대동맥과 우심실사이의 누루를 동반한 대동맥판막 및 삼첨판막의 감염성 심내막염 치험 1례

서필원,안혁,Seo, Pil-Won,Ahn, Hyuk 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.5

We experienced a case of infective endocarditis of aortic valve and tricuspid valve associated with a fistula between aorta and right ventricle. The patient was 35 years old woman and showed severe congestive heart failure. Large and multiple vagetations were found on the valvular surfaces and a fistula was present between aorta and right ventricle. Probably infective endocarditis of aortic valve resulted in annular abscess and as it healed, a fistula was formed and tricuspid valve endocarditis followed. We replaced the aortic valve and tricuspid valve with St. Jude mechanical prostheses, and closed the fistula opening with suture. The postoperative course was smooth and the patient has no problems till now 4 months after operation.

중증 근무력증의 외과적 요법 - 25례 보고 -

서필원,성숙환,김주현,Seo, Pil-Won,Seong, Suk-Hwan,Kim, Ju-Hyeon 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

Myasthenia gravis is a disorder of neuromuscular transmission characterized by weakness and fatigue of voluntary muscles. It is now reasonably established to be due to an autoimmune attack directed against the postsynaptic nicotinic acetylcholine receptors of voluntary muscles. Thymectomy has become increasingly important in the treatment of this disease after the successful case of Blalock in 1939. From January 1984 to December 1988, we performed total thymectomy in 25 cases of myasthenia gravis except one, and get the results as follows. l. Among 25 cases, male to female was 10:15 and the age was ranged from 16 years to 65 years. 2. Thymectomy was done in 24 cases and 1 case of malignant thymoma was not resectable. 3. There were 2 deaths after thymectomy due to myasthenic crisis. 4. There were 19 cases [76 %] of improvement after thymectomy as follows; complete remission was 6 cases [24 %], marked improvement was 9 cases [36 %] and subjective improvement was 4 cases [16 %]. 5. The effect of age, and duration of disease on operative result was not statistically significant, but that of thymic pathology was significant.

폐암세포주에서 NFκ 활성 억제를 통한 Proteasome 억제제 MG132의 TRAIL-유도성 Apoptosis 감작 효과

서필원,이계영,Seo, Pil Won,Lee, Kye Young 대한결핵및호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.6

연구배경: 정상세포는 보호되고 종양세포에 독성을 보인다고 알려진 TNF유전자족으로 새로이 확인된 TRAIL이 폐암세포에서 보이는 아포프토시스 효과를 확인하고, 아포프토시스로부터 세포를 보호하는 전사인자 $NF-{\kappa}B$가 TRAIL에 의하여 활성화 되는 정도를 평가하여 MG132의 $NF-{\kappa}B$활성억제가 TRAIL 유도성 아포프토시스를 감작시키는지를 확인하기 위하여 본 연구를 시행하였다. 방법: A549(wt p53) 및 NCI-H1299(null p53) 폐암세포주를 사용하였다. 세포독성 검사는 MTT assay를 이용하였고 아포프토시스는 Annexin V assay와 FACS 분석을 이용하였다. $NF-{\kappa}B$ 전사활성은 luciferase reporter gene assay를 이용하였고 $I{\kappa}B{\alpha}$ 분해는 western blot을 이용하였으며, TRAIL에 의해 활성화된 $NF-{\kappa}B$와 DNA 결합은 electromobility shift assay와 anti-p65 antibody를 이용한 supershift assay로 확인하였다. 결과: 1) TRAIL 100 ng/ml 농도에서 wild-type p53인 A549 폐암세포는 34.4%, p53 null인 NCI-H1299 폐암세포는 26.4%의 세포사를 관찰하였다. 2) Luciferase reporter gene assay로서 TRAIL에 의한 $NF-{\kappa}B$의 활성이 A549 $IgG{\kappa}B-luc$세포에서 2.45배 증가하고 NCI-H1299 $IgG{\kappa}B-luc$세포에서는 1.47배 증가함을 관찰하여 TRAIL에 의하여 $NF-{\kappa}B$가 활성화됨을 확인하였다. 3) MG132의 전처치로 TRAIL에 의한 $NF-{\kappa}B$의 활성이 A549 세포와 NCI-H1299 세포에서 각각 기저수준의 0.24, 0.21배로 강력히 억제되었다. 4) TRAIL단독으로 30% 전후의 세포독성이 MG132 전처치 후 TRAIL을 투여하면 두 세포주 모두에서 80% 이상의 세포독성이 관찰되어 MG132가 TRAIL유도성 아포프토시스에 감작효과가 있음을 확인하였다. 결론: 이상의 결과로 TRAIL에 상대적인 내성을 보이는 폐암세포주에서 MG132가 $NF-{\kappa}B$ 활성억제로서 TRAIL유도성 아포프토시스를 강화시키는 효과가 있음을 확인할 수 있었다. 따라서 본 연구는 향후 폐암치료에 있어서 TRAIL유도성 아포프토시스가 이용될 수 있는 가능성을 확인한 기초자료가 된다고 생각된다. Background: TRAIL (TNF-related apoptosis inducing ligand) is a newly identified member of the TNF gene family which appears to have tumor-selective cytotoxicity due to the distinct decoy receptor system. TRAIL has direct access to caspase machinery and induces apoptosis regardless of p53 phenotype. Therefore, TRAIL has a therapeutic potential in lung cancer which frequently harbors p53 mutation in more than 50% of cases. However, it was shown that TRAIL also could activates $NF-{\kappa}B$ in some cell lines which might inhibit TRAIL-induced apoptosis. This study was designed to investigate whether TRAIL can activate $NF-{\kappa}B$ in lung cancer cell lines relatively resistant to TRAIL-induced apoptosis and inhibition of $NF-{\kappa}B$ activation using proteasome inhibitor MG132 which blocks $I{\kappa}B{\alpha}$ degradation can sensitize lung cancer cells to TRAIL-induced apoptosis. Methods: A549 (wt p53) and NCI-H1299 (null p53) lung cancer cells were used and cell viability test was done by MTT assay. Apoptosis was confirmed with Annexin V assay followed by FACS analysis. To study $NF-{\kappa}B$-dependent transcriptional activation, a luciferase reporter gene assay was used after making A549 and NCI-H1299 cells stably transfected with IgG ${\kappa}-NF-{\kappa}B$ luciferase construct. To investigate DNA binding of $NF-{\kappa}B$ activated by TRAIL, electromobility shift assay was used and supershift assay was done using anti-p65 antibody. Western blot was done for the study of $I{\kappa}B{\alpha}$ degradation. Results: A549 and NCI-H1299 cells were relatively resistant to TRAIL-induced apoptosis showing only 20~30% cell death even at the concentration 100 ng/ml, but MG132 ($3{\mu}M$) pre-treatment 1 hour prior to TRAIL addition greatly increased cell death more than 80%. Luciferase assay showed TRAIL-induced $NF-{\kappa}B$ transcriptional activity in both cell lines. Electromobility shift assay demonstrated DNA binding complex of $NF-{\kappa}B$ activated by TRAIL and supershift with p65 antibody. $I{\kappa}B{\alpha}$ degradation was proven by western blot. MG132 completely blocked both TRAIL-induced $NF-{\kappa}B$ dependent luciferase activity and DNA binding of $NF-{\kappa}B$. Conclusion: This results suggest that inhibition of $NF-{\kappa}B$ can be a potentially useful strategy to enhance TRAIL-induced tumor cell killing in lung cancer.

외상에 의한 상행 대동맥 박리증의 치험 1례

서필원,채헌,Seo, Pil-Won,Chae, Hurn 대한흉부심장혈관외과학회 1990 Journal of Chest Surgery (J Chest Surg) Vol.23 No.1

Aortic dissection is a challenging disease and the causes of that are well-known. Blunt chest trauma is one of the causes of aortic dissection. In such cases, nearly all cases involves the isthmic portion of descending aorta, but ascending aorta is involved in about 10. We experienced a patient who had ascending aortic dissection due to automobile accident and who showed spontaneous rupture of the aorta during operation. In this case, after installation of aortic line via left femoral artery, ascending aorta ruptured and a large amount of blood gushed out, which was suckered by cardiotomy sucker. A little delay of cardiopulmonary bypass may cause the fatal outcome in such a case because the bleeding from aorta is too much to be controlled. Fortunately, we controlled the bleeding with cardiopulmonary bypass and got the good outcome of this patient by interpositioning the vascular graft. One should suspect the possibility of aortic dissection in blunt chest trauma, and prepare all the facilities against bleeding due to rupture.

폐암세포주에서 NF-κB 활성 억제를 통한 Proteasome 억제제 MG132의 TRAIL-유도성 Apoptosis 감작 효과

서필원 ( Pil Won Seo ),이계영 ( Kye Young Lee ) 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.6

연구배경: 정상세포는 보호되고 종양세포에 독성을 보인다고 알려진 TNF유전자족으로 새로이 확인된 TRAIL이 폐암세포에서 보이는 아포프토시스 효과를 확인하고, 아포프토시스로부터 세포를 보호하는 전사인자 NF-κB가 TRAIL에 의하여 활성화 되는 정도를 평가하여 MG132의 NF-κB활성억제가 TRAIL 유도성 아포프토시스를 감작시키는지를 확인하기 위하여 본 연구를 시행하였다. 방법: A549(wt p53) 및 NCI-H1299(null p53) 폐암세포주를 사용하였다. 세포독성 검사는 MTT assay를 이용하였고 아포프토시스는 Annexin V assay와 FACS 분석을 이용하였다. NF-κB 전사활성은 luciferase reporter gene assay를 이용하였고 IκBα 분해는 western blot을 이용하였으며, TRAIL에 의해 활성화된 NF-κB와 DNA 결합은 electromobility shift assay와 anti-p65 antibody를 이용한 supershift assay로 확인하였다. 결과: 1) TRAIL 100 ng/ml 농도에서 wild-type p53인 A549 폐암세포는 34.4%, p53 null인 NCI-H1299 폐암세포는 26.4%의 세포사를 관찰하였다. 2) Luciferase reporter gene assay로서 TRAIL에 의한 NF-κB의 활성이 A549 IgGκB-luc세포에서 2.45배 증가하고 NCI-H1299 IgGκB-luc세포에서는 1.47배 증가함을 관찰하여 TRAIL에 의하여 NF-κB가 활성화됨을 확인하였다. 3) MG132의 전처치로 TRAIL에 의한 NF-κB의 활성이 A549 세포와 NCI-H1299 세포에서 각각 기저수준의 0.24, 0.21배로 강력히 억제되었다. 4) TRAIL단독으로 30% 전후의 세포독성이 MG132 전처치 후 TRAIL을 투여하면 두 세포주 모두에서 80% 이상의 세포독성이 관찰되어 MG132가 TRAIL유도성 아포프토시스에 감작효과가 있음을 확인하였다. 결론: 이상의 결과로 TRAIL에 상대적인 내성을 보이는 폐암세포주에서 MG132가 NF-κB 활성억제로서 TRAIL유도성 아포프토시스를 강화시키는 효과가 있음을 확인할 수 있었다. 따라서 본 연구는 향후 폐암치료에 있어서 TRAIL유도성 아포프토시스가 이용될 수 있는 가능성을 확인한 기초자료가 된다고 생각된다. Background: TRAIL (TNF-related apoptosis inducing ligand) is a newly identified member of the TNF gene family which appears to have tumor-selective cytotoxicity due to the distinct decoy receptor system. TRAIL has direct access to caspase machinery and induces apoptosis regardless of p53 phenotype. Therefore, TRAIL has a therapeutic potential in lung cancer which frequently harbors p53 mutation in more than 50% of cases. However, it was shown that TRAIL also could activates NF-κB in some cell lines which might inhibit TRAIL-induced apoptosis. This study was designed to investigate whether TRAIL can activate NF-κB in lung cancer cell lines relatively resistant to TRAIL-induced apoptosis and inhibition of NF-κB activation using proteasome inhibitor MG132 which blocks IκBα degradation can sensitize lung cancer cells to TRAIL-induced apoptosis. Methods: A549 (wt p53) and NCI-H1299 (null p53) lung cancer cells were used and cell viability test was done by MTT assay. Apoptosis was confirmed with Annexin V assay followed by FACS analysis. To study NF-κB-dependent transcriptional activation, a luciferase reporter gene assay was used after making A549 and NCI-H1299 cells stably transfected with IgGκ-NF-κB luciferase construct. To investigate DNA binding of NF-κB activated by TRAIL, electromobility shift assay was used and supershift assay was done using anti-p65 antibody. Western blot was done for the study of IκBα degradation. Results: A549 and NCI-H1299 cells were relatively resistant to TRAIL-induced apoptosis showing only 20~30% cell death even at the concentration 100 ng/ml, but MG132 (3μM) pre-treatment 1 hour prior to TRAIL addition greatly increased cell death more than 80%. Luciferase assay showed TRAIL-induced NF-κB transcriptional activity in both cell lines. Electromobility shift assay demonstrated DNA binding complex of NF-κB activated by TRAIL and supershift with p65 antibody. IκBα degradation was proven by western blot. MG132 completely blocked both TRAIL-induced NF-κB dependent luciferase activity and DNA binding of NF-κB. Conclusion: This results suggest that inhibition of NF-κB can be a potentially useful strategy to enhance TRAIL-induced tumor cell killing in lung cancer. (Tuberc Respir Dis 2008;65:476-486)

미만성 간질성 폐질환의 개흉 폐 생검

성숙환,서필원,Seong, Suk-Hwan,Seo, Pil-Won 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.10

Open lung biopsy was performed in thirty patients for the diagnosis and staging evaluation of interstitial lung disease during the period from January 1987 until December 1992. The age of the patients ranged from 14 to 71 years [mean 48 years], and the patients consisted of 14 males and 16 females. Preoperative FEV1`s were from 0.80 liter to 3.88 liters [mean 1.66]. Other non-invasive diagnostic studies such as PCNA, bronchoalveolar lavage, TBLB, and gallium scan were also done in addition to X-ray and high-resolution chest CT. Tweaty-eight were correctly diagnosed and 2 cases were not [diagnostic yield rate 93.3%]. Among the 28 cases,pathologic diagnosis influenced further treatment regimens and prognostic expectations in 23 cases [82.1%]. The diagnostic non-invasive studies other than open lung biopsy yielded a correct diagnosis without staging only in 5 cases. There was no mortality and only one complication, ARDS ; however, the patient recovered after 5 days ventilator support. Open lung biopsy, which is the gold standard for the diagnosis and staging evaluation of interstitial lung disease can be done safely and has value in clinical decision making. Also knowledge of the involvement of the lesion is important for proper selection of the biopsy site.

공압식 심실 보조기의 동물실험

박성식,김삼현,서필원,최창휴,이상훈,이혁수,황승옥,안혁,Park, Seong-Sik,Kim, Sam-hyun,Seo, Pil-won,Choi, Chang-hyu,Lee, Sang-hoon,Lee, Hyuk-soo,Hwang, Seung-ok,Ahn, Hyuk 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.12

Background : Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. Material and Method : The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. Result: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. Conclusion : e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.

소아심장판막치환술

김혁,유재현,서필원,이원용,백완기,박국양,이영탁,박영관,홍승록,이영균,Kim, Hyuk,Yu, Jae-Hyeon,Seo, Pil-Won,Lee, Won-Yong,Baek, Wan-Ki,Park, Kook-Yang,Lee, Young-Tak,Park, Young-Kwan,Hong, Sung-Nok,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.4

Between 1985 and 1993, 29 children from 1 to 15 years of age have undergone cardiac valve replacements at Buchon Sejong Hospital. The patients were composed of 20 males and 9 females and 17 patient had congenital heart disease and 12 patients had acquired heart disease. Two of these patients have had second valve replacements due to paravalvular leakage and valve thrombosis. Single valve replacements were 29 and double valve replacements were 2. All the patients had received prosthetic valves except one. Among the 25 patients who had definite post-operative records, the overall mortality was 12%[4% was early mortality and 8% was late mortality].25 patients were followed up with coumadin anticoagulation for total 633 patient-months[minimum 2 months to maximum 93 months, mean 25.3 months] and actuarial survival rate was 88.5 $\pm$ 6.3% at 7 years and event free rate was 70.3 $\pm$ 11.7% at 7 years. These results suggest that pediatric valve replacements can now be performed at a low operative risk although various problems are still remained and the choice of valve is prosthetic valve mainly due to its durability at the present time.

간병 로봇을 위한 합성곱 신경망 (CNN) 기반 의약품 인식기 설계

김현돈,김동현,서필원,배종석,Kim, Hyun-Don,Kim, Dong Hyeon,Seo, Pil Won,Bae, Jongseok 대한임베디드공학회 2021 대한임베디드공학회논문지 Vol.16 No.5

Our final goal is to implement nursing robots that can recognize patient's faces and their medicine on prescription. They can help patients to take medicine on time and prevent its abuse for recovering their health soon. As the first step, we proposed a medicine classifier with a low computational network that is able to run on embedded PCs without GPU in order to be applied to universal nursing robots. We confirm that our proposed model called MedicineNet achieves an 99.99% accuracy performance for classifying 15 kinds of medicines and background images. Moreover, we realize that the calculation time of our MedicineNet is about 8 times faster than EfficientNet-B0 which is well known as ImageNet classification with the high performance and the best computational efficiency.

둔상성 외상에 의한 심장파열에 대한 수술적 치험

노태욱 ( Tae Ook Noh ),서필원 ( Pil Won Seo ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.1

Although blunt traumatic cardiac rupture is an uncommon injury, it can be associated with a high mortality rate. Two cases of cardiac rupture in blunt trauma patients are described herein. In those cases, applications of mechanical support devices such as ECMO (extracorporeal membrane oxygenation) and early surgery for exploration under cardiopulmonary bypass may be helpful for treating blunt chest trauma patients.