만성 발목 불안정성, 코퍼, 건강 대조군의 발목 느슨함, 자가 발목 기능, 인지적 불안정성 분석

이홍석 ( Hongsuk Lee ),김현수 ( Hyunsoo Kim ),타이홉킨스 ( Ty Hopkins ),손성준 ( S. Jun Son ) 한국운동생리학회(구 한국운동과학회) 2021 운동과학 Vol.30 No.1

PURPOSE: This study aimed to identify differences in ankle laxity in chronic ankle instability (CAI), coper, and control groups, and a correlation between ankle laxity, self-reported function, and perceived instability. METHODS: Sixty-six participants (22 CAI patients, 22 copers, and 22 controls) selected by recommendations of the International Ankle Consortium volunteered for this study. Foot and Ankle Ability Measure Activities of Daily Living (FAAM-ADL), FAAM-Sports, and Ankle Instability Instrument (AII) were used to assess participants’ self-reported function and perceived instability. The FAAM-ADL and FAAM-Sports are reported as a percentage. Higher scores indicate better function. The AII is reported as “yes” responses while more “yes” responses indicate higher instability. Three trials of anterior/posterior (A/P) displacement and inversion/eversion (I/E) displacement were assessed by an instrumented ankle arthrometer. Greater displacement indicates higher laxity. The ankle positioned in sagittal- and frontal-plane neutral while A/P and I/E displacement were assessed with 125 N and 4 N-m, respectively. The means of three trials were used for data analysis. One-way ANOVA and Tukey post-hoc comparisons (α=0.05) were performed to identify differences in ankle laxity between groups. Pearson correlation analysis was performed to identify a relationship between ankle laxity, self-reported function, and perceived instability. RESULTS: CAI patients show greater A/P displacement compared to control group (p<.03), and greater I/E displacement compared to coper and control groups (p<.03). Several positive and negative correlations were found between ankle laxity, self-reported function, and perceived instability (p<.00). CONCLUSIONS: As self-reported function and perceived instability are correlated with greater laxity (I/E displacement), improving static stability (ankle laxity) may play an important role in improving perceived ankle function and instability in CAI.

정상인과 퇴행성 아래 눈꺼풀 속말림 및 눈물 흘림 환자에서 안쪽, 가쪽 눈구석 인대 이완의 측정

이태은,이화,이종미,백세현,Tae Eun Lee,Hwa Lee,Jongmi Lee,Sehyun Baek 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: The degree of laxity of the medial and lateral canthal tendon in Korean subjects with and without involutional entropion and epiphora was evaluated in the present study. Methods: The present study included 180 normal subjects (360 eyes), 12 patients (15 eyes) with involutional entropion, and 41 patients (58 eyes) with epiphora. The degree of laxity of the medial and lateral canthal tendon, which grades the position of the inferior punctum, was measured using the lateral and medial distraction test. Results: The mean degree of medial and lateral canthal tendon laxity was 1.83/1.08 in normal subjects. A statistical difference was not observed between sexes, and the mean degree of laxity tended to be higher in older patients. The mean degree of laxity was 2.78/2.18 and 2.28/1.22 in the involutional entropion group and the epiphora group, respectively. The involutional entropion group and the epiphora group underwent endoscopic endonasal dacryocystitis (D), medial spindle procedure (M), and endoscopic endonasal dacryocystitis with the medial spindle procedure and/or the tarsal strip procedure (T). The mean degree of laxity was 1.84/1.04 in group D, 3.00/1.20 in group M, 2.33/2.00 in group D + T, 3.20/1.40 in group D + M and 3.50/2.00 in group D + T + M before surgery. Conclusions: The results from the present study may aid in the selection of a basic treatment plan for Korean patients with involutional entropion or epiphora. J Korean Ophthalmol Soc 2011;52(12):1385-1390

관절이완성 및 무릎관절 정렬이상 발생율의 성차와 운동경험의 관계

석원향(Tohru Ishigaki),김준동(Jun Dong Kim) 한국발육발달학회 2009 한국발육발달학회지 Vol.17 No.4

The present study was to investigate the relationships between exercise experience and, joint laxity and lower extremity alignment. Participants were 916 university students (Male: 200, Female: 716). They divided into three groups according with their exercise experiences: none-exercise experience group (NEE), exercise experience until junior high school group (JH) and exercise experience until high school group (H). Anthropometric parameters were height, weight and percentage of body fat. back strength, sit-ups and standing trunk flexion were measured. General joints laxity test (7 items) and lower extremity alignment test were executed. As a result, general joints laxity score in female student is significantly higher than that of male. In contrary, prevalence rate of malalignment in male was higher than that of female. In both gender, physical fitness level of H was significantly higher than that of NEE. Joint laxity points of female exercise experience groups were higher than those of NEE and those parts were spine and hip joints. In female, exercise during school age probably increase magnitude of joint laxity. However, there is not clearly relationship between joint pain in the future and joint laxity and malalignment in ypung age.

하안검 이완이 건성안 치료에 미치는 영향

한재욱,임혜빈,이나영,Jae Wook Han,MD,Hye Bin Yim,MD,PhD,Na Young Lee,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.9

Purpose: To compare the response of dry eye treatment in patients divided by the degree of lower lid laxity. Methods: Thirty patients were classified into three groups - normal, moderate and severe, according to the degree of lower lid laxity. Tear break-up time (TBUT), Schirmer test (ST), ocular surface disease index (OSDI) scores and changes in OSDI score in each group were compared before and at 3 months after the treatment. Results: TBUT, ST and OSDI scores were not different among the three groups at baseline. TBUT improved to 6.60 ± 1.43, 6.0 ± 2.54 and 6.0 ± 1.45 sec in normal, moderate and severe lower lid laxity group, respectively at 3 months after the treatment and no difference among the groups was found. ST scores did not increase after the treatment, while OSDI scores improved to 12.20 ± 1.40, 16.10 ± 4.63 and 20.80 ± 4.52 in each group, respectively and they were significantly different (<EM>p</EM> = 0.029, 0.029, <0.001, respectively). The response to the dry eye treatment as assessed by changes in OSDI scores was poorer in patients in the severe lower lid laxity group (<EM>p</EM> = 0.019 vs. moderate laxity group, <0.01 vs. normal group). Conclusions: As the degree of lower lid laxity increases, the response to dry eye treatment becomes poorer even when TBUT increases. J Korean Ophthalmol Soc 2014;55(9):1307-1312

안면주름과 안면이완 개선을 위한 매선요법 시술 방법 고찰과 제안

윤영희,김태열,임태정,황용호,최인화,Yun, Young-Hee,Kim, Tae-Yeol,Lim, Tae-Jung,Hwang, Yong-Ho,Choi, In-Hwa 대한한방안이비인후피부과학회 2015 한방안이비인후피부과학회지 Vol.28 No.1

Objective : Thread embedding acupuncture has become popular as a minimally invasive treatment for facial wrinkles and laxity. However, there is little published clinical practice guidelines. This study is to developing a specific procedure of thread embedding acupuncture for facial wrinkles and laxity. Method : We reviewed and summarized 6 studies on thread embedding acupuncture for facial wrinkles and laxity. And, four practitioners who have more than four year of clinical experience and one hundred of cases were participated in developing a thread embedding acupuncture procedure for facial wrinkles and laxity. Result and conclusion : We developed a thread embedding acupuncture procedure for facial wrinkles and laxity which consists of correction of lower jaw, facial laxity, nasolabial fold and eye wrinkles.

고주파와 근적외선 병합요법을 이용한 피부 이완과 얼굴 주름의 치료

조희령 ( Hee Ryung Cho ),유박린 ( Bark Lynn Lew ),최봉근 ( Bong Keun Choi ),김낙인 ( Nack In Kim ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.4

Background: A device using radiofrequency and infrared has been used as a nonablative method for producing noninvasive skin tightening. However, the method combining radiofrequency and infrared light has not been used widely for treating both skin wrinkling and tightening. Objective: To investigate the efficacy of a new nonablative Korean medical device, AntiLaxTM (Jeisys Medical, Seoul, Korea), which uses both radiofrequency and infrared light, on facial wrinkling and laxity. Methods: Thirty-three patients with facial laxity and wrinkles were enrolled in this study. Three patients failed to complete the three treatment sessions spaced 4 weeks apart so, ultimately, 30 patients completed the scheduled procedure. Serial photographs of the patients were obtained during the study period. A final clinical assessment was made 3 months after the last treatment. Punch biopsies of the treatment areas were obtained 1 week before treatment and 1 month after the last treatment in five patients who agreed to undergo skin biopsies. Results: Doctors` assessments of the photographs taken before and 3 months after the treatment observed marked differences in the effect of treatment on skin laxity, according to location, but no differences in the effect of treatment on skin wrinkling, according to location. The efficacy of treatment of both skin laxity and wrinkling increased with the number of treatments. Patient satisfaction scores paralleled the clinical improvements observed. Secondary benefits reported by patients 3 months after treatment included decreased pore size, reduced sebum secretion, and improved skin texture. The side effects were mild and limited to transient erythema, edema, and rare vesicle formation. Histopathologically, there were increased, thickened collagen fibers 1 month after the last treatment, as compared to pretreatment. However, quantitative morphometric methods are needed to evaluate the histological changes objectively. Conclusion: Noninvasive radiofrequency combined with infrared light appears to be a safe, effective method for treating skin laxity and facial wrinkles. (Korean J Dermatol 2008;46(4):480~486)

퇴행성 눈꺼풀속말림의 수술방법에 따른 치료결과 분석

윤재문,김선아,노주헌.Jae Moon Yoon. M.D.. Sun A Kim. M.D.. Joo Heon Roh. M.D.. Ph.D 대한안과학회 2008 대한안과학회지 Vol.49 No.12

Purpose: To evaluate the long-term effectiveness of different surgical procedures according to horizontal eyelid laxity in correcting involutional entropion. Methods: This retrospective study reviewed 104 eyes of 79 patients with involutional lower eyelid entropion who underwent surgical repair. The 62 eyes with horizontal eyelid laxity were classified as group I. In 17 eyes of group I, we performed the lateral tarsal strip procedure alone (group Ia), while in 45 eyes of group I, we performed the lateral tarsal procedure and Quickert suture (group Ib). The 42 eyes without horizontal eyelid laxity were classified as group II. In 13 eyes of group II, we performed a lower eyelid retractor reinsertion procedure only (group IIa), and in 29 eyes of group II, we performed combined lower eyelid retractor reinsertion and orbicularis resection (group IIb). Results: The recurrence rate in these four surgical subsets (group Ia , group Ib, group IIa, group IIb) was 11.7%, 0%, 15.4%, and 6.9%, respectively, with an average follow-up of 11 months. Six recurrent eyelids and two overcorrected eyelids successfully underwent procedures to correct recurrent entropion and ectropion, respectively. Conclusions: The lateral tarsal strip procedure is an effective approach for achieving long-lasting correction of involutional entropion with horizontal eyelid laxity, whereas the lower eyelid retractor reinsertion procedure is an effective approach for achieving long-lasting correction for involutional entropion without horizontal eyelid laxity. Use of the Quickert suture reduced the need to repeat the lateral tarsal strip procedure and additional orbicularis resection decreased the need to repeat the lower eyelid retractor reinsertion procedure. J Korean Ophthalmol Soc 2008;49(12):1877-1887

Improvement of Infraorbital Laxity and Wrinkles by Combined Use of Microfocused Ultrasound and Absorbable Polydioxanone Threads in a Post-Blepharoplasty Patient

Nark-Kyoung Rho,Sung Tae Chung 대한의학레이저학회 2018 MEDICAL LASERS Vol.7 No.1

There are limitations to the conventional transconjunctival lower orbital fat removal surgery in subjects with severe infraorbital laxity. This may be because the reduction of orbital fat volume does not provide sufficient improvement of age-related skin laxity and wrinkles. Post-surgical adjuvant non-surgical procedures may be required in this subset of patients. This case report describes a successful infraorbital rejuvenation using an approach that combined microfocused ultrasound and absorbable thread in an old post-blepharoplasty patient whose surgical outcome was not satisfactory.

아래눈꺼풀 이완이 있는 기능적 눈물길폐쇄 환자에서 가쪽눈꺼풀판띠고정술의 효과

우정민,신동민,박정민,안희배,Jung Min Woo,Dong Min Shin,Jung Min Park,Hee Bae Ahn 대한안과학회 2006 대한안과학회지 Vol.47 No.9

Purpose: To evaluate the effects of the lateral tarsal strip procedure in the treatment of lacrimal pump dysfunction related to lower lid laxity. Methods: This study investigated 46 eyes of 35 patients diagnosed with dysfunction of the lacrimal pump on which the lateral tarsal strip procedure was performed between June 2001 and February 2004. We retrospectively reviewed patients’ medical records for information including age, gender, history, follow-up period, change of fluorescein dye disappearance test (DDT), tear meniscus height (TMH), symptoms, and complications. Results: Improvement of tearing was noted in 26 patients (78.8%). Thirty-seven eyes (80.5%) were improved by more than 1 grade on DDT. Significant improvement above 2 grades was observed in 16 eyes (34.7%). With respect to age, 62.5% of 3rd-decade patients improved most effectively by more than 2 grades on DDT. Postoperative TMH compared with preoperative TMH measures were significantly lower according to statistics. The most common complication was discomfort or tenderness over the orbital rim (13.0%). Conclusions: Performance of the lateral tarsal strip procedure for tearing caused by dysfunction of the lacrimal pump and related to lower lid laxity improved patients’ tearing, DDT and TMH status. We therefore expect the lateral tarsal strip procedure to be effective in the surgical treatment of lacrimal pump dysfunction secondary to lower eyelid laxity.

전신적 인대 이완성을 동반한 소아에서 편평외반족의 수술적 치료

황보현(Bo-Hyun Hwang),이기석(Ki-Seok Lee),김현우(Hyun-Woo Kim) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.5

목적: 전신적 인대 이완성이 동반된 소아의 편평외반족은 일반적으로 유연성이고 무증상이지만 일부에서 중증의 변형 및 기능 장애를 보인다. 본 연구의 목적은 전신적 인대 이완성 및 기능적 문제가 동반된 소아의 편평외반족에 대해 수술 후 임상적, 방사선, 족저압력 검사 결과를 분석하는 것이다. 대상 및 방법: 종골 연장술 또는 거골하 관절외 유합술을 받은 24명의 환자, 42예의 족부를 대상으로 후향적 분석을 시행하였다. 수술 시 평균 연령은 10.5세(6-15.6세), 평균 추시 기간은 51개월(18-92개월)이었다. Oxford Ankle Foot Questionnaire, AOFAS 점수 및 Mosca criteria를 이용한 임상적 평가, 족부 방사선 사진, 그리고 족저압력 검사를 이용하여 수술 전후의 결과를 비교하였다. 결과: 총 42예의 족부 중 3예를 제외하고 수술 후 우수한 임상적 결과를 보였으며, 일상 활동에 지대한 제한을 주는 경우는 없었다. 방사선 검사는 모든 평가 항목에서 수술 후 의미 있는 호전을 보였다. 족저 압력 검사상 relative vertical impulse와 peak pressure 모두 수술 후 내측은 감소하고 외측이 증가하는 소견을 보이며, 압력 중심은 내측에서 외측으로 이동하는 양상을 보였다. 결론: 전신적 인대 이완성을 동반한 소이의 편평외반족에 대해 종골 연장술 또는 거골하 관절외 유합술은 단기-중기 추사상 동통의 감소, 기능적 정해의 개선 및 해부학적인 변형의 교정에 우수한 결과를 보였다. 하지만 골격 성장 및 이완성의 변화에 따른 결과 및 술식의 후기 합병증에 대해 장기적 추시기 필요하겠다. Purpose: Planovalgus deformity in children with generalized ligamentous laxity is usually asymptomatic, but it sometimes causes severe deformity and functional problems The aim of this study was to evaluate, post-operatively, functional outcomes, plantar pressure and radiographic results of symptomatic planovalgus with generalized ligamentous laxity. Materials and Methods: This retrospective study included a total of 42 feet of 24 patients that had undergone a calcaneal lengthening osteotomy or an extra-articular subtalar arthrodesis. The mean age of the patients at the time of the index operation was 10.5 years (range, 6-15.6 years). and the mean duration of follow-up was 51 months (range, 18-92 months) Patients were evaluated clinically and radiographically using the Oxford Ankle Foot Questionnaire, AOFAS score, Mosca criteria, standard radiographs and dynamic pedobarographs. Results: Functional outcomes at the latest available follow-up were excellent except for three feet. No foot had a significant limitation affecting the patient's daily activities. Both surgical treatments improved radiographic parameters The parameters of dynamic pedobarographs, including the relative vertical impulse and the peak pressure, decreased for the medial aspect of the forefoot and midfoot, while they increased for the lateral aspect of the forefoot. midfoot and calcaneus after surgical treatment. The change in the center of pressure indicated a significant lateral shift in the weight-bearing surface of the foot. Conclusion: Calcaneal lengthening osteotomy and extra-articular subtalar arthrodesis appear to be effective means for pain relief and clinical improvement in children with symptomatic planovalgus deformity and generalized ligamentous laxity Further followup evaluation is needed to obtain long-term clinical and radiographic results with regard to skeletal maturation and changes in generalized ligamentous laxity.