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

Neurofibromatosis is a disease which involves both neuroectodermal and mesodermal tissue, and is characterized by cafe-au-lait spot, multiple subcutaneous neurofibromas, elephantiasis neuromatosa, a positive family history, and specific dystrophic osseous changes such as scoliosis, penciling of ribs, vertebral scalloping, a paravertebral soft tissue tumor, and congenital pseudarthrosis. The classic type of scoliosis in neurofibromatosis was known as a sharp localized short curve that is often rapidly progressive and produces severe deformity with dystrophic changes, but another form with long gentle curve is reported. Since conservative treatment is usually unsuccessful, posterior fusion with or without Harrington instrumentation is the treatment of choice even in young age when the curve is progressive. This paper was aimed to review our experience with 11 patients having neurofibromatosis and scoliosis, who were treated with posterior fusion and Harrington instrumentation from Jan. 1971 to Dec. 1980, and the results were as follows: 1. The average age that spinal deformity was observed was 7.7 years old, but the average age at treatment was 14.4. 2. Cafe-au-lait spot was observed in all cases, subcutaneous nodule in 7 cases, local gigantism in 2 cases, and positive family history in 3 cases. 2 cases were combined with congenital spinal anormalies. 3. Specific pattern in spinal deformity was not significant. There were 7 short curves less than 5 vertebrae involved and 6 long curves more than 6 vertebrae involved. 4. There were 5 kyphosis which had more than 50°, and those were usually combined with severe scoliosis. 5. Preoperative average degree of scoliosis was 93.8, and the final correction was 41.2° (43.9%) with loss of correction 5.3°(5.7%) after 3.2 year follow-up in average. 6. It shouid be educated for early detection at home and school, and for the importance of early treatment for the scoliosis, to prevent rapid increase of scoliosis in neurofibromatosis.
Cafe-au-Lait Spots ; Congenital Abnormalities ; Elephantiasis ; Follow-Up Studies ; Gigantism ; Humans ; Kyphosis ; Mesoderm ; Neural Plate ; Neurofibroma ; Neurofibromatoses ; Neurofibromatosis 1 ; Pectinidae ; Pseudarthrosis ; Ribs ; Scoliosis ; Spine

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Anesthesia, General* ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Pulmonary Atelectasis*

No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Prenatal Diagnosis*

No abstract available.

No abstract available.
Neural Tube Defects* ; Neural Tube* ; Prenatal Diagnosis*

No abstract available.
Diagnosis* ; Maternal Age*