• Archives of Plastic Surgery
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• v.50 no.6
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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.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.8 no.1
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• pp.16-20
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• 2015

Glomus tumors are rare benign neoplasm commonly found in the subcutaneous layer on nail bed that arises from a neuromyoarterial glomus. Histologically, they are classified into three group; solid glomus tumor, glomangioma, and glomangiomyoma which is the most uncommon. Unlike other type, glomangiomyomas have rarely been described in the nail bed. Although glomus tumors are often diagnosed primarily by their characteristic clinical symptoms, imaging modalities, such as ultrasonography and magnetic resonance imaging can be helpful. We present a rare case of a recurrent subungal glomangiomyoma that diagnosed by ultrasonography and treated with surgical excision.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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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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• v.6 no.4
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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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• v.51 no.2
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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.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.107-112
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• 2004

Purpose: We described our experience with subungual exostosis in the foot for which we used different surgical technique according as location and size of lesion and revealed excellent results. Materials and Methods: We experienced 12 cases of subungual exostosis that were treated surgically and followed them more than one year between October 1995 and July 2003. There were nine females and three males. The average age of patients at surgery was 13.4 years. Duration of symptoms was 20.3 months on average. The lesion involved the hallux in nine cases; eight dorsomedial and one dorsolateral aspect of distal phalangeal bone. It involved the second, the third, and the fifth toe in one each; all central aspect of dorsum of distal phalanx. We used surgical technique that involves approaching the exostosis under the nail to preserve nail coverage for lesion in the hallux. The nails were extracted totally but preserved nail bed as much as possible in other toes. Results were based on appearance of the regenerated nail and presence of recurrence. Excellent results were those in which the nail appeared nearly normal and there was no clinical or radiographic evidence of recurrence. Good results were associated with a minor nail deformity such as ridging, and no evidence of recurrence. Fair results had obvious nail deformity or a minimal asymptomatic recurrence that was discernable only on radiograph. Poor results were associated with a clinically evident symptomatic recurrence. Results: When the lesion involved hallux, there were six excellent and two good results, and one poor result. All cases that involved other toes revealed good results. Conclusion: We suggest that different surgical technique might be applied according as location and size of the lesion to achieve satisfactory results for subungual exostosis in the foot.

• Archives of Plastic Surgery
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• v.42 no.3
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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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• v.36 no.1
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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.

• Aerospace Engineering and Technology
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• v.9 no.1
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• pp.143-150
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• 2010

This study examined the effect of cold water finger immersion at various water temperature on cold-induced vasodilation (CIVD) and its reproducibility to the cold stress. Ten healthy collegiate men ($21.4{\pm}2.5$ yrs, $175.8{\pm}4.1$ cm, $69.6{\pm}7.6$ kg, $11.2{\pm}3.7$ %fat) underwent two tests. At the first test (1ST), subjects immersed their middle fingers at $43^{\circ}C$ water for 5 min followed by a resting at an ambient air for 25 min. Then they immersed the finger at one of the five water temperatures (Tw: 5, 8, 11, 14, or $17^{\circ}C$) at random order for 20 min. Once a testing at one Tw was completed, they immediately repeated the testing procedure for another Tw. The second test(2ND) was performed within a week after 1ST with having an identical procedure of 1ST except the order of Tw. During the test, rectal temperature, finger temperature from middle finger nail bed, and heart rate were measured every six second. In conclusion, maximal finger temperature(Tfmax), and Tfmax minus Tw was highly reproducible in this experiment. Minimal finger temperature (Tfmin) and Tfmax were higher as Tw decreased. And Tfdiff was higher as the colds tress decreased. No differences were found in time variables of temperature responses.

• 보존과학연구
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• s.7
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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.