Management of hypotension after spinal anesthesia administered for caesarean section

지영석 대한마취통증의학회 2017 Anesthesia and pain medicine Vol.12 No.2

Spinal anesthesia is widely used for parturients undergoing scheduled elective caesarean section. Hypotension associated with spinal anesthesia is a major concern in obstetrics. Preventive methods for post-spinal hypotension include intravenous fluid preloading, bolus or continuous injection of vasopressors. Intravenous fluid preloading reduces the incidence and severity of maternal hypotension during spinal anesthesia administered for cesarean section. Although fluid preloading prevents maternal hypotension, it is not advisable to delay spinal anesthesia for preloading a fixed volume of intravenous fluid. Ephedrine, the drug of choice to prevent maternal hypotension during spinal anesthesia for caesarean delivery, acts by maintaining the uteroplacental blood flow. Phenylephrine is also effective in reducing maternal hypotension during this procedure. Both the vasopressors are acceptable for preventing hypotension. However, in the absence of maternal bradycardia, phenylephrine is the preferred drug for the management of hypotension during regional anesthesia for caesarean section, because of its improved fetal acid-base status.

수술스케줄 전산화로 업무 효율성 향상

지영석 한국의료QA학회 2006 가을학술대회 Vol.2005 No.2

친수성 아크릴릭 인공수정체 삽입술의 임상적 고찰

지영석,이광훈,박영걸,윤경철,Yong Sok Ji,M,D,Kwang Hoon Lee,M,D,Yeoung Geol Park,M,D,Ph,D,Kyung Chul Yoon,M,D,Ph,D 대한안과학회 2006 대한안과학회지 Vol.47 No.7

Purpose: To evaluate the clinical results of Akreos? hydrophilic acrylic intraocular lens (IOL) implantation compared with implantation of Acrysof? hydrophobic acrylic IOL. Methods: We retrospectively analyzed each fifty eyes in 50 patients who had undergone phacoemulsification and implantation of Akreos? and Acrysof? IOLs, with a minimum follow-up period of one year. Results: Final visual acuity better than 0.5 and 0.8 was 70% and 27% in the Akreos? implanted group, and 82% and 46% in the Acrysof? group. Predictability less than 1.0D was seen in 23 eyes (46%) in the Akreos? group. This is a significantly low percentage compared with that seen in 43 eyes (86%) in the Acrysof? group. The final spherical equivalent of -0.93±0.92D in the Akreos? group represented statistically significant myopic refractive error compared with -0.49±0.82D in the Acrysof? group. Conclusions: It is necessary to consider the myopic refractive error toDetermine the proper target refraction for the implantation of Akreos? IOL.

Fabrication of Thin Solid Oxide Film Fuel Cells

지영석,장익황,손지원,이종호,강상균,차석원 한국세라믹학회 2010 한국세라믹학회지 Vol.47 No.1

Recently, thin film processes for oxides and metal deposition, such as physical vapor deposition (PVD) and chemical vapor deposition (CVD), have been widely adapted to fabricate solid oxide fuel cells (SOFCs). In this paper, we presented two research area of the use of such techniques. Gadolinium doped ceria (GDC) showed high ionic conductivity and could guarantee operation at low temperature. But the electron conductivity at low oxygen partial pressure and the weak mechanical property have been significant problems. To solve these issues, we coated GDC electrolyte with a nano scale yittria-doped stabilized zirconium (YSZ) layer via atomic layer deposition (ALD). We expected that the thin YSZ layer could have functions of electron blocking and preventing ceria from the reduction atmosphere. Yittria-doped barium zirconium (BYZ) has several orders higher proton conductivity than oxide ion conductor as YSZ and also has relatively high chemical stability. The fabrication processes of BYZ is very sophisticated, especially the synthesis of thin-film BYZ. We discussed the detailed fabrication processes of BYZ as well as the deposition of electrode. This paper discusses possible cell structure and process flow to accommodate such films.

척추마취 하 제왕절개술 환자에서 발생한 발작성 심실상성 빈맥의 경험 -증례 보고-

지영석,김수미,윤희조,조홍제,손주형 대한마취통증의학회 2011 Anesthesia and pain medicine Vol.6 No.4

We experienced a case of paroxysmal supraventricular tarchycardia (PSVT) in a 31-year-old pregnant woman undergoing elective cesarean section under spinal anesthesia. About 15 minutes after delivery of the baby, PSVT suddenly developed. PSVT was difficult to control with a number of medications including esmolol,adenosine and verapamil. Normal sinus rhythm was finally restored after repeated trials of biphasic cardioversion. The patient fully recovered and was discharged without any complication 5 days later.

수평 에지 분석을 통한 실시간 전방 차량 검출 기법

지영석,한영준,한헌수 제어로봇시스템학회 2010 제어로봇시스템학회 국내학술대회 논문집 Vol.2010 No.5

Clinical Experience of Male Primary Choriocarcinoma at the Samsung Medical Center

지영석,박세훈 대한암학회 2021 Cancer Research and Treatment Vol.53 No.3

Purpose The objective of this study was to describe and analyze the clinicopathological features of primary choriocarcinoma (PCC) observed in male patients treated at the Samsung Medical Center between 1996 and 2020. Materials and Methods We reviewed the clinical records of 14 male patients with PCC retrospectively to assess their demographic, histological, and clinical characteristics at the time of diagnosis as well as identify the treatment outcomes. Results The median age of the patients was 33 years. The primary tumor site was the testicles in seven cases (50%), the mediastinum in six cases (43%), and the brain in one case (7%). The most common metastatic site was the lungs (79%), followed by the brain (43%). All patients with PCC received cytotoxic chemotherapy. Twelve patients had records of their response to cytotoxic chemotherapy; of these 12 patients, eight (8/12, 67%) achieved an objective response, and four (4/12, 33%) achieved stable disease response as the best response during chemotherapy. Conclusion It is known that most male PCC patients eventually develop resistance to cytotoxic chemotherapy and die. Factors such as poor response to chemotherapy, high disease burden, brain metastasis, and hemoptysis at the time of diagnosis are associated with shorter survival time in male PCC patients. Programmed death-1/programmed death-ligand 1 blockade therapy can be a salvage treatment for chemotherapy-resistant male PCC patients.

Clinical Experience of Allogeneic Hematopoietic Stem Cell Transplantation in Elderly Patients Aged 60 Years and Older in South Korea

지영석,안재숙,윤진아,장금하,임성희,김세형,김찬규,원종호,박성규 연세대학교의과대학 2023 Yonsei medical journal Vol.64 No.2

Purpose: The purpose of this study is to share our outcomes and experiences on allogeneic hematopoietic stem cell transplanta tion (HSCT) in elderly patients aged 60 years and older with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) in South Korea, and to compare them with other studies. Materials and Methods: We analyzed the clinical outcomes of 116 patients with AML or MDS aged 60 years and older who un derwent allogeneic HSCT. We also analyzed which pretreatment factors affect the overall survival (OS) after allogeneic HSCT. Results: Neutrophil and platelet engraftment were achieved at median day +11 [interquartile range (IQR) 10–15] and +14 (IQR 11–19), respectively. A complete donor chimerism was confirmed in 65 (56.0%) patients at 3 weeks and in 63 (54.3%) patients at 3 months after HSCT. The estimated incidence of grade II–IV acute graft-versus-host disease (GVHD) at day 100 was 13.7%. The es timated incidence of chronic GVHD at 2 years was 38.8%. Within a median follow-up of 14 months after HSCT, OS was 64% at 1 year and 55% at 2 years, and non-relapse mortality (NRM) was 20% at 1 year and 28% at 2 years. Multivariate analysis revealed that male sex and Hematopoietic Cell Transplantation-Specific Comorbidity Index ≥3 were associated with poor OS. Conclusion: This study showed that allogeneic HSCT in elderly adults aged 60 and older can be performed with successful en graftment and acceptable NRM and OS are expected given the generally known survival of patients with higher risk MDS and poor risk AML.

치료레이저각막절제술과 양막이식술의 동시 시행에 의한 수포각막병증의 치료효과

지영석,윤경철.Yong-Seok Ji. M.D.. Kyung-Chul Yoon. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.4

Purpose: To evaluate the therapeutic effects of excimer laser phototherapeutic keratectomy (PTK) combined with amniotic membrane transplantation (AMT) in patients with symptomatic bullous keratopathy and poor visual potential. Methods: Fifteen eyes of 15 patients were included. After mechanical removal of the epithelium, the central 7.0~7.5 mm zone was ablated with the excimer laser (ablation depth of 50 μm) and the peripheral cornea was additionally polished with other pulses of diameter 2.0 mm in an annular fashion. After PTK, the preserved amniotic membrane was sutured onto the cornea. Vision and symptom changes, epithelization time, statue of amniotic membrane, cosmesis, recurrence of bulla, and postoperative complication were analyzed. Results: Mean follow-up period was 8.4 months (range, 6~20). Postoperative visual acuity improved or unchanged in 13 eyes (86.7%) and decreased by 1 line in 2 eyes (13.3%). Symptoms improved in all patients. Ten patients (66.7%) had complete resolution of symptoms. Mean epithelization time was 12.4 days, and cosmetic result was excellent or good in 13 eyes (86.7%). At last examination, though some patients showed a loss of amniotic membrane, epithelial bulla had not recurred in 14 eyes (93.3%). No postoperative complication was detected. Conclusions: Combined PTK and AMT is effective in symptom relief and prevention of recurrence in the treatment of bullous keratopathy.

정맥 내 자가 조절 진통을 받는 환자의 술 후 초기 통증 조절을 위한 진통제의 비교

지영석 대한마취통증의학회 2008 Anesthesia and pain medicine Vol.3 No.4

Background: This study was performed to compare postoperative pain and sedation among meperidine 50 mg PRN intramuscular injection, meperidine 50 mg routine intramuscular injection and fentanyl 50μg routine intravenous injection at the end of surgery for early postoperative pain control in patients with intravenous patient-controlled analgesia (IV PCA). Methods: In group P (n = 35), meperidine 50 mg was injected intramuscularly on request of patients. In group M (n = 35) and F (n = 35), meperidine 50 mg was injected intramuscularly or fentanyl 50μg was injected intravenously at the end of surgery, respectively. Pain score was measured with verbal rating scale (VRS; 0−10) at 30 min, 1 hr, and 6 hr, and sedation score was evaluated with Observer’s assessment of alertness/sedation scale (OAA/S) at 30 min, and 1 hr after extubation. Additional fentanyl 50 μg was injected intravenously if patient requested pain control in group P and if VRS was higher than 5 point at 30 min after extubation or patients requested pain relief in group M and group F. Results: Sedation scores of group M were higher than group P and group F. Group P had a higher VRS score than group M and group F at 30 min after extubation. Dose of additional fentanyl 50 μg injection was similar among three groups. Conclusions: Fentanyl 50μg intravenous injection at the end of surgery with additional fentanyl 50μg injection on patient’s request may be good method for early pain control for IV-PCA patients.