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신중욱,이호기 한양대학교 의과대학 2016 Hanyang Medical Reviews Vol.36 No.2
According to the Jastreboff’s neurophysiological model of tinnitus, if negative associations are attached to the tinnitus signal, tinnitus is perceived to be a threat or a danger and it activates the autonomic nervous and limbic systems. Consequently patient’s awareness of tinnitus is heightened and so patient perceives it to be louder and more persistent. Jastreboff and Hazell started tinnitus retraining therapy (TRT) based on the neurophysiological model of tinnitus. The purpose of TRT is blocking tinnitus from activating the sympathetic nervous and limbic systems (habituation of reaction) and from reaching the cerebral cortex (habituation of perception). TRT is composed of two components directive counseling that tries to reclassify tinnitus into the meaningless stimuli and sound therapy that decreases the relative strength of the tinnitus signal. Physicians try to put patient’s tinnitus into the territory of meaningless stimuli through retraining the brain (habituation of reaction). Because the brain habituates all unimportant stimuli, if habituation of reaction is fully achieved, habituation of perception will follow automatically. In most clinical results, clinical success rates of TRT approach or exceed 80% improvement. Early improvement can be achieved during the first few months, followed by additional progressive improvement. It should be recommended that the patient continue treatment at least 18 months.
신중욱,김정훈,이호기 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.10
(MRI). Cochlear implants (CI) have been contraindications to MRI, because of potential device displacement, generation of heat within the device and surounding tisues and potential com-promise of device integrity. The CI-MRI incompatibility has led to changes in the designing of CI. One aproach has ben to enable the magnet to be surgically removed before MRI. We report an experience of performing MRI on a cochlear implant recipient after magnet removal. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :938-40) 저자들은 인공와우 이식수술을 받은 환자에서 자기공명영상 촬영이 필요했던 예를 경험했기에 문헌고찰과 함께 보고하는 바이다.
연조직 제거 없이 단순수직절개를 통한 Bone Anchored Hearing Aid 시술
신중욱,박홍준,이승철,박한규,이호기 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.3
Background and Objectives After the bone anchored hearing aid (BAHA) surgery, soft tissue problems have frequently been reported. To solve this problem, a surgical procedure that routinely involves so-called skin thinning using BAHA dermatome has been utilized. But, this procedure includes many peri-implant complications and cosmetic trouble. Recently, a single vertical incision technique that does not involve skin thinning has been reported with favorable results. In this study, we evaluated the benefits of performing this procedure without skin thinning compared with the dermatome technique. Subjects and Method We evaluated 10 patients who were operated on without skin thinning using longer (8.5 mm) abutments (the test group) and 5 patients with the routine skin thinning and 5.5-mm abutments (the control group). A mean follow-up time was 11.3 months, the mean age was 34.2 years in the test group, the mean follow-up time was 54.5 months and a mean age is 24.5 years in the control group. Results The mean time required for surgery was 25 minutes and 55 minutes for the test and control groups, respectively. The wound healing time was 28 days and 56 days for the test and control groups, respectively. Fixture extrusion, skin infection and skin overgrowth were not observed in the test group but fixture extrusion case, two skin infection cases and two skin overgrowth cases were observed in the control group. Two cases of abutment loosening were observed in the test group. Conclusion The single vertical incision technique without skin thinning has many benefits when compared with the BAHA dermatome. With this technique, infection and skin overgrowth could be reduced, and a more rapid procedure and a more short healing time could also be possible. Moreover, the aesthetic outcome was far better when no skin thinning was involved.
Surgical and Audiologic Comparison Between Sophono and Bone-Anchored Hearing Aids Implantation
신중욱,김성헌,최재영,박홍준,이승철,최지선,박한규,이호기 대한이비인후과학회 2016 Clinical and Experimental Otorhinolaryngology Vol.9 No.1
Objectives. Bone-anchored hearing aids (BAHA) occasionally cause soft tissue problems due to abutment. Because Sophono does not have abutment penetrating skin, it is thought that Sophono has no soft tissue problem relating to abutment. On the other hand, transcutaneous device’s output is reported to be 10 to 15 dB lower than percutaneous device. Therefore, in this study, Sophono and BAHA were compared to each other from surgical and audiological points of view. Methods. We retrospectively reviewed the medical records of 9 Sophono patients and 10 BAHA patients. In BAHA cases, single vertical incision without skin thinning technique was done. We compared Sophono to BAHA by operation time, wound healing time, postoperative complications, postoperative hearing gain after switch on, and postoperative air-bone gap. Results. The mean operation time was 60 minutes for Sophono and 25 minutes for BAHA. The wound healing time was 14 days for Sophono and 28 days for BAHA. No major intraoperative complication was observed. Skin problem was not observed in the 2 devices for the follow-up period. Postoperative hearing gain of bilateral aural atresia patients was 39.4 dB for BAHA (n=4) and 25.5 dB for Sophono (n=5). However, the difference was not statistically significant. In all patients included in this study, the difference of air-bone gap between two groups was 16.6 dB at 0.5 kHz and 18.2 dB at 4 kHz. BAHA was statistically significantly better than Sophono. Conclusion. Considering the audiologic outcome, BAHA users were thought to have more audiologic benefit than Sophono users. However, Sophono had advantages over BAHA with abutment in cosmetic outcome. Sophono needed no daily skin maintenance and soft tissue complication due to abutment would not happen in Sophono. Therefore, a full explanation about each device is necessary before deciding implantation.
중소형 플랜트의 표준화된 플랜트 엔지니어링 활동 모델 개발: 상세설계를 중심으로
신중욱,염충섭,Shin, Jung Uk,Yeom, Choong Sub 한국시스템엔지니어링학회 2018 시스템엔지니어링학술지 Vol.14 No.1
Plant Engineering is a series of activities going through following life cycle phases: planning, basic design, detailed design, procurement and construction, commissioning, operation and maintenance, to produce a target product. From among these phases of plant engineering life cycle, a detailed design phase is an important phase producing final design deliveries. Luckily, through technical co-operation and experiences of constructing plants, large Korean engineering companies have accumulated know-hows of efficient detailed designs. However, smaller engineering companies have less experience of performing detailed designs so there is always a risk of causing design errors in the detailed design phase. To mitigate the risk of design errors in the detailed design phase, it is necessary to systematize a concrete activity model of a detailed design phase. In this paper, we have developed a prototype of a detailed design activity model through a widely used function modeling methodology called IDEF0.
측두골 외상후 진주종성 중이염으로 오인된 중이강내 뇌허니아 1예
박시영,신중욱,정범조,김민석 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.1
Brain herniation into the middle ear cavity is a rare entity that occurs mostly as a complication of otologic surgery. Other causes include a congenital skull base defect, infection, trauma, neoplasm and irradiation. It gives rise to cerebrospinal fluid otorrhea, progressive hearing loss, tinnitus, meningitis and other neurologic symptoms. Such patients tend to be misdiagnosed as having chronic otitis media and are often treated for long periods with inadequate conservative therapy. We report a case of brain herniation into the middle ear following traumatic temporal bone fracture, which was treated surgically via a transmastoid approach. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:84-7)