지정 토론 및 자유 토론

지성인,문성제,박형욱(토론자),김준래(토론자),이의주(토론자),한성훈(토론자),안덕선(토론자),김해영(토론자) 대한의사협회 의료정책연구소 2021 의료정책포럼 Vol.19 No.1

코로나19 시대, 원격의료 반드시 필요한가

지성인 대한의사협회 의료정책연구소 2020 의료정책포럼 Vol.18 No.3

Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report

지성인,김승오 大韓小兒齒科學會 2015 大韓小兒齒科學會誌 Vol.42 No.1

폐동맥 고혈압은 좌우단락을 가진 선천성 심장질환의 흔한 합병증으로 폐동맥 고혈압 환자에서 높아진 폐혈관 저항은 생명에 위협을 초래한다. 전신마취시의 양압환기는 폐동맥압을 높이고, 폐혈류량은 감소시키므로 저산소증을 유발할 수 있으며,이는 폐동맥 고혈압 환자에게서 불리하게 작용할 수 있다. 따라서 폐동맥 고혈압 환자에서는 양압환기보다는 자발호흡이 보다 안전할 것으로 생각된다. 만 5세 남환이 심한 저체중으로 본원으로 의뢰되었으며, 내원 당시 환아의 몸무게는 11 kg이었고, 2009년 팔로사징후로완전 교정 수술을 받은 의과적 병력이 있었으며, 2007년부터 현재까지 고혈압 약을 복용하고 있다고 하였다. 환아는 다발성우식을 가지고 있었으며, 치료는 경비캐눌라를 사용한 세보플루란 흡입 진정 하에 진행하엿다. 치료 내내 환아는 정상적인생징후와 자발호흡을 유지하였으며, 이후에도 폐동맥 고혈압과 연관된 다른 합병증은 보이지 않았다. 폐동맥 고혈압 환자에서의 세보플루란 흡입 진정의 안전한 사용 증례를 통해서, 세보플루란 흡입 진정이 심혈관계 질환을가진 환자들에서 전신마취의 대안으로 사용될 수 있는 가능성을 보여주었다 Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) withleft-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerablemorbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, becausethe positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonaryblood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressureventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy ofFallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited theDankook University Dental Hospital. He had multiple dental caries, and the treatment was completed undersevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operationwhile maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment ofpatients with PAH.

소아환자의 세보플루란 흡입진정시미다졸람 병용 투여의 효과에 관한 예비연구

지성인,김종수 大韓小兒齒科學會 2014 大韓小兒齒科學會誌 Vol.41 No.4

Patients with extreme anxiety who are unable to cope with dental treatment under non-pharmacologicalbehavioral management method may require sedation, or other forms pharmacological behavioral managementmethod. The aim of this retrospective study was to investigate the effect of concomitant administration of 0.1mg/kg intramuscular midazolam with or without sevoflurane insufflation sedation on sedation depth andcardiopulmonary function in pediatric patients. We analysed the records of anesthesia on patients who receiveddental treatment under deep sedation using sevoflurane insufflation from January 2013 to March 2014. Thirtysixchildren, aged 3 to 6 years, undergoing dental treatment were sedated using either sevoflurane insufflationalone (Group S, n = 18) or a combination of intramuscular injection of 0.1 mg/kg midazolam plus sevofluraneinsufflation (Group SM, n = 18). Upon comparison, the average entropy value of group SM was lower than thatof group S, but there were no statistically significant difference between the two groups (p > 0.05). The averageheart rate and mean arterial pressure of group SM were higher than those of group S (p < 0.05). Concomitantintramuscular injection of 0.1 mg/kg midazolam with sevoflurane insufflation sedation is not sufficient to enhancethe quality of sedation. 심한 치과적 공포와 불안으로 치과적 행동조절에 문제를 일으키는 환자의 경우, 진정법과 같은 약물적 행동 조절 방법이요구될 수 있다. 이번 연구에서는 소아 환자에서 세보플루란 흡입진정시에 추가적으로 0.1 mg/kg의 미다졸람을 근육주사하였을 때 진정 깊이와 심폐기능에 미치는 영향을 알아보기 위해 2013년 1월부터 2014년 3월 사이 본원에서 세보플루란 흡입진정 하에 치과치료를 받은 환자의 마취기록지를 후향적으로 분석하였다. 3~6세의 환자를 대상으로 하였으며, 세보플루란 단독 사용군이 18명, 미다졸람 병용 투여군이 18명이었다. 미다졸람 병용 투여군의 평균 엔트로피 값은 세보플루란 단독사용군에 비해 10정도 낮게 측정되었으나 통계적 유의성은 없었으며(p > 0.05), 분당 심박수와 평균동맥압은 미다졸람 병용투여군이 세보플루란 단독 사용군에 비해 높은 값을 보였다(p < 0.05). 즉, 0.1 mg/kg의 미다졸람 근육주사는 세보플루란흡입진정시 진정의 질을 높이는데 큰 도움이 되지는 않았으며, 추후 세보플루란 흡입진정과 병용 사용하기에 적절한 미다졸람의 용량을 결정하기 위한 추가적인 연구가 필요할 것으로 사료된다.

What is the gold standard of the dental anxiety scale?

지성인 대한치과마취과학회 2023 Journal of Dental Anesthesia and Pain Medicine Vol.23 No.4

It is important to understand patients' anxiety and fear about dental treatment. A patient's anxiety can be quantified through a self-report questionnaire, and many related scales have been developed. In this review, I tried to find out which scale is most suitable for the patient's dental anxiety and fear evaluation by examining the contents of previously developed scales and comparing the strengths and weaknesses of each scale.

A Validation Study of the CARS-2 Compared With the ADOS-2 in the Diagnosis of Autism Spectrum Disorder: A Suggestion for Cutoff Scores

지성인,박형서,윤선아,홍순범 대한소아청소년 정신의학회 2023 소아청소년정신의학 Vol.34 No.1

Objectives: This study examined the validity of the Childhood Autism Rating Scale, Second Edition (CARS-2) compared with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in identifying autism spectrum disorder (ASD). Methods: A total of 237 children were tested using both the CARS-2 and ADOS-2. We examined the correlation using Pearson’s correlation analysis. In addition, we used a receiver operating characteristic graph to determine the optimal standard version of the CARS-2 (CARS2-ST) cutoff score for ASD diagnosis using the ADOS-2. Results: The concurrent validity of the CARS2-ST was demonstrated by a significant correlation with the ADOS-2 (r=0.864, p<0.001). The optimal CARS2-ST cutoff scores were 30 and 28.5 for identifying autism and autism spectrum, respectively, based on the ADOS-2. Conclusion: We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.

N-Screen 방송융합서비스의 모바일 환경에서 보안 위협 연구

지성인,서희석 한국지식정보기술학회 2012 한국지식정보기술학회 논문지 Vol.7 No.1

Today, new television service is activated called IPTV. Content delivery method called VOD(Video On Demand) can watch the program which viewers want to watch. And be on the rise N-Screen Service which use same platform and clouding system in multiple terminal. Recently, Smart Phone, Tablet PC and Smart TV is appear, so it is said N-Screen Service is becoming. IT convergence service like IPTV as appear threaten on the original internet, because it is stand on the basis IP network and broadcasting technology. Therefore, security threaten and weak point should be identified for Security mechanism of IT convergence service is correctly applied.

Use of ADMSTM during sedation for dental treatment of an intellectually disabled patient: a case report

지성인,김현정,서광석,Martin Yang,장주혜 대한치과마취과학회 2016 Journal of Dental Anesthesia and Pain Medicine Vol.16 No.3

Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMSTM), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMSTM values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min..

T-Commerce의 현황과 보안에 관한 연구

지성인 ( Seong-in Ji ),서희석 ( Hee-suk Seo ) 한국정보처리학회 2011 한국정보처리학회 학술대회논문집 Vol.18 No.2

최근 TV에 인터넷이 접목되면서 방송과 통신이 융합된 새로운 환경이 생성되었다. 다양한 볼거리를 제공해 주는가 하면 TV를 이용해 전자상거래까지 가능하게 되었다. 인터넷TV는 컴퓨터 사용에 미숙한 사람들도 TV를 이용하여 쉽게 사용할 수 있기 때문에 넓은 층의 사람들이 이용하고 있다. 이 중, TV를 통하여 이루어지는 전자상거래를 T-Commerce라 하는데, 유럽에서는 이미 상용화되어 있다. 본 연구에서는 전 세계적으로 주목받고 성장하고 있는 T-Commerce 서비스의 현황은 어떠한지, 또 어떠한 인증, 보안 기술을 사용하고 있는지에 대해 알아보고, 앞으로 보안이 어떠한 방향으로 나아가야 하는지에 대해 알아보았다.

드리프트 오차 최소화를 위한 관성-기압센서 기반의 수직속도 추정 알고리즘

지성인(Sung-In Ji),이정근(Jung Keun Lee) 제어로봇시스템학회 2016 제어·로봇·시스템학회 논문지 Vol.22 No.11

Vertical velocity is critical in many areas, such as the control of unmanned aerial vehicles, fall detection, and virtual reality. Conventionally, the integration of GPS (Global Positioning System) with an IMU (Inertial Measurement Unit) was popular for the estimation of vertical components. However, GPS cannot work well indoors and, more importantly, has low accuracy in the vertical direction. In order to overcome these issues, IMU–barometer integration has been suggested instead of IMU–GPS integration. This paper proposes a new complementary filter for the estimation of vertical velocity based on IMU–barometer integration. The proposed complementary filter is designed to minimize drift error in the estimated velocity by adding PID control in addition to a zero velocity update technique.