Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine

No abstract available.
Basement Membrane*

No abstract available.
Hyperaldosteronism*

We report a case of anosacral cutaneous amyloidosis in a 74 year-old-man. The skin finding is a patch of the size of a childs palm on the sacral area, consisting of brownish macular lines that radiate frorn the anus. Histopathology revealed defiosits of homogenous eosinophilic mateial s in the papillary dermis. Congo red staining and dylon staining was positive. Immuohistochemical staining using anti SAP antibodies and anti-keratin antibodies showed positive reactions.
Amyloidosis* ; Anal Canal ; Antibodies ; Child ; Congo Red ; Dermis ; Eosinophils ; Humans ; Skin

Apert described acrocephalosyndactyly as a clinical entity in 1906. At first he included a patient with craniofacial deformities combined with syndactyly of both the upper and lower extremities. This is a rare congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. More than 200 cases have been reported in the world literature, and three cases in Korea. Authors experienced one case of the classic pattern of Apert's syndrome and treated surgically for syndsctyly.
Acrocephalosyndactylia ; Congenital Abnormalities ; Foot ; Hand ; Head ; Humans ; Korea ; Lower Extremity ; Syndactyly

Pagets disease has been well known disease in western countries, but it is extremely rare in orient and no case has been reported in Korea yet. It is a chronic osseous disease affecting middle and late life, characterized by progressive skeletal deformities which consist of excessive resorption and abnormal regeneration. We experienced a case of Paget's disease in a 57-year old man with involvement of pelvis, femur and skull, and confirmed with open biopsy.
Biopsy ; Congenital Abnormalities ; Femur ; Korea ; Pelvis ; Regeneration ; Skull

Paralytic scoliosis is a disease characterized by its long severe curve and the continuous progression of the deformity even after cessation of growth. It is also resistent to conservative treatment and more patients require surgical treatment than those with idiopathic or congenital curvature. Patients suffer from marked limitation of normal activities in walking and sitting due to imbalanced paralysis of trunk muscles and pelvic obliquity. The indication for the conservative treatment with Milwaukee brace allowing for skeletal growth in a straight alignment is much limited and surgical correction and fusion are almost always indicated even in a young age. This paper was aimed to review our experience with ninteen patients with paralytic scoliosis who were treated with various methods of preoperative corrections and surgery from Jan. 1970 to Dec. 1981 and the following results were obtained. 1. The average age when scoliosis was observed was 7.7 years but the average age of surgery was deferred to 17.7 years. 2. No treatment had been done until most of the patients could no longer maintain balanced posture in sitting and walking due to collapsing spine and marked pelvic obliquity. 3. The causes of paralysis were poliomyelitis in 15 cases, meningocele in two, cerebral palsy and Charcots disease in each one. 4. Preoperative average degree of scoliosis was 107.8° and the final correction was 47.9°(44.4%) with loss of correction 3.6° (3.4%) after 5.6 years of follow-up in average. 5. The more severe the curve was, the more flail was the spine and the more correction could be obtained. 6. Preoperative correction was performed for 16 cases and Harrington instrumentation and posterior fusion were performed for all cases except one meningocele with defect of posterior element in which Dwyer instrumentation was indicated. 7. Breakage of Harrington rod was observed in two cases 1.3 and 3.8 years postoperatively but no problem arose from it in seven and two years of follow-up respectively. 8. Significant pelvic obliquity was observed in seven cases, which were treated by Harrington instrumentation with sacral bar or sacral hook and posterior fusion extended to sacrum.
Braces ; Cerebral Palsy ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Meningocele ; Muscles ; Paralysis ; Poliomyelitis ; Posture ; Sacrum ; Scoliosis ; Spine ; Walking

We reviewed the 43 medical records of patients with cellulitis or erysipelas who had been admitted at the depar1ment of dermatology of Seoul National University Hospital and followed them up for mean 21.6 months. The results were as follows. 1. The sex ratio of patients with cellulitis was 1:1.4 and the average age was 49 years. 2. The lower extremity as the most frequently invloved site of cellulitis with the frequency of 58.1% (25 cases), with the head and neck being involved in 16 cases(37.2%) and trunk and upper extremity in 1 case each(2.3% ). 3. The portals of infecticin were suspected in 33 cases(76% ), where tinea pedis was detect,ed in 18 cases(41.9%), previous skin infeection 10 cases(23.3%) and trauma in 9 cases(20.9%). 4. Initial systemic symptoms were fever(76.7%), chill(65.1%) and headache(37.2%). Erythema(100%), local heating(90,7%), tenderness(88.4%), swelling(86.0%), ulcer(16.3%), bulla(14.0%), lymphangitis(9.2%) and lymphadenit,is(9.2%) were found in the skin lesions. 5. The laboratory findings revealed leukocytosis in 35.7%, elevaed ESR in 86.8% positive 6. ASO titer in 63.0% and positive CRP in 80%, Microorganism. were detected in only 1 of 15 blood cultures, in 2 of 4 bulla fluid cultures and in 7 of 9 bus cultures. There was no growth of causative microorganisms in 3 tissue cultures and 9 saline needle aspiration cultures. Penicillin was used as primary antibiotics in 19 cases, which changed to another antibiotics due to lack of improvement in 3 cases and cefazolin was used in 21 cases, which changed in 2 cases due to the same reason. 7. Average admission priod was 11 days(range from 3 to 20 days) and 30.2% of patients wit.h cellulitis experienced recurrence, but 48% on low extrernity in contrast with 6.7% on head and neck.
Anti-Bacterial Agents ; Cefazolin ; Cellulitis* ; Dermatology ; Erysipelas ; Head ; Humans ; Leukocytosis ; Lower Extremity ; Medical Records ; Neck ; Needles ; Penicillins ; Recurrence ; Seoul ; Sex Ratio ; Skin ; Tinea Pedis ; Upper Extremity

A case of dedifferentiated liposarcoma in a fifty-one year old man is presented. The patient received a wide extirpation for a relatively rapidly growing mass in his right gluteal region. The mass was multinodular and consisted of two clearly distinct elements; well differentiated liposarcoma and non-lipogenic spindle cell sarcoma (fibrosarcoma). This is first proven case of dedifferentiated liposarcoma of the soft tissue in Korean literature, and its histogenesis is discussed along the dedifferentiation-redifferentiation pathway of fibrohistiocytic differentiation.
Male ; Humans

Two cases of malignant histiocytosis, in which skin involvement was a prominent finding at initial clinical presentation, are reported. 1nteresting histopathologic findings, including Langerhans granule in one case and numerous eosinophils in another, were observed. In one case remission was achieved with BACOP chemotherapy (Bleomycin, Adriamycin, Cyclophosphamide, Vincristine, and Prednisone). In the other case, the patient died nine months after the onset of the disease without any treatment.
Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Eosinophils ; Histiocytic Sarcoma* ; Humans ; Skin ; Vincristine