In the 2009 edition of the Journal of Korean Neurosurgical Society, we published an article entitled "Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow" (Volume 45, Pages 260-263), which was written by Joon Ho Chung, M.D.,1 Yong Sam Shin, M.D.,1 Yong Cheol Lim, M.D.,2 Minjung Park, M.D.3. The first author's name is mistyped. Thus, we correct the first author's name from Joon Ho Chung to Joonho Chung.

It has been well known that ischemia reperfusion injury to skeletal muscle following an acute arterial occulusion causes significant morbidity and mortality. The skeletal muscle, which contains high energy phosphate compounds, has ischemic tolerance. During the ischemia, the ATP is catalyzed to hypoxanthine anaerobically and hypoxanthine dehydrogenase is converted to xanthine oxidase. During reperfusion, the hypoxanthine is catalyzed to xanthine by xanthine oxidase under O2 presence and that results in production of cytotoxic oxygen free radicals. The authors perform the present study to investigate the effects of allopurinol, the inhibitor of xanthine oxidase, on reperfused ischemic skeletal muscles by measuring of the immunoreactivities and exzyme activities of superoxide dismutase(SOD) and the formation of malondialdehyde(MDA). A total of 104 healthy Sprague-Dawley rats weighting from 200 gm to 250 gm were used as experimental animals. Under urethane(3.0mg/kg., IP) anesthesia with 3.0mg/kg of urethane, lower abdominal incision was made and the right and left common iliac artery were ligated by using vascular clamp for 2 hours. Both the quandriceps femoris muscles were obtained at 0 hour, half hour, 1 hour, 3 hours, 6 hours and 12 hours after the removal of vascular clamp. In the allopurinol pretreated group, 50mg/kg of allopurinol was administered once a day for 2 days and before 2 hours of ischemia. The specimens were sectioned in 14µm thickness with cryostat and homogenated ischemia. The specimens were sectioned in 14 µm thickness with cryostat and homegenated in the phosphate buffer. The immunoreactivities and enzyme activities of SOD were observed. The results were as follows: 1. The immunoreactivitiy and enzyme activity of SOD are decreased and the MDA level is increased in the 2 hours inchemic quadriceps femoris muscle of rats. 2. During the reperfusion of ischemic quadriceps femoris muscle of rats, the immunoreactivities of SOD in the half hour reperfused ischemic group and the enzyme activities of SOD in the 1 hour reperfused group are the highest and the immunoreactivities and enzyme activities of 6 hours reperfused ischemic group are the lowest. 3. Pertreatment of allopurionl decreased the immunoreactivities and enzyme activities of SOD during the ischemia and reperfusion of the quadriceps femoris muscles of rat. This results suggest that the allopurinol decreases the damages of skeletal muscles of rate during ischemia and reperfusion.
Adenosine Triphosphate ; Allopurinol ; Anesthesia ; Animals ; Free Radicals ; Hindlimb ; Hypoxanthine ; Iliac Artery ; Ischemia ; Mortality ; Muscle, Skeletal ; Muscles ; Oxygen ; Quadriceps Muscle ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase ; Superoxides ; Urethane ; Xanthine ; Xanthine Oxidase

BACKGROUNDS/OBJECTIVES: The effects of malnutrition on growth of toddlers and preschoolers by socioeconomic status are not well known. This study aimed to examine the effects of dietary intake on growth outcomes in toddlers and preschoolers by household income level. SUBJECTS/METHODS: The study population was a total of 1,687 children aged 1 to 5 years that participated in the KNHANES from 2009 to 2011. Growth of children was assessed by height for age (HFA) and weight for height (WFH). Children were classified into three groups according to children's HFA and WFH compared to the 10th and 90th percentiles of the 2007 Korean Children and Adolescent Growth Standard. Average monthly household income was divided into quartile groups. Dietary intake data were obtained by using the one day 24-hr recall method. Risks of inadequate intake of nutrients and unfavorable growth were estimated by using a multiple logistic regression model adjusted for sex, age, region, and energy intake. RESULTS: The low HFA group (< 10th percentile) had significantly lower intakes of energy, carbohydrate, and thiamin as compared with the high group (> or = 90th percentile). For WFH status, vitamin C intake was lower in the low group than in the high group. Household income level was related to WFH status but not HFA. Children from lower income households were more likely to have high WFH than those from higher income households (P for trend = 0.038). Household income status was also significantly related with risk of inadequate intake of micronutrients such as thiamin (P for trend = 0.032) and vitamin C (P for trend = 0.002), showing higher odds of inadequate intakes in children from lower income households. CONCLUSIONS: Children from lower income households were prone to be overweight and to have inadequate intakes of micronutrients such as thiamin and vitamin C. To reduce nutritional and health disparities, collective action in the public sector is required from early life.
Adolescent ; Ascorbic Acid ; Child ; Energy Intake ; Family Characteristics* ; Humans ; Logistic Models ; Malnutrition ; Micronutrients* ; Nutritional Status* ; Overweight* ; Public Sector ; Social Class

OBJECTIVE: Both endovascular coil embolization and microsurgical clipping are now firmly established as treatment options for the management of cerebral aneurysms. Moreover, they are sometimes used as complementary approaches each other. This study retrospectively analyzed our experience with endovascular and microsurgical procedures as complementary approaches in treating a single aneurysm. METHODS: Nineteen patients with intracranial aneurysm were managed with both endovascular and microsurgical treatments. All of the aneurysms were located in the anterior circulation. Eighteen patients presented with SAH, and 14 aneurysms had diameters of less than 10 mm, and five had diameters of 10-25 mm. RESULTS: Thirteen of the 19 patients were initially treated with endovascular coil embolization, followed by microsurgical management. Of the 13 patients, 9 patients had intraprocedural complications during coil embolization (intraprocedural rupture, coil protrusion, coil migration), rebleeding with regrowth of aneurysm in two patients, residual sac in one patient, and coil compaction in one patient. Six patients who had undergone microsurgical clipping were followed by coil embolization because of a residual aneurysm sac in four patients, and regrowth in two patients. CONCLUSION: In intracranial aneurysms involving procedural endovascular complications or incomplete coil embolization and failed microsurgical clipping, because of anatomical and/or technical difficulties, the combined and complementary therapy with endovascular coiling and microsurgical clipping are valuable in providing the best outcome.
Aneurysm ; Humans ; Intracranial Aneurysm ; Retrospective Studies ; Rupture

Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxicon-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxicon-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

Intracranial pial arteriovenous fistulas (AVFs) are uncommon, high-flow connection between an artery and a vein without an intervening nidus, vascular lesions treated using endovascular approach with a variety of embolic materials. To our knowledge, hyperperfusion syndrome as a result of embolization of pial AVFs has not been reported before. We report our experience in the treatment of high-flow pial AVF using detachable coils and hyperperfusion syndrome after coil embolization.
Arteries ; Arteriovenous Fistula* ; Embolization, Therapeutic* ; Veins

We report a case of unruptured aneurysm associated with basilar fenestration treated with coil-assisted coil embolization. A 46-year-old man had suffered from intermittent, progressive occipital headache for 2 months. Magnetic resonance (MR) angiography showed a large aneurysm at the proximal basilar artery. Both three-dimensional CT angiography and angiography demonstrated a saccular, 20x15-mm aneurysm arising at the proximal end of associated fenestration at the basilar artery. The aneurysm was successfully occluded with stent-assisted coil embolization. The patient was discharged home after 1 week and received 75 mg clopidogrel once daily for 4 weeks and 100 mg aspirin once daily for life.
Aneurysm* ; Angiography ; Aspirin ; Basilar Artery* ; Embolization, Therapeutic* ; Headache ; Humans ; Middle Aged ; Stents*

BACKGROUND: Smoking is the single most considerable factor, which may likely affect one's health most adversely. Therefore, an effective control upon smoking has been the most important issue for all of the practitioners. Furthermore, the latters concern an the alternative medicine has been steadily mounting these days. Accordingly, a series of clinical group study has been mapped aut in order to clarify the effect and the outcome of acupuncture treatment and its rate of success. METHODS: The survey has been conducted fram April 7th, 1998 for six months with the voluntary help of 130 students as our study objects, who were the 1st, 2nd and 3rd graders at two metropolitan high-schools in Seoul A basic questionnaire has been prepared and collected at the first interview. The acupuncture treatment has been alternately administered at each side of ears once a week for the respective object-students and the information had been questioned in the survey. When 5 months lapsed with no treatment after the initial four weeks of intensive application, a further follow-up survey was repeated all over again(once every week for 4weeks and another after 6 months). For the analysis of our finding, the SAS V6.12 has been used together with the one way ANOVA test, t-test, and Cochran-Armitage trend test. RESULTS: Those who managed to stop smoking after the acupuncture treatment of one week, four weeks and six months respectively were found as follows; 2 students(61%), 12 students(37.5%), and 8 students(25%), proving that the success rate for smoking cessation after six months was 25%. Those who decreased their number of smoking more than half were; 13 students(39.4%), 15 students(46.9%), 25 students(75%). The number of withdrawal symptom and the smoking cessation as well as the smoking reduction rate were not found co-related each other. The frequency of their smoking, the frequency of the smoking attempt, the period of their abstinence from smoking, the facts whether their family-members of relatives smoked or not, the FTQ(Fagerstrom Tolerance Questionnaire), the frequency of their drinking and the motivation types of smoking(Why test) were found not influential upon the change of smoking tastes and their intensity of smoking wish by the treatment of the auricular acupuncture. CONCLUSIONS: The change of smoking taste and the change on the intensity of smoking wish as the outcome of acupuncture treatment for the stop-smoking has been statistically siganificant.
Acupuncture* ; Acupuncture, Ear ; Complementary Therapies ; Drinking ; Ear ; Follow-Up Studies ; Humans ; Motivation ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking* ; Substance Withdrawal Syndrome ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by carotid artery stenting (CAS) only. METHODS: From February 2003 to June 2008, there were 78 stents placed in 75 symptomatic patients (mean age : 67.3 years); 69 patients had carotid stenosis > or =70%, and 6 patients had asymptomatic stenosis > or =80%. No carotid endarterectomy (CEA) was performed during the same period. The patients were clinically followed-up for a mean of 20.1 months. RESULTS: The procedures were technically successful in all cases. Three (3.8%) patients had procedure-related complications. During the 30-day postprocedural period, there were no restenosis or major stroke. Minor stroke was noticed in 3 (3.8%) patients and 1 (1.3%) of the 75 patients suddenly expired 2 days after discharge. There were no new neurological symptoms that developed during the clinical follow-up period. The results of our series were not inferior to those the previously published in CAS studies, and in fact they were better. CONCLUSION: Our results suggest that CAS may be safe and useful for the treatment of cervical carotid artery stenosis when it is used as the first line treatment in those institutions that lack enough experience with CEA.
Carotid Arteries ; Carotid Stenosis ; Constriction, Pathologic ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Stents ; Stroke