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      • KCI등재

        소리 자극 강도와 흉쇄유돌근의 수축의 변화에 따른전정유발근전위의 변화

        박홍주,한수희,심대보,신향애,임상균,안재윤,정용수,신정은 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.7

        Background and Objectives:The aim of this study was to investigate the effect of the strength of SCM muscle contraction and the intensity of the sound stimulation on the VEMP parameters (amplitude, latency and threshold). Subjects and Method: Twenty normal subjects were included. Subjects pushed with their jaw against the hand-held inflated cuff to generate cuff pressures of 20, 40 and 60 mmHg and sequential stimulation intensities were applied. Variances of each parameter were analyzed. Results:There was no significant difference in terms of threshold according to the side and strength of SCM contraction. P1-N1 amplitude demonstrated no significant differences according to the side;however, the amplitude increased significantly as the cuff pressure and stimulation intensity increased. Interaural amplitude difference ratios showed an increased difference at 20 mmHg when compared to those at 60 mmHg. There was neither a cuff pressure effect, nor stimulation intensity effect when considering the P1 latencies. As for the N1 values, there was no stimulation intensity effect but there was a delayed latency at 20 mmHg when compared to those at 40 or 60 mmHg. Interaural latency difference of N1 latencies did not differ significantly according to the cuff pressure; however, there was an increased difference at 20 mmHg when compared to those at 40 or 60 mmHg. Conclusion:This study shows that VEMP response is influenced by the cuff pressure and stimulation intensity, and we recommend to get each VEMP parameter using this feedback method in the clinical setting. (Korean J Otorhinolaryngol-Head Neck Surg 2007;50:579-83)

      • KCI등재

        편두통성 현훈 환자의 임상 양상

        박홍주,신정은,심대보,신향애,임상균,안재윤,정용수 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.3

        Background and Objectives:The clinical association between migraine and vestibular symptoms has been indicated in many studies and it is believed that migraine-associated vertigo is one of the most common Subjects and Method:We investigated the nature of vestibular and migrainous symptoms of 26 patients suffering vertigo associated with migraine and their responses to antimigrainous medications. Neurotologic tests such as oculomotor tests, caloric test, and audiometry were performed between attacks. Results:A marked female predominance was found. The duration of rotational (77% ) and/or to-and-fro vertigo (23% ) lasted from a few seconds to several hours or, less frequently, even days. We found that patients showed vestibular abnormalities in central and peripheral types. In the symptom-free interval, 31% of the ic latency and horizontal saccadic pursuit. On the other hand, 15% showed unilateral weakness in the caloric test and 15% showed positive results in the head thrust tests. Overall, 85% of patients experienced resolution or significant reduction of their attacks of vertigo with medication. Conclusion:Most patients with migraine-associated vertigo showed normal results on the vestibular tests and responded well to preventive medication. Migraine-associated vertigo caused various clinical manifestations and there should be relevant diferential diagnosis for epiodic vertigo. (Korean J Otolaryngol 2007 ;50 :209-14)

      • KCI등재

        한국인에서 MRI로 측정한 유양돌기간 간격과 난형낭간 간격

        박홍주,장현종,심대보,신향애,안재윤,신정은 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.8

        Background and Objectives:The distance between the utricles is important in vestibular tests like the unilateral centrifugation test for examining the utricular function. In this test, the axis of rotation crosses precisely through one utricle, thus only theopposite utricle is stimulated. The interutricular distance needs to be known in order to stimulate one utricle maximally for thistest, and it would be better if the distance could be estimated from surface landmarks like intermastoid distance. Subjects andMethod:We investigated the correlation between the interutricular distance (IUD) and the intermastoid distance (IMD),measured on magnetic resonance images. Data were collected from 177 subjects (72 men and 105 women), who suffered fromdizziness, sensorineural hearing loss and facial nerve disorders. Results:We found that IUDs were 7.33±0.42 cm (6.03- 8.75cm) and the maximum difference of IUDs between the subjects was 2.73 cm. There was a significant correlation between IUDand IMD. The IUDs of men (7.57±0.38 cm) and women (7.17±0.38 cm) showed the similar correlation with those of IMD.The correlation was not different from that published for Caucasian subjects. Conclusion:These findings show that there is asignificant correlation between IUD and IMD. IMD can be useful for estimating IUD, which enables exact stimulation to begiven to the unilateral utricle in the unilateral centrifugation test. Moreover, individual assessment of IUD gives more precisestimulation than using a fixed IUD in the unilateral centrifugation test. (Korean J Otolaryngol 2006;49:781-5)

      • KCI등재

        Serous-lined Extramural Tunnel 방법의 Ileal W-neobladder의 종양학적, 기능적 결과

        박홍주,유창희,김청수 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.9

        Purpose: We wanted to analyze the oncologic and functional outcomes of radical cystectomy and creation of an orthotopic ileal neobladder with a serous-lined extramural tunnel. Materials and Methods: There were 110 patients and 101 patients were male(mean age: 58.7 years, age range: 35-78 years). All these patients underwent radical cystectomy and creation of a ileal W-shaped neobladder with a serous-lined extramural tunnel, and all the procedures were done by one surgeon. The median period of follow-up was 28.9(range: 6-95) months. The Assessing the patients’ clinical history, physical examinations, complete laboratory tests, CT scans and bone scans were performed postoperatively for the evaluation of recurrence and complications. The voiding patterns of 77 patients of the 110 patients were surveyed. Results: Five-year-overall survival was 56% and the median survival period was 66.1 months. The tumor recurrence rate was 39.1%(43 patients) and 21(19.1%) patients died due to progression of cancer. The daytime and nighttime urinary continence rates at postoperative 1 year were 87% and 79%, respectively. Sixty three(81%) patients among the 77 patients had no voiding problems after the procedures. Nine patients still had severe incontinence and 5 patients still suffered from voiding difficulty. Renal functional deterioration developed in 3 patients(2.8%); however, no patients were on dialysis. Acute pyelonephritis was observed in 12 patients and recurrent pyelonephritis occurred in 6 patients. Ureter-ileal anastomosis site stricture was occurred in 5 renal units. No reflux from the ileal bladder into the ureter was observed. Conclusions: Radical cystectomy and an orthotopic ileal neobladder using a serous-lined extramural tunnel for patients with invasive bladder cancer were effective and durable procedures in terms of the oncologic and functional outcomes. Purpose: We wanted to analyze the oncologic and functional outcomes of radical cystectomy and creation of an orthotopic ileal neobladder with a serous-lined extramural tunnel. Materials and Methods: There were 110 patients and 101 patients were male(mean age: 58.7 years, age range: 35-78 years). All these patients underwent radical cystectomy and creation of a ileal W-shaped neobladder with a serous-lined extramural tunnel, and all the procedures were done by one surgeon. The median period of follow-up was 28.9(range: 6-95) months. The Assessing the patients’ clinical history, physical examinations, complete laboratory tests, CT scans and bone scans were performed postoperatively for the evaluation of recurrence and complications. The voiding patterns of 77 patients of the 110 patients were surveyed. Results: Five-year-overall survival was 56% and the median survival period was 66.1 months. The tumor recurrence rate was 39.1%(43 patients) and 21(19.1%) patients died due to progression of cancer. The daytime and nighttime urinary continence rates at postoperative 1 year were 87% and 79%, respectively. Sixty three(81%) patients among the 77 patients had no voiding problems after the procedures. Nine patients still had severe incontinence and 5 patients still suffered from voiding difficulty. Renal functional deterioration developed in 3 patients(2.8%); however, no patients were on dialysis. Acute pyelonephritis was observed in 12 patients and recurrent pyelonephritis occurred in 6 patients. Ureter-ileal anastomosis site stricture was occurred in 5 renal units. No reflux from the ileal bladder into the ureter was observed. Conclusions: Radical cystectomy and an orthotopic ileal neobladder using a serous-lined extramural tunnel for patients with invasive bladder cancer were effective and durable procedures in terms of the oncologic and functional outcomes.

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