• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.146-151
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• 2006

Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the tibial nerve within fibrous tunnel on the medial side of the ankle. The most common cause of TTS is idiopathic. This is a retrospective study to define the electrophysiological characteristics of idiopathic TTS. Methods: We reviewed the medical and electrophysiological records of consecutive patients with foot sensory symptoms referred to electromyography laboratory. Inclusion of patients was based on clinical findings suggestive of TTS. Among them, patients with any other possible causes of sensory symptoms on the foot were excluded. Control data were obtained from 19 age-matched people with no sensory symptoms or signs. Routine motor and sensory nerve conduction study (NCS) including medial plantar nerve (MPN) using surface electrodes were performed. Result: Twenty one patients (13 women, 8 men, 9 unilateral, 12 bilateral) were enrolled to have idiopathic TTS (total 31 feet). Tinel's sign was positive in 16 feet (51.6%) of TTS and four feet (10.5%) in control group. The statistically significant electrophysiological parameter was difference of sensory conduction velocity (SCV) between sural nerve and MPN. Amplitude of sensory nerve action potential and SCV of MPN were not different significantly between idiopathic TTS feet and controls. Conclusion: Bilateral development in idiopathic TTS was more common. Tinel's sign and difference of SCV between sural nerve and MPN may be helpful for the diagnosis of idiopathic TTS.

• Archives of Plastic Surgery
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• 제34권5호
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• pp.557-561
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• 2007

Purpose: Malignant melanoma is a fatal tumor arising in the melanocytic systems of the skin. The incidence of malignant melanoma, formerly considered a rare tumor in Korea, is observed to increase. The aim of this study is to analyze the clinical and histopathological pattern of malignant melanoma in one institute. Methods: Thirty patients with ages ranging from 33 to 80 years, diagnosed as malignant melanoma at our skin tumor department, were enrolled in a retrospective study over a 6 year period(2000. 9-2006. 7). The analyzed data included age, sex, location, duration before diagnosis, clinical type, level of invasion, and stage. Results: The cases were identified and analyzed by clinical and histopathologic study. The male to female ratio was 1:1.7. Lower extremities(especially, feet) were favored sites. The majority of cases were acral lentiginous melanoma(40%), followed by nodular melanoma (36.7%), superficial spreading melanoma(20%) in this study. Clark level IV was predominant in histopathologic study. There was merely narrow gap among each stage by AJCC. Conclusion: The clinicopathological characteristic of melanoma in our patients is quite different with that in the West. In this retrospective study, primary lesions of the foot were predominant with melanoma, and a high percentage of these were classified pathologically as acral lentiginous melanomas. Patients had a more advanced stage of disease at first presentation and a more deeply invasive primary lesion than Western patients. These suggest that malignant melanoma has a worse prognosis in our patients than in the West. So, further organized prospective studies are needed to approach the prudent and accurate diagnosis and management of melanoma in Korea.

• 대한족부족관절학회지
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• 제26권3호
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• pp.136-142
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• 2022

Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

• 대한족부족관절학회지
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• 제26권1호
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• pp.9-15
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• 2022

Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic techniques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization. The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfixation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favorable outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotopic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidence-based treatment options for unstable syndesmotic injury should be considered.

• 대한족부족관절학회지
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• 제26권1호
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• pp.22-29
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• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• Journal of Acupuncture Research
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• 제18권1호
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• pp.226-236
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• 2001

Objects : To evaluate clinical efficiency of The A-Shi point for the herniated lumbar intervertebral disc. Methods : The patients who had a diagnosis of herniated lumbar intervertebral disc by lumber CT and MRI, and were observed from the twentieth March 2000 to the tenth Novemsber 2000, were divided into two classes ; the "A" group was 15 cases practiced with Acupuncture treatment used of A-Shi point and the twelve-Meridian, the "B"group 15cases only Acupuncture treatment used of twelve-Meridian, Results : the most type of low back pain was, the Gall bladder channel of Foot-souyang 15 cases (50%) and the Gall-Bladder Meridian Muscle was 45 cases the most in the existence part of A-Shi point On the result of treatment due to clinical symptoms, the "A" group was 57.9% as excellent and "B" group 19.8%. On the measurement of Lumber flexion, the "A" group proceed more excellent result than the "B group at the whole grade. Conclusion : These results suggest that The A-shi point was effective treatment of herniated intervertebral disc.

• 혜화의학회지
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• 제13권1호
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• pp.287-293
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• 2004

Objective : The purpose of this study is to examine the clinical effect of Auricular Acupuncture therapy on ankle sprain Methods : This study was carried out on the 48 patients who had been treated at chonan oriental hospital from December 1st, 2003 to April 30th, 2004. 48 patients had a diagnosis of ankle sprain by x-ray or physical test. we treated 48 patients by Auricular Acupuncture therapy. Results and Conclusions 1. We operated Auricular Acupuncture on the foot point(발점), the ankle point(발목점), the heel point(발뒤꿈치점), the zero point(제로점)and the thalamus point(시상점). 2. The efficacy of Auricular Acupuncture therapy was 75% when we set a standard thing more than good(良好) 3. The Auricular Acupuncture therapy is effective of ankle sprain patients, but we thought that it needed to prove effect of Auricular Acupuncture therapy for efficient application by more clinical researches.

• Journal of Korean Neurosurgical Society
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• 제63권3호
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• pp.346-357
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• 2020

During the follow-up period after surgery for spinal dysraphism, a certain portion of patients show neurological deterioration and its secondary phenomena, such as motor, sensory or sphincter changes, foot and spinal deformities, pain, and spasticity. These clinical manifestations are caused by tethering effects on the neural structures at the site of previous operation. The widespread recognition of retethering drew the attention of medical professionals of various specialties because of its incidence, which is not low when surveillance is adequate, and its progressive nature. This article reviews the literature on the incidence and timing of deterioration, predisposing factors for retethering, clinical manifestations, diagnosis, surgical treatment and its complications, clinical outcomes, prognostic factors after retethering surgery and preventive measures of retethering. Current practice and opinions of Seoul National University Children's Hospital team were added in some parts. The literature shows a wide range of data regarding the incidence, rate and degree of surgical complications and long-term outcomes. The method of prevention is still one of the main topics of this entity. Although alternatives such as spinal column shortening were introduced, re-untethering by conventional surgical methods remains the current main management tool. Re-untethering surgery is a much more difficult task than primary untethering surgery. Updated publications include strong skepticism on re-untethering surgery in a certain group of patients, though it is from a minority of research groups. For all of the abovementioned reasons, new information and ideas on the early diagnosis, treatment and prevention of retethering are critically necessary in this era.

• 대한족부족관절학회지
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• 제5권2호
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• pp.103-111
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• 2001

Purpose: The purpose of this study was to evaluate prognostic factors of ankle arthroscopy and the effectiveness of high anteromedial and anterolateral portals in diagnosis and treatment for various disease entities. Materials and Methods: The results of ankle arthroscopy were evaluated between March 1992 and January 2000 by one surgeon. Total 169 patients who were followed for a minimum of 12 months, were included in this study. Using high anteromedial and high anterolateral portals, all procedures were done with accessory portals if necessary. A functional evaluation was performed using the Karlsson score and questionnaire subjectively. Results: Fifty-six synovial impingement, 48 osteochondral lesion on talus, 10 impingement exostosis, 8 loose body, 27 osteoarthritis and chondromalacia, 10 postfracture fibrosis, 3 lateral plica, and 1 pigmented villonodular synivitis(PVNS) among 169 patients were diagnosed. Patients with the former four groups had satisfactory results and the latter four groups had not. Remaining 6 patients underwent arthroscopic arthrodesis, and 5 had satisfactory results. Conclusion: Using high anteromedial and anterolateral portals, we could get better visualization of talar dome and posterior chamber of ankle. For better clinical results, in ankle arthroscopy, not only operative skill but also proper indications are important. In case of synovial impingement after trauma, arthroscopy should be considered within one year after initial trauma. There were little correlation between the radiographic findings and arthroscopic findings of articular cartilage in osteochondral lesion of talus, and it is better to determine treatment modality based on the arthroscopic or MRI findings. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

• 동의생리병리학회지
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• 제20권4호
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• pp.807-813
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• 2006

The purpose of this study is to investigate the acupuncture points and the The Meridians and Collaterals which are often applicable to Allergic Rhinitis treatment and to help us do a clinical diagnosis. In my discretion, to study Allergic Rhinitis, investigating rhinitis, syuffy nose and nasal mucus is essential. And 1 investigated the acupuncture points and The Meridians and Collaterals and dialectic patterns which are useful for the acupuncture and moxibustion treatment. 1 also investigated the correlation of the acupuncture points, and The Meridians and Collaterals and other dialectic patterns. The order of frequency in use of The Meridians and Collaterals is The Governor Vessel, The Large Intestine Meridian of Hand-Yangming, The Bladder Meridian of Foot-Taiyang and the order of frequency in moxibustion is The Governor Vessel, The Large Intestine Meridian of Hand-Yangming. In the acupuncturation of stuffy nose, there are 33 points, and the order of frequency in use is LU2O, GV23, LU4, GBI 5, GV2O, BL7, GV22. In the acupuncturation of nasal mucus, there are 21 points, and the order of frequency in use is LU2O,, GV23, GVl6, GV26, BLl2, GV2O, GB2O. It is thought that acupuncture points LU2O, GV23, LU4 can go through the nasal cavity and remove wind fever. And those are used for the face and the five sensory organs diseases. It means that those acupuncture points have similar efficacy. It is thought that The Meridians and Collaterals of The Governor Vessel, The Large Intestine Meridian of Hand-Yangming, The Bladder Meridian of Foot-Taiyang go on a patrol near nose and cure nose disease.