Early detection of spine deformities by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 1,620 middle and high school male students Seoul who were chosen arbitrarily, to determine the incidence rates of scoliosis. Authors diagnosed scoliosis on a combination of at least one positive physical sign and a lateral curvature more thar 5 degrees on an antero-posterior standing X-ray. According to this criteria 12 students were diagnosed as having scoliosis. They were analyzed for positive physical signs, etiology, degree of curvature. distribution of size of curvature, patterns of curvature, direction of curvation, and following results were obtained. 1. The overall incidence of scoliosis was 0.74%. 2. Idiopathic scoliosis was found in 10 students, congenital scoliosis in 1, and paralytic scoliosis in 1. 3. Rib humps, whose right to left ratio was 5, were found in 6 students, lumbar humps, whose right to left ratio was 0. 2. in 6 students, and shoulder elevation, whose direction were all to right, in 4 students. 4. Close observations were required for all the 12 students and treatment was required in 2 students who had more than 20 degrees, one for Milwaukee brace, and the other for surgical correction. 5. The most common pattern of curvature was thoracic curve. 6. in single curve right to left ratio was 2.7.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Ribs ; Scoliosis ; Seoul ; Shoulder ; Spine

Peripheral Intravenous Catheters (PIC) are widely used. Nurses are required to possess appropriate knowledge and practice. The present study aimed to determine nurses' knowledge and practice towards care of PIC. A cross-sectional descriptive study was conducted and 84 respondents participated in the study. A 26-item questionnaire comprising 11 items on knowledge and 15 items related to nursing practice was adapted and modified. The findings reported higher mean score from specialty unit respondents, with knowledge (M = 49.19, SD = 3.44) and practice (M = 66.38, SD = 5.15), compared to medical surgical wards with knowledge (M = 46.25, SD = 4.68) and practice (M = 63.17, SD = 4.63) towards the care of PIC, which was significant (p value = 0.010 and p value = 0.009, respectively). The study indicated a higher mean score of charge nurse respondents as compared with registered nurse with knowledge (M = 49.68, SD = 3.23); (M = 46.20, SD = 4.62) and practice (M = 67.11, SD = 4.84); (M = 63.06, SD = 4.61), which was significant (p value = 0.003 and p value = 0.001, respectively). There were no significant differences between respondents’ education qualification towards care of PIC with p > 0.05. However, the findings reported that respondents who possessed Bachelor of Nursing were deemed to score slightly higher in their knowledge and practice towards the care of PIC. In conclusion, the specialty unit and charge nurse respondents were deemed to possess better knowledge and practice towards the care of PIC in the hospital.
Phlebitis

Post operative pain is an expected adverse outcome following surgery and it often delays mobilization and overall recovery. Acute post operative pain is subjective and cannot be measured directly. The objective of this study was to determine nurses’ knowledge and attitude towards post operative pain management. A cross sectional study was conducted in surgical wards and the Intensive Care Unit of Universiti Kebangsaan Malaysia Medical Centre from February to April 2008. A 28 item questionnaire which comprised of two domains: knowledge and attitude towards post operative pain management was used. Eighty four respondents successfully responded to the study. Twenty respondents (25%) possessed high level, 58 respondents (69%) possessed moderate level and 5 respondents (6%) had low knowledge level of post operative pain management. Positive attitude towards post operative pain management was reported by 66 respondents (78.5%). There was a significant relationship between nurses’ academic qualifications and attitude towards post operative pain management (χ² =29.96, p <0.05). In conclusion, nurses in UKMMC possessed moderate level of knowledge and positive attitude towards post operative management. Results of this study show the need to enforce continuing medical education in pain management amongst UKMMC nurses in enhancing the quality of post operative care.

Our experience with 150 patients with congestive heart failure has been reviewed with particular reference to physical and laboratory findings on admission, precipitating factors and diagnostic clues. Congestive heart failure has been defined as that heart failure due to myocardial failure (primary or secondary). (1) Congestive heart failure was found in 3.65% of total medical admissions and in 24.0% of total cardiovascular patients. There was no difference between two sexes and incidence was peak in the 6th decade. (2) Rheumatic heart disease was the most common cause of congestive heart failure (41.0%). Hypertensive and/or atherosclerotic heart disease (36.5%), cor pulmonary (6.6%), postpartum heart failure (5.3%), pericardial disease (3.6%), thyrotoxic heart disease (2.0%) and congenital heart disease (0.6%) were the etiologies of the remainder. In male hypertensive and/or atherosclerotic heart disease was most common cause of congestive heart failure. (3) The precipitating factors of congestive heart failure were found in 31% and infection, pregnancy, discontinuation of digitalis and physical exertion were major causes. (4) Dyspnea, cervical vein distension, pulmonary rale, hepatomegaly and cardiac murmur were important symptoms and signs on admission. (5) Peripheral venous pressure was elevated in 883.2% and circulation time was prolonged in 90.9%. (6) Leucocytosis (39.8%) albuminuria (60.2%), elevated GOT (serum glntamin oxaloacetic transaminase) (12.0%) and azotemia (50%) were observed. (7) Chest X-ray on admission revealed increased vascularity including pulmonary edema (88.8%), cardiomegaly (83.3%) and hydrothorax (27.1%). (8) Electrocardiographic findings was abnormal in 99.4% and left ventricular hypertnophy (45.7%), atrial fibrillation (27.3%), Right ventricular hypertrophy and low voltage were frequently observed.
Albuminuria ; Atrial Fibrillation ; Azotemia ; Cardiomegaly ; Digitalis ; Dyspnea ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Defects, Congenital ; Heart Diseases ; Heart Failure* ; Heart Murmurs ; Hepatomegaly ; Humans ; Hydrothorax ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Physical Exertion ; Postpartum Period ; Precipitating Factors ; Pregnancy ; Pulmonary Edema ; Respiratory Sounds ; Rheumatic Heart Disease ; Thorax ; Veins ; Venous Pressure

A clinical observation of 30 cases of pyogenic abscess and 18 cases of tuberculous abscess in the metaphysis of long bones during the past 15 years was carried out and following results were obtained. 1. The highest age incidence was the second decade (53.3%) in pyogenic abscess and the first decade (44.4%) in tuberculous abscess. 2. Average duration of symptoms were 1.6 years in pyogenic abscess and 2.3 years in tuberculous abscess. 3. Chief complaint on admission was pain both in pyogenic abscess (56.7%) and in tuberculous abscess (27.8%). 4. The tibia was the most common site in pyogenic abscess and the femur in tuberculous abscess. 5. Leucocyte count was increased more than 15, 000/mm in 23.3% of pyogenic abscess and 22. 2% of tuberculous abscess. 6. Erythrocyte sedimentation rate was increased more than 21mm/hr in 60.0% of pyogenic abscess and in 44.4% of tuberculous abecess. 7. Epiphysis was involved in 23.3% of pyogenic abscess and 38.9% of tuberculous abscess. 8. The positive result on bacteriologic culture was 46.7% in pyogenic abscess and 22.2% in tuberculous abscess. Coagulase positive staphylococcus aureus was cultured in 12 cases and other organisms were cultured in 2 cases. 9. Differential diagnosis between pyogenic, tuberculous abscess, and cystic tumors was not easy in many cases. Preoperatively, 5 cases of pyogenic abscess were misdiagnosed as tuberculosis and 2 cases as osteod osteoid osteoma. 3 cases of tuberculous abscess were misdiagnosed as pyogenics and 1 case as giant cell tumor. 10. Various methods of surgery including saucerization, curettage and bone graft, resection of bony focus, and arthrodesis were carried out. There was no difference in the end result between them. 11. Shortening or deformity due to epiphyseal plate damage was occurred in 3 cases (10.0%) in pyogenic abscess and 4 cases (22.2%) in tuberculous abscess. Those complications could be minimized with meticulous surgery not damaging the epiphyseal plate.
Abscess ; Arthrodesis ; Blood Sedimentation ; Coagulase ; Congenital Abnormalities ; Curettage ; Diagnosis, Differential ; Epiphyses ; Femur ; Giant Cell Tumors ; Growth Plate ; Incidence ; Osteoma, Osteoid ; Staphylococcus aureus ; Tibia ; Transplants ; Tuberculosis

One hundred patients with 119 curves with idiopathic scoliosis, age ranged from 2 to 32 years, were-treated at Seoul National University Hospital from 1968 to 1979. Of 100 patients, 63 were adolescent type, 20 juvenile, and 17 infantile. The distribution of curve-patterns was 49 right thoracic, 19 double major (Rt. thoracic & Lt. lumbar), 18 left thoracic, 12 thoracolumbar, and 2 left lumbar. Of these patients, 67 with 83 curves were treated with Milwaukee-brace for one to seven years with an average of three and one-half years. Seven patients were treated surgically because of a poor response to the brace or progression of the curve.Sixteen patients with 20 curves followed for average 4. 6 years after the completion of brace treatment showed some loss of correction: 2.8 degrees for thoracolumbar, 3.1 degrees for thoracic, 4.2 degrees for lumbar segments and 4, 9 degrees for thoracic segments of double major curves. The brace was more effective for curves with 6 to 9 involved vertebrae and of less than 40 degrees. Thirty three patients with 36 curves were treated with Harrington instrumentation and posterior spinal fusion and followed from 1 to 12 years with an average of six and one-half years. The initial preoperative curves ranged from 50 to 120 degrees with an average of 75.3 degrees. Immediate postoperative correction ranged from 30 to 70 degrees with an average of 36. 2 degrees (48.1%). The average loss of correction at follow-up was 1.5 degrees (2.8%) for curves of less than 60degrees and 1.4 degrees (1.3%) for those of more than 101 degrees. Varioua methods of preoperative correction were applied. Halofemoral traction was applied for rigid and severe curve in 9 patients, Cotrel traction for less rigid one in 11 patients, Risser localizer cast for flexible one in 9 patients, and no preoperative correction for mild and flexible one in 4 patients.
Adolescent ; Braces ; Follow-Up Studies ; Humans ; Scoliosis ; Seoul ; Spinal Fusion ; Spine ; Traction

No abstract available.
Cough*

No abstract available.

Msny clinical and experimental studies trying to elucidate the cause of idiopathic scoliosis have been carried out. There, however, is no established theory to explain it. This paper is aimed at approaching one of various causes of idiopathic scoliosis by producing thoracic scoliosis in growing rabbits with unilateral resection of thoracic spinal nerves. All 43 rabbits were divided into four different groups. The first group(11 rabbits) consisted of rsbbits whose primary anterior and posterior divisions of the unilateral thoracic spinal nerves were resected. The second(11 rabbits) and the third(11 rabbits) were groups of rabbits whose primary anterior and posterior devisions were resected respectively. The fourth(10 rabbits) was the control group. The first group of rsbbits showed the most prominent curvature of the spine. The group of resection of primary posterior division showed less severe scoliosis than the first group but more marked scoliosis than the group of resection of primary anterior division. The biopsy of the denervated muscles included in the scoliosis revealed atrophy. It is concluded from the animal experiments with 43 growing rabbits that unilateral paralysis of the thoracic spinal nerves could be one csuse of iniopathic scoliosis and the primary posterior division of the thoracic spinal nerve contributed to the production of scoliosis more than the primary anterior division.
Animal Experimentation ; Atrophy ; Biopsy ; Muscles ; Paralysis ; Rabbits ; Scoliosis ; Spinal Nerves ; Spine

The most important spinal disorders in childhood are malformations and mass lesions. High-resolution, real-time ultrasonography of the spine enables the differentation of intraand paraspinal structures in a significant way. This examination does not require sedation, does not use radiation, can be performed in the nursery or an incubator and is less expensive than computed tomography or magnetic resonance imaging. The sonographic appearence of the various kinds of spinal dysraphism is demonstrated and illustrated. Based on our preliminary experience spinal sonography appears to be useful in neonates and infants as the first imaging device for differentiation of cmplex malformation and as a screeing method for occult spinal dysraphism.
Humans ; Incubators ; Infant* ; Infant, Newborn* ; Magnetic Resonance Imaging ; Neural Tube Defects ; Nurseries ; Spinal Dysraphism* ; Spine ; Ultrasonography*