티아민 보충 치료로 호전된 급성 어지럼: Wernicke Encephalopathy 1예

김브라이언,홍성은,안정민 대한이비인후과학회 2022 대한이비인후과학회지 두경부외과학 Vol.65 No.11

Wernicke encephalopathy (WE) is an uncommon but severe neurological disorder caused bythiamine (vitamin B1) deficiency. It is characterized by the sudden onset of altered consciousness,ophthalmoplegia, and ataxia. Apart from chronic alcoholism, a lot of other conditionscausing malnutrition and decreasing thiamine absorption must be considered as predisposingfactors. Due to its low prevalence and clinical heterogeneity, WE is often misdiagnosed, resultingin persistent dysfunctions or death. Therefore, early diagnosis and prompt treatmentwith intravenous thiamine supplement might prevent encephalopathy and other neurologic orsystemic complications of thiamine depletion. We hereby report of our experience of a WEpatient who presented with predominantly vestibular symptoms and signs; the patient wassuccessfully diagnosed and treated with high-dose intravenous thiamine repletion.

이비인후과 의사가 직접 시행하는 초음파 및 초음파 시술의 유용성

김브라이언,최익준,홍성은,이병철,이명철,안정민 대한이비인후과학회 2022 대한이비인후과학회지 두경부외과학 Vol.65 No.12

Background and Objectives The purpose of this study was to examine the benefits of ultrasonographyperformed by a surgeon rather than a radiologist. Subjects and Method This retrospective study enrolled 122 cases of ultrasonography performedby a head and neck surgeon and 116 cases of the same examination performed by a radiologistbefore surgery. The time intervals between the first visit and surgery were comparedin both groups. Results The average waiting time for surgery after the first hospital visit was significantlyreduced when a surgeon performed the ultrasound examination. Furthermore, there was nosignificant difference in sampling inadequacy rate on thyroid fine needle aspiration (FNA) betweenFNA performed by a head and neck surgeon and a radiologist. Conclusion Surgeons can utilize ultrasound as a diagnostic and therapeutic tool in an officebasedsetting. For patients, diagnosis and treatment provided by a single doctor will lead tomore efficient outcomes.

갑상선 여포암과 휘틀세포암의 임상양상과 예후인자에 대한 비교 연구

김정준,김브라이언,최익준,이병철,안정민,공준석,이명철 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.12

Background and Objectives Follicular thyroid carcinoma (FTC) is the second commonthyroid cancer which comprises about 10% of differentiated thyroid carcinoma. Hurthle cellcarcinoma (HCC) is a relatively rare disease that has been classified as a subtype of FTC. However, there have been insufficient reports about these two similar thyroid cancers in SouthKorea due to low incidences. This study aims to present clinical features and evaluate prognosticfactors of FTC and HCC. Subjects and Method We reviewed data of 189 FTC and 12 HCC patients who underwentsurgery in our center from January 2000 to December 2020. Variables such as clinical characteristics,surgical method, pathologic result, post-operative treatment, survival rate and prognosticfactors were included in our study. Results As for age, 67.2% of patients in FTC group and 33.3% of patients in HCC groupwere older than 55 years-old (p=0.017). The average tumor sizes of FTC and HCC were 2.98and 3.1 cm, respectively. The 10-year overall survival rates of FTC and HCC were 96.5% and100%, respectively. The 10-year disease free survival rates of FTC and HCC were 89.1% and91.7%, respectively. Subclassification (widely invasive: p=0.036) and initial distant metastasis(p<0.001) were significant prognostic factors in FTC. Conclusion This study will be helpful for diagnosis and treatment of FTC and HCC, whichare relatively rare.

어머니의 직업활동이 선천성 근육사경에 미치는 영향

김기전(Ki-Jeon Kim),송브라이언병(Brian Byung Song) 한국콘텐츠학회 2013 한국콘텐츠학회논문지 Vol.13 No.9

본 연구의 목적은 선천성 근육사경과 산모의 직업적 활동 간의 관련성을 알아보는 것이다. 2006년부터 2011년 4월까지 수원“C병원 재활의학과를 내원한 선천성 근육사경아동의 산모 89명을 대상으로 실시하였다. 결과는 첫째, 연구대상자의 일반적 특성을 보면, 출산 평균연령은 30.09세, 교육수준은 대졸이상이 많았으며, 초산이 82.0%로 나타났으며, 자연분만, 제왕절개, 흡입분만 순이었고, 분만 시 둔위여부는 20.2%로 나타났으며, 첫째 아동이 사경인 경우가 82.0%로 나타났고, 둘째, 연구대상자의 직업적 특성에서 직장생활을 한 산모가 59.6%이고 전문가 및 관련종사자가 45.3%를 차지하였고, 직장생활을 임신 3기까지 한 산모가 75.5%로 나타났고, 주로 서서 일하는 자세보다 앉아서 일하는 자세로 앉아서 일하는 시간이 7시간 이상이 54.7%로 나타났으며, 하루 평균 근무시간은 8.75시간으로 나타났고, 셋째, 연구대상자의 직무스트레스는 하위 25%이하 수준으로 나타났으며, 하위 요인별 정도에선 관계갈등영역에서만 상위 50%이상으로 나타났다. 넷째, 연구대상자의 직무스트레스와 직업적 업무 특성간의 상관관계를 보면, 스트레스(100점 환산)와 직무스트레스의 직무요구, 관계갈등, 보상 부적절, 직장문화와 양의 상관관계가 높게 나타났으며, 직장문화와 보상 부적절간에도 양의 상관관계가 높게 나타났다. 직업적 업무 중 하루 평균 근무시간과 평균 일주일 근무시간과 양의 상관관계가 높게 나타났다. The Purpose of this study was to investigate the relationship between congenital muscular torticollis and maternal work activity. This study was conducted with a total of 89 outpatient pregnant women whose child presented congenital muscular torticollis at the Department of Rehabilitation of “C” Hospital in Suwon within the period from 2006 to April 30, 2011. The results were as followings: (1) The mean age at the time of giving birth was 30.09years; the proportion of pregnant women with college education or higher was high; the proportion of first delivery was 82.0%; the most common way of delivery was natural childbirth, followed by Cesarean section and vacuum extraction; the proportion of breech delivery was 20.2%; and in 82.0% of the women, the first child had congenital muscular torticollis. (2) 59.6% of the women had a career; 45.3% had engaged in professional practice or had a related job; 75.5% had worked until the third trimester of their pregnancy; 54.7% had worked for seven hours or more in a seated position; and the mean number of working hours was 8.75 (3) The level of work-related stress was a low 25% or less, and in the subdivisions of work-related stress, only the level of strained relations belonged to the upper 50% or higher. (4) For the correlation between the survey respondents’ job stress and job features, stress (full score: 100 points) showed a strong positive correlation with job demand, strained relations, inadequate reward, and workplace culture. Workplace also showed a strong positive correlation with inadequate reward. Mean daily working hours showed a strong positive correlation with mean weekly working hours.

물리치료사의 장애인에 대한 사회적 거리감 연구

김기전(Ki-Jeon Kim),송브라이언병(Brian Byung Song) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.1

본 연구에서는 임상에서 재활을 담당하는 물리치료사가 장애인에 대해 갖고 있는 사회적 거리감을 알아보고자 실시하였다. 연구대상자는 경기지역 8곳을 선정하여 146명을 대상으로 하였으며, 성별, 연령, 종교, 근무연수, 주변인 장애유무, 주변인 장애 유형 별로 장애인에 대한 사회적 거리감을 알아보았다. 연구결과는 다음과 같다. 첫째, 장애인에 대한 사회적 거리감 지각 정도는 사회적 거리감(5점만점 평균 3.47점)과 하위요인인 신체적 거리감(5점만점 평균 3.77점), 대인적 거리감(5점만점 평균 3.17점)으로 지각하는 것으로 나타났다. 둘째, 연령이 높을수록(p<.05), 근무연수가 많을수록(p<.05), 남성에게서 사회적 거리감이 더 가깝게 느끼는 것으로 나타났으며(p<.05), 성별에 있어서 남성이 대인적 거리감에서 가깝게 느끼는 것으로 나타났다(p<.05). 셋째, 접촉요인에서 장애인 친구 유무에 따른 신체적 거리감과 사회적 거리감에서 통계적으로 유의한 차이를 나타났다(p<.05). 마지막으로, 치료사의 장애인에 대한 사회적 거리감 간의 상관관계에서 연령은 정적, 성별은 부적으로 유의미한 상관이 나타났으며, 근무연수와 연령의 정적 상관, 성별과 종교와는 부적 상관이 나타났다. 이러한 결과를 볼 때, 장애인과의 접촉 경험의 질과 기회에 따라 장애인에 대한 긍정적인 인식이 형성된다. 이를 통해 치료사를 대상으로 임상 초기부터 장애인 인식의 개선과 장애인과의 직접적인 경험을 통해 긍정적인 장애인에 대한 태도 및 행동의 변화를 유도할 교육을 실시할 필요가 있을 것이다. The purpose of this study is to investigate the social distance that physical therapists in rehabilitation clinics have for the person with disability. The subjects were 146 physical therapists at 8 sites in kyunggi provinces, investigated the social distance of the subjects by gender, age, religion, working years, circumstantial disorder. The results of this study were as follows. First, as for the social distance of the person with disability, the physical therapists showed relatively intimate perceived by the social distance and the sub-factors, physical distance and interpersonal distance. Second, they showed close social distance to the disabled when they had sex, age, working years, and showed close interpersonal distance to the disabled when they had male. Third, the subjects with disabled friends showed close physical and social distance to the disabilities. Finally, There was a significant correlation between the age of the physical therapist and the social distance to the disabled, there was a negative correlation between the number of years of work and the age, sex. Based on these results, interactions with disabled person affect the positive cognition toward disabilities. In addition, It is necessary to educate the therapist to change the attitudes and behaviors of the disabled person positively through improvement of the cognition of the disabled and direct experience with the disabled from the beginning of the clinic.

이개강에 발생한 지루각화증 1예

홍성은,김브라이언,공준석,안정민 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.5

Seborrheic keratosis is a common type of epidermal tumor caused by benign proliferation ofimmature keratinocytes. They usually appear as well-demarcated, slightly raised brownishpatches or plaques. They are typically slow-growing, can increase in thickness over time, andrarely resolved spontaneously. Seborrheic keratosis is frequently found on sun-exposed skinsurfaces such as the trunk, extremities, head and neck of elderly people. However, it is rare tofind these lesions in the auricle or external auditory canal. In addition, seborrheic keratosis isoften distinguished as a benign tumor, but there can be some morphological overlap with oth-er malignant skin lesions. Herein, we report, along with a literature review, a case of seborrhe-ic keratosis in a patient who presented with a mass in the left cavum concha with a sudden in-crease in size.

자가 면역 병인이 의심되는 감각신경성 난청: Cogan 증후군 2예

안정민,김브라이언,조경래,장영수 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.12

Cogan’s syndrome is a rare inflammatory disease characterized by non-syphilitic keratitis andvestibulo-auditory symptoms including hearing loss, tinnitus, and vertigo. Although its precisepathogenesis is not known, Cogan’s syndrome is generally considered an autoimmunedisease. This hypothesis is supported by the frequently successful remission of hearing lossafter steroid administration and the association with other autoimmune disorders such asrheumatoid arthritis. Medical treatment of Cogan’s syndrome depends on disease severity andon how extensive the disease is. The involvement of inner ear pathology requires systemiccorticosteroid therapy. In cases of treatment failure or the need for a corticosteroid-sparing effect,other immunosuppressive drugs can be used. We experienced two patients with typicalCogan’s syndrome, presenting bilateral progressive sensorineural hearing loss and dizzinesswith ocular involvement, which we have successfully treated with systemic steroid administrationand immunosuppressive therapy.

n-Type Electrical Memory and Thin Film Morphology Controlled by Brush Polymer Bearing Perylene Diimide Moieties

김영용,브라이언 지원 리,Makoto Kido,고용기,Ryohei Ishige,Tomoyasu Hirai,위동우,김제한,정유진,김원종,Atsushi Takahara,이문호 한국고분자학회 2016 한국고분자학회 학술대회 연구논문 초록집 Vol.41 No.1

폐쇄성 수면무호흡증과 만성 어지럼의 연관성: 국민건강영양조사 2019-2021

홍성은,김브라이언,이병철,이명철,최익준,안정민 대한이비인후과학회 2023 대한이비인후과학회지 두경부외과학 Vol.66 No.12

Background and Objectives The present study was aimed to investigate whether chronicdizziness is associated with obstructive sleep apnea (OSA) in Korean adults. Subjects and Method We analyzed data from the 2019-2021 Korea National Health andNutrition Examination Survey and enrolled 2323 participants over the age of 40 who complet-ed the sleep health and dizziness survey. Participants were assessed for the risk of OSA usingthe STOP-Bang questionnaire and then classified into three groups: low-, intermediate-, andhigh-risk. Logistic regression analyses were used to identify the relationship between chronicdizziness and OSA. Results The intermediate-, high-, and intermediate/high-risk groups comprised older par-ticipants with a higher proportion of male and higher body mass index compared to the low-risk groups (all p<0.001). They also had higher rates of current smoking, high-risk alcoholconsumption, hearing loss, and a higher prevalence of anemia, stroke, hypertension, diabetes,and dyslipidemia. The risk of chronic dizziness was significantly associated with the severityof OSA. Compared to the low-risk OSA group, the risk of chronic dizziness was significantlyhigher in the intermediate- (odds ratio [OR] 2.096; 95% confidence interval [CI] 1.507-2.913),high- (OR 2.119; 95% CI 1.013-4.434), and intermediate/high risk OSA groups (OR 2.097;95% CI 1.508-2.917) after adjusting for the relevant variables. Conclusion These findings suggest that early detection and intervention of OSA may benecessary to prevent the worsening of chronic dizziness in adults.

경부 림프절 진단에서 초음파 유도하 세침흡인검사와 중심바늘생검의 유용성 비교

강주용,김정준,김브라이언,이명철,최익준 대한이비인후과학회 2021 대한이비인후과학회지 두경부외과학 Vol.64 No.8

Background and Objectives The purpose of this study is to compare diagnostic outcomeand safety of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with cervicallymphadenopathy. Subjects and Method This retrospective studies were conducted on 164 cases with cervicallymphadenopathy that had undergone FNA, and 44 cases that had undergone CNB. The cytopathologicalresults from FNA and CNB were compared with the histopathological resultsconfirmed by excisional biopsy in the nodes according to different sizes and radiological levels,respectively. Diagnostic sensitivity, specificity, positive predictive value (PPV), negativepredictive value (NPV), and accuracy were evaluated according to disease entities. Results FNA is more accurate than CNB in most of the sizes and at all cervical levels. However,there is no statistically significant difference between the results of the two tests. Sensitivityand NPV for diagnosis of malignant lymphoma are higher with FNA than with CNB. However, specificity and PPV for malignant lymphoma are higher with CNB than with FNA. Also CNB showed superior sensitivity, PPV and NPV for metastatic lymphadenopathy. Conclusion Although CNB is beneficial in reducing the false negative rate, it still has severallimitations. Since CNB has no statistically significant advantage over FNA, FNA can bea good alternative method with less complication and high diagnostic value for lesions whereCNB is difficult to perform.