• Archives of Plastic Surgery
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• 제50권6호
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• pp.573-577
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• 2023

Pachyonychia congenita is a rare genetic disorder characterized by hypertrophic nail plates, hyperkeratotic nail beds, and thickened hyponychium of the fingers and toes, impairing manual dexterity and resulting in poor aesthetics. The current body of literature describes various treatment modalities, but no singular approach has been defined as the gold standard. In this case, the authors employed different surgical techniques for treating pachyonychia congenita to evaluate the most effective approach. A 3-year-old boy presented with hypertrophic nail growth involving all digits of both hands and feet. Three surgical procedures were performed on the patient's fingers and toes using germinal matrix excision (GME) alone, GME plus partial sterile matrix excision (pSME), or GME plus complete sterile matrix excision (cSME). The digits treated with GME + cSME exhibited no recurrence of nail growth. Those treated with GME alone exhibited recurrence of hypertrophic nail growth, although their growth slowed. Excision of GME + cSME prevented recurrence of hypertrophic nails, while GME alone or with pSME led to slower-growing hypertrophic nails. Complete excision of the germinal and sterile matrices with skin graft closure may be a definitive treatment for pachyonychia congenita, but further studies are needed to validate these findings.

• 대한정형외과 초음파학회지
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• 제8권1호
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• pp.16-20
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• 2015

사구종은 신경근동맥성 사구에서 발생하는 손톱 밑의 피하 지방층에 발생하는 드문 종양이다. 조직학적으로 고유 사구종양, 사구맥관종, 사구맥관근종으로 분류하고 있는데 이 중 사구맥관근종은 가장 드물다고 알려져 있다. 또한 다른 사구체 종양과는 다르게 사지나 손톱 밑에서 호발하지 않는다. 사구체 종양은 특징적인 임상 증상으로 일차 진단이 가능하지만 방사선학적으로는 초음파 또는 자기공명 영상이 이용되고 있다. 저자들은 수지에 발생한 재발성 손톱밑 사구맥관근종에 대한 초음파를 이용한 진단 및 수술적 치료에 대한 경험을 보고하고자 한다.

• 대한족부족관절학회지
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• 제20권1호
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• pp.50-53
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• 2016

We report on a rare case of an intraosseous epidermoid cyst in the distal phalanx of the great toe with concurrent infection in a 71-year-old woman with diabetes mellitus. The lesion was initially considered simple infectious arthritis and concomitant osteomyelitis in a patient with diabetes. However, after surgery, an intraosseous epidermoid cyst originating from the nail bed and involving the articular surface of the distal phalanx was detected. The epidermoid cyst may have contributed to the infectious arthritis in the interphalangeal joint. The lesion was treated via mass excision, arthrotomy, debridement, and intravenous antibiotics.

• Geomechanics and Engineering
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• 제6권4호
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• pp.391-401
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• 2014

In an attempt to make a numerical modeling of the nailed walls with a view to assess the stability has been used. A convenient modeling which can provide answers to nearly situ conditions is of particular significance and can significantly reduce operating costs and avoid the risks arising from inefficient design. In the present study, a nailing system with a excavation depth of 8 meters has been modeled and observed by using the three constitutive behavioral methods; Mohr Coulomb (MC), hardening soil (HS) and hardening soil model with Small-Strain stiffness ensued from small strains (HSS). There is a little difference between factor of safety and the forces predicted by the three models. As extremely small lateral deformations exert effect on stability and the overall deformation of a system, the application of advanced soil model is essential. Likewise, behavioral models such as HS and HSS realize lower amounts of the heave of excavation bed and lateral deformation than MC model.

• Archives of Plastic Surgery
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• 제51권2호
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• pp.202-207
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• 2024

Background Ingrown toenail is a common condition that results in chronic pain, recurrent infections, and difficulty in performing daily activities. Our aim is to compare two surgical methods for the treatment of ingrown toenails: wedge resection with curetting versus wedge resection curetting followed by electrocauterization of the nail bed. Methods A prospective, comparative study that included 130 patients with ingrown toenails. All patients had stage II or III disease. We divided the participants into two groups according to the type of surgery and all patients were followed up for 6 months. The outcomes measured were the incidence of postoperative bleeding and infection, recovery time, patient satisfaction, and recurrence rate 6 months after surgery. Results Of the 130 patients included, 59 (45.4%) underwent excision and curetting of the nail matrix (group 1) and 71 (54.6%) underwent excision, curetting, and electrocauterization of the nail matrix (group 2). The postoperative infection rates were 20.3 and 4.2% in the first and second groups, respectively (p = 0.004). Patient satisfaction was 76.3% among the first group, while 91.5% of patients in the second group were satisfied with the results of surgery. Six months postoperatively, recurrence rates were 25.4 and 4.2% in the first and second groups, respectively (p = 0.001). Conclusion Wedge excision and curettage, followed by electrocauterization of the ingrown toenail is a safe treatment modality with a high success rate, that is evident by a lower recurrence rate, and greater patient satisfaction, with no effect on postoperative pain score or recovery time.

• 대한골관절종양학회지
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• 제10권2호
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• pp.107-112
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• 2004

목적: 저자들은 족부에 발생한 조갑하 외골증에서 병변부위 및 크기에 따라 다른 수술방법을 시도하여 좋은 결과를 얻었기에 이에 대한 경험을 보고하고자 한다. 대상 및 방법: 1995년 10월부터 2003년 5월까지 1년 이상 추시가 가능하였던 12례를 대상으로 하였다. 여자가 9례, 남자가 3례였다. 수술 당시 평균나이는 13.4세였으며, 증상 발현기간은 평균 20.3개월 이었다. 무지에 발생한 경우가 9례였으며, 제 2, 3, 5족지에 발생한 경우가 각각 1례였다. 무지에 발생한 9례 중 8례가 원위지골의 배내측에 위치하였으며, 1례에서 배외측에 발생하였다. 제 2, 3, 5족지의 경우 모두 중앙부에 발생하였다. 무지에 발생한 경우 조갑을 절제하지 않고 보존하는 방법으로 외골증에 대한 수술적 접근을 시도하였고, 다른 족지에 생긴경우 조갑의 완전절제를 시도하였으나 가능한 조상은 보존하도록 노력하였다. 술후 판정은 조갑의 모양이 거의 정상이고, 임상적 및 방사선적으로 재발이 없는 경우 우수, 재발은 없으나 조갑의 융기와 같은 약간의 변형이 있는 경우 양호, 확실한 조갑의 변형 또는 방사선적으로만 발견되는 무증상의 경미한 재발이 있는 경우 보통, 임상적 및 방사선적으로 확실한 증상이 있는 재발의 경우 불량으로 하였다. 결과: 무지의 경우 6례에서 우수, 2례에서 양호, 1례에서 재발하여 불량으로 판정되었으며 기타 족지에 발생한 경우 3례 모두에서 양호 소견을 보였다. 결론: 족부에 발생한 조갑하 외골증에서 병변의 부위와 크기에 따라 다른 수술방법으로 치료하여 만족할 만한 결과를 얻었기에 저자들의 수술법은 권장할 만한 치료법으로 생각된다.

• Archives of Plastic Surgery
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• 제42권3호
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• pp.295-301
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• 2015

Background Glomus tumors were first described by Wood in 1812 as painful subcutaneous tubercles. It is an uncommon benign neoplasm involving the glomus body, an apparatus that involves in thermoregulation of cutaneous microvasculature. Glomus tumor constitutes 1%-5% of all hand tumors. It usually occurs at the subungual region and more commonly in aged women. Its classical clinical triad consists of pain, tenderness and temperature intolerance, especially cold sensitivity. This study reviews 15 cases of glomus tumor which were analyzed according to its anatomic location, surgical approach and histologic findings. Methods Fifteen patients with subungual glomus tumors of the hand operated on between January 2006 and March 2013, were retrospectively reviewed. Patients were evaluated preoperatively with standard physical examination including ice cube test and Love's test. Diagnostic imaging consisted of ultrasonography, computed tomography, and magnetic resonance imaging. All procedures were performed with tourniquet control under local anesthesia. Eleven patients underwent excision using the transungual approach, 3 patients using the volar approach and 1 patient using the lateral subperiosteal approach. Results Total of 15 cases were reviewed. 11 tumors were located in the nail bed, 3 in the volar pulp and 1 in the radial aspect of the finger tip. After complete excision, patients remained asymptomatic in the immediate postoperative period. In the long term follow up, patients exhibited excellent cosmetic results with no recurrence. Conclusions Accurate diagnosis should be made by physical, radiologic and pathologic examinations. Preoperative localization and complete extirpation is essential in preventing recurrence and subsequent nail deformity.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.46-50
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• 2009

Purpose: Finger injury by green onion cutting machine is one of the common hand injuries in the kitchen. It has a unique feature: there are multiple parellel laceration 3 - 5 mm wide. There are two directions of injuries(vertical, oblique). It may involve bone, tendon, nerve, and vessel injuries. We discuss its management and the long - term progress. Methods: We have treated six patients from 2003 to 2007. We carried out low tension approximation with thin suture materials to avoid ischemia and performed the additional operation as nail bed repair, tenorrhaphy, open reduction, vessel anastomosis, and composite graft. We reviewed the record of initial injury and collected the follow - up record. Results: They were all middle aged - women who had worked in the kitchen. Right hand was dominent over left hand. The ratio of the directions was 3 : 3 (vertical : oblique). They were all competely healed although there were three atrophy, four hyperesthesia, and one nail deformity. Conclusion: Finger injury by green onion cutting machine is a unique pattern of laceration with various accompanied injuries. It may look like a severe form of injury, but in most cases have relatively favorable progress. We have to perform careful examination of accompanied injuries and carry out the proper management. First and foremost, the user especially in the middle aged women should be warned to be careful in handling this risky machine.

• 항공우주기술
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• 제9권1호
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• pp.143-150
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• 2010

본 연구는 다양한 찬물 온도에 손가락을 침수시켰을 경우 추위유발성혈관확장(Cold-induced vasodilation)이 어떻게 나타나며, 이 반응이 재발현되는지 평가하는데 목적을 두었다. 이를 위해 10명의 건강한 대학생($21.4{\pm}2.5$ yrs, $175.8{\pm}4.1$ cm, $69.6{\pm}7.6$ kg, $11.2{\pm}3.7$ %fat)이 두 번의 실험에 참가하였다. 첫 번째 실험은 상온환경에서 다섯 번의 실험과정 반복으로 이루어졌다. 실험과정은 $43^{\circ}C$의 물에 오른손 가운데 손가락을 5분 동안 담갔다가, 그 후 25분 동안 상온에서 휴식을 가지고, 그 다음 무작위로 물 온도 5, 8, 11, 14, 또는 $17^{\circ}C$ 중 하나에 손가락을 담갔다. 한 과정이 끝나면 다른 수온에서 같은 방식으로 실험이 진행되었다. 재발현 반응을 평가하기 위해 첫 실험 후 최소 5일 후에 같은 방법으로 두 번째 실험이 진행되었다. 실험 중 심박수, 직장온도, 손톱주위온도가 매 6초마다 측정되었다. 결론적으로 재현성에는 최대손가락온도(Tfmax)와 Tfmax-물온도(Tw)에서 재생산 반응을 보였다. 추위자극에 따른 CIVD의 반응은 추위자극이 높을수록 최소손가락온도(Tfmin)와 Tfmax의 반응은 높게 나타났으며, 추위자극이 낮을수록 Tfdiff의 반응은 증가되었다. 그러나 모든 반응시간에는 유의한 차이는 보이지 않았다.

• 보존과학연구
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• 통권7호
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• pp.278-291
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• 1986

In this report the practical case of Viking ship's conservation in Denmarke specially among the Eurpoean nations is introduced. The contents of it are summarized as follows :From 1957 to 1962 the Danish National Museum Salvaged five Viking ships from the bottom of Roskilde Fjord, Which were composed of the pieces of timber whose surface was soft because they had lain on the sea bed for about a thousand years. Excavation had been carried out in the same way as in the field by driving down a sheet piling around the wrecks and pumping the water out. These pieces of the wreck ships were packed in airtight plastic bags one by one to be transported for Brede and then immidiately had to go through the treatment for conservation. The conservation treatment process for the pieces includes three steps ; the preliminary process prior to the hardening treatment, the hardening and the assemble of the ships. In the first step ; the preliminary process, all remains of mud and shells from the fjord bed are washed off, and measuring followed ; every single piece of wreckage was drawn so that the form and size of the piece, nail holes, and breaks were registered before conservation. In the second ; the hardening treatment step, the pieces of the woreckage were filled with P.E.G. This Polyethylene Glycol method was the best to handle in the subsequent mounting of the ships in the museum. In the final, the Glycol-treated pieces were pieced together to spips with support of a system of reinforcements. They were to fit in place after corrections of the form were made several times.