• Archives of Plastic Surgery
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• v.37 no.2
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• pp.178-181
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• 2010

Purpose: Retronychia is the embedding of the nail into proximal nail fold. Retronychia starts with disruption of the longitudinal growth of the nail. With the growth of a new nail, the old one is pushed upwards and backwards. This leads to embedding of the top nail into the ventral aspect of the proximal nail fold and results with chronic paronychia. We present a case of retronychia that was rarely reported in the literature. Methods: A 46-year old female presented with a 3-month history of painful right first, 2nd, 3rd toenail changes. Although she was initially treated with broad spectrum antibiotics, she did not response to therapy. Later, she presented to our department because of progressively worsening pain that impaired her walking. Physical examination revealed with proximal nail fold erythema, painful swelling, yellowish nail discoloration, and distal onycholysis. Bacterial and fungus culture showed no organism. Treatment was surgical nail avulsion under local anesthesia. Results: The postoperative course was uneventful. 10 months later, the patient had a normal growing nail and was free of symptoms. Conclusion: We report a case of retronychia on toenail. Retronychia is a proximal nail plate ingrowth into the proximal nail fold which is associated with multiple generations of nail plate misaligned beneath the proximal nail. Management consisted of simple avulsion of superimposed nail. Retronychia is suspected with a persistent paronychia, particularly in the setting of trauma. Avulsion of the top nail confirms the diagnosis and may be curative if the underlying nail appears healthy.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1036-1041
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• 1999

Background: To know the clinical aspects of varicose vein and the effectiveness of operative treatment, the patients who had been operated during the five and a half years were reviewed. Material and Method: From September 1993 to February 1999, 227 patients with varicose vein were operated upon. These patients were reviewed with history taking, physical examination, laboratory tests, operation and follow up visits at an out patient department. Result: The ages of the patients were from 20 to 69 years, mean 40.2 years. varicose veins. Occupations of the patients include housewives, store or factory owners, cooks, waiter or waitresses in a restaurant, salary men(women), teachers, hair stylists, professional athletes, in sequence, most of them require standing all day long. The 126 women had experienced child birth, among them 116 patients delivered more than 2 babies. All patients had protruding leg veins as the symptom. Most of them(61%) had pain. Other additional symptoms were heaviness, heatness, tingling, cramp, fatigue, etc. 68.3% of the patients had the symptoms for more than 10 years. Anatomical location of varicose vein was in long saphenous vein in 157 patients, in small saphenous vein in 27, and in other regions(combined or perforating vein) in 43 patients. There was no operative mortality. There were 2 patients who underwent reoperation due to recurrence during this study period. In one patient, it recurred in the distal perforating vein in small saphenous vein. The other patient had recurrence at the saphenofemoral junction in groin. The patients are doing well after the reoperation, but a long term observation is needed. Conclusion: Clinical aspects of varicose vein were reviewed. For the patients with varicose vein who had saphenofemoral regurgitation, operative treatment seemed to bea safe and effective modality of treatment.

• The Journal of Korean Medicine
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• v.16 no.1 s.29
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• pp.21-35
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• 1995

The female's part-cold hypersensitivity syndrome is a disease which the oriental people better than the western people suffer from and if it would be sick for a long time, it could bring into the other diseases. In the Oriental Medicine, the coldness is regarded as one of the most important causes which induce female's diseases. Nowadays the number of the female patients are ascending that serously appeal the coldness-sense and pain-sense at the particular part of the body, for example, hand, foot, abdomen, waist, external genital portion and so on. These are caused by female's own characteristics of the menstration and delivery, and the influence of the circumstances. The Oriental Medicine have better effects by the diagnosis and treatment according per symptom in the contrast with the Western Medicine having difficulties in the point of accurate diagnosis and treatment. This epidemiologic study was undertaken by using specifically designed questionair and physical examination to evaluate the incidence and degree of female's part-cold hypersensitivity syndrome in 362 parous women, Who were randomly selected among the patients visiting the Department of Gynecology, Kyung Hee Medical Center from Feb. to Jul. 1995. The results were as follows: 1. The overall incident of female's part-cold hypersensitivity syndrome was 92.8%. 2. Subdivision of 336 patients was made according to severity Grade I - 31.9%, severity Grade II - 46.9%, severity Grade III - 21.4%. 3. As for the appealed portion of female's part-cold hypersensitivity syndrome, foot and hand, lower abdomen, knee, waist, hip, shoulder, leg, and ankle were in desending order. 4. As for the causes of female's part-cold hypersensitivity syndrome, it was deeply associated with the management of the abortion, delivery and puerperium. 5. The incidence of female's part-cold hypersensitivity syndrome did not show incerased tenency according to the quantity and quality of female's menstration, leukorrhea, and the increase of parity. 6. 165 patients among 336 patients wanted the treatments of the Oriental Medicine.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.642-646
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• 2001

A 12-years-old female admitted to the hospital with the complaint of pain on the right upper chest area which persisted about 1 month prior to admission. $Caf{\acute{e}}$-au-lait spots of various size laying on a whole body and freckling on the axilla were found on physical examination. A huge mass was found on the plain chest X-ray and on chest MRI. The mass encroached thoracic spine, posterior rib, back muscles, and then into the neural canal and compressed thoracic spinal cord. On the 5th day of hospitalization, the patient complained tingling on the both legs and 2 days later, monoparesis on the right leg. Open thoracotomy and decompressive laminectomy was done to remove mass. Pathologic reports confirmed rhabdomyosarcoma, embryonal type.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.344-349
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• 2005

Objective : The Bertrand's method of selective peripheral denervation for spasmodic torticollis has already been established as being an effective and safe method. However, such effectiveness has not yet been established in Korea. The authors have performed several cases of selective denervation for the treatment of spasmodic torticollis and we hereby describe the details of the operative method to determine the effectiveness of the method. Methods : Ten patients who had the selective denervation for the spasmodic torticollis from October 1997 to December 2003, were analyzed. There were 4 rotational and 6 combined types [3 rotational plus retrocollis, 3 rotational plus laterocollis]. We performed preoperative electromyograms and neck muscle tonograms in all cases. The technique was used to involve denervation of the ipsilateral posterior paraspinal muscles. Denervation of the sternocleidomastoid muscle was performed on the contralateral side for rotational torticollis and on the ipsilateral side for laterocollis combined type. The surgery was followed by a rigorous physical therapy program. Results : The surgical results were divided into 4 groups labeled excellent, good, fair, and poor. There were 5 excellent patients who showed no detectable abnormal movements, 4 good patients who showed slight residual deviations or slight residual abnormal movements, and 1 fair patient with appreciable residual abnormal movements. Postoperative pain was well tolerated. There was no significant surgical complications. Conclusion : The study confirms that selective peripheral denervation for the treatment of spasmodic torticollis is a very useful and safe surgical technique.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.183-188
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• 2013

Objective : The aim of this study is to assess outcomes during first one year for patients with severe motor weakness caused by lumbar disc herniation that underwent surgical or nonsurgical treatment. Methods : The 46 patients with motor weakness because of lumbar disc herniation who were treated at neurosurgical department and rehabilitation in our hospital from 2006 to 2010, retrospectively. Each group had 26 surgical treatments and 20 conservative treatments. We followed up 1, 3, 6 months and 12 month and monitored a Visual Analogue rating Scale (VAS) of back and leg pain, Oswestry Disability Index (ODI) and degree of motor weakness. We analyzed the differences between surgical and nonsurgical groups using Mann-Whitney U test and repeat measure ANOVA in each follow-up periods. Results : In the recovery of motor weakness, surgical treatment uncovered a rapid functional recovery in the early periods (p=0.003) and no difference between groups at the end of follow-up period was found (p>0.05). In VAS of back and leg, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). In ODI, the interaction between time and group was not found (p>0.05) and there was no difference between groups (p>0.05). Conclusion : Surgical treatment for motor weakness caused by herniated intervertebral disc resulted in a rapid recovery in the short-term period, especially 1 month. We think early and proper surgical treatment in a case of motor weakness from disc herniation could be a good way for providing a chance for rapid alleviation.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.15 no.3
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• pp.223-234
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• 2011

Objectives: This study shows feasibility and suitability of a microelectromechanical system inertial measurement unit(MEMS-IMU) as a helpful measurement device for evaluating movement system impairment syndrome. Methods: We reviewed articles of two fields in this study. First, we reviewed articles about movement system impairment syndrome(MSIS) as a brand new viewpoint of diagnosing and treating musculoskeletal pain. Second, we reviewed articles about conventional motion analysis system and inertial measurement unit(IMU) to show the superiority of IMU in analyzing the human movement. All papers were searched by SciVerse, world largest search engine and database about many academic fields including engineering and medicine. Results: Some physical quantities of human motions can be useful to the diagnosis of MSIS, and those data can be obtained by the MEMS-IMU without the weak points of the conventional motion analysis systems. Conclusions: Using MEMS-IMU as a measurement unit for diagnosing and evaluating MSIS is feasible and can be extended to many further studies.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.231-240
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• 2005

Objectives: In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo­controlled, randomized clinical trial of patients with osteoarthritis of the knee was undertaken. Methods: Data were obtained from 80 patients with OA of the knee. After enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transaminase (ALT) level, blood mea nitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results: The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions: Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.263-269
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• 2006

Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.615-618
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• 2008

Purpose: Pyoderma gangrenosum is a rare cutaneous ulcerative disease. First described in 1930, the condition is characterized by progressive ulceration with deeply undermined purple-red edge. The lower extremities are most commonly affected but other parts of the skin and mucous membranes may also be involved. Although medical treatments with topical wound therapy are commonly used, surgical intervention is still controversial. In this paper, we report an atypical case of pyoderma gangrenosum which was characterized by extensive soft tissue breakdown. Methods: A 27-year-old male patient was referred to our institution with a $7{\times}8cm$ sized deeply undermined ulceration with pus-like discharge and fever. Incision and drainage was performed at another clinic 3 days prior to admission to our institution. After a thorough physical examination and the MRI review, a diagnosis of necrotizing faciitis was made. Accordingly, fasciotomy and debridement was performed. However, the wound enlarged progressively and the patient remained highly febrile for 9 days after the treatment. Septic screening did not reveal any occult infection. After a secondary review of the case, the initial diagnosis of necrotizing fasciitis was rejected and changed to pyoderma gangrenosum. With the use of dexamethasone intravenously, the wound improved dramatically and the fever was eliminated. Steroid mediation was tapered with duration of 1 month. The wound was stabilized and subsequently covered with split-thickness skin graft. Results: Split-thickness skin grafting with 1 : 1.5 mesh was successfully taken. Conclusion: Initial clinical features of pyoderma gangrenosum are very similar to that of necrotizing fasciitis. High fever and progressive ulceration with severe pain could invite earlier surgical approach. The advancing wound margins (the well defined violaceous, undermined border and necrotic ulcer base) and lack of isolation of pathogenic organism was used to make the correct diagnosis of pyoderma gangrenosum. We achieved a good result with proper medication and split-thickness skin graft.