As the number of outings increases due to the easing of restrictions on wearing masks, more and more people are complaining of discomfort due to pollen or seasonal allergies. In fact, 20-30% of the people in Korea suffer from various allergic diseases, and according to the Health Insurance Review and Assessment Service, the number of patients treated for allergic diseases in 2021 increased by 57.6% from 1,543,135 in January to 2,432,365 in April. Allergy is caused by various substances contained in the surrounding environment, and more special attention is required because it is highly likely to occur at the time of reduced immunity or in infancy when the immune system is immature.

Typical symptoms of allergic conjunctivitis include itching and congestion of the eyes (congestion of the cornea). Symptoms appear in both eyes at the same time, and sticky mucous secretion, foreign body sensation, tears, blurred vision, and glare symptoms may also appear. In the case of an acute allergic attack, conjunctival congestion may be prominent, followed by severely swollen conjunctival edema with a whitish color.

Among them, vernal corner conjunctivitis, which has severe symptoms, causes severe itching of the eyes, production of thread-like secretions, and severe inflammatory reactions that may cause drooping or spasms of the eyelids. Repetitive wounds, especially if mismanaged. Corneal opacity accompanied by neovascularization and, in severe cases, corneal ulcers may occur, but care is needed as vision may remain permanently impaired. Atopic keratoconjunctivitis is also similar to vernal keratoconjunctivitis, and is characterized by red rashes appearing on the skin around the eyes and becoming rough.

Allergy refers to a series of immunological reactions showing hypersensitivity to a specific causative agent. Allergies do not occur with only one cause, but are caused by several factors, such as genetic influences, the degree of exposure to ‘allergens’ that cause allergic reactions, lifestyle, and environment. After initial exposure to an antigen, when a person sensitized to that antigen encounters the antigen again, basophils and mast cells with IgE (immunoglobulin E that responds to a specific antigen) react to substances (such as histamine, prostaglandins, and leukotrienes). , which causes swelling or inflammation of the surrounding tissues. This chain reaction continues to irritate and damage tissues, and these reactions can range from mild to severe.

As a genetic factor, it is known that if one of the parents has an allergic disease, the probability of their child suffering from an allergic disease is about 50%, and if both parents have an allergic disease, about 75% will suffer from an allergic disease. As environmental factors, dry air and changing seasons have a great effect. Especially in spring, the immune system overreacts to pollen or dust, which are usually harmless to the human body, and causes inflammation in the nasal passages and bronchi. Common allergy symptoms include sneezing, watery eyes, itchy eyes, runny nose, itchy skin, and rashes.

When an allergic disease is suspected, it is important to identify the causative antigen through a prompt diagnostic test and to prevent exposure to the causative substance. A representative allergen test is the MAST (Multiple Allergen Simultaneous Test) test. After blood sampling, it is a principle to determine whether IgE is present in the serum for 108 allergens such as animal hair, food, pollen, house dust mite, mold, and insect.

Since there is no risk of shock that can appear in skin test and various allergens can be identified at the same time, infants and children and patients with a wide range of skin diseases can be tested safely.

Drug therapies such as antihistamines and intranasal steroids can be applied first, but it is known that avoidance therapy to keep away from allergens is the best option for allergic diseases. This is also a strong recommendation specified in the guidelines of the Korean Academy of Asthma, Allergy and Clinical immunology.

For example, in response to fine dust and pollen, it is necessary to refrain from going out in spring when the air quality is bad, and to reduce irritation by using glasses instead of contact lenses on days when eye irritation is severe. In the case of allergic conjunctivitis that reacts to house dust or dust mites, it is better to pay more attention to ventilation and cleanliness in the house, and to wash bedding frequently. It is also helpful to frequently put eye drops in the eyes to wash away contaminants. Also, if itchiness appears, do not rub your eyes, and it is helpful to relieve itching with cold compresses.
Allergic conjunctivitis itself rarely causes visual impairment, but if the symptoms last for a long time and are severe, it is recommended to receive appropriate treatment after an ophthalmologic examination.

In winter, there are more musculoskeletal injuries due to falls than in other seasons, and when you enjoy leisure activities such as skiing and boarding, you often experience falls and collisions. As the weather gets colder, the roads become icy and slippery, because the body and muscles become stiff and shrink, and their flexibility decreases, making them more prone to falls than usual. The problem is that even a small fall can lead to serious injuries in winter. In particular, in the case of the elderly, who have low bone density due to aging, a fall accident in winter can lead to spinal compression fractures, so more attention is needed. Find out more about spinal compression fractures with Nanoori Spine Surgery (neurosurgery) specialists.

What is a Spine compression fracture?

Since the spine supports most of the body weight, it is always bearing a lot of load. Therefore, the cartilage of the spine acts as a shock absorber and protects the spine so that it can withstand the weight. However, when the spine receives a strong shock that it is difficult to withstand, it breaks down and leads to fractures. Spinal compression fractures are literally fractures of the spine due to compression," he said, "generally, it occurs most frequently in T12 (12th thoracic vertebrae). "It can also be caused by maintaining bad posture for a long time and constantly putting pressure on the spine." Spinal compression fracture is a disease in which a fracture occurs in the spine, so it is difficult to confirm with the naked eye. Other fractures can be confirmed with the naked eye or by physical examination, but spinal compression fractures require imaging confirmation. Nanoori Spinal Surgery (Neurosurgery) Vice President Lee Joon-hyeong (Gangnam Nanoori Hospital) said, "Reading the radiologic images by the spine specialist is essential for spinal compression fractures. In particular, incomplete or central fractures can be judged only with images."

Who is at risk for Spinal compression fractures?

Spinal compression fractures occur more frequently with age. This is because bone density is low due to aging. In fact, according to the Health Insurance Review and Assessment Service, the number of elderly people in their 70s and older who visited the hospital with a lumbar fracture, a representative symptom of spinal compression fractures in 2020, was 47,708. Compared to 11,589 lumbar fracture patients in their 50s and 2,239 lumbar fracture patients in their 30s, this is a very large number. “Spinal compression fractures often occur in the elderly and osteoporotic patients with low bone density,” he said. In addition, people who are underweight or have a history of fractures are also at risk of Spinal compression fractures. "Middle-aged women also belong to a high-risk group. This is because as menopause passes, the secretion of estrogen, the female hormone responsible for bone health, decreases and bone density decreases," he said. Smokers and drinkers are also at risk of spinal compression fractures. Smoking and drinking reduce calcium levels in the body, lowering bone density.

What are the symptoms and treatment of spinal compression fractures?

When a Spinal compression fracture occurs, the pain in the back and lower back, which is the fracture site, is so severe that it is impossible to move. Also, when you lie down and get up, the pain gets worse when you turn around and spreads to the whole body, such as the chest and lower abdomen. The body also gradually bends forward, and if the front part of the spine collapses, the height of the spine may change or deform, resulting in a decrease in height and a curved back. Therefore, if a spinal compression fracture is suspected, treatment should be urgent. Treatment varies according to severity. If the fracture is minor, the brace can be worn for 3 to 4 months to control the pain. However, if the extent of the fracture is severe, vertebroplasty should be performed. Vertebroplasty is a procedure in which cement is injected into the fractured area to stabilize it. It is necessary when the pressure on the spine becomes stronger due to a fracture or when the patient is in a high-risk group. It can be uncomfortable to inject the cement that you only see at construction sites into your body. “The cement used in vertebroplasty is medical bone cement, not general cement, and serves to fill the compressed fracture site using a tube,” he said. In general, it takes at least 6 weeks for the fracture site to harden. However, when bone cement is injected through vertebroplasty, it hardens immediately and the fracture site becomes hard. If the procedure goes well, you can move the next day," he said. However, the pain may still remain. Therefore, even if you can move, it is better not to exercise too drastically. In addition, if possible, the patient's own It is advisable to visit the hospital regularly to keep an eye on your condition.

Gangnam Nanoori Hospital Spine Surgery (Neurosurgery) Specialist Junhyung Lee

One of the most popular plastic surgeries is blepharoplasty, namely double eyelid surgery, and its surgical method is relatively simple, so you can easily find those who have received or are considering getting a procedure. Like any surgery, however, double eyelid surgery can also have side effects.

One of the most common side effects of double eyelid surgery is a what is referred to as "sausage" double eyelid. The medical term is "pretarsal fulness," and it refers to the puffy and unnatural shape of the eyelids like a sausage.

Revision blepharoplasty may have to be considered when dealing with side effects resulting from double eyelid surgery. New double eyelid lines should be created after finding and solving the cause of the side effects. Sausage double eyelids can occur when the double eyelid line is excessively formed, when only the double eyelid line is corrected without addressing the blepharoptosis, or when there is insufficient fat on the eyelids.

A new double eyelid line should be set according to the patient's eye shape and eye opening muscles when the double eyelid line is too high. It is possible to remove the skin between the existing double eyelid line and the target double eyelid line if there is enough room, but the problem arises if there is insufficient eyelid skin.

Insufficient skin can't be removed, so you have to use a method such as picking two lines to lower the line while preserving the skin. By making an incision along the target double eyelid line, the existing double eyelid line is removed while the skin is preserved. Due to the complexity and difficulty of the surgical procedure, recurrence and scarring can only be reduced with technical expertise and experience.

In the event that blepharoptosis is not corrected, revision surgery is performed to correct the eyelids. A solution in this case is simply to make the double eyelid line look smaller naturally by correcting the eyelids. If there is insufficient eyelid fat, the double eyelid line appears larger as the eyes are deep, so the symptoms may be improved by adding volume to the eyelids with filler and fat.

Generally, revision blepharoplasty is recommended to be performed six months after the first surgery. It is because scarred skin needs to be soft to find the exact cause of the problem and improve its symptoms. You should, however, consult a physician immediately if you experience pain or side effects that make daily living difficult.

Author: Dr. Hae-won Yang, Inique Plastic Surgery

Source: Inique Plastic Surgery