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.

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.

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.

수술스케줄 전산화로 업무 효율성 향상

지영석 한국의료QA학회 2006 가을학술대회 Vol.2005 No.2

Comparisons of the system performance for the small solid oxide fuel cell applications

지영석,Seyun Lah,손지원,차석원 한국물리학회 2010 Current Applied Physics Vol.10 No.2

Among the various sizes of the fuel cell applications, the field of portable power sources shows the best feasibility due to the price competitiveness. Solid oxide fuel cells have various sub system types such as internal reforming/external reforming, single chamber/dual chamber, hydrogen feeding/hydrocarbon feeding and so on. We supposed that the performance gaps must exist except the stack performance. So we calculated many factors on the basis of the mass/species balance, thermal balance and power balance. In this study we were able to compare the power efficiency, fuel efficiency and portability from the calculations. And we could estimate the operation conditions of each type. At the result the hydrogen feeding dual chamber type showed the best performance in most fields of comparison.

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.

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.

부인과 복강경 수술에서 고용량 metoclopramide, dexamethasone 병용투여와 haloperidol, midazolam, dexamethasone 병용투여의 수술 후 오심, 구토 예방 효과의 비교

지영석,윤희조,박연수,김동우 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.3

Background: This prospective randomized double-blinded study was designed to compare the efficacy of a combination of high dose metoclopramide and dexamethasone with that of haloperidol, midazolam and dexamethasone, for the prevention of postoperative nausea and vomiting (PONV) in patients scheduled for laparoscopic gynecologic surgery who are receiving fentanyl intravenous-patient controlled analgesia. Methods: The subjects were randomly allocated to either group M (20 mg metoclopramide and 10 mg dexamethasone was administered at induction, n = 35) or group H (1 mg haloperidol, 3 mg midazolam and 10 mg dexamethasone were administered at induction, n = 35). The incidence of PONV and the severity (measured by numeric rating scale) of the patients’ nausea and pain were evaluated at 6 hours, 24 hours, and 48 hours, postoperatively. Results: The overall incidence of the PONV was not significantly different between the two groups during the 48 hours period (group M: 21% vs. group H: 12%). The severity of the nausea and pain were similar between the two groups. Conclusions: The prophylactic use of a combination of 1 mg haloperidol, 3 mg midazolam and 10 mg dexamethasone is as effective and inexpensive as 20 mg metoclopramide and 10 mg dexamethasone to prevent PONV.

골수이형성증후군이 있는 임산부에서 발생한 수혈관련 급성폐손상- 증례 보고 -

지영석,성태윤,이석진,유황주,정기순,강포순 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.1

Transfusion-related acute lung injury (TRALI) is defined as a new episode of acute lung injury that occurs during or within 6 hours of a completed transfusion, which is one of the leading causes of transfusion-related morbidity and mortality. We present a case of TRALI in a 29-year-old parturient with myelodysplastic syndrome scheduled for cesarean section. The parturient developed hypoxemia and dyspnea after preoperative transfusion of platelets following apheresis to eliminate a unit of leucocyte in order to correct thrombocytopenia. She underwent emergent caesarean section for fetal distress. After surgery, the chest radiograph showed diffuse haziness of both lung fields. Direct and indirect antiglobulin tests were negative, and hemolytic transfusion reaction was ruled out. Pro-BNP 347.3 pg/ml also excluded transfusion-associated circulatory overload. The parturient completely recovered after oxygen support for 2 days. It is important to recognize TRALI as soon as possible to minimize perioperative morbidity and mortality.

미국 보건의료체계에서의 사기 근절을 위한 빅데이터 및 선진 분석 기술의 활용

지영석,( Lee Rivas ) 건강보험심사평가원 심사평가연구소 2014 HIRA 정책동향 Vol.8 No.6