방정중 접근법으로 흉부 경막외 카테터 삽입시 삽입 각도가 카테터 첨단의 위치에 미치는 영향

류춘근 대한마취통증의학회 2007 Anesthesia and pain medicine Vol.2 No.4

Background: Thoracic epidural analgesia is the mainstay of postoperative pain control after thoracotomy. Usually the epidural catheter is blindly inserted and secured without confirming the tip position. The purpose of this study was to determine the influence of epidural approach angle on the position of the thoracic epidural catheter tip. Methods: 129 patients scheduled for thoracotomy were enrolled. Patients were randomized into two groups: narrow angle group and wide angle group. The epidural needle was inserted at the skin of T8-9 level in both groups. In the narrow angle group the epidural space was approached at T7-8, whereas in the wide angle group the epidural space was approached at T6-7. After epidural space confirmation, a B-D nylon multi-hole epidural catheter was threaded 8cm into the epidural space. The epidural catheter tip position was assessed using a small amount of radiocontrast dye under fluoroscopy. Results: The mean (95% confidence interval) position of the catheter tip was the mid-body of T5 (T5-6-T5 upper body) in the narrow angle group and T3-4 (mid-body of T4-T3 lower body) in the wide angle group (P = 0.037). Conclusions: When approaching the thoracic epidural space by a wide angle, we can place the epidural catheters at a higher level because of a straighter threading.

Propofol과 Remifentanil을 이용한 감시하 마취관리에서 동결견의 수동적 조작

류춘근,길남수,김용철,이상철,노영진,김종수,심성은 대한마취통증의학회 2008 Korean Journal of Anesthesiology Vol.53 No.3

Background: Manual manipulation under anesthesia in primary frozen shoulder is recommended for restoring range of motion and improving function. Usually, manipulation is performed briefly under general anesthesia, which accompanies some anesthesia- related risks for outpatients. Methods: 12 patients suffered from primary frozen shoulder were received manipulation under monitored anesthesia care (MAC) with propofol (1 mg/kg) and remifentanil (25μg) as an initial dose. And then we injected additional bolus dose (propofol 20 mg, remifentanil 10μg) in case of inadequate sedation. After manipulation, sodium hyaluronate 20 mg, 0.75% ropivacaine 22.5 mg and ketorolac 30 mg were injected into the glenohumeral joint. Clinical data were gathered at baseline and at 4 weeks after manipulation. Results: The procedure was carried out successfully under MAC. Clinical results including improvements of visual analogue scale of pain and range of motion were comparable to previous studies. 2 patients who received relatively large doses of anesthetics have required triple airway maneuver and manual mask ventilation for 1 to 2 minutes respectively because of desaturation below 90%. There are not any serious adverse effects. Conclusions: MAC with propofol and remifentanil makes it possible to get adequate level of sedation for shoulder manipulation and to reduce recovery time from anesthesia at the same time. MAC, therefore, is the adequate outpatient anesthetic method for shoulder manipulation. Background: Manual manipulation under anesthesia in primary frozen shoulder is recommended for restoring range of motion and improving function. Usually, manipulation is performed briefly under general anesthesia, which accompanies some anesthesia- related risks for outpatients. Methods: 12 patients suffered from primary frozen shoulder were received manipulation under monitored anesthesia care (MAC) with propofol (1 mg/kg) and remifentanil (25μg) as an initial dose. And then we injected additional bolus dose (propofol 20 mg, remifentanil 10μg) in case of inadequate sedation. After manipulation, sodium hyaluronate 20 mg, 0.75% ropivacaine 22.5 mg and ketorolac 30 mg were injected into the glenohumeral joint. Clinical data were gathered at baseline and at 4 weeks after manipulation. Results: The procedure was carried out successfully under MAC. Clinical results including improvements of visual analogue scale of pain and range of motion were comparable to previous studies. 2 patients who received relatively large doses of anesthetics have required triple airway maneuver and manual mask ventilation for 1 to 2 minutes respectively because of desaturation below 90%. There are not any serious adverse effects. Conclusions: MAC with propofol and remifentanil makes it possible to get adequate level of sedation for shoulder manipulation and to reduce recovery time from anesthesia at the same time. MAC, therefore, is the adequate outpatient anesthetic method for shoulder manipulation.

학교장의 조직헌신과 학교조직 효과성과의 관계

류춘근 ( Choon Geun Rhew ) 안암교육학회 2013 한국교육학연구 Vol.19 No.3

이 연구는 학교장이 인식하는 조직헌신이 학교조직 효과성에 미치는 영향을 분석하는 데 목적이 있다. 이를 위해 2012년 교육과학기술연수원의 학교경영선진화 연수과정에 참여한 전국 16개 시.도의 초·중등 학교장 927명을 대상으로 설문조사를 하고 이에 대해 t검증, 일원 변량분석, 상관관계 및 회귀분석을 실시하였다. 분석 결과에 의한 결론은 다음과 같다. 첫째, 학교장이 인식하는 조직헌신도와 학교조직 효과성에 대한 인식 수준은 각각 4.64와 4.40으로 나타났다. 또한 배경 변인별 학교장의 조직 헌신도에서는 성별, 공모제 학교장 경험 유무에서, 학교조직 효과성에서는 성별, 학교장 경력 정도, 공모제 학교장 경험 유무, 학교 소재지에 따라 유의미한 차이를 보였다(*p<.05). 둘째, 학교장의 조직헌신도는 학교조직 효과성(r=.725)에 정적인 상관관계를 보이며 통계적으로 유의미한 것으로 나타났다. 이러한 연구결과는 학교장 자신이 조직헌신도를 높게 인식 할수록 학교조직효과성을 높게 인식한다는 것을 보여준다. 셋째, 학교장이 인식하는 조직헌신도는 학교조직 효과성에 의미 있는 영향을 미치는 것으로 나타났다(56.4%). 또한 학교장의 조직헌신도가 학교조직 효과성의 하위변인 중 직무만족(R2=0.432), 조직적응(R2=0.440), 직무성과(R2=0.424)에 긍정적인 영향을 미치는 것으로 나타났다. 이러한 결과는 학교장 자신이 학교조직에 높은 헌신성을 확보할수록 직무만족과 조직적응, 그리고 직무성과를 높일 수 있음을 시사해 주는 것이다. The purpose of this study is to examine the relationship between school principals` organizational commitment, as perceived by themselves, and the effectiveness of school organization. The study is based on results of t-tests, one-way analyses of variance, correlation analyses and regression analyses, which were conducted on data collected from a questionnaire-based survey. The respondents were 927 principals in elementary and secondary schools across 16 local governments, who had participated in a training program hosted by the Educational Institute of Ministry of Education of Republic of Korea in 2012. Based on the analysis of the collected data, three major conclusions can be drawn: First, the recognition level of the organizational commitment and the effectiveness of school organization by the principals were calculated to be 4.40 and 4.44, respectively. In addition, a statistically significant variance was noticed in both organizational commitment, in which gender and the experience of public contest for the principalship were selected as the main variables, and in effectiveness of school organization, in which gender, the experience of public contest for principalship, and the number of years served as a principal, and location of the school were chosen as the main variables. Second, principal`s organizational commitment exhibited positive correlation with the effectiveness of school organization (r=7.25) and proved to be statistically significant. This shows that higher level of recognition of one`s organizational commitment signifies higher level of recognition of effectiveness of school organization. Third, principals` organizational commitment exerts meaningful effect on the effectiveness of school organization (56.40%). Principals` organizational commitment appears to have positive effect on job satisfaction (R2=0.467), adaptability to organization (R2=0.382) and job performance (R2=0.424). These findings suggest that a higher level of organizational commitment by principals will result in higher level of job satisfaction, adaptability to organization and job performance.

Propofol과 Remifentanil을 이용한 감시하 마취관리에서 동결견의 수동적 조작

류춘근 ( Choon Gun Ryu ),길남수 ( Nam Su Gil ),김용철 ( Yong Chul Kim ),이상철 ( Sang Chul Lee ),노영진 ( Young Jin Ro ),김종수 ( Jong Su Kim,),심성은 ( Sung Eun Sim ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.3

학교장의 감성적 리더십이 학교풍토 및 학교효과성에 미치는 영향

김희규,류춘근,최상영 교육종합연구원 2014 교육종합연구 Vol.12 No.2

The purpose of the study is to explore the effects of principal's emotional leadership on school organizational climate and school organizational effectiveness perceived by teachers. The specific purposes of the study is to analyze if there is a difference in emotional leadership, school organizational climate, and school organizational effectiveness according to teacher's background variable. The study also analyzed correlation with the three variables and influences of emotional leadership upon sub-variables of school organizational climate and school organizational effectiveness. As the results of analysis, there were statistically significant differences in recognition in gender and rank of teachers for the principal's emotional leadership, on the other hand, significant differences in rank for school organizational climate and school organizational effectiveness. And there was significant correlation between the three variables and emotional leadership gave significant positive influences on school organizational climate and school organizational effectiveness. And school organizational effectiveness increased when emotional leadership and school organizational climate were input at the same time. In the end, it was known that in order to increase school organizational effectiveness, to use ability to recognize oneself among variables of emotional leadership, and variables of devoted behavior, friendly behavior, and indifferent behavior among variables of school organizational climate can improve performance and quality of educational organization.

홀리스틱교육 관점에서 학교장의 분산적 리더십이 전문가학습공동체에 미치는 영향

김희규,류춘근 한국홀리스틱융합교육학회 2015 홀리스틱융합교육연구 Vol.19 No.3

이 연구는 학교장의 분산적 리더십이 전문가학습공동체에 미치는 영향을 홀리스틱적 관점에서 규명하는 데 있다. 이를 위해 A지역 중등학교 교사 330명을 대상으로 t-검증, 분산분석, 상관관계및 회귀분석을 SPSS 19.0 프로그램을 사용하여 처리하였다. 분석 결과에 의한 결론은 다음과 같다. 첫째, 학교장의 분산적 리더십과 전문가학습공동체에 대한 인식 수준은 각각 높게 나타났다.(M=4.38, M=4.29) 둘째, 학교장의 분산적 리더십과 전문가학습공동체의 두 변인 간에는 통계적으로 유의한 높은 상관관계를 보였다(r=.780, p<.01). 학교장의 분산적 리더십의 하위변인 중 지도자 확대가 교사협력문화에 가장 높은 상관을 보였다. 셋째, 학교장의 분산적 리더십은 전문가학습공동체에 의미 있는 영향을 미치는 것으로 나타났다(64.5%). 분산적 리더십의 하위변인 중 상황을 제외한 지 도자 확대, 조직 문화, 조직 학습은 전문가학습공동체에 긍정적인 영향을 보였으며, 그중 지도자 확대가 전문가학습공동체에 가장 영향을 주었다. 따라서 학교장은 분산적 리더십을 개발 및 촉진하여 자발적인 교사들의 참여와 협력을 유도하여 학생의 학습력을 높일 수 있는 리더십 전략을 홀리스틱 교육의 관점에서 새롭게 조명할 필요가 있다 The purpose of the study is to explore the effects of principal's distributed leadership on learning community perceived by teachers. The specific purposes of the study is to analyze if there is a difference in distributed leadership, learning community according to teacher's background variable. The study also analyzed correlation with the two variables and influences of distributed leadership upon sub-variables of learning community. As the results of analysis, there were statistically significant differences in recognition in school size for the principal's distributed leadership, on the other hand, significant differences in education career of teacher for the learning community. And there was significant correlation between the two variables and distributed leadership gave significant positive influences on learning community. And school change and innovation s increased when distributed leadership and learning community were input at the same time. In the end, it was known that in order to increase learning community, to use ability to recognize oneself among variables of distributed leadership, and variables of devoted behavior, friendly behavior, and indifferent behavior among variables of learning community can improve quality of educational organization.

소규모학교 통폐합에 따른 통합초등학교의 공간구성 및 폐교 활용에 관한 연구

이화룡,류춘근,오세희,박소영,Lee, Hwa-Ryong,Rhew, Choon-Geun,Oh, Se-Hee,Park, So-Young 한국교육시설학회 2012 敎育施設 Vol.19 No.3

According to the decrease in birth rate and reduction of population in rural area, primary schools have brought about many problems for decrease of number of student, and environment of education have became deteriorated. Accordingly, primary schools be required improvement, and it should be altered placement of schools because it change number of student, distance and time of attending school, and formation of school zone are changed by alternating of human and physical environment. Merger and abolition of primary school is inevitable for change of placement standard to primary school and qualitative improvement of environment of education in rural area. This study suggests the effective space planning methods for unified school and appropriate utilization alternatives for closed school following after the merger and abolition of small rural schools. In doing so, it explores the present models of merger and abolition through analysis of all sort of actual condition and the possibilities for various utilizations of the abolished schools. It proposes a classroom-operation type fused the comprehensive class and departmental class system for merged primary schools in rural area. It also suggests the re-use methods of closed school facilities for students and community. Finally, it emphasizes that in order to success the policy of the merger and abolition of small schools, it be attributed to the social-cultural environment based on local residents and community and required provision of a variety of utilization plans reflecting local specifics and guarantee of local residents' participation and selection.

Clinical Significance of Preoperative Virtual Colonoscopy for Evaluation of the Proximal Colon in Patient With Obstructive Colorectal Cancer

허재혁,류춘근,정은주,백진희,황대용 대한대장항문학회 2017 Annals of Coloproctolgy Vol.33 No.4

Purpose: Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope. Methods: A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled. We compared the result of conventional colonoscopy with that of virtual colonoscopy in the nonobstructive group and the results of preoperative virtual colonoscopy with that of postoperative colonoscopy performed at 6 months after surgery in the obstructive group. Results: Of the 164 patients, 108 were male and 56 were female patients. The mean age was 62.7 years. The average sensitivity, specificity, and accuracy of virtual colonoscopy for all patients were 31.0%, 67.2%, and 43.8%, respectively. In the nonobstructive group, the average sensitivity, specificity, and accuracy were 36.6%, 66.2%, and 48.0%, respectively, whereas in the obstructive group, they were 2%, 72.4%, and 25.4%. Synchronous cancer was detected via virtual colonoscopy in 4 of the 164 patients. Conclusion: Virtual colonoscopy may not be an effective method for the detection of proximal colon polyps, but it can be helpful in determining the therapeutic plan when its results are correlated with the results of other studies.

학술지 『사고개발』의 연구동향 분석(2005~2013)

김영환,임유미,류춘근 대한사고개발학회 2014 사고개발 Vol.10 No.2

본 연구의 목적은 학술지 「사고개발」에 게재된 논문을 대상으로 전반적인 연구동향을 분석하여 그간의 연구 성과를 점검하고 앞으로의 발전과제를 탐색하는 것이다. 이를 위해 연구목적, 연구자 소속, 연구자 전공, 연구방법, 하위준거 등의 다섯 개의 분석 준거를 토대로 연도별, 등재후보지 운영시점별, 연구대상별로 구분하여 연구동향을 분석하였다. 분석대상은 2005년 창간호부터 2013년까지 게재된 학술논문 총 126편이다. 연구결과는 다음과 같다. 첫째, 고차적 사고와 문제해결 능력에 관한 연구, 창의력 관련 연구들은 꾸준히 이어져 오고 있으나 사고력 관련 연구는 상대적으로 저조하였다. 둘째, 연구자들의 전공과 소속이 고르게 분포되지 않은 것으로 분석되었다. 학술지의 발전을 위해 보다 다양한 국내외 연구자들의 참여가 권고되었다. 셋째, 주로 기술통계에 의존하는 연구물들이 주류를 이루고 있어서 향후 질적 연구 등 보다 다양한 연구방법을 적용한 연구의 확충이 필요한 것으로 판단된다. 학술지 「사고개발」은 자체의 특성 강화를 통해 학문적 공헌이 크게 기대되는 학술지로서 2009년에 등재후보지로 선정되어 도약의 발판을 공고히 하였다. 이제는 그간의 성과를 바탕으로 학술지로서의 정체성과 연구의 독자성을 보다 강화하는 다각적인 노력이 필요하다. The objective of this research is to analyze the trends of research articles published in the Journal of Creativity and Problem Solving (“JCPS”) and to identify key areas of focus for future research. For the research, we grouped 126 articles, which had been published in JCPS from 2005 to 2013, based on their publication year and the status of JCPS at the time and research target. The criteria on which the articles were assessed were research objectives, major and institution of the authors, research methodology, and other sub-topics of research. The findings are as follows:First, research in the area of higher-order thinking, problem-solving, and creativity has been consistently active but research on thinking skills has been relatively lacking. Second, the distribution of researchers’ major and affiliated institution is not even. We believe participation from a more diverse group of local and foreign researchers is needed for an academic advancement of the journal. Third, most of the articles were based on descriptive statistics. We propose a wider variety of research method, such as qualitative research, is required. We expect significant academic contribution from JCPS going forward. In order for it to improve as an academic journal, it is imperative that more effort is made to strengthen the journal’s identity and forge its own unique characteristics.

포스터 전시 발표 : 혈액종양 ; Typhilitis 합병한 중증 재생불량성 환자의 자연관해 1예

최효선,정현식,류춘근,박정식,이현영,어중건,이승세 대한내과학회 2002 대한내과학회 추계학술대회 Vol.63 No.-