The degenerative arthritis following total menisectomy has led to consideration of the need for meniscal transplantation, this study evaluates the morphologic and histologic changes fol lowing fresh meniscal autograft and allograft in therabbits. Transplantation of the medial meniscus was carried out in two groups of 32 rabbits(autograft group=16 rabbits, allograft group=16 rabbits). The morphological and histological changes of the transplanted auto-and allografted menisci and the articular cartilage of the medial femoral and tibial condyle were observed at 2,4,6,8,10,12,22,28 weeks postoperatively. There were no significant differences between auto and allograft groups in gross appearance. Histologically, the fibrous adhesion was noted between grafted meniscus and joint capsule 2 weeks after operation, but complete healing was seen at the suture sites without rejection phenomenon at 6 weeks in both groups. There were prominent inflammatory reactions such as lymphocytes and inflammatory cells infiltration during early postoperative stages(2,4 weeks) only in the allograft group, and more prominent fibrotic reactions in the allograft group than auto-graft group. The results of this study suggest that meniscal allografts are able to adapt to the host tissues, survive within the joint environment, and provide a functional replacement for the removed meniscus, but further studies for graft-host immune response and a method to take the maintenance and deposits of graft must be needed to perform the meniscal allograft in human.
Allografts ; Autografts ; Cartilage, Articular ; Humans ; Joint Capsule ; Joints ; Knee Joint ; Knee ; Lymphocytes ; Menisci, Tibial ; Methods ; Osteoarthritis ; Rabbits ; Sutures ; Transplants

There has been no adequate diagnostic method for the diagnosis of intrascrotal lesions until recent days. Butafter the development of radionuclide testicular scan, early and relatively accurate diagnosis of the testicularlesions are possible. So the authors analyzed the 32 cases of patients who were examined by testicular scan andconfirmed by follow up study or operation, and the results are as follows; 1. These 32 cases consists of 13 casesod epididymitis, 7 cases of testicular torsion, 4 of cryptorchism, 2 of testicular tumor and etc. The over alldiagnostic accuracy is about 69%. 2. In epididymitis, the diagnostic accuracy is 85%(11/13) and the findings ofscan are increased perfusion in radionuclide angiogram and hot activity noted mainly in peripheral portion of thetesticle in static image. 3. In cases o testicular torsion, diagnostic accuracy is 86%(6/7). Acute torsion showsnormal perfusion in angiogram and round cold area instatic image. But in missed torsion, perfusion is increasedand round cold area wit surrounding hyperemia is noted in static image. Radionuclide testicular scan seems to benoninvasive, inexpensive, easily available and simple to perform with low gonadal radiation dose. So it can bevery useful as the first study in patients with acute testicular symptoms.
Cryptorchidism ; Diagnosis ; Epididymitis ; Follow-Up Studies ; Gonads ; Humans ; Hyperemia ; Male ; Methods ; Perfusion ; Spermatic Cord Torsion

PURPOSE: This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. METHODS: This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. RESULTS: Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. CONCLUSION: To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.
Animals ; Animals, Wild ; Bites and Stings ; Child ; Child Health ; Health Personnel ; Humans ; Isothiocyanates ; Medical Records ; Post-Exposure Prophylaxis ; Rabies ; Vaccination

BACKGOUND: Narrow-band ultraviolet B (NBUVB) phototherapy has appeared to be effective in clearing psoriatic lesions. Calcipotriol has been combined with a number of the systemic antipsoriatic treatments, improving efficacy or reducing the systemic treatment required. OBJECTIVE: We performed calcipotriol-NBUVB combination therapy to evaluate the clinical efficacy and the safety in Korean psoriasis patients. METHOD: In the psoriasis clinic at Seoul National University Hospital, 69 psoriasis patients were treated with calcipotriol-NBUVB. Phototherapy was given once daily, three times a week, and the dose was gradually increased. Calcipotriol ointment was applied twice a day. The PASI score was used to evaluate the effects of the treatment and the patients were classified according to clearance, improvement, or failure. RESULTS: The therapeutic results showed 53.6% for clearance, 31.9% for improvement and 14.5% for failure. The total number, duration, final and cumulative doses to achieve grade IV were 16.1, 41.8days, 1487.3mJ/cm2, and 15234.5mJ/cm(2) respectively. Of 69 patients, 44 patients experienced variable adverse effects, but there was no significant adverse effect to discontinue the therapy. CONCLUSION: Our results demonstrated that using calcipotriol ointment with NBUVB phototherapy is an effective therapeutic method for psoriatic patients.
Humans ; Phototherapy* ; Psoriasis ; Seoul

No abstract available.
Humans* ; Tooth*

No abstract available.
Humans* ; Tooth*

BACKGROUND: Facial involvement of psoriasis requires a different approach than that used for typical plaque psoriasis on other skin areas. Calcitriol ointment may improve lesions on the face without atrophy or other local side effects associated with the use of topical corticosteroids. OBJECTIVE: Our purpose was to determine the efficacy and tolerability of calcitriol 3 microgram/g ointment for the treatment of facial psoriasis. METHODS: In the psoriasis clinic of Seoul National University Hospital, a total of 53 patients were treated with calcitriol 3 microgram/g for 8 weeks. Efficacy was evaluated by an investigator's assessment of the area and a severity index score of facial psoriasis at the 2nd, 4th, and 8th week. Global assessment was also determined at the 8th week. RESULTS: A total of 10 patients discontinued prematurely from the study, due to disappearing during follow-up treatment (n=9) and combined use of topical corticosteroids (n=1). The remaining patients showed the following response to treatment; excellent (n=10), good (n=14), fair (n=11), and poor (n=8). After 8 weeks of treatment with calcitriol ointment, clinical improvement was achieved in 81.4% of the patients. Among them, 55.8% showed excellent (23.3%) or good effect (32.5%) with calcitriol ointment. Five patients (11.6%) showed a local adverse reaction such as erythema, exfoliation, or an itching sensation, and 2 patients discontinued treatment due to adverse reactions. However, no patient showed telangiectasia, skin atrophy, or systemic side effects. CONCLUSION: Our results suggest that calcitriol ointment is an effective and tolerable agent for treatment of psoriasis on the face.
Adrenal Cortex Hormones ; Atrophy ; Calcitriol* ; Erythema ; Follow-Up Studies ; Humans ; Pruritus ; Psoriasis* ; Sensation ; Seoul ; Skin ; Telangiectasis

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

PURPOSE: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. METHODS: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) > or =10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. RESULTS: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. CONCLUSION: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.
Advance Directives ; Anti-Bacterial Agents ; Cross-Sectional Studies ; Enteral Nutrition ; Glasgow Coma Scale ; Hospices ; Humans ; Korea ; Life Support Care ; Medical Records ; Palliative Care ; Parenteral Nutrition, Total

BACKGROUND: We investigated effect-site median effective concentration (EC50) of propofol for loss of consciousness and effect-site concentration at each anesthetic stage and awakening time to compare the differences by gender or age of patients using Schnider model. METHODS: Total 91 patients were allocated into 4 groups: male patients aged 18-34 year (Group 1), male patients aged 35-55 years (Group 2), female patients aged 18-34 years (Group 3) and female patients aged 35-55 years (Group 4). The effect-site EC50 for loss of consciousness was calculated and the effect-site concentration of propofol at each anesthetic stage and the awakening time of each group were recorded. RESULTS: The effect-site EC50 of propofol for loss of consciousness was 4.53 +/- 0.30microgram/ml, 4.60 +/- 0.25microgram/ml, 4.13 +/- 0.39microgram/ ml and 4.47 +/- 0.65microgram/ml in group 1, 2, 3, and 4, respectively. The effect-site concentrations in male patients aged 18-34 years were significantly higher than those in female patients. The awakening time of female patients aged 35-55 years was shorter than that of male patients. CONCLUSIONS: There were no significant differences of effect-site EC50 for the loss of consciousness of propofol with target effect-site controlled infusion by Schnider model among the groups. However the effect-site concentrations and the awakening time of propofol by Schnider model showed differences in patients' gender and age.
Female ; Humans ; Male ; Propofol* ; Unconsciousness