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고영일 ( Young Il Koh ) 대한내과학회 2013 대한내과학회지 Vol.85 No.5
Rhinitis is divided into allergic and non-allergic rhinitis. Non-allergic rhinitis includes inflammatory rhinitis, such as non-allergic rhinitis with eosinophilia syndrome (NARES) and infective rhinitis, and non-inflammatory rhinitis, such as vasomotor rhinitis and idiopathic rhinitis. Allergic rhinitis is diagnosed based on the presence of allergen-specific IgE and the documentation of relationship between the allergen and symptoms in patients with typical rhinitis symptoms, such as rhinorrhea, nasal obstruction, itchiness and/or sneezing. Local allergic rhinitis can be considered for differential diagnosis. Allergic rhinitis should be differentiated from non-allergic rhinitis by using skin prick test, serum specific IgE test, nasal cytology and/or allergen nasal provocation test. Allergic rhinitis should be differentiated from structural nasal diseases, such as septal deviation and nasal polyps. Rhinitis is frequently accompanied by paranasal sinusitis, which should be recognized in clinical practice. Management strategies differ between allergic and nonallergic rhinitis. In addition to pharmacotherapy, allergen avoidance and allergen-specific immunotherapy can be tried in patients with allergic rhinitis. Thus, the exact diagnosis is very important for the effective treatment in allergic rhinitis. The diagnostic tests for allergic rhinitis are reviewed. (Korean J Med 2013,85:452-456)
골다공성 압박골절의 풍선 후만성형술 시 추체의 변형 교정에 영향을 미치는 인자
고영도 ( Young Do Koh ),윤종석 ( Jong Seok Yoon ),김성일 ( Sung Il Kim ) 대한골절학회 2008 대한골절학회지 Vol.21 No.1
목적: 골다공성 압박골절의 풍선 후만성형술 시 추체의 변형 교정에 영향을 미치는 인자를 알아보고자 한다. 대상 및 방법: 골다공성 압박골절로 내원한 환자 중 풍선 후만성형술을 시행한 25예를 대상으로 하였으며 술 전 측와위, 시술 시 복와위 자세, 풍선압력 주입 후, 풍선압력 제거 후, 골시멘트 주입 후의 각각의 단계에 대해 추체 압박 정도와 후만각의 변화에 대해 방사선학적 결과를 분석하였다. 결과: 최초 복와 시, 추체 후만각과 전방 및 중간 추체 높이는 의미 있는 회복을 보였으며, 풍선압력 주입 시 또한 추체 후만각과 전방 및 중간 추체 높이의 의미 있는 회복을 보였다. 풍선압력 제거 시, 전방 및 중간 추체 높이는 유의한 감소를 보였지만, 추체 후만각의 증가는 보이지 않았다. 추체 후방부위는 각 단계에 대해 의미 있는 변화는 보이지 않았다. 최초 복와위 자세에서 풍선압력 제거 후의 변화 정도는 추체의 후만각과 전방 및 중간 추체 높이 모두 유의한 변화는 보이지 않았다. 결론: 골다공성 압박골절에서 풍선 후만성형술 시행 시 추체의 높이와 후만변형은 풍선압력 주입에 의해 회복되나, 풍선압력 제거 시 감소 소견을 보여 최초 복와위 시에 비해 유의한 차이는 보이지 않았다. 따라서, 풍선 후만성형술 시 추체의 후만변형 교정에 가장 큰 영향을 미치는 요소는 복와위 자세에 따른 골절 정복이라고 생각한다. Purpose: To study which factors affect the deformity correction of vertebral body during kyphoplasty procedure. Materials and Methods: 25 osteoporotic vertebral compression fractures were treated with balloon kyphoplasty from October 2006 to May 2007. Lateral radiographs were taken at 5 different stages with preoperative lateral decubitus position, after placing the patient in prone position on an operation table, after inflating balloon, after deflation and removal of the balloon, after inserting the cement. Then we analyzed the compression ratios and kyphotic angles of the vertebral bodies in each stage. Results: Placing the patient in prone position showed significant postural reduction in kyphotic angle and restorement of the anterior and middle body height. The inflation of the balloon demonstrated significant reduction of kyphotic angle and restorement of the anterior and middle body height. After the deflation, anterior and middle body height has decreased significantly. After the deflation, the kyphotic angle and the anterior and middle body heights were not restored signigicantly compared with those of initial prone position. Conclusion: Vertebral height and kyphotic angle were partially recovered by inflating the balloon, but the correction was lost after deflating the balloon. Statistically, the body deformity was not restored significantly after deflating the balloon compared with that of intraoperative prone position. Therefore, we concluded that, in kyphoplasty of osteoporotic compression fractures, the postural reduction is the most important factor in deformity correction of fractured vertebral bodies.
고영도 ( Young Do Koh ),정훈 ( Hoon Jeong ),권영삼 ( Young Sam Kwon ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.1
Purpose: We report the radiologic and the clinical results for surgical treatment of calcaneal fractures involving the subtalar joint. Methods: We evaluated the findings of radiographs and computed tomographs of 39 patients (40 cases) with intra-articular calcaneal fractures. The fractures were treated with open reduction via an extended lateral approach and internal fixation using a plate. We assessed the radiologic results, such as the Bohler angle, the Gissane angle, and the height/width ratio. We assessed the clinical results based on the critieria of Salama et al. Results: According to the Essex-Lopresti classification, 9 cases were classified as tongue type and 31 cases as joint depression type. According to the Sanders classification, 10 cases were classified as type IIA, 4 cases as IIB, 16 cases as IIIAB, 4 cases as IIIAC, and 6 cases as type IV. The mean preoperative Bohler angle was 7.7, the mean postoperative Bohler angle was 21.1, and the mean last follow-up Bohler angle was 16.8. Clinical results classified as 10 excellent, 13 good, 11 fair, and 6 poor. Conclusion: In the treatment of intra-articular fractures of the calcaneus, open reduction via an extended lateral approach seems to be a useful method in that it can provide direct exposure of the subtalar joint with little morbidity.