• Title/Summary/Keyword: laxity

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Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction (만성 족관절 외측 불안정성의 수술적 치료: 봉합술과 재건술의 비교)

  • Kim, Keun Soo;Park, Young Uk
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.1-5
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    • 2019
  • Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

Comparison of postoperative pain according to the harvesting method used in hair restorative surgery

  • Kim, Yang Seok;Na, Young Cheon;Park, Jae Hyun
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.241-247
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    • 2019
  • Background Postoperative pain is one of the most common concerns of patients undergoing hair transplantation surgery. Because most patients are satisfied with the cosmetic improvement after transplantation, amelioration of postoperative pain would help to increase patient accessibility to hair restorative surgery and greatly impact patient satisfaction with the final cosmetic results. This study was performed to investigate postoperative pain after hair transplantation. Methods In total, 241 patients (202 who underwent follicular unit transplantation [FUT] and 39 who underwent follicular unit extraction [FUE]) were eligible for the study. Postoperative pain was evaluated on postoperative days 1, 2, 3, 4, 5, and 7 using the Wong-Baker Faces Pain Scale. The patients' medical records were retrospectively reviewed for information on the harvesting method, number of transplanted grafts, size of donor design, and laxity, elasticity, and glidability of the scalp in relation to postoperative pain. Results Postoperative pain after hair transplantation, assessed with the Wong-Baker Faces Pain Scale, seemed to provide very subjective results. None of the variables were correlated with postoperative pain in the FUT group. Such pain, however, tended to disappear by postoperative day 3. Patients in the FUE group experienced significantly less severe pain than those in the FUT group. Conclusions Postoperative pain was significantly less severe in patients whose donor hair was harvested by the FUE than FUT method. Postoperative pain had almost disappeared by postoperative day 3 in the FUT group, whereas only minimal pain was present even on postoperative day 1 in the FUE group.

Youth throwing athletes do not show bilateral differences in medial elbow width or flexor tendon thickness

  • Morrow, Rudolph M.;McIlvian, Gary E.;Johnson, Jenifer;Timmons, Mark K.
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.188-194
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    • 2022
  • Background: Medial elbow laxity develops in throwing athletes due to valgus forces. Medial elbow instability in professional, collegiate, and high school athletes is well documented; however, the medial elbow of young throwing athletes has received less attention. This study investigated the medial elbow and common flexor tendon during applied elbow valgus stress of youth baseball players. Methods: The study included 15 participants. The medial elbow width and thickness of the common flexor tendon were measured on ultrasound images. Results: No significant side differences in medial elbow width or common flexor tendon were found at rest or under applied valgus stress. At rest, the medial elbow joint width was 3.34±0.94 mm on the dominant side and 3.42±0.86 mm on the non-dominant side. The dominant side increased to 3.83±1.02 mm with applied valgus stress, and the non-dominant side increased to 3.96±1.04 mm. The mean flexor tendon thickness was 3.89±0.63 mm on the dominant side and 4.02±0.70 mm on the non-dominant side. Conclusions: These findings differ from similar studies in older throwing athletes, likely because of the lack of accumulated stress on the medial elbow of youth throwing athletes. Maintaining elbow stability in young throwing athletes is a vital step to preventing injury later in their careers.

Dual Mobility Cup for Revision of Dislocation of a Hip Prosthesis in a Dog with Chronic Hip Dislocation

  • Jaemin Jeong;Haebeom Lee
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.390-394
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    • 2022
  • A 6-year-old, 36.5 kg castrated male Golden Retriever presented for revision surgery for left total hip replacement. The patient underwent removal of the cup and head implants due to unmanageable prosthetic hip dislocation, despite revision surgery. On physical examination, the dog showed persistent weight-bearing lameness after exercise of the left hindlimb with mild muscle atrophy. Radiographic examination revealed dorsolateral displacement of the femur with a remnant stem and bony proliferation around the cranial and caudal acetabulum rims. The surgical plan was to apply the dual mobility cup to increase the range of motion and jump distance to correct soft tissue elongation and laxity caused by a prolonged period of craniodorsal dislocation of the femur. The preparation of the acetabulum for cup fixation was performed with a 29-mm reamer, and the 29.5-mm outer shell was fixed with five 2.4-mm cortical screws. The head and medium neck of the dual-mobility system were placed on the cup, and the hip joint was reduced between the neck and stem. The dog exhibited slight weight bearing on a controlled leash walk the day after surgery. The patient was discharged 2 weeks postoperatively without any complications. Six months postoperatively, osseointegration and a well-positioned cup implant were observed, and the dog showed excellent limb function without hip dislocation until 18 months of phone call follow-up.

Self Sustainable Win-Win Growth Model for Korea Franchise Corporate Sustainability (한국 프랜차이즈 지속가능경영을 위한 자생적 동반성장 모형)

  • Kim, Insook;Lee, Sang-Seub
    • The Korean Journal of Franchise Management
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    • v.9 no.1
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    • pp.7-15
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    • 2018
  • Purpose - The purpose of this study was to establish self sustainable win-win growth model for Korea franchise corporate sustainability and to suggest theoretical and practical implications for franchise management. Research design, data, and methodology - This study is based on literature review methodology. Result - The study suggested the ways of self sustainable win-win growth model for Korea franchise corporate sustainability. First, franchiors should strengthen requisite & specify in the contract, share information & strengthen transparency, and establish win-win management support system for control & autonomy balance. Second, franchises should develop CEO management competency & employee work competency, and establish recognition for Intellectual Property Rights Use. Third, franchisors and franchises should implement contract sincerely, strengthen Organizational Citizenship Behavior, and solve moral laxity. Forth, franchisors and franchises should establish trust and value with communication to make Creating Social Value. Fifth, franchisors and franchises should realize self sustainable social value for corporation and social community. To make this, franchsors and franchise should establish self sustainable win-win growth ecosystem with people, system, culture, innovation. Conclusions - First, Franchisors and franchises should distribute 'Self sustainable win-win growth 2025 for Korea franchise corporate sustainability' and 'Self sustainable win-win growth model for Korea franchise corporate sustainability'. Second, Franchisors and franchises should change their perspective about franchise industry. Third, Franchisors and franchises should develop various training and development plans for franchise industry. Fourth, Franchisors and franchises should establish franchise performance certificate system.

Changes of Internal Labor Market in Firms and Incentives for Investment in Human Resource Developments (기업 내부노동시장 변화와 인적자원개발 투자 유인)

  • Bai, Jin Han
    • Journal of Labour Economics
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    • v.41 no.1
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    • pp.83-124
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    • 2018
  • In this study, with the data of Human Capital Corporate Panel(HCCP) we find that the explaining power of the new hiring rate of experienced regular workers is very strong and statistically significant as a main causal factor to the decreasing trend of investment on education and training for workers in corporates, which means a sign of weakening of the internal labor market. Possibility of wage penalty from switching jobs has been weakened considerably too. The effective alternative policy measures to the weakening or laxity of the internal labor markets and whereby followed reduction in investment on education and training for workers in corporates are construction of social system outside of individual corporates to upbring field-tailored manpower of high quality for young generations and small and medium sized enterprises.

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Arterial Tortuosity Syndrome in a Neonate

  • Kim, Kyung Min;Hur, Sun-Mi;Yoon, Ji Hong;Lee, Eun-Jung;Lee, Jae Young
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.49-52
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    • 2018
  • Arterial tortuosity syndrome (ATS) is a very rare autosomal recessive connective tissue disease characterized by generalized elongation and tortuosity of the medium- to large-sized arteries, and other systemic connective tissue manifestations. To date, this disease entity has not been reported in Korea. We report a case of ATS diagnosed in a neonate who presented with severe elongation and tortuosity of the aorta and its major branches, as well as the intracranial arteries. Additionally, the patient presented with a tortuous dilatation of the inferior vena cava, an aneurysmal dilatation of the extra-hepatic bile ducts, and an inguinal and sliding hiatal hernia. The diagnosis was confirmed using DNA sequencing analysis, and the patient demonstrated a compound heterozygosity for two novel mutations (c.738delG [p.Gln247Serfs*33] and c.362T>C [p.Ile121Thr]) in exon 2 of the SLC2A10 gene. Genetic analysis also confirmed that both parents were heterozygous carriers of the responsible mutations. Owing to such clinical manifestations, ATS is often misdiagnosed as other connective tissue diseases including Loeys-Dietz syndrome, Marfan syndrome, and Ehlers-Danlos syndrome. In patients presenting with a high index of suspicion, thorough clinical evaluation and screening for ATS including computed tomography or magnetic resonance angiography and target gene analysis are necessary for early diagnosis and management.

Treatment of Multidirectional Instability of the Shoulder with Inferior Capsular Shift (하방 관절낭 이동술을 이용한 다방향 견관절 불안정의 치료)

  • Lee Byoung Chang;Chun Churl Hong;Park Seong Kyu
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.79-86
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    • 2000
  • Purpose: We analysed the clinical efficacy of inferior capsular shift operation in multidirectional instability of the shoulder joint in terms of functional aspects and patient's satisfaction Materials and Methods: From July, 1998 to March, 2000, we treated 23 cases of multidirectional instability of the shoulder joint with T-shaped inferior capsular shift and/or Bankart repair. All of them have complained of an experience about frank dislocations. Two of them has a voluntary component. We evaluated them according to complication, function, range of motion, stability and patient's satisfaction with an average follow-up of 15 months(the range of 9 to 27 months). Results: Eight cases were atraumatic multidirectional instability and coexisting Bankart lesion were present in 15. There was no redislocation, but one case of symptomatic subluxation, 3 cases of transient nerve palsy and 2 cases of feeling of laxity developed. Limitation of motion after surgery was an average of 3.4° in flexion, and 8.5° in external rotation. With Rowe scoring system, the clinical result was excellent or good in 22 cases and poor in one. According to American shoulder and elbow society, pain score improved to 1.4 from 6.1, and stability score also improved to 1.8 from 9.1. Conclusion: In multidirectional shoulder instability, one should pay attention to finding a coexisting Bankart lesion. In that case, adequate capsular volume reduction by using inferior capsular shift as well as repair of Bankart lesion is needed to get a good surgical outcome.

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The Preparation of Mask-pack Sheet Blended with Styela clava tunics and Natural Polymer (미더덕껍질과 천연고분자 혼합물을 이용한 마스크팩시트의 제조방법)

  • Yun, Woobin;Lee, Yechan;Kim, Dasom;Kim, Jieun;Sung, Jieun;Lee, Hyunah;Son, Hongju;Hwang, Daeyoun;Jung, Youngjin
    • Textile Coloration and Finishing
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    • v.29 no.1
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    • pp.45-54
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    • 2017
  • Ultraviolet radiation have much influenced with a deep wrinkles, roughness, laxity of skin damage and pigmentation through oxidative stress and oxidative photo-damage. This study investigates the functional properties of hydrogel facial mask sheets made from agar, Styela clava tunics and Broussonetia papyrifera tunics. The skin of S. clava is covered with a hard cellulose containing glycoprotein, glycosaminoglycan and chondroitin sulfate. B. papyrifera is better known as Paper mulberry. It contains kazinol which serves as a tyrosinase inhibitor and skin whitening agent. The tensile strength of facial mask sheet was measured by universal testing machine, and the water absorption and moisture permeability of facial mask sheet were measured by dryer. Additionally, the DPPH assay and MTT assay were conducted for anti-oxidative activity and cytotoxicity of facial mask sheet. The whitening effect of the facial mask sheet was measured by tyrosinase inhibitor assay. These tests showed that the three ingredients are suitable cosmetic materials. The results reveal that they produce a high quality hydrogel facial mask sheet when the membrane contains 1%(W/V) of agar, 0.1%(W/V) of B. papyrifera tunics and 0.05%(W/V) of S. clava tunics.

Posterior C1-2 Transarticular Screw Fixation without C1-2 Sublaminar Wiring in Atlantoaxial Instability (제 1, 2 경추간 판하철사고정술 없는 후방 경관절 나사못 고정술 및 골유합술)

  • Shin, Yong Hwan;Hwang, Jeong Hyun;Sung, Joo Kyung;Hwang, Sung Kyu;Hamm, In Suk;Park, Yeun Mook;Kim, Seung Lae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1469-1475
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    • 2000
  • Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

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