus migration rate was also lower (15.8% vs. 40.7%; p=0.021) in the combined technique group. Early strong neurologic improvement (improvement of National Institutes of Health Stroke Scale ≥11 or National Institutes of Health Stroke Scale ≤1 at discharge) rate (57.9% vs. 36.2%; p=0.02) and favorable clinical outcome (mRS at 3 months ≤2) rate (59.6% vs. 33.9%; p=0.005) were also better in the combined technique group.CONCLUSION: The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes.
Academies and Institutes ; Brain Ischemia ; Catheters ; Cerebral Infarction ; Humans ; National Institutes of Health (U.S.) ; Reperfusion ; Retrospective Studies ; Stents ; Stroke ; Thrombectomy ; Thrombosis

BACKGROUND: Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults. METHODS: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defined according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under influence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. RESULTS: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classified into problem drinkers. For identification of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women. CONCLUSION: Above results suggest that AUDIT is most effective in identifying university students' problem drinking.
Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Eye ; Female ; Health Services ; Humans ; Male ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; ROC Curve

Since the authors participated in the editorial committee in October 2001, many dramatic changes have been introduced to the Journal of Korean Neurosurgical Society(JKNS). The format, the external appearance, the editorial system, and the reviewing process have been transformed with new standpoints to enhance the quality and to raise the level of JKNS. The authors reviewed papers published on JKNS in 2006 with special interest on the changes of JKNS during last five years.In total, 186 articles were published on JKNS in 2006. Because the editorial committee asked two review articles to renowned neurosurgeons, there were 184 peer-reviewed articles. Eighty seven clinical articles, eighty one case reports, seven laboratory investigations, four special articles and five technical reports were published. This distribution changed from the previous year with marginal value of statistical significance (p=0.101). The ratio of the original articles (laboratory investigations and clinical articles) decreased to 51.1% from 57.5% of 2005 but the difference was not statistically significant (p=0.222). The number of laboratory investigations significantly decreased to 7 (3.8%) from 19 (10.4%) of 2005 (p=0.014). Other changes such as number of authors per article, number of institutes which published papers on JKNS have been examined to assess the trend and/or change in characteristics of papers published on JKNS.
Academies and Institutes

No abstract available.
Academies and Institutes

BACKGROUND: Probability of causation (PC) is a reasonable way to estimate causal relationships in radiation-related cancer. This study reviewed the international trend, usage, and critiques of the PC method. Because it has been used in Korea, it is important to check the present status and estimation of PC in radiation-related cancers in Korea. METHODS: Research articles and official reports regarding PC of radiation-related cancer and published from the 1980s onwards were reviewed, including studies used for the revision of the Korean PC program. PC has been calculated for compensation-related cases in Korea since 2005. RESULTS: The United States National Institutes of Health first estimated the PC in 1985. Among the 106 occupational diseases listed in the International Labor Organization Recommendation 194 (International Labor Office (ILO), ILO List of Occupational Diseases, 2010), PC is available only for occupational cancer after ionizing radiation exposure. The United States and United Kingdom use PC as specific criteria for decisions on the compensability of workers’ radiation-related health effects. In Korea, PC was developed firstly as Korean Radiation Risk and Assigned Share (KORRAS) in 1999. In 2015, the Occupational Safety and Health Research Institute and Radiation Health Research Institute jointly developed a more revised PC program, Occupational Safety and Health-PC (OSH-PC). Between 2005 and 2015, PC was applied in 16 claims of workers’ compensation for radiation-related cancers. In most of the cases, compensation was given when the PC was more than 50%. However, in one case, lower than 50% PC was accepted considering the possibility of underestimation of the cumulative exposure dose. CONCLUSIONS: PC is one of the most advanced tools for estimating the causation of occupational cancer. PC has been adjusted for baseline cancer incidence in Korean workers, and for uncertainties using a statistical method. Because the fundamental reason for under- or over-estimation is probably inaccurate dose reconstruction, a proper guideline is necessary.
Academies and Institutes ; Compensation and Redress ; Evaluation Studies as Topic ; Great Britain ; Incidence ; Korea ; Methods ; National Institutes of Health (U.S.) ; Occupational Diseases ; Occupational Health ; Radiation, Ionizing ; United States

It is sufficient to justify distinguishing age-appropriate and age-inappropriate forms of age-related memory decline. The former, of which AAMI is an example, represents a normal age-related phenomenon, whereas the latter, the true descendent of benign senescent forgetfulness, is by definition abnormal and possibly, pathological. Whether age-inappropriate forgetfulness is progressive, whether it can be distinguished from other concepts of mild cognitive decline by virtue of being specific to memory, and whether it is qualitatively different from normal memory or merely worse is not yet certain. The prevalence of age-inappropriate forgetfulness is undetermined, but it is certainly less common than AAMI. The construct of AAMI was introduced by an NIMH work group. It was the group's declared intention to facilitate communication and stimulate research into late-life memory loss, particularly its treatment. Completely satisfactory diagnostic criteria do not yet exist for AAMI. Improved criteria would take an individual's overall level of intellectual functioning or educational background into account when setting the standard against which to rate memory, distinguish age-appropriate from age-inappropriate decline. AAMI differs from BSF in several points. First, the AAMI criteria define impairment with respect to healthy young adult levels, not to those of the older individual's age peers as was implied in the description of BSF. Second, the term AAMI is non-specific with regard to etiology and does not necessarily imply that the disorder is non-progressive. Thus, patients whose memory impairment is subsequently shown to be the earliest stage of a dementing illness are not necessarily excluded from the category of AAMI, and it is sensible to ask how often AAMI is, in fact, a dementia prodrome.
Aging ; Dementia ; Humans ; Intention ; Memory Disorders ; Memory* ; National Institute of Mental Health (U.S.) ; Prevalence ; Virtues ; Young Adult

BACKGROUND: The authors produced a new citation index of the Korean Journal of Blood Transfusion (KJBT). The index, which was developed to determine the internal impact score (IIS), could examine contributions to the KJBT according to the manuscript, author and institute. METHODS: For manuscripts published in the KJBT from Volume 1 No. 1 in 1990 to Volume 17 No. 1 in 2006, a database of the journals and their references was constructed, and an index was created. The citation index was analyzed using three indicators, the internal impact score for the manuscript (IIS-M), internal impact score for the author (IIS-A) and the internal impact score for the institute (IIS-I). RESULTS: The total number of references cited in the manuscripts was 5,392. Of these references, 498 (9.2%) were published in the KJBT. The mean IIS-M of all manuscripts cited was 0.97. The total number of authors who participated in the cited manuscripts was 351. The highest IIS-A score, which was calculated in consideration of each author's participation and the weight of the manuscript, was 203.26. The number of institutes that had produced the cited manuscripts was 35. The highest IIS-I score, which was calculated in consideration of each organization's participation and the weight of manuscripts, was 187.45. CONCLUSION: If the indicators developed by the authors are used as tools to analyze the citation indices of the journals, they can quantify the contribution of the manuscripts, authors and institutes to each journal, and promote the development of academic journals based on the quantified contribution.
Academies and Institutes ; Blood Transfusion*

Endoscopic Submucosal Dissection (ESD) is curative treatment for early gastrointestinal neoplasia, and this procedure does not involve open surgery. Significant advances of the techniques and instruments for ESD have been made and many medical institutes have the facilities to perform ESD. This article reviews the current status of ESD in Korea.
Academies and Institutes ; Korea

Thesedays, the computer network has become the most popular means of communicating and sharing of information. With the rapid growing of Internet usage, various kinds of medical-related Internet sites are appearing. Due to the popularity of World Wide Web, many hospitals and medical centers establish their own homepage. In Korea, the number of home pages about medicine and medical institutes is increasing. Although many medical-related sites in Korea are providing Internet services on WWW, the quality is still far behind from foreign countries. For constructing the homepage for each department in Soonchunhyang University Hospital Homepage, this paper first investigates the University Hospital's Internet Homepage. After rewiewing the homepage, the new homepage of Soonchunhyang University Hospital has een implemented. From the experience in implementing the homepage for Soonchunhyang University Hospital, this paper suggests the method to build and manage a homepage for other medical related sites.
Academies and Institutes ; Internet ; Korea