폐쇄성 수면 무호흡증 환자에서 체위에 따른 비인강 부피 변화와 음향비강통기도검사

박시내,원유성,방충일,안재신,윤희로,서병도 대한이비인후과학회 1996 대한이비인후과학회지 두경부외과학 Vol.39 No.8

Small-Group Counseling in a Modified Tinnitus Retraining Therapy for Chronic Tinnitus

박시내,배성천,김동기,박용수,여상원,박소영 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.4

Objectives. The authors have treated chronic tinnitus patients using a combination of a simplified tinnitus retraining therapy (TRT) and medications, which we called modified TRT. In this clinical setting, we have attempted small-group counseling to find a time-effective equivalent of individual counseling. The aim of the present study was to evaluate the effectiveness of small-group counseling by comparing the treatment outcomes between individual and small-group counseling. Methods. The patients who had distressing chronic tinnitus with normal hearing or mild hearing loss were included. The subjects were placed into the small-group (group 1:4) or the individual (group 1:1) counseling group, and underwent a modified TRT composed of a single session of directive counseling and ambient sound stimulation. In addition, alprazolam (0.25 mg) and ginkgo biloba extract (80 mg) were administered orally to the subjects for 3 months. The 3- and 6- month outcomes were assessed using the follow-up rates and tinnitus severity scores: awareness, tinnitus handicap inventory (THI), loudness, annoyance, and effect on life. The treatment responses were classified as improvement,no changes, and worsening. Results. Of the total 149 patients (77 in group 1:1; 72 in group 1:4), 104 patients completed the protocol at 3 months, and 55 patients at 6 months. The follow-up rates were similar in both groups. Over the period of 6 months, all scores declined significantly except the loudness score at 3 months in both groups. Treatment responses showed no between-group differences. The success rate based on THI was 70% in group 1:1, and 64% in group 1:4 at 6 months. Conclusion. The small-group counseling of our modified TRT was comparable to the individual counseling for tinnitus relief. We suggest that this protocol can be implemented effectively in any crowded otolaryngology clinics.

Palatal Myoclonus Associated with Orofacial Buccal Dystonia

박시내,박경호,김도현,여상원 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.1

Palatal myoclonus is a rare condition in which there are rhythmic jerky movements of the soft palate and sometimes of the other muscles innervated by the brainstem A particularly annoying symptom is a rhythmic clicking sound in the ear due to the opening and closing of the Eustachian tube. Orofacial buccal dystonia is a focal dystonia with sustained spasms of the masticatory, facial or lingual muscles. The frequent symptoms of this disease have mainly been reported to be involuntary and possibly painful jaw opening, closing, deflecting and retruding, or a combination of the above. However, the subtle and unnoticeable involuntary movement of multiple facial muscles, which might be an infrequent symptom of orofacial buccal dystonia, makes this disease hard to diagnose. Understanding the functional orofacial anatomy that is responsible for the clinical signs and symptoms is necessary for making a proper diagnosis. Here we report on a rare case of palatal myoclonus that was associated with orofacial buccal dystonia, and such a case has not been previously reported. We describe the diagnostic approach and excellent treatment results after Botulinum toxin A (Dysport) injection and proper counseling.

이명재훈련치료의 적용 방법과 치료 효과

박시내,여상원,정상희,이수진,박용수,서병도 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.3

Background and Objectives:Tinnitus retraining therapy (TRT) has been presented as a new approach to tiniutus mana-eficacy of TRT based on questionnaires and tinnitograms. Materials and Methods:Using the clinical implication method of TRT, 60 patients with tinnitus, who visited Tinnitus Clinic, Kangnam St. Marys Hospital from May, 1999 to July, 2001, and who had received TRT for their tinitus, were included for the evaluation of therapeutic efficacy of TRT. Their psy-choacoustic characteristics of tinnitus and changes of subjective tinnitus were analyzed. Results:Loudness, awareness, (p<0.05). Forty-eight patients among the sixty patients (80% ) showed relief of their tinnitus in more than 2 of 4 subjective parameters (loudnes, awarenes, annoyance and efect on life of tinnitus). Conclusion:TRT has been shown to be efective in the treatment of subjective tinnitus. Modification of TRT may be necesary for easy application of this therapy in Korea. (Korean J Otolaryngol 2002;45:231-7)

이명 환자에서 청각과민-청각학적 평가 및 임상적 특성

박시내,여상원,조주은,박소영,장기홍,양명재,서병도 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.10

Background and Objectives:Hyperacusis, defined as increased sound sensitivity or decreased sound tolerence, has been re-ported to be related to tinnitus. The purposes of this study are to investigate the audiometrical characterization of hyperacusis Materials and Method:A total of 128 tinitus patients, who visited the Tinnitus Clinic, Kangnam St. Marys Hospital from May, 1999 to September, 2000, were included in this study. Their audiometrical study results were analyzed, and their hearing impairment was compared with those of normal controls. Results:The prevalence of hyperacusis in the patients with tinitus were as high as 37.8% according to the patients with normal hearing, the tinnitus handicap scores between hyperacusis and non-hyperacusis patients were significantly different, though the results of tinnitogram showed no diference. Conclusion:The hyperacusis test using pure tone stimuli may scren hyperacusic patients. It is necesary to consider the presence of hyperacusis in tinnitus patients so as to understand patient discomfort and to seek appropriate treatment modality. (Korean J Otolaryngol 2002;45:946-51)

Objective Tinnitus

박시내 한양대학교 의과대학 2016 Hanyang Medical Reviews Vol.36 No.2

Objective tinnitus originates from the para-auditory structures of the head and neck and can be heard or documented by examiner. Three representative forms of objective tinnitus, according to the causal organs are myoclonic tinnitus, vascular tinnitus and tinnitus caused by the patulous Eustachian tube. Etiologies, pathologic mechanisms, diagnostic approaches, and proper treatment methods of objective tinnitus are comprehensively discussed with a review of literatures. Objective tinnitus can be cured in many cases. Clinicians need to be well aware of the clinical characteristics of objective tinnitus since early, correct diagnosis with proper management are mandatory for its cure.

타각적 이명

박시내 대한이비인후과학회 부산,울산,경남 지부회 2011 임상이비인후과 Vol.22 No.1

3D 비디오 부호화 표준 기술

박시내,심동규 대한전자공학회 2010 전자공학회지 Vol.37 No.9

최근 디스플레이 기술의 비약적인 발전과 함께 3D 영화의 흥행으로 인해 국내 뿐 아니라 전 세계적으로 3DTV에 대한 관심이 높아지고 있다. 3DTV는 사람의 눈 사이의 간격 때문에 두 눈에 맺히는 상이 달라지는 양안시차의 원리를 이용하는 기술로, 두 눈에 맺힐 두 영상을 각각 획득하고, 이를 사람의 두 눈에 각각 보여지도록 하는 방식으로 3차원 입체 비디오를 실현하게 된다. 이를 위한 3D 비디오의 부호화 표준 기술로는 기존에 MPEG-2 stereo 및 MPEG-C part 2가 ISO/IEC MPEG을 통하여 제정된바 있으며, 최근에는 ITU-T의 VCEG과 ISO/IEC MPEG이 비디오 부호화 표준을 위하여 Joint Video Coding (JVT)를 구성하여, Multi-view Video Coding (MVC)를 제정하였다. 그리고 현재 진행되는 3D비디오 관련 표준화로는 MPEG에서 Free view-point TV (FTV)등의 응용을 위한 3DV라는 이름으로 차세대 비디오 표준을 준비하고 있다. 본 고에서는 기존에 MPEG을 통해 진행된 3DTV 관련 표준화 기술을 알아보고, 현재 진행되고 있는 3DTV 부호화 표준화 동향을 살펴본다.

내경정맥 결찰로 치료한 고위 경정맥구 박동성 이명 1례

박시내,박경호,임동재,여상원 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.12

lb which may cause sleep disturbance or hearing impairment can be treated by surgical therapy of ligation of internal jugular vein. We present a case of pulsatile tinnitus with high jugular bulb which has ben treated by surgical therapy. Otologic examination demonstrated bluish mas in hypotympanic portion behind intact tympanic membrane and temporal bone CT showed the high he site for venous ligation was confirmed by compresion of internal jugular vein with the probe of dopler sonogram. The patients pulsatile tinitus has completely disapeared two weks after surgery. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ; 50 :1152-6)

Expression of HSP70 and Its Relation with Other Cytokines in Human Middle Ear Effusion

박시내,박경호,최혁기,신지현,이동희,장기홍,여상원 대한이비인후과학회 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.1

Objectives. While other cytokines are known to be associated with otitis media with effusion (OME), the involvement of heat shock protein 70 (HSP70) in middle ear effusion (MEE) is unknown. This study was undertaken to investigate the possibility of there being a HSP70 expression in human MEE and to determine its potential role as a cytokine in OME. Methods. The levels of HSP70, tumor necrosis factor-alpha and interleukin-1beta were measured by enzyme-linked immunosorbent assay in the effusion of different groups of OME patient following collection of the MEE using our new collection system. The clinical characteristics of the OME patients and the MEE status were analyzed. Results. HSP70 was expressed in all the types of MEE. The mucous and seromucous effusions showed higher HSP70 levels than that of the serous effusion. The HSP70 level was correlated with the levels of tumor necrosis factor (TNF)-a and interleukin (IL)-1b in the effusions. The positive correlations between HSP70, TNF-a and IL-1b were statistically significant (P<0.05). Conclusion. The highly elevated level of HSP70 in the seromucous and mucous effusions implicates this protein in the chronicity of OME.