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원지성 수평반고리관 양성돌발성체위변환성 어지럼증에서 Barbecue 및 변형 Semont 수기법의 조합에 의한 단기치료 효과
정규환,백무진,김용완 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.7
Background and Objectives Benign paroxysmal positional vertigo (BPPV) of horizontal canal shows reversible direction changing positional nystagmus and diverse clinical courses because of the frequent clinical presentation of cupulolithiasis. The aim of this study is to find out the early effect of particle repositioning maneuver (PRM) including the barbecue and the modified Semont in single treatment session for the apogeotropic horizontal canal BPPV. Subjects and Method Thirty-three episodic vertigo patients with direction-changing apogeotropic horizontal nystagmus were enrolled in this study. The patients were initially treated with barbecue rotation and the second PRM was applied 15 minutes after the first PRM. Barbecue rotation was applied when the positional nystagmus was changed its direction to that of geotropic. The modified Semont maneuver or barbecue rotation was randomly applied when nystagmus was not changed. Patients were followed-up 2 or 3 days after the initial visit and the nystagmus was rechecked to determine the single session treatment result. Results The combination of PRMs in a single treatment session was effective in 23 out of 33 (69.7%) patients. An initial barbecue rotation was effective in 17 patients (51.5%); geotropic nystagmus was obtained in 12, and no nystagmus in 5. Eleven out of 16 (68.8%) patients with persistent apogeotropic nystagmus after initial treatment were successfully treated with the second PRM. There was no statistical difference between the second PRMs of the modified Semont maneuver and barbecue rotation (p=1.000). Conclusion The combination of PRMs including barbecue rotation and the modified Se-mont maneuver in a single treatment session showed a comparable success rate as the previously reported studies.
정규환,정재현,안태식,이중섭,조성용,정창욱,이승배,김현회,오승준 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.7
Purpose: To investigate surgical outcomes between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL)groups for a main stone sized 15 to 30 mm and located in the lower-pole calyx. Materials and Methods: Patients who underwent PNL or RIRS for a main stone sized 15 to 30 mm and located in the lower-polecalyx were retrospectively reviewed. Each patient in the RIRS group was matched to one in the PNL group on the basis of calculatedpropensity scores by use of age, sex, body mass index, previous treatment history, stone site, maximum stone size, and stonevolume. We compared perioperative outcomes between the unmatched and matched groups. Results: Patients underwent PNL (n=87, 66.4%) or RIRS (n=44, 33.6%). After matching, 44 patients in each group were included. Mean patient age was 54.4±13.7 years. Perioperative hemoglobin drop was significantly higher and the hospital stay was longer inthe PNL group than in the RIRS group. The operative time was significantly longer in the RIRS group than in the PNL group. Stonefreerates were higher and complications rates were lower in the RIRS group than in the PNL group without statistical significance. The presence of a stone located in the lower-anterior minor calyx was a predictor of stone-free status. Conclusions: RIRS and single-session PNL for patients with a main stone of 15 to 30 mm located in the lower-pole calyx showedcomparable surgical results. However, RIRS can be performed more safely than PNL with less bleeding. Stones in the lower-anteriorminor calyx should be carefully removed during these procedures.
만성 부비동염 환자에서의 비강 내 Helicobacter Pylori집락화에 대한 연구
정규환,동헌종,정승규,김효열,정영준,소윤경 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.2
Background and Objectives:Helicobacter pylori (HP) has been reported to be detected in lower esophagus, palatine tonsil, and adenoid. The object of this study was to investigate the prevalence of HP in the nasal cavity of chronic rhinosinusitis (CRS) patients and compare the results with those of healthy controls. Subjects and Method:43 patients aged 18 to 68 years with CRS who underwent endoscopic sinus surgery and 16 healthy controls aged 24 to 72 years without sinus diseases were enrolled in this study. Tissue samples were collected from nasal polyp or the mucosa of sphenoethmoidal recess. HP infection of nasal cavity was investigated using rapid urease (CLO) test and immunohistochemical (IHC) analysis. GER symptoms and esophagogastroscopic findings were gathered by questionnaire or medical records. Results:HP was detected in nasal cavity by CLO test in 17 of 43 patients (40%) with CRS compared with none of 16 healthy controls (0%) (p=0.003), and 19 of 43 patients (44%) by IHC analysis compared with 2 of 16 healthy controls (13%) (p=0.032). Eleven of 43 patients (26%) were positive in both CLO test and IHC analysis but none of controls (0%) was positive in both two tests (p=0.026). Four of 8 patients (50%) who complained GER specific symptoms were HP positive in both two tests (p=0.033). Conclusion:HP was detected in nasal cavity and it was more prevalent in patients with CRS than healthy controls without sinus diseases. GER may have a positive correlation with the colonization of HP. However, whether HP is a causative agent for CRS or a result of CRS is not known. (Korean J Otolaryngol 2006;49:162-7)