Mycoplasma Pneumoniae폐렴의 임상적 고찰

신유섭,서승현,민기식,김종완,김광남,유기양 한림대학교의료원 1991 人間科學 Vol.15 No.11

Gasless Transaxillary Robot-Assisted Neck Dissection: A Preclinical Feasibility Study in Four Cadavers

신유섭,고윤우,홍현준,정웅윤,이혜연,홍재민,황치상,장재원,최은창 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.1

Purpose: We hypothesized that comprehensive neck dissection could be achieved via a gasless transaxillary approach using a robotic system. We intended to evaluate the accessibility of level I, IIB and VA nodes with transaxillary robot-assisted neck dissection of four cadavers. Materials and Methods: Transaxillary robotic neck dissection was performed in four cadavers through a 7-cm longitudinal incision at the anterior axilla and a 0.8-cm-sized incision in the chest wall. Results: We successfully performed neck dissection from level II to V in all four cadavers. However, dissection of levels IIB and VA, which lie on the cephalic portion of the spinal accessory nerve, was difficult. Vital structures, including the internal jugular vein, carotid artery, vagus nerve, phrenic nerve, superior thyroid artery and hypoglossal nerve, were successfully identified and preserved. Conclusion: Our results demonstrate the feasibility of robot-assisted neck dissection using a transaxillary approach. We suggest that gasless, transaxillary robotic neck dissection is a promising technique for treating nodal metastasis in thyroid cancers or in selected squamous cell carcinomas of the head and neck. However, some modification of the approach might be needed when performing comprehensive neck dissections of all levels of the neck.

Selective Neck Dissection for Clinically Node-Positive Oral Cavity Squamous Cell Carcinoma

신유섭,고윤우,김세헌,최은창 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.1

Purpose: The treatment of a clinically node-positive (cN+) neck is important in the management of oral cavity squamous cell carcinoma (OSCC). However, the extent of neck dissection (ND) remains controversial. The purpose of our study was to evaluate whether level IV or V can be excluded in therapeutic ND for cN+ OSCC patients. Materials and Methods: We performed a retrospective chart review of 92 patients who underwent a comprehensive or selective ND as a therapeutic treatment of cN+ OSCC from January 1993 to February 2009. Results: The incidence rate of metastasis to level IV or V was 22% (16 of 72) on the ipsilateral neck. Of 67 cases without clinically suspicious nodes at level IV or V, 11 cases (16%, 11 of 67) had pathologically proven lymphatic metastasis to level IV or V. Only a nodal staging above N2b was significantly relevant with the higher rate of level IV or V lymph node metastasis (p=0.025). In this series, selective ND, combined with proper adjuvant therapy, achieved regional control and survival rates comparable to comprehensive ND in patients under the N stage of cN2a OSCC. Conclusion: In conclusion, level IV and V patients can avoid recurrence under cN2a OSCC.

Ureteral Penetration Caused by Drilling During Internal Pelvic Bone Fixation: Delayed Recognition

신유섭,박종혁,Omer A Raheem,정영범,김형진,김영곤 대한배뇨장애요실금학회 2013 International Neurourology Journal Vol.17 No.2

A 49-year-old man was referred to our department with profuse serous fluid discharge from a Penrose drain after undergoing internal fixation with metal screws for multiple pelvic bone fractures. A definite ureteral penetration was identified that was orientated from the lateral to the medial aspect of the right distal ureter. The patient was surgically treated with excision of the 2-cm injured ureteral segment, end-to-end ureteroureterostomy, and double J ureteral stent placement. To our knowledge, a penetrating ureteral injury caused by bone drilling has not been reported previously in the published literature. This case shows that surgeons who do pelvic surgery, including orthopedic surgeons, should be familiar with the anatomical relationship of the ureter and its potential injuries.

無能力者의 相對方保護에 關한 小考

申由燮 成均館大學校 法政大學 法律學會 1964 成均法學 Vol.9 No.1

Persistent Dysphonia after Laryngomicrosurgery for Benign Vocal Fold Disease

신유섭,장재원,양석민,우희원,조민혁,김철호 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.3

Objectives. Laryngomicrosurgery (LMS) is used to manage most vocal fold lesions. However, the functional voice outcome of the LMS might be diverse due to the influence of various factors. We intend to evaluate the incidence and etiologic factors of persistent dysphonia after LMS for benign vocal fold disease (BVFD). Methods. We performed a retrospective review of 755 patients who underwent LMS for BVFD. We analyzed the clinical characteristics, preoperative and postoperative two months voice studies. Postsurgical dysphonia was defined as grade 1 or above in GRBAS (grade, roughness, breathiness, asthenia, and strain) scale. Thirty nine patients (5.2%; 25 males and 14 females; average, 42.9 years; range, 21 to 70 years) were diagnosed with postsurgical dysphonia. Results. There was no correlation between the diagnosis, coexistence with laryngopharyngeal reflux disease, habit of smoking,or occupational voice abuse and voice outcome. The patients with a worse preoperative acoustic parameter had a worse voice outcome. Stroboscopic findings showed excessive scarring or bowing in 21 cases, presence of lesion remnant in eight cases, prolonged laryngeal edema in five and no abnormal findings in three. Conclusion. Great care should be taken in patients with worse preoperative jitter. With a few exceptions, postoperative dysphonia can be avoided by the use of an appropriate surgical technique.

Endotoxin Is Not Essential for the Development of Cockroach Induced Allergic Airway Inflammation

신유섭,박중원,손정호,김주영,이재현,조상헌,홍수종,이주실,홍천수 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.3

Purpose: Cockroach (CR) is an important inhalant allergen and can induce allergic asthma. However, the mechanism by which CR induces airway allergic inflammation and the role of endotoxin in CR extract are not clearly understood in regards to the development of airway inflammation. In this study, we evaluated whether endotoxin is essential to the development of CR induced airway allergic inflammation in mice. Materials and Methods: Airway allergic inflammation was induced by intranasal administration of either CR extract, CR with additional endotoxin,or endotoxin depleted CR extract, respectively, in BALB/c wild type mice. CR induced inflammation was also evaluated with toll like receptor-4 (TLR-4) mutant (C3H/HeJ) and wild type (C3H/HeN) mice. Results: Intranasal administration of CR extracts significantly induced airway hyperresponsiveness (AHR), eosinophilic and neutrophilic airway inflammation, as well as goblet cell hyperplasia in a dose-dependent manner. The addition of endotoxin along with CR allergen attenuated eosinophilic inflammation, interleukin (IL)-13 level, and goblet cell hyperplasia of respiratory epithelium; however, it did not affect the development of AHR. Endotoxin depletion in CR extract did not attenuate eosinophilic inflammation and lymphocytosis in BAL fluid, AHR and IL-13 expression in the lungs compared to CR alone. The attenuation of AHR, eosinophilic inflammation, and goblet cell hyperplasia induced by CR extract alone was not different between TLR-4 mutant and the wild type mice. In addition, heat inactivated CR extract administration induced attenuated AHR and eosinophilic inflammation. Conclusion: Endotoxin in CR extracts may not be essential to the development of airway inflammation.

Is Party Identification Responsible in Korea? An Explanation of Unstable Party Identification in Terms of Voters’ Evaluations

신유섭 한국학술연구원 2012 Korea Observer Vol.43 No.2

Party identification in Korea is characterized by frequent change. This situation raises the important question of whether unstable party identification can still be responsible. It remains to be determined whether such frequent changes are caused by voters’responsible consideration, taking the form of behaviors such as candidate evaluations, or simply a consequence of the unstable political party system. If party identification merely fluctuates with the unstable party system, then the role of party identification in political choices needs to be discounted. This article tests this point with panel data collected during a nine-month period around the seventeenth presidential election and shows that although Korean party identification is highly unstable, it also tends to be responsible and meaningful: Korean party identification varies according to voters’ various evaluations, even after controlling for ideology and past party identification. This tendency is more obvious among voters who are more educated, younger, and who live in large cities.

Legislative Oversight of Intelligence Agencies in Democratic Countries: The Case of South Korea and the United States

신유섭 인하대학교 국제관계연구소 2012 Pacific Focus Vol.27 No.1

Public worry about the potential for human rights abuse in the name of gathering intelligence can significantly reduce when the legislative branch successfully carries out control over intelligence agencies. This article analyzes the legislative oversight of intelligence agencies in South Korea, comparing it with intelligence oversight in the United States. Various factors related to Intelligence Committee characteristics and legislators’ behavior can reduce the effectiveness of intelligence oversight, and their deleterious effect can be more serious in Korea than in the United States. To reduce any deleterious effect of these problems especially in emerging democratic countries such as South Korea, this article made several suggestions.

보수적 가치관의 재부상 배경과 의미

신유섭 한국국제정치학회 2008 한국국제정치학회 학술대회 발표논문집 Vol.- No.-