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

Purpose: To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint. Materials and Methods: Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed. Results: Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement. Conclusion Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds. Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included. Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between –5.90 and –4.40. In the case of visual analog scale score, the MD ranged from –1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of –2.0 to 0.4. Conclusions There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.

Purpose: To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint. Materials and Methods: Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed. Results: Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement. Conclusion Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.

Purpose: To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint. Materials and Methods: Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed. Results: Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement. Conclusion Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds. Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included. Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between –5.90 and –4.40. In the case of visual analog scale score, the MD ranged from –1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of –2.0 to 0.4. Conclusions There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.