비전형적인 다발성 신경섬유종증 1예

김현직,장정현,이헌석,최홍식 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.12

A case of neurofibromatosis in a 51 year old woman, with no other evidences of genetic defect, is described. Neurofibromatosis affects primarily cel growth of neural tisues and can cause tumors to grow on nerves. In the past, neurofibromatosis has been divided into 2 groups, Type I and Type I. The two groups have been shown to be distinct at clinical and molecular the distinctive features of neurofibromatosis Type I, whereas bilateral vestibular schwanoma, family history and defect of chromosome 22q characterize the neurofibromatosis Type II. We experienced a case of neurofibromatosis having multiple neurofibromas in both neck, left thoracic inlet, and spinal cord without abnormal chromosomal findings. We present this case with a review of the literature.

중증근무력증에서 반복신경자극검사시 각 근육들의 진단적 민감성

김현직,임성환,이승엽,하정상,김욱년 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.2

This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test(RNST) for myasthenia gravis (MG) patients. Materials and Methods: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial(orbicularis oculi and nasalis) and upper extremity(flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. Results: The significant electrodecremental response of RNST were noted in orbicularis oculi(58.9%), nasalis(51.3%), flexor carpi ulnaris(42%), anconeus(41%) and abductor digiti quinti muscles(27%) Among the 3 muscles of upper extremity(abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles(p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. Conclusion: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.

이하선 천엽에 국한된 이하선암종 치료로서의 이하선 천엽절제술과 전 이하선절제술과의 비교

김현직,임영창,김상철,최현승,서용석,최은창,박정수 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.2

Background and Objectives:Although there is little consensus regarding the extent of surgical ablation needed to attain cure in parotid cancers, most surgeons has been used to perform total parotidectomy. However, the chance of development for postoperative facial palsy may be incresed in case of total parotidectomy. The aim of this study was to determine whether superficial parotidectomy (SP) yielded local control and resulted in overall survival rates that are comparable to those of total parotidectomy (TP). Materials and Method:2000 and diagnosed with the parotid cancers confined to the superficial lobe and had parotidectomy were reviewed. There were 42 males and 40 females, ranging in age from 8 to 84 years. There were 47 patients in group 1 (SP) and 35 in group 2 (TP). 52 patients underwent neck dissection simultaneously with primary lesion. Surgical treatment was followed by radiotherapy in 48 patients. The follow-up period ranged from 2 to 132 months with the mean of 37.7months. Data were analyzed using the Kaplan-Meier method and Log-Rank test and Fishers exact test. Results:group were not significantly asociated with the folowing variables:histologic grade, tumor size, surgical margin, facial nerve involvement and postoperative radiotherapy. The overall crude 2- and 5- survival rates for the SP group were 87% and 79%, respectively, and those for the TP group were 80.5% and 64.9% (p>0.05), respectively. Also, there was no statistically significant difference in the locoregional recurence between the SP group and TP group (p>0.05). However, there was statistically significant (p<0.05). Conclusion:Therefore, in terms of oncologic integrity, superficial parotidectomy may be a safe procedure without potential morbidity, such as postoperative facial palsy in the treatment of parotid cancer confined to the superficial lobe.

Uncovering the Mysterious: Jean-Luc Marion’s Phenomenological Approach to Christian Revelation

김현직 서강대학교 서강대학교 신학연구소 2020 신학과 철학 Vol.- No.37

The French phenomenologist, Jean-Luc Marion, suggests the possibility of a new approach to Christian Revelation in his book Givenness and Revelation (2016). Marion criticizes Neo-Scholasticism and contends that we should return to apokalypsis, ‘uncovering the will of God.’ He claims that the Revelation of the Divine Trinity must be uncovered in a trinitarian way. When the Son as icon, reveals the invisible Father, the Holy Spirit guides a person to have the proper perspective to see the icon, completing the threefold manner of God’s uncovering himself. There are some hermeneutical points that can be questioned about Marion’s idea. Nevertheless, Marion’s new approach to understanding Revelation provides meaningful insights in terms of theological concerns. Such a phenomenological understanding of Revelation can help the Church a richer realm for Christians to share their real-life personal experiences in the context of a relationship with God who wants to communicate with us.

One-Stage Reconstruction for Midfacial Defect after Radical Tumor Resection

김현직,이광호,박상용,김한구 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.1

A serious midface defect involving resection of squamous cell carcinoma originating from the hard palate was treated by an unusual reconstructive strategy. After tumor resection, surgical reconstruction was accomplished in one stage using one free flap with one distant and local flap: a radial forearm flap to reconstruct the upper lip, a forehead flap to reconstruct the external nose, a cantilever calvarial bone graft to replace the nasal skeleton and a nasolabial flap and split thickness skin graft to cover the internal nasal lining. The rationale for this one-stage reconstruction and the problems associated with midfacial reconstruction after wide tumor excision are discussed.

후신경아세포종의 치료 결과 분석:11예

김현직,김창훈,신유섭,이헌석,김규보,윤주헌 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.7

Compositional Alterations of the Nasal Microbiome and Staphylococcus aureus–Characterized Dysbiosis in the Nasal Mucosa of Patients With Allergic Rhinitis

김현직,김종화,김원용,한선아 대한이비인후과학회 2022 Clinical and Experimental Otorhinolaryngology Vol.15 No.4

Objectives. Host–microbial commensalism can shape the innate immune response in the nasal mucosa, and the microbial characteristics of nasal mucus directly impact the mechanisms of the initial allergic responses in the nasal epithelium. We sought to determine alterations of the microbial composition in the nasal mucus of patients with allergic rhinitis (AR) and to elucidate the interplay between dysbiosis of the nasal microbiome and allergic inflammation. Methods. In total, 364,923 high-quality bacterial 16S ribosomal RNA-encoding gene sequence reads from 104 middle turbinate mucosa samples from healthy participants and patients with AR were obtained and analyzed using the Quantitative Insights into Microbial Ecology pipeline. Results. We analyzed the microbiota in samples of nasal mucus from patients with AR (n=42) and clinically healthy participants (n=30). The Proteobacteria (Ralstonia genus) and Actinobacteria (Propionibacterium genus) phyla were predominant in the nasal mucus of healthy subjects, whereas the Firmicutes (Staphylococcus genus) phylum was significantly abundant in the nasal mucus of patients with AR. In particular, the Ralstonia genus was significantly dominant in the clinically healthy subjects. Additional pyrosequencing data from 32 subjects (healthy participants: n=15, AR patients: n=17) revealed a greater abundance of Staphylococcus epidermidis, Corynebacterium accolens, and Nocardia coeliaca, accounting for 41.55% of mapped sequences in the nasal mucus of healthy participants. Dysbiosis of the nasal microbiome was more pronounced in patients with AR, and Staphylococcus aureus exhibited the greatest abundance (37.69%) in their nasal mucus, in association with a positive response to house dust mites and patients’ age and height. Conclusion. This study revealed alterations in the nasal microbiome in the nasal mucus of patients with AR at the levels of microbial genera and species. S. aureus-dominant dysbiosis was distinctive in the nasal mucus of patients with AR, suggesting a role of host-microbial commensalism in allergic inflammation.

일측 전정기능 소실 환자에서의 galvanic 전정 자극에 대한 연구

김현직,김창우,이원상 대한평형의학회 2003 Research in Vestibular Science Vol.2 No.2

Apocalypsis of the Triune God in Jean-Luc Marion’s Phenomenology

김현직 연세대학교 신과대학 연합신학대학원 2023 신학논단 Vol.114 No.-

The philosopher Jean-Luc Marion presents a phenomenological approach to the Trinity. He argues that God reveals himself in a trinitarian way because God is the Trinity. He criticizes traditional trinitarian theology based on metaphysics in that it fails to resolve the intrinsic contradiction between the unicity of the one God and the plurality of the persons of the Trinity. He proposes, rather, ‘trinitarian revelation.’ In this, Jesus Christ, the revelation par excellence, unveils the Father, while the Holy Spirit guides the beholder to see the icon of the Son from the proper perspective. This anamorphosis model overcomes the limitations of the traditional metaphysical-oriented theology of the Trinity. It stresses that the beholder sees the sole visibility of the Son and appreciates the communion of plurality in charity within the mutual relationships of the persons of the Trinity. Marion’s trinitarian revelation was influenced by Karl Barth, Karl Rahner, and Hans Urs von Balthasar; but his understanding of revelation is marked by an ‘absence of soteriology.’ Different from their holistic soteriology of traditional Christian theology, he presents only a passive kind of soteriology based on the epistemological conversion of those who encounter revelation through faith. His phe nomenological approach to revelation and the Trinity provides a new interpretation, but it needs further development.

부비동에서 발생한 악성 말초 신경초종 1예

김현직,김진영,김창훈,윤주헌 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.2

Malignant peripheral nerve sheath tumor, a highly aggresive neoplasm of nerve sheath origin (also known as malignant schwan-noma, malignant neurilemoma)malignant peripheral nerve sheath tumors are found in the extremities, folowed by the ocurence in the paravertebral region of the thorax and abdomen. The head and neck are involved in les than 10% of cases, which is especialy true in rare diseases of the nasal cavity and paranasal sinuses. We present a case of malignant peripheral nerve sheath tumor of the paranasal sinus without a definite evidence of von Recklinghausens disease or benign prexisting peripheral nerve sheath tumor with a review of literatures.