A new modified inside-out repair technique of arthroscopic meniscal repair for peripherally torn menisci is described. Under arthroscopic control, after conventional inside-out technique using meniscal repair set using outside-in technique with 18-gauge needle, horizontal mattress sutures of absorbable monofilament(PDS 2-0) were placed across the tom site and tied over the capsule or fascia. Nearly all portions of meniscus were possible with this technique except most posterior and anterior portions. As this is the modification of inside-out technique, neurovascular complications could be avioded. The problem of outside-in technique, knot irritation inside joint could be avoided also because the knot is outside of the joint.
Fascia ; Joints ; Needles ; Sutures

No abstract available.
Epidermal Cyst* ; Melanins*

The elective course was introduced to Inha university college of medicine in clinical clerkship from 1998. In August, 1999, a questionnaire about the change of the curriculum was distributed to 36 senior students and 157 clinical professors in Inha university college of medicine. To the elective course, the students' response was : 41.7% answered 'good', 22.2% answered 'non-judgemental', 36.1% answered 'bad', and the professors' response was : 56.4% answered 'good', 30.9% answered 'non-judgemental', 12.8% answered 'bad'. As for the merit of the elective course, the students' response was : 72.2% answered 'to choose the course they want to study (to provide them study motivation)', 41.7% answered 'to study the subject deeply', 19.4% answered 'to be helpful to choose a course after graduation'. Of the professors' response, 83.0% answered 'to choose the course they want to study (to provide them study motivation)', but 44.7% answered 'self-regulating study attitude'. As for the defect of the elective course, the students' response was : 91.7% answered 'the subjects are restricted', 55.6% answered 'to be too long not efficiently', ?% answered 'to hinder from preparing for Korean medical licensing examination'. And the professors answered in the same order. 55.6% of the students' respond answered 'rarely prepared' even though the term of elective course in each department got longer, but 28.7% of the professors' answered 'prepared very much'. As for the period of elective course, the students' response was : 2 weeks for 6 each subjects (72.2%), 1 week for every subjects(22.2%). But the professors' response was : 3 weeks for 4 each subjects(35.1%), 2 weeks for 6 each subjects(35.1%), over 4 weeks for less 3 each subjects (9.6%). As a conclusion the professors in clinical department must prepare meticulously for the elective course.
Clinical Clerkship* ; Curriculum ; Education, Medical ; Humans ; Licensure ; Surveys and Questionnaires

PURPOSE: Fever is one of the most common symptoms in children visiting the emergency department. When oral antipyretics use is limited, IV antipyretics may be necessary for control of fever. In this study, we examined the current status of use and antipyretic effect of propacetamol, a precursor of acetaminophen, in fever management for children of age younger than 15 in an emergency center. METHODS: We reviewed medical records of 101 patients who were prescribed IV propacetamol from September 1st to December 31st in 2013. Among these patients, 59 children received propacetamol via intravenous injection for control of fever. We investigated variable data including age, sex, weight, chief complaint, reason for use of intravenous propacetamol, history of liver disease, and body temperature before the injection. In addition, to examine the antipyretic efficacy of IV propacetamol, we thoroughly investigated administration dose, number of injections, use of other antipyretics, other antipyretic therapy (ex. like tepid massage or ice bag), fever clearance time, etc. RESULTS: Intravenous propacetamol at a dose of 26.16 mg/kg was used in 59 patients and fever was controlled under 38degrees C within 2 hours in 39 patients (66.1%). Fever was relieved under 38degrees C within 4 hours or general condition was improved in 49 patients (83.0%). CONCLUSION: In this study, we examined the antipyretic efficacy of intravenous propacetamol in management of fever for children younger than 15 years of age in an emergency center. Optimized uses of intravenous propacetamol according to age and weight were effective for pediatric patients with fever who cannot swallow oral medications.
Acetaminophen ; Antipyretics ; Body Temperature ; Child* ; Emergencies* ; Emergency Service, Hospital ; Fever* ; Humans ; Ice ; Injections, Intravenous ; Liver Diseases ; Massage ; Medical Records ; Pediatrics

Inula helenium L. is rich source of eudesmane-type sesquiterpene lactones, mainly alantolactone and isoalantolactone, which have the various pharmacological functions. In this study, we examined the inhibitory effects of nitric oxide (NO) production of hexane, methylene chloride, ethyl acetate, butanol, and water fractions from I. helenium and investigated the anti-inflammatory effect of hexane fraction of I. helenium (HFIH) in LPS-induced RAW 264.7 cells. Quantification of alantolactone and isoalantolactone from HFIH was carried out for the standardization by multiple reaction monitoring using triple quadrupole mass spectrometer. HFIH significantly inhibited inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) protein as well as their downstream products NO and prostaglandin E₂ (PGE₂) in LPS-stimulated RAW 264.7 cells. Moreover, HFIH suppressed NF-κB transcriptional activity by decreasing the translocation of p65 to the nucleus. The in vivo study further confirmed that HFIH attenuated the paw edema induced by carrageenan in an acute inflammation model. These findings suggest that HFIH may be useful as a promising phytomedicine for inflammatory-associated diseases.
Carrageenan ; Cyclooxygenase 2 ; Edema ; Inflammation ; Inula ; Lactones ; Methylene Chloride ; Nitric Oxide ; Nitric Oxide Synthase ; RAW 264.7 Cells ; Staphylococcal Protein A ; Water

Idiopathic portal hypertension (IPH) is a rare disorder which is clinically characterized by portal hypertension, splenomegaly, hypersplenism and the absence of liver cirrhosis. Patients with IPH have massive splenomegaly leading to increased portal venous flow and subsequent portal hypertension. In selected IPH patients with splenomegaly and hypersplenism, splenectomy can be regarded as an effective treatment protocol for decreasing portal hypertension. We report a case of a 44-year-old woman who was diagnosed with IPH accompanied by splenomegaly and hypersplenism. She underwent laparoscopic splenectomy and clinical symptoms and hypersplenism resolved. Our study shows that laparoscopic splenectomy can be considered as a procedure for treating patients with splenomegaly and hypersplenism due to IPH.
Adult ; Clinical Protocols ; Female ; Humans ; Hypersplenism* ; Hypertension, Portal* ; Liver Cirrhosis ; Splenectomy* ; Splenomegaly*

BACKGROUND: The Damus-Kaye-Stansel (DKS) procedure is a method for mitigating the risk of systemic ventricular outflow tract obstruction (SVOTO). However, there have been few reports on which surgical technique shows a better outcome. The objective of this study was to compare the outcome of the DKS procedure according to the surgical technique used. METHODS: We retrospectively reviewed 12 consecutive patients who underwent the DKS procedure from March 2004 to April 2013. When the relationship of the great arteries was anterior-posterior, the double-barrel technique (group A) was performed. If the relationship was side-by-side, the ascending aortic flap technique (group B) was performed. RESULTS: There was no early mortality and 1 late mortality in group B. There was no statistically significant difference in the median peak pressure gradient of preoperative subaortic stenosis in both groups: 14 mmHg (range, 4 to 53 mmHg) in group A and 15 mmHg (range, 0 to 30 mmHg) in group B (p=0.526). Further, a significant postoperative pressure gradient was not observed in either group A or group B. More than moderate postoperative neoaortic regurgitation was observed in 1 patient of group B; this patient underwent neoaortic valve replacement 66 months after the DKS procedure. No one had a recurrent SVOTO during follow-up. CONCLUSION: The DKS procedure is an effective way to minimize the risk of SVOTO, and there is little difference in the outcomes of the DKS procedure according to the surgical technique used.
Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Fontan Procedure ; Humans ; Mortality ; Retrospective Studies

A 13-year-old girl, who had undergone the total correction of partial atrioventricular septal defect at the age of 4 years, was admitted with severe tricuspid regurgitation in echocardiography. She had received one-and-a-half ventricle repair during follow-up. Her right ventricle showed global akinesia, and the ejection fraction of the left ventricle was 25% with paradoxical interventricular septal motion. We performed right ventricular exclusion adjunct to the Fontan procedure. She is doing well two years after the operation without complications.
Adolescent ; Echocardiography ; Female ; Follow-Up Studies ; Fontan Procedure* ; Heart Ventricles* ; Humans ; Magnetic Resonance Imaging ; Tricuspid Valve Insufficiency

Transplantation studies about the clinical differences according to the type of donors are mostly conducted in western countries with rare reports from Asians. The aims of this study were to evaluate the clinical impacts of the type of donor, and the predictors of 1-year mortality in patients who underwent liver transplantation (LT). This study was performed for liver transplant recipients between May 2010 and December 2014 at the Pusan National University Yangsan Hospital. A total of 185 recipients who underwent LT were analyzed. Of the 185 recipients, 109 (58.9%) belonged to the living donor liver transplantation (LDLT) group. The median age was 52.4 years. LDLT recipients had lower model for end-stage liver disease (MELD) score compared with better liver function than deceased donor liver transplantation (DDLT) recipients (mean ± standard deviation [SD], 12.5 ± 8.3 vs. 24.9 ± 11.7, respectively; P < 0.001), and had more advanced hepatocellular carcinoma (HCC) (62.4% vs. 21.1%, respectively; P = 0.001). In complications and clinical outcomes, LDLT recipients showed shorter stay in intensive care unit (ICU) (mean ± SD, 10.8 ± 8.8 vs. 23.0 ± 13.8 days, respectively, P < 0.001), ventilator care days, and post-operative admission days, and lower 1-year mortality (11% vs. 27.6%, respectively, P = 0.004). Bleeding and infectious complications were less in LDLT recipients. Recipients with DDLT (P = 0.004) showed higher mortality in univariate analysis, and multi-logistic regression analysis found higher MELD score and higher pre-operative serum brain natriuretic peptide (BNP) were associated with 1-year mortality. This study may guide improved management before and after LT from donor selection to post-operation follow up.
Asian Continental Ancestry Group ; Busan ; Carcinoma, Hepatocellular ; Donor Selection ; Follow-Up Studies ; Gyeongsangnam-do ; Hemorrhage ; Humans ; Intensive Care Units ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Mortality* ; Natriuretic Peptide, Brain ; Tissue Donors* ; Transplant Recipients ; Ventilators, Mechanical

Herpes simplex virus type 2 (HSV2) meningitis primarily develops during or following a primary genital HSV2 infection that was acquired from sexual contact or through the birth canal during delivery from mother. We describe a 15 year old virgin without history of previous herpes simplex infection who developed 2 episodes of HSV2 meningitis. Although recurrent meningitis due to HSV is primarily seen in young or sexually active adults. HSV2 meningitis should be in the differential diagnosis of recurrent meningitis in adolescent patients.
Adolescent* ; Adult ; Diagnosis, Differential ; Female ; Herpes Simplex ; Herpesvirus 2, Human ; Humans ; Meningitis* ; Mothers ; Parturition ; Simplexvirus*