The use of lung ultrasonography to confirm lung isolation in an infant who underwent emergent videoassisted thoracoscopic surgery -a case report-

남재식,박인경,서형석,민홍기 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.4

Video-assisted thoracoscopic surgery for pediatric patients has gained popularity due to better outcomes than open surgery. For this procedure, one-lung ventilation may be necessary to provide an adequate surgical field. Confirming lung isolation is crucial when one-lung ventilation is required. Recently, we experienced a case in which one-lung ventilation was confirmed by ultrasonography using the lung sliding sign and the lung pulse in an infant. Since lung ultrasonography can be performed easily and quickly, it may be a useful method to confirm lung isolation, particularly in emergency surgeries with limited time, devices, and experienced anesthesiologists.

신체 수련 역량 강화를 위한 초등학교 생존 수영교육 프로그램의 적용 및 효과성 탐색

남재식,이영석 한국초등체육학회 2018 한국초등체육학회지 Vol.24 No.2

The purpose of this study is to develop and apply a survival swimming education program to reinforce physical practice competence in elementary school students and to verify its effectiveness both quantitatively and qualitatively. To accomplish this, 25 students in the third grade class 1 of D elementary school in Seoul, participated in the experimental group, and 24 students in the third grade class 2 participated in the comparative group. For quantitative verification about the effectiveness of the survival swimming education program, I conducted a T-test for the independent sample and responding sample. For practical skill evaluation I compared and analyzed 10 second floating and 10 meter moving. Qualitative verification was conducted by an in-depth interview, writing a review, and participation observation. As a result, the elementary school survival swimming education program contributed to the improvement of swimming efficacy, exercise function efficacy, and exercise participation efficacy among four sub factors of physical self-efficacy. However, it did not contribute to improvement of body shape and appearance efficacy. The study showed that short term swimming education did not have a significant effect on student body shape change, and that there was a limit to changing thoughts on one's own appearance. However, the elementary school survival swimming education program contributed to the improvement of all four sub factors of satisfaction of physical education class, namely, interaction satisfaction, physical education satisfaction, athletic performance satisfaction, and exercise evaluation satisfaction. Also a statistical significant improvement was also shown in 10 second floating and 10 meter moving. The elementary school survival swimming education program not only improved students' physical self-efficacy and physical education class satisfaction, but also showed the necessity of introducing survival swimming education in school. It also confirms the problems of freestyle centered swimming education and the need for the expansion of administrative, financial and environmental support for swimming education. 본 연구는 초등학교 학생들을 대상으로 실시되는 수영교육에서 신체 수련 역량 강화를 위한 생존 수영교육 프로그램을 개발 및 적용하여 그 효과성을 양적, 질적으로 검증하는데 목적이 있다. 이러한 목적을 달성하기 위하여 서울시 소재 D초등학교 3학년 1반 학생 25명은 실험반으로, 3학년 2반 학생 24명은 비교반으로 설정하여 연구를 진행하였다. 생존 수영교육 프로그램의 효과성에 대한 양적 검증은 검사지를 바탕으로 한 대응표본 t-검증과 독립표본 t-검증을 실시하였으며, 실기 평가 검증으로 10초 떠 있기와 10m 이동하기를 측정하여 비교ㆍ분석하였다. 질적 검증은 연구 참여자와의 심층 면담, 수업 소감문 작성, 참여 관찰의 방법을 실시하였다. 그 결과 초등학교 생존 수영교육 프로그램은 신체적 자기 효능감의 네 가지 하위 요소 중 수영 효능감, 운동 기능 효능감, 운동 참여 효능감의 향상에 기여한 것으로 분석되었다. 그러나 체형 및 외모 효능감의 향상에는 기여하지 못한 것으로 나타났는데, 이것은 단기간의 수영교육이 학생들의 체형 변화에 큰 영향을 주지 못했으며, 자신의 외모에 대한 생각을 변화시키는 것에도 한계가 있는 것으로 분석되었다. 또한 초등학교 생존 수영교육 프로그램은 체육수업 만족도의 네 가지 하위 요소인 상호작용 만족도, 체육 환경 만족도, 운동 능력 만족도, 운동 평가 만족도 모두의 향상에 기여한 것으로 분석되었으며, 실기 평가 검증인 10초 뜨기와 10m 이동하기에서도 통계적으로 유의미한 교육적 성과를 제공하였다. 질적 연구 결과로써 초등학교 생존 수영교육 프로그램은 학생들의 신체적 자기 효능감 및 체육수업의 만족도 향상뿐만 아니라 학교 수영교육에서 생존 수영교육 도입의 필요성을 인식하게 하였고, 자유형 중심의 영법 수영교육에 대한 문제점을 확인하였으며, 수영교육을 위한 행정적, 재정적, 환경적 지원의 확대가 필요하다는 것을 확인시켜주었다.

Effects of Nefopam on Streptozotocin-Induced Diabetic Neuropathic Pain in Rats

남재식,정유선,감명환,안호수,심지훈,김진선,최성수,임정길 대한통증학회 2014 The Korean Journal of Pain Vol.27 No.4

Background: Nefopam is a centrally acting non-opioid analgesic agent. Its analgesic properties may be related to the inhibitions of monoamine reuptake and the N-methyl-D-aspartate (NMDA) receptor. The antinociceptive effect of nefopam has been shown in animal models of acute and chronic pain and in humans. However, the effect of nefopam on diabetic neuropathic pain is unclear. Therefore, we investigated the preventive effect of nefopam on diabetic neuropathic pain induced by streptozotocin (STZ) in rats. Methods: Pretreatment with nefopam (30 mg/kg) was performed intraperitoneally 30 min prior to an intraperitoneal injection of STZ (60 mg/kg). Mechanical and cold allodynia were tested before, and 1 to 4 weeks after drug administration. Thermal hyperalgesia was also investigated. In addition, the transient receptor potential ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) expression levels in the dorsal root ganglion (DRG) were evaluated. Results: Pretreatment with nefopam significantly inhibited STZ-induced mechanical and cold allodynia, but not thermal hyperalgesia. The STZ injection increased TRPM8, but not TRPA1, expression levels in DRG neurons. Pretreatment with nefopam decreased STZ-induced TRPM8 expression levels in the DRG. Conclusions: These results demonstrate that a nefopam pretreatment has strong antiallodynic effects on STZ-induced diabetic rats, which may be associated with TRPM8 located in the DRG.

The Pattern of Care for Brain Metastasis from Breast Cancer over the Past 10 Years in Korea: A Multicenter Retrospective Study (KROG 16-12)

김재식,김규보,정원근,신경환,임석아,김희준,김용배,장지석,김지현,최두호,박연희,김대용,김태현,최병옥,이시원,김수지,권진이,강기문,정웅기,김경수,남지호,윤원섭,김진희,차지혜,오윤경,김인아 대한암학회 2022 Cancer Research and Treatment Vol.54 No.4

Purpose We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea. Materials and Methods We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients). Results Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance. Conclusion The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years. Purpose We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea.Materials and Methods We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients).Results Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance.Conclusion The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

Reproductive and Developmental Toxicity Screening Test of Ethyl Hydrogen Adipate in Rats

남춘자,황재식,한경구,조은혜,유선경,엄익춘,강종구 한국독성학회 2016 Toxicological Research Vol.32 No.4

This study aimed to evaluate the potential toxicity and safety of ethyl hydrogen adipate (EHA) by determining its effect on the reproductive function and development of Sprague-Dawley (SD) rats at dose levels of 0 (control), 200, 400, and 800 mg/kg/day. One male and five females of the 800 mg/kg/day died. Body weight loss was observed in the males of the 800 mg/kg/day and in females of the 400 and 800 mg/ kg/day. In addition, mating indices decreased and pre-implantation loss rates increased in parental animals of the 400 and 800 mg/kg/day. The gestation index decreased in the male and female rats of the 800 mg/ kg/day. Moreover, the body weight of the pups from the 800 mg/kg/day group decreased on post-parturition day 4. These results indicated that the no-observed-adverse-effect level of EHA for parental males and females was 400 mg/kg/day and 200 mg/kg/day, respectively, and that for pups was 400 mg/kg/day.

Lean Six Sigma를 적용한 물류 프로세스 개선에 관한 연구

장재식,남호기,박상민 대한안전경영과학회 2007 대한안전경영과학회지 Vol.9 No.4

Single- and Repeat-dose Oral Toxicity Studies of Lithospermum erythrorhizon Extract in Dogs

남춘자,황재식,김명준,최영환,한경구,강종구 한국독성학회 2015 Toxicological Research Vol.31 No.1

Lithospermum erythrorhizon has long been used in traditional Asian medicine for the treatment of diseases,including skin cancer. The oral toxicity of a hexane extract of Lithospermum erythrorhizon root(LEH) was investigated in Beagle dogs by using single escalating doses, two-week dose range-finding,and 4-week oral repeat dosing. In the single dose-escalating oral toxicity study, no animal died, showedadverse clinical signs, or changes in body weight gain at LEH doses of up to 2,000 mg/kg. In a 2 weekdose range-finding study, no treatment-related adverse effects were detected by urinalysis, hematology,blood biochemistry, organ weights, or gross and histopathological examinations at doses of up to 500 mgLEH/kg/day. In the 4 week repeat-dose toxicity study, a weight loss or decreased weight gain was observed at300 mg/kg/day. Although levels of serum triglyceride and total bilirubin were increased in a dose dependentmanner, there were no related morphological changes. Based on these findings, the sub-acute noobservable adverse effect level for 4-week oral administration of LEH in Beagles was 100 mg/kg/day.

초등체육 원격 직무연수의 문제점 분석 및 개선방안 탐색

성기훈,남재식 한국초등체육학회 2016 한국초등체육학회지 Vol.22 No.3

본 연구의 목적은 초등체육 원격 직무연수의 활성화를 위하여 초등체육 원격 직무연수의 문제점을 분석하고, 개선방안을 탐색하는데 있다. 이를 위해 2016년 7월 현재 초등학교 교사를 대상으로 초등체육 원격 직무연수 프로그램을 운영하는 기관의 체육 연수 강사 4명과 초등체육 원격 직무연수 및 출석 직무연수를 모두 수강한 경험이있는 초등학교 교사 5명을 연구 참여자로 선정하였다. 심층면담을 통하여 자료를 수집하였으며, 귀납적 범주 분석의 방법을 통하여 자료를 분석하였다. 연구 결과 초등체육 원격 직무연수의 문제점으로 단방향 의사소통의 한계, 학습자를 위한 개별화 방안의 부재, 놀이 및 게임 중심의 편중된 내용 구성, 원격 직무연수 고유의 한계적 특성, 초등체육 원격 직무연수에 대한 편견 및 홍보 부족이 있었다. 이를 개선하기 위한 방안으로 양방향 의사소통을 통한 상호작용, 학습자의 요구와 수준을 고려한 프로그램 마련, 전체 영역을 고려한 균형 있는 내용 구성, 연수 이수 과정의 철저한 확인 및 평가, 초등체육 원격 직무연수에 대한 편견 극복 및 홍보 강화가 필요한 것으로나타났다. The purpose of this study is to analyze problems and explore solutions for elementary physical education distance teacher training programs. For this purpose, four training lecturers were selected as research participants who had experience lecturing elementary school teachers in this program as of July of 2016. Also five elementary school teachers who had experience with both distance and in class, elementary physical education teacher were also selected as participants for this study. I conducted in-depth interviews with each of the nine participants and collected data to be analyzed through inductive category analysis. As a result, the following problems of elementary physical education distance teacher training program were identified : the limitations of one way communication, the absence of individualized learning methods, the weighted composition of content towards play and game, the unique limited characteristics of distance teacher training, the prejudice against elementary physical education distance teacher training program, and the lack of public relations. To improve these problems, this study considers the following measures necessary : improving the interaction by two-way communication, providing programs that consider learners’ demands and levels, balanced composition of contents that consider the whole domain, thorough comprehension check and assessment during the teacher training course, overcoming prejudices, and strengthening public relations for elementary physical education distance teacher training program.

초등교사의 체육수업 전문성에 관한 국내 연구동향 분석

이영석,남재식 한국초등체육학회 2019 한국초등체육학회지 Vol.24 No.4

The purpose of this study is to analyze the trends of previous studies on the physical education teaching expertise of elementary school teachers and to present a directions to be pursued in future related research based on the results. To this end, a total of 91 papers published in Korea from 2000 to 2018 were examined in the Research Information Sharing Service(RISS) related to elementary school teacher, physical education, and professionalism. The results of the study were analyzed according to the study subjects, research period, published journals and research methods. First, as a result of research subject analysis, there is a need to revitalize research that analyzes the concept of physical education teaching expertise and its correlation with other areas, which tend to be concentrated on measures for enhancing professionalism. Second, as a result of research period analysis, because of the small number of papers published and the large variation of the research in each despite the continuous research, it is necessary to increase in the number of papers in terms of quantity, and to diversify the subjects and methods in terms of quality. Third, as a result of published journals, because of the bias to specific journals, it needs to be studies in diverse viewpoints in diverse academic journals. Lastly, as a result of research method, due to the bias to qualitative research and specific data collection methods, it is necessary to carry out qualitative and quantitative research in a balanced manner and apply various data collection methods which have not been performed previously. 본 연구는 국내 학술지에서 발표된 논문을 중심으로 초등교사의 체육수업 전문성에 관한 선행 연구의 동향을 분석하고, 이를 바탕으로 향후 관련 연구가 추구해야 할 방향을 제시하는 것에 목적이 있다. 이를 위해 2000년부터 2018년까지 국내에서 발표된 학술지 논문 중 학술연구정보서비스(RISS)에서 ‘초등교사’,‘체육수업’,‘전문성’ 으로 검색되어 세부 준거를 충족하는 총 91편의 논문을 선정하고 분석하였다. 연구 동향을 연구 주제, 연구 시기, 발행 학술지, 연구 방법별로 분석한 결과는 다음과 같다. 첫째, 연구 주제별 분석 결과, 전문성 신장을 위한 방안에 편중되는 경향이 있어 연구가 미흡했던 체육수업 전문성에 대한 개념 분석 및 다른 영역과의 상관관계를 분석하는 연구의 활성화가 필요하다. 둘째, 연구 시기별 분석 결과, 지속적인 연구에도 불구하고 발행된 논문 수가 적고, 연구 주제의 연도별 편차가 크기 때문에 양적 측면에서 논문의 수 증가와 질적 측면에서 연도별 주제 및 방법의 다양성이 필요하다. 셋째, 발행 학술지별 분석 결과, 특정 학술지에 편중되어 다양한 분야의 학술지에서 다양한 관점으로 연구될 필요가 있다. 넷째, 연구 방법별 분석 결과, 질적 연구 및 특정 자료 수집 방법에 치중되어 질적, 양적 연구를 균형 있게 수행하고, 기존에 수행되지 않던 다양한 자료 수집 방법을 적용할 필요가 있다.

Predictive value of rotational thromboelastometry during cardiopulmonary bypass for thrombocytopenia and hypofibrinogenemia after weaning of cardiopulmonary bypass

지성미,김성훈,남재식,윤혜주,최정현,이은호,최인철 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.3

Background: The early detection of coagulopathy helps guide decisions regarding optimal transfusion management during cardiac surgery. This study aimed to determine whether rotational thromboelastometry (ROTEM) analysis during cardiopulmonary bypass (CPB) could predict thrombocytopenia and hypofibrinogenemia after CPB. Methods: We analyzed 138 cardiac surgical patients for whom ROTEM tests and conventional laboratory tests were performed simultaneously both during and after CPB. An extrinsically activated ROTEM test (EXTEM), a fibrin-specific ROTEM test (FIBTEM) and PLTEM calculated by subtracting FIBTEM from EXTEM were evaluated. Correlations between clot amplitude at 10 min (A10), maximal clot firmness, platelet count, and fibrinogen concentrations at each time point were calculated. A receiver operating characteristic analysis with area under the curve (AUC) was used to assess the thresholds of EXTEM, PLTEM and FIBTEM parameters during CPB and for predicting thrombocytopenia and hypofibrinogenemia after weaning of CPB. Results: The A10 on EXTEM, PLTEM, and FIBTEM during CPB showed a good correlation with platelet counts (r = 0.622 on EXTEM and r = 0.637 on PLTEM; P < 0.0001 for each value) and fibrinogen levels (r = 0.780; P < 0.0001) after CPB. A10 on a FIBTEM threshold of 8 mm during the CPB predicted a fibrinogen concentration < 150 mg/dl (AUC = 0.853) after CPB. Additionally, the threshold level of A10 on EXTEM during CPB for predicting platelet counts < 100,000 /μl after CPB was 42 mm (AUC = 0.768). Conclusions: EXTEM, PLTEM, and FIBTEM parameters during CPB may be useful for predicting thrombocytopenia and hypofibrinogenemia after weaning of CPB.