Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty Patients

최승효,한주희,정종우 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.2

Objectives. The Eustachian tube (ET) plays an important role in maintaining a normally aerated middle ear. Inflammation in middle ear disease is related to ET dysfunction, and postoperative restoration of middle ear integrity and hearing are closely related to ET function in chronic ear disease patients. After successful tympanoplasty, restoration of a well-aerated middle ear with good ET function can permit better compliance of the tympanic membrane. In this study, we evaluated the predictive validity of preoperative ET function measurements. Methods. We reviewed 137 patients who underwent type 1 tympanoplasty. All patients had non-cholesteatomatous chronic otitis media and received canal wall-up-type tympanomastoidectomies. Patients were categorized into four groups according to preoperative ET function measurements using a modified pressure inflation-deflation equilibration test. Group I patients had residual pressures less than 10 daPa, and Group IV patients showed no pressure change (poor results). Groups II and III were intermediate. Hearing levels were determined using pure tone averages at four frequencies. Postoperative tympanography was performed to determine middle ear aeration. Results. The preoperative air bone (AB) gap was 29.6±7.0 dB, and the postoperative gap was 16.5±5.7 dB; thus, there was significant overall improvement. In all groups, hearing was significantly better after surgery, but the worst postoperative hearing level was seen in Group IV patients. Type B tympanograms were more frequently recorded in Group IV patients than they were in Group I or II patients. Postoperative AB gaps were 9.2±3.8 dB in patients with type A tympanograms, 13.4±2.1 dB in those with type As, 24.1±2.5 dB in those with type C, and 18.5± 2.8 dB in those with type B. Conclusion. ET function measured with a modified pressure equilibration test using an inflation-deflation manometric method is a good indicator of an aerated middle ear and is predictive of improved postoperative hearing.

진행된 구강암 및 후두암 환장의 혈청 Intercellular Adhesion Molecule-1(ICAM-1) 및 Sialic acid(SA)농도

최승효,윤두환,강진욱,임현우,권현자,박정제,남순열,Choi Seung-Hyo,Yun Doo Hwm,Kang Jin Wook,Kwan Hyun Ja,Lee Jae Dong,Park Jung Je,Nam Soon Yuhl 대한기관식도과학회 2004 大韓氣管食道科學會誌 Vol.10 No.1

Adhesion molecules have been implicated in tumor progression. In this study, we aimed to investigate serum soluble intercellular adhesion molecule-1 (ICAM-1) and sialic acid (SA) levels in oral cavity cancer and laryngeal cancer and correlate their levels with cancer progression. Method : The sera from 31 patients with advanced oral cavity cancer (5 at stage III, 10 at stage IV) and advanced laryngeal cancer (1 at stage III, 15 at stage IV) were extracted before treatment. The concentrations of ICAM-1 was measured by Endogen kit (measured absorbance at 490nm) and the concentration of SA was measured by Roche kit (measured absorbance at 550nm). Respectively, gained data was compared with those from a control group (n=12). Result : Mean serum ICAM-1 and SA levels were found to be higher in oral cavity cancer group and laryngeal cancer group than control group. But statistical meaning was at SA (p<0.001, oral cavity cancer and laryngeal cancer versus control). Conclusion : These data reveal that the significant correlations serum SA level in advanced oral cavity cancer and laryngeal cancer. Serum ICAM-1 level was higher at advanced oral cavity cancer and laryngeal cancer than at control group but that was not significant.

요약하기 실태와 지도방안 연구

최승효 광주교육대학교 초등국어연구소 2021 초등국어과교육 Vol.28 No.-

요약하기란 글의 전체적인 짜임과 맥락 속에서 글을 분석하고 통합하여 이해하는 것과 관련된 행위로서 이해하고 기억하는 사고 과정일 뿐만 아니라 내용을 재구성하여 정리하는 종합적인 사고 과정이라고 할 수 있다. 요약하기 지도의 중요성과 단계적이고 구체적인 지도 필요성에 대한 인식을 바탕으로 2015개정 교육과정의 성취 기준 및 학습 주제를 분석하고 요약하기의 교수 학습 원리를 살펴보고 이를 바탕으로 실제 교수 학습 활동 시 활용할 수 있는 지도 방안을 모색해 보았다. 학생들이 단계적이고 체계적으로 요약하기 능력을 향상시켜 가는데 도움이 되기를 바란다.

Fibrinogen-Based Collagen Fleece Graft Myringoplasty for Traumatic Tympanic Membrane Perforation

최승효,송형용,송찬일 대한청각학회 2016 Journal of Audiology & Otology Vol.20 No.3

Background and Objectives: The aim of this study was to investigate how fibrinogenbased collagen fleece (Tachocomb®) graft myringoplasty (FCGM), performed under microscopic guidance, improves both hearing and tympanic membrane tissue repair in patients with traumatic tympanic membrane perforation (TMP). Subjects and Methods: Between August 2009 and March 2015, a total of 52 patients with traumatic TMP visited the department of otorhinolaryngology at a secondary medical center. Twenty-nine of these underwent FCGM under microscopic guidance in our outpatient clinic. For each patient, we recorded the location and size of the perforation, the time elapsed from the onset of TMP until the myringoplasty, and the hearing level both before and after myringoplasty. Results: The TMP closed completely in all cases (29 of 29 patients). After myringoplasty, the postoperative airbone gap (ABG) differed significantly from the preoperative ABG. Three of the 29 patients (10.3%) experienced complications. Specifically, 2 presented with otorrhea after FCGM, but conservative management led to improvement without recurrence of perforation. One patient showed delayed facial palsy 1 week after the procedure. The condition of this patient also improved and the palsy was not permanent. Conclusions: FCGM may be an effective treatment option in case of traumatic TMP. The procedure requires no hospitalization, and can be used to avoid traditional tympanoplasty.

경부심부감염에서 동정균 및 항생제 감수성 고찰

송형민,최승효,최승호,김상윤,남순열 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.1

Background and Objectives:The incidence of deep neck infection has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. The purposes of this study are to find out common organisms, rates of antimicrobial resistance in the deep neck infection. Subjects and Method: We have conducted a retrospective study of 76 patients with the diagnosis of deep neck infection that had been seen between January 1998 and December 2003. Results:The most common pathogens found were Streptococcus viridans (34%), followed by Klebsiella pneumoniae (19.4%), Streptococcus Group F (11.9%), β-hemolytic streptococci (11.9%) and Peptostreptococcus (7.5%). Staphylococcus species was not found. Of the aerobes found, 74.1% were sensitive to all antibiotics. All Streptococci, with one exception, were not resistant to any antibiotics. All Klebsiella pneumoniae were resistant to ampicillin. Klebsiella pneumoniae were cultured in 50% of DM patients. Conclusion:The most common pathogens were Streptococcus viridans (34%). Of these aerobes, 74.1% were sensitive to all antibiotics. All isolated microorganisms were sensitive to ampicillin/sulbactam (Unasyn??) used before the results of bacterial cultures. (Korean J Otolaryngol 2006;49:66-71)

Apoptotic Pattern of Cochlear Outer Hair Cells and Frequency-specific Hearing Threshold Shift in Noise-exposed BALB/c Mice

임현우,최승효,안중호,정종우 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.2

Objectives. Apoptosis of outer hair cell (OHC) can be identified through nuclear staining by specific nuclear changes. The change of filamentous actin (F-actin) is also involved in early cell death process. The study was designed to investigate OHC death along the whole length of the organ of Corti. Methods. BALB/c hybrid mice were used in this study. The noise group was exposed to white noise of 120 dB SPL for 3 hr per day for 3 consecutive days. The tone burst auditory brainstem response (ABR) test was conducted and cochleas from each group were obtained for the immunostaining of FITC phalloidin for F-actin and propidium iodide (PI) for nuclei. Results. ABR threshold of the noise group significantly increased after noise exposure (P<0.001). No threshold shift was found in the control group. Threshold shift of the noise group constantly increased from 4 to 16 kHz, but threshold shifts at 16 kHz and 32 kHz were similar. Patterns of OHC staining were subclassified as FITC+PI- cells, FITC+ PI+ cells, FITC-PI+ cells and missing cells. Proportion of normal live OHCs (FITC+PI-) rapidly decreased from the apex to the base. In the basal turn, FITC-PI+ cells and vacancy OHC (missing cells) were observed easily. Apoptotic and missing cells were most abundant at 60% of the whole length of the Corti organ. Conclusion. We could subclassify morphologic changes in OHC death after noise exposure. Quantitative changes in OHCs along the whole Corti organ showed a plateau pattern similar to that of a frequency-specific threshold shift. Objectives. Apoptosis of outer hair cell (OHC) can be identified through nuclear staining by specific nuclear changes. The change of filamentous actin (F-actin) is also involved in early cell death process. The study was designed to investigate OHC death along the whole length of the organ of Corti. Methods. BALB/c hybrid mice were used in this study. The noise group was exposed to white noise of 120 dB SPL for 3 hr per day for 3 consecutive days. The tone burst auditory brainstem response (ABR) test was conducted and cochleas from each group were obtained for the immunostaining of FITC phalloidin for F-actin and propidium iodide (PI) for nuclei. Results. ABR threshold of the noise group significantly increased after noise exposure (P<0.001). No threshold shift was found in the control group. Threshold shift of the noise group constantly increased from 4 to 16 kHz, but threshold shifts at 16 kHz and 32 kHz were similar. Patterns of OHC staining were subclassified as FITC+PI- cells, FITC+ PI+ cells, FITC-PI+ cells and missing cells. Proportion of normal live OHCs (FITC+PI-) rapidly decreased from the apex to the base. In the basal turn, FITC-PI+ cells and vacancy OHC (missing cells) were observed easily. Apoptotic and missing cells were most abundant at 60% of the whole length of the Corti organ. Conclusion. We could subclassify morphologic changes in OHC death after noise exposure. Quantitative changes in OHCs along the whole Corti organ showed a plateau pattern similar to that of a frequency-specific threshold shift.

일과성 소음성 난청을 유발한 마우스에서 고려홍삼의 청력보호 및 회복에 관여하는 역할에 관한 연구

안중호,최승효,이나영,정하나,정종우 고려인삼학회 2008 고려인삼학회 학술대회 Vol.2008 No.12

저음역 돌발성 난청 환자에서 고실 내 덱사메타존 주입술 및 경구 스테로이드 병합 요법의 효과와 경구 스테로이드 복용량 조절을 위한 예비연구

임길채,최승효 대한이비인후과학회 부산,울산,경남 지부회 2012 임상이비인후과 Vol.23 No.2

Prevalence of low tone sudden sensorineural hearing loss (LSSNHL) has increased. However there was no definite treatment regimen of LSSLHL. The objective of this study is to analyze results of oral steroid therapy and intratympanic steroid injection (ITSI) as first line therapy for LSSLHL. Addtionally, we compared side effects as treatment modality. Materials and Methods:We studied retrospectively 43 patients with LSSLHL at Jeju National University Hospital from March 2010 to July 2011. Under approval of patients we classified patients into 3 groups as treatment types. Patients to be treated with only ITSI were classified as group I (n=11), patients to be treated with ITSI and high dose oral methylprednisolone (1 mg/kg/day) were classified as group II (n=9) and patients to be treated with ITSI and half dose oral methylprednisolone (0.5 mg/kg/day) were classified as group III (n=23). Patients got 3 times of ITSI for a week. Before injection we warm-ed up dexamethasone (5 mg/mL) ample and we injected at posterosuperior portion of tympanic membrane. We carried out a pure tone audiometry (PTA) on the 1st day of their visit to hospital and before injection. We compared change of bone conduction threshold at 250, 500 and 1,000 Hz between 3 groups. Results:The hearing threshold of patients improved regardless of groups since the treatment. And there was no clinically significant differences in the outcome between groups. Conclusions:We could use ITSI as therapy in LSSLHL. If we used oral steroids for treatment of LSSLHL, we could consider reduction dosage of them.

성문상부후두절제술 후 흡인에 영향을 주는 인자

허성철,최승효,최승호,김상윤,남순열 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.1

Background and Objectives:Supraglottic laryngectomy is a well established technique for the treatment of appropriate carci-noma of supraglottic larynx. The purpose of this study was to determine factors that may contribute to postoperative aspiration related to deglutition problem following supraglottic laryngectomy. Materials and Method:A retrospective analysis of medical records of 19 patients who consecutively underwent supraglottic laryngectomy was undertaken. Contribution of the following factors was investigated:age, T stage, pack-years of smoking, and parameters of pulmonary function test. The authors used a computerized acoustic analysis program (CSL-MDVP) to measure fundamental frequency, jitter, shimer, and noise to harmonics ratio. Results:derate problem in postoperative 6 months. A greater number of pack-years of smoking and decreasing FEV1/FVC were signi-ficantly corelated with poor outcome with regards to postoperative aspiration and deglutition problem. No statistically significant difference was sen betwen patients with supraglottic laryngectomy and the control group. Conclusion:This study showed that less than 60% FEV1/FVC signifies a greater risk for postoperative aspiration. (Korean J Otolaryngol 2003 ;46 :59-62)

후두 미세수술과 연관된 구강 및 후두 합병증

강진욱,최승효,남순열 대한후두음성언어의학회 2003 대한후두음성언어의학회지 Vol.14 No.1

Introduction : Laryngomicrosurgery(LMS) is frequent procedure applying to benign and early malignant larygeal disease such as vocal cord polyp, nodule and early glottic cancer. LMS has been known as safe procedure and short time consuming treatment. So few reports about complications in LMS was done. In this study, complications and problems from LMS were investigated and reported. Method : From 2000, January to 2001, December, 180 patients who were treated with LMS in Asan medical center were studied by retrograde chart review. Results : In these patients, total 9 patients(5%) were suffered from complication. 4 patients (2%) had teeth injury and 4(2%) were suffered from foreign body sensation in tongue and 1(1%) had hypoglossal nerve injury. Main mechanism of complications is thought by pressure injury by laryngoscope blade. No definite correlation between procedure and complication was observed. Conclusion : There are few neural complications with LMS such as lingual and hypoglossal nerve injury. Before operation of LMS, warning and informing of complications by mechanical stress must be done. Gentle procedure and short operation time are necessary to avoid these problems. And patients who have risk factors of oral complications such as dental disease or dental prosthesis must have dental evaluation and treatment before LMS procedure.