사례연구 : 가업승계와 가족기업의 경쟁력: 에스엘 사례

이장우 ( Jang Woo Lee ),마윤주 ( Yoon Joo Ma ),정수철 ( Su Chul Jung ) 한국중소기업학회 2010 中小企業硏究 Vol.32 No.4

본 연구의 목적은 가족기업의 핵심역량 축적과정을 살펴보고 성공적인 가업승계의 중요성을 논의하는 것이다. 이를 위해 가족기업의 경쟁우위를 설명한 Miller and Le Breton-Miller (2005)의 4C(Continuity, Community, Connection, Command)모델을 기반으로 3대에 걸친 성공적인 가업승계를 기반으로 한 에스엘의 핵심역량 축적과정을 조사했다. 국내 자동차부품회사인 에스엘의 성장과정에 관한 2차 자료를 분석하고, 대표이사와의 심층인터뷰를 통해 그 연관성을 구체적으로 살펴보았다. 분석결과 창업자 가족이 공유한 가치관과 비전, 노하우, 경험 등은 장기적인 지향성을 가지고 지속적으로 핵심역량을 개발하는데 큰 역할을 하였다. 또한 신뢰의 가치관이라는 사회적 자본을 효과적으로 전달받은, 다음 세대의 후계자는 가족 가치관을 토대로 대외 네트워크를 더욱 견고히 하고 지속적으로 발전시켰다. 에스엘은 성공적인 가업승계로 소유와 지배구조를 집중화 할 수 있었고, 이에 따라 외부 이해관계자들의 압력 없이, 가족 내부 조화를 통해 독립적이고 과감한 의사결정이 가능하였다. 이는 가족기업의 경우 고유한 공동체적 문화와 신뢰에 기반 한 외부 네트워크 형성을 통해 경쟁력 구축에 힘쓸 필요가 있으며, 일반기업의 경우에도 공동체 적 조직문화와 중장기적 관점의 외부 협력관계가 기업의 영속성 유지에 중요하다는 시사점을 제공한다. 또한 가엽승계가 기업경쟁력의 유지와 세대 간 이전에 중요한 기능을 함에 따라 이에 대한 적절한 정책적 배려가 필요하다. The purpose of this study is to examine the process of accumulating com-petences and competitiveness by family companies, and discuss the importance of successful succession of a family business. The core competence accumulation process and competitiveness sources of SL, which is based on successful succession of the family business for three generations, was examined based on the 4C (Continuity, Community, Connection, Command) model of Miller and Le Breton-Miller (2005), which explains the competitive superiority of family companies. Secondary data on the growth process of SL, a domestic auto-mobile parts company, was analyzed and their strategic implications were examined in detail through an in-depth interview with the CEO. The 4C factors, which are antecedent variables of a successful family business, played an important role on the growth process of SL. The continuity factor existed through continuous research and development that focuses on and invests in improving technology quality such as mold pro-duction, lamp production, sash production, and design automation. 2 to 3 percent of the sales amount each year was spent on research and development, regardless of the condition of the economy. As a result, the intellectual property of the company reached 1,108 items (583 applications, 440 registered properties, 47 in review, 38 trademarks) by 2006. From a long-term perspective, the company is improving their technical power to an international standard through technical investments. The continuity of investments in research and development is apparent through three generations, and it can be said that this reflects the characteristics of family business management that shares a goal, and confirms and develops the core capacities of the company. The factor of community started with the "people first" business, management philosophy of the late presi-dent, Hae-joon Lee. Then, it expanded to "human respect" during the president Choong-kon Lee`s generation, and to "ethical management" for the CEO Sung-yup Lee`s generation. The sense of community was revealed to be in the form of a community corporate culture based on a good welfare system for employees and com-munity awareness. Diverse benefits including a housing support system, housing fund support system, child-ren`s education fee support system, scholarship system, and company clubs support system were used to make people feel like "the company and I are one" and work with a sense of ownership. The fact that there has not been one conflict between labor and management since 1968, when the labor union was first established, is especially a noteworthy point. The business management based on "people first" stresses the responsibility and roles of employees and reflects the belief that a workplace should not simply be a place to make a living, but a part of life where you can cultivate character and fulfill your role as a member of society. The connection factor appears as continuous partnerships and networks with domestic and international parts suppliers and technologically advanced companies. The late honorary chairman Hae-joon Lee maintained partnerships and networks with Hyundai Motor Company and Daewoo Motors. Then, chairman Choong-kon Lee expanded the network to include KIA and Ssangyong Motors and maintained long-term relationships with domestic automobile makers. In addition, the company is maintaining cooperative relations with the Japanese company Stanley and German company Hella, and has started dealing with the U.S. company GM, too. CEO Sung-yup Lee`s generation improved the company`s relationship with GM and made the achievement of re-ceiving the QSTP Award (an award GM gives to selected skilled companies out of all the parts companies in the world) from GM for 14 consecutive years (1997-2010), solidifying its position as a skilled partner of GM. SL is also advancing into China through collaborations with the local branch to extract new cooperative relations. The value of "trust" is the motivation that helped SL maintain and strengthen relationships and networks. This value started with the founder of the company and was handed down to chairman Choon-kon Lee and CEO Sung-yup Lee, and worked as a core factor to strengthen external cooperative relationships. The factor of command is apparent from the decisions of business managers who take on a challenge, structural management that includes an endless will for innovation, and leadership. When the late honorary chairman Hae-joon Lee could not cultivate a road for the automobile parts industry because of smuggled goods, he recognized the importance of the automobile parts industry and folded his bicycle parts business, which was number one in the market at the time, without hesitation thanks to his owner-focused independent and bold decision-making skills. In the mid-1990s, when most automobile production companies experienced difficulties because of the economic crisis where Korea was dependent on the IMF, and the aftershocks of restructuring affected automobile parts manufacturing companies, chairman Choong-kon Lee considered the crisis an opportunity and acquired and merged with Seogu Industry (currently known as SL Litech), Oriental Construction and Poongi Building (currently known as SL Seo Bong Co., Ltd. Shiheung factory), creating a turning point to develop further after the crisis. CEO Sung-yup Lee pursues continuous innovation including a corporate culture that places importance on learning and admitting mistakes, change of the structural system to a project based system, and a human resources system that focuses on human resources management, and is emphasizing corporate changes according to the situation of the times. An examination of the SL core competence accumulation process based on the 4C model shows that it is establishing positive relationships and continuity based on connection and trust, leading to a cooperation sys-tem based on the value of trust. It also establishes a positive relationship with command focusing on a com-munity structure culture, which leads to structure capacity based on community culture. The factors of con-nection and community were found to be especially strong at SL. The factor of connection was a core growth motivation, influenced by the key values of family. SL reveals its growth motivation to be "unification of all employees," shares the goals and visions of family with its employees, and offers a variety of different benefits. The active will of employees to participate in this community is seen to be the background behind big accomplishments such as innovations in the field, which are still being pursued. Successful succession of the family company and family business management are strengths that lie in the center of the motivation that allowed SL to continue to grow for three generations, starting with the founder, the late honorary chairman Hae-joon Lee, who provided a foundation of growth with values of trust and peo-ple first, moving on to the second generation chairman Choong-kon Lee, who accomplished a rapid development of the company based on technological developments and respect for people, and finally through to the third generation CEO Sung-yup Lee, who is making efforts for globalization and innovation based on ethical management and change. This shows that the values of trust set by the founder have continued on for a long time, through his son, chairman Choong-kon Lee, and grandson, CEO Sung-yup Lee. Chairman Lee, CEO Lee and executive director Lee Seung-hoon are learning corporate culture and management know-how through a great will to participate and actual participation in management. SL was able to gain competitiveness and continuously reach excellent management performance through cooperation based on the value of trust and structural management that focuses on community culture. As a result of analyzing the company through the 4C model and conducting in-depth interviews with man-agement, it can be said that the values, vision, know-how and experience the founder shared with his family largely contributed to continuous development of core competence with a long-term goal. This in turn had a positive effect on establishment of a corporate community based on trust. By inducing loyalty, participation, and focus on employees in the organizational structure with something more than just financial incentives, the core values of the company are relayed through generations and play an important role in maintaining the community, and also emotionally motivating members of the community. Another point is that the successor who effectively received the social capital of trust as a value, strengthened and continued to develop the ex-ternal network based on the family values. The value of "trust" started by the founder played a key role in strengthening external cooperative relations as it was succeeded through generations. This had a positive ef-fect on connection based on the value of trust, and especially decisively contributed to maintaining close rela-tions of cooperation in the external network and long-term cooperative relationships. SL was able to focus the possession and domination structure through successful succession of the family business, and make in-dependent bold decisions through internal harmony of the family, without pressure from people involved externally. The results above lead to the following points of discussion regarding corporate management. From a busi-ness management perspective, first, a family company needs to establish an external network based on a unique community culture and trust to work on establishing competitiveness. Second, there is a need to reflect the fact that a community-like structural culture and external cooperative relations from a mid- to 0long-term perspective have an important effect on maintenance of corporate continuity, even for companies that are not family businesses, on business management. Third, there is a need to focus on the fact that a structural man-agement method that uses values such as community help secure continuity of a company. From a policy per-spective, since succession of a family business can be not succession of wealth but succession of accumulated technological core competence and good management philosophy and know-how, it is important for improve-ing national competitiveness, to maintain corporate competitiveness, and transfer the competitiveness between generations. Therefore, there is a need for appropriate policies that support the successful transgenerational succession of family businesses.

Hybridizing Genres and Cultural Ambivalence in Chang-rae Lee`s Native Speaker

이정화 ( Jung Hwa Lee ) 한국영미문화학회 2009 영미문화 Vol.9 No.3

This essay examines the thematic continuum between Chang-rae Lee`s reworking of generic conventions of the bildungsroman and the spy novel in Native Speaker. Reading Native Speaker as a novel not only about Asian American inclusion but also about Asian American authoring, I posit that Lee courts the mainstream American reading public by tactfully mixing conventions of the bildungsroman and the spy novel. Appropriating the two genres, Lee enacts a literary equivalent of John Kwang`s political project that privileges heterogeneity and hybridity. The bildungsroman, a representative Asian American literary expression, has tended to articulate Asian American integration into the nation, often subscribing to the `model minority` myth. Native Speaker uses a major staple of the bildungsroman by following how Henry makes sense of his childhood to construct a public identity. Unlike conventional bildungsromans, however, Lee presents Henry`s coming-to-terms with society as something to be undone rather than something to be accomplished by the end of the novel. Native Speaker problematizes successful cultural bildung by describing Henry`s spying as a function of his successful American education. Lee exploits the familiar trope of the inscrutable Asian spy by casting a Korean American spy as his protagonist, but he complicates the old association between the Asian spy and the `yellow peril`; Distinguishing Henry from stereotypical Asian agents as well as conventional spies, Lee opposes the logic behind the `yellow peril` in favor of a principle of hybridity. Appropriating as well as disrupting cultural expectations of Asian Americans and the literary conventions that code such expectations, Lee suggests "a double articulation" (in the Bhabhaian sense) as a viable strategy for Asian American authorship.

이양지 문학과 모국어

이한정(Lee Han-jung) 한국비평문학회 2008 批評文學 Vol.- No.28

Unlike other Korean-Japanese writers, Yangji Lee actually stayed in Korea for numbers of years in order to learn the language of his mother country. Her master piece works, Koku and Yuhi are the stories of Korean-Japanese students living in Korea in order to learn the language of their mother country. For Yangji Lee, Japanese is the 'mother tongue', while Korean is the 'language of mother country(national language)'. When he had tried to learn the language of mother country after becoming an adult, the 'mother tongue' only presented itself as an obstacle for learning the language of mother country. At the same time, the language of mother country could not be just treated as another 'foreign language'. He had to be confronted by a difficult situation in which his self identity was disintegrated by the mother tongue and the language of mother country. With that said, let's examine how he has portrayed the language of mother country in his writings? In each of Koku and Yuhi, Lee presents the life of Korean-Japanese who learns Korean from the people of mother country, in the 'ocean of the language of mother country'. To Korean-Japanese who are accustomed with Japanese being their mother rongue, the language of mother country could not become 'our language' which they could share with Koreans. In the end, Yuhi, the main character of Yuhi, returns to Japan after giving up the study for the language of mother country as she calls herself a hypocrite for easily using a word 'we or us'. In Yuhi, Yuhi lives a life of a bilinguist who also speaks the mother tongue while living in the mother country. When a Korean language teacher scolds the Korean-Japanese students for recite Korean with 'Japanese like accents' in Koku, Soony speaks against the teacher in an adverse tone of voice by saying that it is only natural for them to do so as Korean-Japanese. Also in Yuhi, Yuhi's roommate 'Na' reproaches her for writing Korean correct spacing of words just as in 'japanese'. Yuhi feels very resentful about this. Lee's literature reveals the anguishes of Korean Japanese learning the language of mother country in disadvantageous situations compared to Koreans. Korean Japanese must meet Koreans as their first step in learning the language of mother country and often receives condemnation for not knowing the language well enough. Lee depicts such struggles in her novels without filtration. Yuhi is different from Koku in its narrative point of view by designating Yuhi's roommate 'Na' as the storyteller. 'Na' was told from Yuhi that there are hardly any 'passive expression' in Korean language. As 'Na' teaches Korean to Yuhi, she finds that it is possible to have the language of mother country, Korean in her case, presented as if it were a language of strange person, not as a self evident language of her own. Ishi no Koe, Lee's posthumous work, is the story of a Korean Japanese poet Jooil Lim. Lim must fight a battle against the language of mother country while writing poems in Japanese. He expresses the ironical situations in which he must struggle while studying the ideas of Korean but intentionally suppressing the language of mother country as he writes poetries in Japanese. Thus, the character makes an attempt to take a view of the language of mother country from a standpoint which transcend the political notions of 'nation'. We can notice how the character of Ishi no Koe attempts to explore the language of mother country as same as the mother tongue which is the language naturally inherited from parents and does not contain any political ideas of 'nation'. Yangji Lee has consistently depicted the lives of Korean-Japanese who makes attempts to find self identity through the language of mother country. However, these characters explore the language of mother country as their personal language by eliminating political significances within after experiencing self disintegration from the incompatible conflicts between the mother tong

論文(론문) : 大腸正格證(대장정격증)과 장누수증후군(Leaky Gut Syndrome)과의 관계 考察(고찰)

이진철 ( Jin Cheoul Lee ),박상균 ( Sang Kyun Park ),방정균 ( Jung Kyun Bang ) 대한한의학원전학회(구 대한원전의사학회) 2013 대한한의학원전학회지 Vol.26 No.4

A Study on the Relationship between Dae-Jang-Jung-Gyeok(大腸正格) and Leaky Gut Syndrome Lee Jin-Cheoul1·Park Sang-Kyun2·Bang Jung-kyun3 *1Dept. of Medical History, College of Korean Medicine, Kyunghee University 2Dept. of Meridian, College of Korean Medicine, Sangji University 3Dept. of Korean Medical Classics and History, College of Korean Medicine, Sangji University Objective: If the penetration ratio of the intestinal mucosa is increased, the toxic or unhealthy materials - which should not be absorbed into our bodies - will be come into our bodies. They cause a sort of anti-toxic response or confusion of the immune system, and ultimately bring various types of diseases. This syndrome is related "Poison in Excrement" or "Internal Damage(內傷發□)" and Leaky Gut Syndrome, so I will study on the relationship between them. Method: Study on the relationship between Dae-Jang-Jung-gyeok and Leaky Gut Syndrome. Result: Korean doctors in ancient times called this syndrome "Poison in Excrement" or "Internal Damage(內傷發□)" and treated it with "Dae-Jang-Jung-Gyeok(大腸正格)". Leaky Gut Syndrome is a sort of clinical lesion, which allows foreign and harmful toxins in and results in a disorder of the immune system due to the leaking intestinal mucosa. Conclusion: Based upon the analyses, Dae-Jang-Jung-Gyeok and Leaky Gut Syndrome are closely related. Therefore diseases caused by the Leaky Gut Syndrome might be expected to be cured by Dae-Jang-Jung-Gyeok. Particularly the use of treatments for self-immune diseases and allergic diseases such as atopyic dermatitis and articular rheumatism should be expected to reveal a new path of treatment for other disorders such as Leaky Gut Syndrome. Key Words: Poison in Excrement, Internal Damage(內傷發□), Dae-Jang-Jung-Gyeok(大腸正格), Leaky Gut Syndrome

정안침요법(整顔鍼療法)을 응용하여 호전된 후천성 사경환자 치험 2례

박서영,김재수,홍의재,이윤경,이봉효,임성철,정태영,이경민,Park, Seo-Young,Kim, Jae-Su,Hong, Eui-Jae,Lee, Yoon-Kyoung,Lee, Bong-Hyo,Lim, Seong-Chul,Jung, Tae-Young,Lee, Kyung-Min 대한침구의학회 2008 대한침구의학회지 Vol.25 No.4

Objectives : This report intended to estimate effects of Jung-an acupuncture on the acquired torticollis caused by muscle contraction. Methods : The patients were treated by Jung-an acupuncture, herb medication and Physical treatment daily. The improvement of the patients was judged by Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS), Tsui's score and Visual Analogue Scale(VAS). Results : After 7 days of treatment, the 2 patients' neck pain and cervical movement were improved. Also, TWSTRS score, Tsui's score and VAS were all reduced. Conclusions : As the Jung-an acupuncture's theological base is organized with meridian theory and myofacial release therapy, We considered the Jung-an acupuncture is effective not only for the skin disease but also for the muscle problem such as torticollis.

권정생과 톨스토이 작품의 비교 연구 -모티프와 주제, 구성을 중심으로

이희정 ( Lee Hee Jung ) 세계문학비교학회 ( 구 한국세계문학비교학회 ) 2018 世界文學比較硏究 Vol.63 No.-

본고는 권정생의 사상과 작품, 그리고 톨스토이의 사상과 작품의 영향관계에 대한 언급이 수차례 이루어졌으나 둘의 작품을 실증적으로 비교하며 논의를 진행한 본격적인 연구가 없는 점에 착안하여 두 작가가 생산한 문학작품을 각각 2편 선정하여 모티프와 주제, 구성측면을 중심으로 살펴보았다. 권정생의 「오두막 할머니」와 톨스토이의 「사랑이 있는 곳에 신이 있다」를 비교해보면, 두 작품은 기독교라는 종교적 배경을 바탕으로 가난하고 배고픈, 또는 소외되고 의지할데 없는 이들을 어떻게 대해야 하는가라는 모티프를 공유한다. 이에 대해 두 작가는 ‘지극히 작은 자에게 한 행위가 하느님께 한 것이다.’라는 주제를 구현하기 위해 조건없는 환대를 하는 인물을 내세운다. 두 작품의 구성과 전개도 유사한데, 대표적인 예로는 작품 내에 손님을 환대하는 세 개의 에피소드를 공유하고 작품의 결말에서 주인공이 예수님(하느님)의 현현을 경험하는 것이다. 권정생의 「중달이 아저씨네」와 톨스토이의 「바보 이반의 이야기」의 모티프는 세상 사람들이 바보라고 지칭하는 인물들의 생활을 통해 정말 누가 바보인가를 묻는 것이다. 현명하고 똑똑하다고 하는 사람들은 웃음이 적고 만족할 줄 모르며 다투고 전쟁까지도 일으킨다. 반면 바보로 불리는 인물은 스스로 만족하고 나눔과 평화를 실현하며 산다. 구성적 측면에서 두 작품 모두 도입부에서 바보 주인공을 직접적인 서술로 소개하고 그들이 어떻게 바보인가는 에피소드의 전개를 통해 제시된다. 각 두 편의 작품을 통해 살폈을 때, 권정생이 작품을 쓰기 위한 모티프를 얻고 주제를 설정하여 그것을 구현하기 위한 구성을 하면서 톨스토이 작품을 읽은 영향이 직·간접적으로 작용했을 가능성은 무척 큰 것으로 여겨진다. This article has pointed out that there is no full-fledged research on the relationship between the ideas and works of Kwon-Jung-saeng and the relationship between Tolstoy's ideas and works. Comparing Kwon jung-saeng's Grandma in the Cabin with Tolstoy's There is a God in Love, the two pieces share a motif of how to treat poor, hungry, or alienated and unreliable people. The two writers portray a person with unconditional hospitality in order to implement the theme, 'An act done to the very little person is to God.' The composition and development of the two works are similar. A typical example is sharing the three episodes of hospitality in the work, and the protagonist experiences the manifestation of Jesus (God) at the end of the work. The motif of Kwon Jung-ju's Jungdari Uncle and Tolstoy's Fool Ivan Lee's Story is the question of who really is a fool through the lives of the people whom the world people call idiots. Those who say that they are smart and smart do not know how to laugh and are satisfied, but they also argue and cause war. On the other hand, a person called a fool lives by realizing satisfaction and sharing and peace. In terms of composition, both works introduce the stupid characters in the introductory section as direct narratives, and how they are stupid are presented through the development of episodes. It is very likely that the effect of reading Tolstoy's work was directly or indirectly influenced by Kwon Jung-saeng's motif for writing his works and his motivation for setting themes and constructing works to realize them.

췌장염에 의한 가성낭종내에 생긴 가성동맥류 : 1례 보고

오연희,이채경,김승현,이성우,양창현,이정호,이영현 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

만성 췌장염의 합병증으로 생긴 가성동맥류는 드문질환으로, 반복적으로 다량의 출혈을 일으킬 수 있으며, 치료를 하지 않을 경우 사망율이 높기 때문에, 조기 진단과 치료가 필수적이다. 저자들은 38세 남자 환자에서 췌장염의 합병증으로 생긴 가성낭종내에서 발생한 가성동맥류 1예를 경험하였기에 보고하는 바이다. 가성 동맥류의 색혈류도플러상 낭종내에 양방향 흐름의 와류를 볼 수 있었다. Pancreatic Pseudoaneurysm within Pseudocyst from Pancreatitis: 1 Case Department of Diagnostic Radiology and Internal Medicine, College of Medicine,DongGuk University Yeon Hee OH M.D., Chae Kyeong Lee M.D., Seoung Hyeon Kim M.D., Sung Woo Lee M.D., Chang Heon Yang M.D., Jung Ho Lee M.D., Young Hyun Lee M.D. Pseudoaneurysm from pancreatitis is uncommon, but it can cause recurrent and massive hemorrhage. Because of high morbidity and mortality, early detection and treatment of the pseudoaneurysm is needed. We report a case of pseudoaneurysm within pseudocyst from pancreatitis. Color-flow Doppler sonography shows bidirectional flow and turbulent arterial flow, within anechoic mass.

폐암 환자의 활동상태, 불안, 우울, 사회적 지지, 증상경험과 기능적 상태의 관계: 불쾌감이론 기반으로

김금순 ( Keum Soon Kim ),이명선 ( Myung Sun Yi ),방경숙 ( Kyung Sook Bang ),조용애 ( Young Ae Cho ),이정림 ( Jung Lim Lee ),이은 ( Eun Lee ) 서울대학교 간호과학연구소 2013 간호학의 지평 Vol.10 No.2

본 연구는 불쾌감 이론을 기반으로 생리적 요인(폐암 병기와 활동상태), 심리적 요인(불안과 우울), 상황적 요인(사회적 지지)과 증상경험 및 기능적 상태와의 관계를 파악하여 폐암 환자의 증상경험을 관리하는 간호실무에 적용하고자 시행되었다. 본 연구에서 대상자가 지각하는 증상경험은 일반 암 관련 증상과 폐암 특이 증상 점수를 합친 것으로 평균 12.62점이었다. 이는 일반 암 관련 증상을 살펴 본 Baek10)의 27.7점과 Lee와 Kim19)의 23.1점과 비교 시 낮았으며, 일반 암 관련 증상과 폐암 특이 증상 점수를 함께 측정한 Lee3)의 평균 17.15점보다 낮은 점수였다. 이러한 차이는 연령과 현재 치료에 의한 것으로 생각된다. 본 연구의 대상자는 70세 미만으로 60대가 50.5%를 차지한 반면에 Baek10)의 연구에서는 60대 이상이 66.5%인 것을 보면 연령이 증가할수록 증상이 심하다는 연구 결과7)를 지지하고 있다. 특히, 폐암은 연령이 증가할수록 발생이 높아져 70대에서의 발생이 34.5%로 가장 높은 것을 볼 때 증상관리에 대한 요구가 높음을 알 수 있다.2) 또한 본 연구에서는 현재 치료를 받고 있는 대상자가 38.6%로 Lee3)의 43.9%와 전체 대상자가 항암화학요법을 받고 있는 Baek10)의 연구와 비교 시 낮았기에 증상경험이 낮은 것으로 생각된다. 또한 대상자가 지각하는 영양상태나 건강상태가 좋을수록 증상경험은 낮은 것을 발견하였다. 그러나 본 연구대상자들의 56.4%가 암을 진단받은 지 2년이 경과하였고, 38.6%가 현재 치료를 받고 있음에도 불구하고 영양상태가 나쁘다고 인지하는 경우는 3.0%였으며 또한 지난 한달 간 4 kg 이상의 체중감소가 있었던 경우도 2.0%에 불과하였다. 또한 대상자의 80.2%가 현재 건강상태를 보통 이상으로 지각하고 있었다. 따라서 추후에 대상자의 영양과 건강상태에 대한 지각이 증상에 미치는 영향을 규명할 필요가 있다고 생각된다. 생리적 요인인 폐암 병기, 활동상태와 증상경험 간의 관계를 살펴보면, 폐암 병기와 증상경험 간에는 유의한 상관관계를 보이지 않았으나 활동상태와 증상경험 간에는 유의한 중등도의 순상관관계를 보여 활동상태가 저하될수록 증상경험이 심한 것으로 나타났다. 폐암 환자에 있어서 병기는 치료의 방향을 결정하는데 중요한 변수이나 대상자가 경험하는 증상과는 유의한 관계를 보이지 않았고, 오히려 병기와 상관없이 현재 항암화학요법과 같은 치료 중에 있는 대상자의 증상경험이 더 심각한 것으로 나타났다.3,19) 그러나 본 연구에서는 항암화학요법을 받고 있는 대상자의 증상점수가 그렇지 않은 대상자보다 높았지만 유의한 차이는 아니었기에, 질병 관련 생리적 요인에 대한 추가적인 탐색이 필요하다고 사료된다. 본 연구는 외래를 방문하는 환자를 대상으로 하여 활동상태가 ECOG PS 0에서 2단계로 활동상태가 저하될수록 증상경험은 유의하게 높았고, 이는 선행연구의 결과를 뒷받침하고 있다.3,10,11) 심리적 요인인 불안, 우울과 증상경험 간의 관계를 살펴보면, 불안과 우울 모두 증상경험과 유의한 중등도의 순상관관계를 보여 불안, 우울과 같은 심리적 디스트레스가 높을수록 증상경험이 심하게 나타난다는 선행연구의 결과와 일치한다.20,21) Lee3)의 연구에서 비소세포폐암 환자들이 지각하는 불안과 우울과 같은 디스트레스는 증상경험에 직접적인 영향을 주며, 증상경험을 통해 삶의 질에 매우 부정적인 영향을 주는 요인으로 밝혀졌다. 따라서 NCCN (National Comprehensive Cancer Network)의 권고와 같이 암의 진행단계마다 대상자의 불안과 우울을 평가하여 필요시 적절한 도움을 제공해야 하며,22) 이때 환자의 내적 능력인 극복력의 개념을 도입하는 것은 Lee3)의 연구에서 입증하였듯이 유용한 간호접근이 될 수 있다고 생각한다. 상황적 요인인 사회적 지지와 증상경험 간에는 유의한 상관 관계가 나타나지 않았으며, 이는 사회적 지지와 증상 간에 유의한 직접적인 관계가 나타나지 않았던 선행연구와 일치하였다.3,23) 그러나 Lee3)의 연구에서 사회적 지지는 극복력을 매개로 디 스트레스에 영향을 줌으로써 증상부담에 영향을 미치는 것으로 밝혀졌다. 또한 본 연구의 대상자가 지각하는 사회적 지지를 살펴보면, 20점 만점에 가족지지는 평균 17.69점, 친구지지는 13.63점, 의료인지지는 10.26점으로, 의료인 지지가 가장 낮으며, 이는 선행연구의 결과와 유사하였다.3,10) 이는 직접간호제공자일 뿐 아니라 옹호자, 지지자로서의 간호사의 역할 수행에 대한 도전적인 결과라 할 수 있다. 따라서 간호사의 지지를 증진시킬 수 있는 방법들에 대한 적극적인 모색이 필요하며, 아울러 증상경험에 영향을 미치는 상황적 요인들에 대한 추가적인 파악이 필요하다고 사료된다. 증상경험과 증상경험의 결과, 즉 기능적 상태와의 관계를 살펴보면, 유의하게 높은 역상관관계를 보여 증상경험이 심할수록 기능적 상태는 저하됨을 보여주고 있다. 이는 다발성 증상군의 경증군은 중증군에 비해 기능이 더 좋았다는 Lee와 Park4)의 연구결과와 호흡곤란 증상이 심할수록 기능상태는 저하되었다는 Mohan 등13)의 연구결과와 일치하였다. 또한 부작용 증상을 심하게 호소할수록 기능적 상태가 저하되었다는 Baek10)의 연구결과를 뒷받침하고 있다. 본 연구에서 폐암 환자가 지각하는 증상경험에 영향을 미치는 요인은 심리적 요인(불안과 우울), 생리적 요인(활동상태), 상황적 요인(사회적 지지)의 순으로 나타났으며, 이러한 요인들은 증상경험의 57.8%를 설명하는 것으로 나타났다. 구체적으로 살펴보면, 우울에 의해 증상경험이 43.4% 설명되었으며, 우울과 불안에 의해서는 50.7%설명되었다. 이는 Lee3)의 연구에서 폐암 환자를 대상으로 불안과 우울로 측정한 디 스트레스에 의해 증상부담이 62.8% 설명되었다는 결과보다는 낮았지만, 두 연구결과 모두 불안과 우울이 증상경험에 미치는 영향이 매우 큼을 보여주고 있다. 또한 활동상태가 증상경험에 미치는 영향을 고려하여 활동상태가 매우 저하된 중증의 환자에서의 반복연구가 필요하다고 생각된다. 또한 간호사는 폐암 환자의 증상에 대한 주기적인 평가를 기반으로 체계적인 관리를 제공함으로써 기능상태를 증진시키고 나아가 삶의 질 향상을 도모하는데 주도적인 역할을 담당해야 한다. 폐암 환자가 지각하는 증상경험, 영향요인들과 증상경험 간의 관계, 증상경험과 기능적 상태 간의 관계를 종합해 볼 때, 불쾌감 이론은 폐암 환자의 증상경험을 설명하는데 적합함을 알 수 있었다. 폐암 환자의 증상경험을 적절히 관리하기 위해서는 반드시 불안과 우울과 같은 심리적 요인들에 대한 평가와 환자상태에 맞는 간호접근이 선행되어야 하며, 이러한 과정에 간호사가 적극적으로 개입함으로써 환자 지지자로서의 역할을 수행해야 한다. 또한 불쾌감 이론과 같은 중범위 이론의 간호실무 적용이 더욱 활성화된다면 이론과 실무의 차이를 줄이고 간호실무가 과학적인 배경을 가지고 더욱 발전될 수 있으리라 사료된다. Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the outpatient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients` needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Light-extraction efficiency control in AlGaN-based deep-ultraviolet flip-chip light-emitting diodes: a comparison to InGaN-based visible flip-chip light-emitting diodes.

Lee, Keon Hwa,Park, Hyun Jung,Kim, Seung Hwan,Asadirad, Mojtaba,Moon, Yong-Tae,Kwak, Joon Seop,Ryou, Jae-Hyun Optical Society of America 2015 Optics express Vol.23 No.16

<P>We study light-extraction efficiency (LEE) of AlGaN-based deep-ultraviolet light-emitting diodes (DUV-LEDs) using flip-chip (FC) devices with varied thickness in remaining sapphire substrate by experimental output power measurement and computational methods using 3-dimensional finite-difference time-domain (3D-FDTD) and Monte Carlo ray-tracing simulations. Light-output power of DUV-FCLEDs compared at a current of 20 mA increases with thicker sapphire, showing higher LEE for an LED with 250-관m-thick sapphire by ~39% than that with 100-관m-thick sapphire. In contrast, LEEs of visible FCLEDs show only marginal improvement with increasing sapphire thickness, that is, ~6% improvement for an LED with 250-관m-thick sapphire. 3D-FDTD simulation reveals a mechanism of enhanced light extraction with various sidewall roughness and thickness in sapphire substrates. Ray tracing simulation examines the light propagation behavior of DUV-FCLED structures. The enhanced output power and higher LEE strongly depends on the sidewall roughness of the sapphire substrate rather than thickness itself. The thickness starts playing a role only when the sapphire sidewalls become rough. The roughened surface of sapphire sidewall during chip-separation process is critical for TM-polarized photons from AlGaN quantum wells to escape in lateral directions before they are absorbed by p-GaN and Au-metal. Furthermore, the ray tracing results show a reasonably good agreement with the experimental result of the LEE.</P>