행정소송의 판결의 주문에(主文) 관하여(1)

최세영 한국사법행정학회 1988 사법행정 Vol.29 No.1

포도당, 인슐린 및 Angiotensin II가 흰쥐 대동맥평활근세포의 Plasminogen Activator Inhibitor-1 발현 및 성장에 미치는 영향

최세영,이인규,한승세,김재현,박창권,이광숙,유영선,김기식,김윤년 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.4

배경: PAI-1은 t-PA의 억제인자로서 섬유소융해계에 작용을 하여 혈전형성을 유발한다. PAI-1은 동맥경화된 혈관벽에서 분비가 된다. PAI-1의 증가는 동맥경화증의 위험인자가 되는 당뇨병과 고혈압이 동반된 환자에서 보이며 혈전증유발에 위험인자가 될 수 있다. 본 연구는 고혈당과 인슐린 및 angiotensin II가 PAI-1의 생성 및 평활근세포의 증식에 미치는 영향을 규명하고자 하였다. 대상 및 방법:흰쥐 대동맥평활근세포를 5.5 mM과 22 mM의 포도당 배양액을 사용하여 배양하였다. 배양액에 angiotensin II 및 인슐린을 농도 및 배양시간에 따라 첨가하여 Northern blotting방법으로 PAI-1 유전자발현을 나타내었다. 또한 세포 증식에 대한 포도당, 인슐린 및 angiotensin II의 영향을 규명하기 위하여 MTT assay를 사용하였다. 결과: 5.5 mM과 22 mM의 포도당 배양액에서 angiotensin II(100 nM)를 첨가하여 배양한 결과, 22 mM 포도당 배양액에서 PAI-1 mRNA 발현이 증가되었으며 angiotensin II 투여 4시간에 최고치에 도달하였고 6시간까지 지속되었다. 5.5 mM, 22 mM의 포도당 배양액에 angiotensin II의 농도를 0, 10, 100, 200 nM 투여하여 배양한 결과, PAI-1 mRNA의 발현은 angiotensin II 농도에 따른 증가를 보였으며 22 mM 포도당 배양액시 더욱 뚜렷하게 증가되었다. 배양액에 angiotensin II(100 nM)과 인슐린(100 nM)을 투여하여 배양한 결과, PAI-1 mRNA의 발현은 angiotensin II 단독으로 투여시 증가하였으나 인슐린을 첨가하였을 때는 감소하였다. 5.5 mM과 22 mM의 포도당 배양액에 1, 10, 100 nM의 인슐린과 1, 10, 100 nM의 angiotensin II를 첨가한 후 대동맥평활근세포의 성장속도를 비교한 결과, 5.5 mM보다 22 mM의 포도당이 든 배양액에서 대동맥평활근세포의 성장이 촉진되었으며, 인슐린 및 angiotensin II를 첨가한 경우도 대동맥평활근세포의 성장이 증가되었다. 결론:흰쥐 대동맥평활근세포에서 PAI-1 mRNA의 발현은 포도당 농도가 높을수록 증가되며 angiotensin II의 농도 및 배양시간에 따라 증가되고 인슐린 투여로 감소하였다. 또한 angiotensin II의 투여는 22 mM의 고농도 포도당 투여 후 증가된 PAI-1 mRNA 발현 증가를 더욱 증가시켜 PAI-1 mRNA 발현 증가에 상승작용이 있음을 알 수 있다. 그리고 22 mM의 고농도 포도당, 인슐린 및 angiotensin II는 흰쥐의 대동맥평활근세포의 성장을 촉진시켰다. Background: Plasminogen activator inhibitor-1(PAI-1) is known as the primary physiological inhibitor of tissue-type plasminogen activator(t-PA) in the plasma, and is present within the atherosclerotic vessels. Increased plasma levels of PAI-1 are one of the major disturbances of the hemostatic system in patients with diabetes and/or hypertension, and may have multiple interrelations with the important risk factors in the development of atherosclerosis. This study was performed to determine whether altered gene expression of PAI-1 occurs within the arterial wall, and thereby potentially contributing to the increase of cardiovascular risks associated with diabetes and/or hypertension. Material and Method: The aortic vascular smooth muscle cells of the rat were exposed to 22 mM glucose, angiotensin II, and insulin increased PAI-1 mRNA expression with the use of Northern blotting were examined. Also examined were the effects of 22 mM glucose, angiotensin II and insulin on the growth of the rat's aortic smooth muscle cells by using MTT assay. Result: Twenty-two mM glucose treatment increased the PAI-1 mRNA expression in a time- and dose-dependent manner. Aniotensin II treatment synergistically increased the glucose-induced PAI-1 mRNA expression. In contrast, addition of insulin attenuated the increase of 22 mM glucose and angiotensin II induced PAI-1 mRNA expression. Furthermore, treatment of 22 mM glucose, angiotensin II and insulin resulted in a significant increase in cell numbers. This study demonstrated that 22 mM glucose and angiotensin II have a synergistic effect in stimulating the PAI-1 mRNA expression and in the cell growth of the rat's aortic smooth muscle cells. Conclusion: Elevation of glucose and angiotensin II may be important risk factors in impairing fibrinolysis and developing atherosclerosis in diabetic patients.

불현성 우회로에 의한 방실회기성빈맥의 수술치험 -1례 보고-

최세영 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.3

A 21-year-old man with atrioventricular[AV] reentry tachycardia secondary to concealed accessory AV connection underwent surgical division of two accessory pathways following failure of radiofrequency catheter ablation. pathways were located in the left free wall area.Before cardiopulmonary bypass, the epicardial mapping confirmed the existence and localization of two accessory pathways. The patient was approached through a left atriotomy with a dissection of the left free wall area beginning with an internal mapping was carried out after separation from cardiopulmonary bypass to confirm the absence of retrograde conduction of accessory pathway. Five weeks after surgery, the electrophysiololgic study demonstrated no retrograde conduction through two accessory pathways.

개심술후 발생한 종격동염의 치료

최세영 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.4

Between January 1984 and January 1994, 13 patients developed mediastinitis after cardiac operations. There were 7 women and 6 men with a mean age of 24.2 years[range 0.7 - 61 . Initial operation included 7 valve replacements and 6 congenital cardiac repairs. The duration between initial operation and diagnosis was 13.5 days[range 4-57 . Organisms cultured from debridement material included S.aurus[n=9 , S.epidermidis[n=3 and Enterobacter[n=1 . Fever was the most frequent complaint and purulent drainage was noticed in 9 patients[69% . Seven patients were treated with radical debridement followed by closed irrigation. In other 6 patients, the wounds were managed by debridement, open granulation and delayed wound closure. Two hospital deaths [15.4% following open granulation method, resulted from sepsis. The 11 survivors were followed-up for 1-120 months, averaging 42 months and had healed wounds. One late death occurred due to massive hemorrhage.

외상성 횡격막 손상: 23례 보고

최세영 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.2

Twenty-three patients with traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center from Aug. 1978 to Nov. 1990 were reviewed. There were 19 male and 4 female patients. The age distribution was ranged from 1.5 to 72 years, with a mean age of 34.3 years. Sixteen patients had blunt trauma[traffic accident 14, fall down 2], and 7 had penetrating injuries[stab wound 6, broken glass 1]. Sixteen [70 percent]of the injuries occurred on the left side and 7[30 percent] on the right side. Fifteen patients were operated on during the acute phase, 5 patients during the latent phase, 2 patients during the obstructive phase. The surgical approach in 20 patients was through a thoracotomy; in 2 patients, a thoracoabdominal incision was necessary, and in 1 patient, a laparotomy was performed. Herniated organs in thorax included stomach[10], colon[5], small bowel[5], spleen[4], liver[2]. Postoperative complications included wound infection, empyema, pneumonia, hepatitis and respiratory failure. There were 3 postoperative deaths, 2 with cerebral dysfunction and 1 with sepsis.

나카가미 페이딩 체널에서 일반화된 선택성 다이버시티를 사용한 MPSK 신호의 평균 심벌 오류 확률

최세영,윤동원,한영열,Choi, Se-Yeong,Yoon, Dong-Weon,Han, Young-Yearl 대한전자공학회 1998 電子工學會論文誌, S Vol.s35 No.6

본 논문에서는 동일한 평균 전력을 가지며 주파수 비선택적 느린 나카가미 m-분포의 페이딩을 겪는 MPSK 신호들에 대한 다수의 다이버시티 가지 중 크기가 센 두세개의 신호를 순서대로 선택하고 합성하는 일반화된 선택성 합성 기법에 대한 평균 심벌 오류 확률식을 유도한다. 오류 확률식을 유도하기 위해 순서 통계량(Order Statistics)의 개념을 적용한다. 유도 과정에서 수신 신호의 확률 밀도 함수에 대한 새로운 전개가 소개되고 있으며, 다양한 수학적 기법들을 사용한다. 기존의 선택적 합성과 최대비 함성 기법과의 성능을 비교하여 적절한 다이버시티 가짓수를 찾는다. In this paper, a new closed form expression for the average symbol error rate(SER) of generalized selection combining(SC), whereby the two(three) signals with the two(three) largest amplitudes are combined from the original diversity branches in the channel, for MPSK signals in a frequency-nonselective slowly m-distributed Nakagami fading channel is derived. In order to analyze the error performance for a generalized SC, the Order-Statistics is applied. To derive the SER of MPSK signals with SC, the new expression of pdf is introduced and many other mathematical methods are used. Comparing the derived SER with that of MRC, we find adequate diversity branch number from total Lth-order diversity branches.

심장질환의 외과적치료 (300례 보고)

최세영,박이태,이광숙,유영선 大韓胸部外科學會 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.4

상행대동맥에서 기시한 우폐동맥 수술치험 1

최세영,박이태,유영선,Choe, Se-Yeong,Park, Lee-Tae,Yu, Yeong-Seon 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.4

Anomalous origin of right pulmonary artery from ascending aorta is a rare congenital heart disease. We experienced a case of anomalous origin of right pulmonary artery from ascending aorta with associated patent ductus arteriosus and patent foramen ovale, which was diagnosed by angiocardiography and cardiac catheterization. The ductus was ligated just before bypass, and a Dacron-graft with a diameter of 16 mm was interpolated posteriorly to the aorta between the right pulmonary artery and the pulmonary trunk. The postoperative course was uneventful. The right heart catheterization and right ventriculography performed on postoperative twelfth day revealed widely patent anastomotic site between the right pulmonary artery and the pulmonary trunk without residual stenosis. She was discharged on postoperative fourteenth day.

Fallot 사징증에 대한 근치수술

최세영 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.2

The experience with operative treatment for total correction of Fallot at the department of Thoracic and Cardiovascular Surgery, Keimyung University Dong San Medical Center from July 1980 to July 1984 was reviewed. There were 37 males and 12 females and their ages ranged from 3 years to 30 years, with the average age of 12.2 years. Sixty nine point four percent of patients were younger than 15 years of age. The most frequent type of right ventricular outflow stenosis was the combined type [pulmonary valvular and infundibular stenosis] containing 41 patients [83.7%] and there were 9 deaths in this group. The major associated lesions included Patent foramen ovale in 20 patients [40.8%], Atrial septal defect in 7 patients [14.3%], Left superior vena cava in 4 patients [8.2%], Right sided aortic arch in 2 patients [4.1%] and Patent ductus arteriosus in 11 patient [2.0%]. The pulmonary valvotomy was performed in 41 patients and patch graft reconstruction of the right ventricular outflow tract was performed in 23 patients. In 11 patients the monocusp patches were used. Thirty-five patients [71.4%] had the right bundle branch block postoperatively. There were 11 postoperative deaths with hospital mortality rate of 22.4% and the leading causes of death were low output syndrome, bleeding, and cerebral embolism.

농흉에 대한 Ranicef 투여의 임상 효과

최세영,유영선,Choe, Se-Yeong,Yu, Yeong-Seon 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.5

Ranicef\ulcorner[Cefpimizole sodium] is a new semisynthetic cephalosporin C derivative, was administered to 30 patients with empyema thoracis to evaluate its efficacy from Nov. 1989 to May 1990 at Department of Thoracic & Cardiovascular Surgery, Dongsan Medical Center, Keimyung University. The results were as follows. 1. The clinical efficacy of therapy was excellent in 15 cases, effective in 11 cases and failure in 4 cases. The effectiveness rate was 86.7%, respectively. 2. Among 30 cases organisms were cultured in 19 cases and 24 clinical strains were isolated. \ulcorner-hemolytic streptococcus[5], S. epidermidis[4], Pseudomonas aeruginosa[3], E. coli[3 of 5 cases], S. aureus[3 of 4 cases] and Klebsiella pneumoniae[1 of 2 cases] were effective to Ranicef\ulcorner 3. Abnormal clinical values, a decrease in platelet was observed in 3 cases and slight increases of s-GOT/GPT in 2 cases. But they were not so severe that they improved without. There were two cases of mild gastrointestinal symptom.