OBJECTIVE. To survey medical graduates from the University of Hong Kong on how well they perceived their learning needs had been fulfilled by the old (before 1997) and the new (after 1997) curricula.

DESIGN. Retrospective questionnaire survey.

SETTING. The University of Hong Kong, Hong Kong.

PARTICIPANTS. Medical graduates from the University of Hong Kong who graduated between 1997 and 2006 were invited to complete a questionnaire online or in paper form; 1997-2001 graduates were trained under the old curriculum, and 2002-2006 graduates under the new curriculum.

RESULTS. The response rate was 23%. The survey showed that the graduates of both curricula felt that research skills, population health, and ophthalmology were not emphasised enough in the medical programme. In addition, some graduates of the old curriculum mentioned interpersonal skills, ethics and professionalism, and language skills, which were pinpointed in the curriculum reform in 1997. Some graduates of the new curriculum mentioned anatomy, microbiology, and diagnostic radiology. Graduates of both the old and the new curricula perceived the same top five areas as being lacking in their respective curricula, in relationship to their clinical career and personal growth, namely: business administration, law, professional English, life coaching, and humanities. A small percentage of graduates also took courses in these areas after graduation.

CONCLUSIONS. The survey showed that the curriculum reform in 1997 at the University of Hong Kong had correctly pinpointed some of the learning needs. The survey also identified educational needs in the existing curriculum that need to be dealt with in the forthcoming curriculum reform in 2012.

Key words: Curriculum; Education, medical, undergraduate; Teaching/methods

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OBJECTIVE. To provide a synopsis of current haemophilia care in Hong Kong.

DESIGN. Retrospective survey.

SETTING. All haematology units of the Hospital Authority in Hong Kong.

PATIENTS. All patients with haemophilia A and haemophilia B.

RESULTS. To date, there were 222 mild-to-severe haemophilia patients (192 type A, 30 type B) under regular public care in Hong Kong (43% were considered severe, 33% moderate, and 24% mild), which gave a crude prevalence of 6.8/100 000 male inhabitants. A total of 12.8 million units of Factor VIII and 3 million units of Factor IX were prescribed annually. This amounts to 1.83 units of FVIII per capita of the population, which is comparable to that of other developed countries. Leading causes of mortality were human immunodeficiency virus–related complications (10 cases) and cerebral bleeding (2 cases). The life expectancy of patients with severe haemophilia in Hong Kong is improving; currently the oldest patient is 60 years old. Such improved survival may be due to enhanced factor availability, prompt treatment of bleeding episodes at home, safer factor products, and better antiviral treatment. Primary prophylaxis is the accepted standard of care for severe and moderate cases, and "Factor First" has become hospital policy. However, 12 patients continue to present treatment challenges, due to the documented presence of factor inhibitors. In all, 28, 100, and 14 cases respectively were positive for human immunodeficiency virus, hepatitis C virus, and hepatitis B virus; the youngest patients with the corresponding infections being 28, 13, and 22 years old. Comprehensive care with dedicated physiotherapy, surgical support, and radionucleotide synovectomy may reduce morbidity further.

CONCLUSION. A multidisciplinary approach can further improve the future care for haemophilia patients in Hong Kong.

Key words: Factor VIII; Hemophilia A; HIV infections; Mutation; Survival rate

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OBJECTIVE. To review the results of arthroscopic treatment of popliteal cysts in our centre and analyse outcomes including complications.

DESIGN. Retrospective study.

SETTING. University teaching hospital, Hong Kong.

PATIENTS. From July 2007 to July 2009, 11 patients with symptomatic popliteal cysts were treated arthroscopically. All of them had preoperative magnetic resonance imaging to confirm the diagnosis, identify the valvular opening, and the associated intra-articular pathology. We used the Rauschning and Lindgren criteria for evaluation.

RESULTS. Intra-articular pathology like cartilage degeneration and meniscus tear were commonly associated with popliteal cysts. All patients achieved symptomatic improvement after treatment and the recurrence rate was low. No major complications were encountered. We failed to identify (and correct) any valvular opening in one patient.

CONCLUSION. From our experience, we conclude that arthroscopic treatment of popliteal cyst with correction of the valvular opening and treatment of associated intra-articular pathology is effective and safe.

Key words: Arthroscopy; Joint diseases; Knee joint; Popliteal cyst; Treatment outcome

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OBJECTIVES. Atopic eczema is a chronic relapsing skin disease associated with atopy, and characterised by reduced skin hydration, impaired skin integrity (transepidermal water loss), and poor quality of life. Proper emollient usage is an important facet of its management. This study aimed to establish an approach to evaluate the efficacy of using an emollient over a 4-week period.

DESIGN. Prospective observational study.

SETTING. A paediatric dermatology out-patient clinic of a university teaching hospital in Hong Kong.

PATIENTS. Consecutive new patients aged 5 to 18 years with atopic eczema diagnosed according to Hanifin and Rajka's criteria were recruited from March to August 2009. They or their parents were instructed to liberally apply the test emollient to the flexures and areas affected with eczema, twice daily. Outcome assessments were repeated 2 and 4 weeks later.

MAIN OUTCOME MEASURES. Skin hydration and transepidermal water loss in the right forearm (2 cm below antecubital flexure), and disease severity (SCORing Atopic Dermatitis index) and Children's Dermatology Life Quality Index. At the end of the study period, a global assessment of treatment was recorded.

RESULTS. Thirty-three patients with atopic eczema were recruited and treated with applications of a pseudoceramide-containing cream (Curel, Kao, Japan). The mean age of the patients (16 males and 17 females) was 12 (standard deviation, 4) years. Four weeks following the use of the cream, skin hydration improved significantly and fewer patients were using topical corticosteroids. In these patients, there was no deterioration in transepidermal water loss, eczema severity, or quality of life.

CONCLUSION. The pseudoceramide cream improved skin hydration but not severity or quality of life over a 4-week usage.

Key words: Child; Dermatitis, atopic; Eczema; Emollients; Water loss, insensible

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OBJECTIVE. To evaluate and compare the laboratory and clinical outcomes of vitrification with slow-freezing method for cryopreservation of embryos and blastocysts in an in-vitro fertilisation programme.

DESIGN. Retrospective analysis of all the 104 cycles of frozen embryo and blastocyst replacements from 2003 to 2008 and all the 149 cycles with embryos or blastocysts for vitrification from 2006 to 2009.

SETTING. Hospital-based Licensed Assisted Reproduction Treatment Centre in Hong Kong.

PARTICIPANTS. All participants having frozen embryos or blastocysts transfer from 2003 to 2008.

INTERVENTIONS. Surplus embryos and blastocysts after fresh transfer were cryopreserved by vitrification method.

MAIN OUTCOME MEASURES. Cryosurvival rate after freeze-thawing of early cleavage embryos and blastocysts by the two cryopreservation methods of slow-freezing and vitrification, and the pregnancy rate, implantation rate, delivery rate and live-birth rate achieved.

RESULTS. Cryosurvival rates of both vitrified blastocysts (79%) and early cleavage-stage embryos (88%) were significantly higher, as compared with the slow-freezing groups (57% and 72% respectively, both P<0.05). Pregnancy rates, delivery rates, and implantation rates were all significantly higher with vitrification regardless of the embryo types. Both implantation and live-birth rates were higher (31%, odds ratio=14 and 27%, odds ratio=11, respectively) per vitrified blastocyst transferred as compared with slow-freezing (both 3%).

CONCLUSION. Vitrification improved clinical outcomes of both frozen embryos and especially blastocyst transfers. It conferred upon both blastocysts and embryos better developmental potential after the vitrify-thaw procedure.

Key words: Blastocyst; Cryopreservation; Embryo implantation; Freezing; Pregnancy rate

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