소비자의 만족과 관계품질(시뢰와 결속)이 구전에 미치는 영향

황용희(Yong Hee Hwang),박설우(Seol Woo Park) 한국경영학회 2014 한국경영학회 통합학술발표논문집 Vol.2014 No.8

소아급성충수염의 임상적 고찰

황용희(Yong Hee Hwang),최건필(Kun Pil Choi) 대한외과학회 1987 Annals of Surgical Treatment and Research(ASRT) Vol.33 No.5

환상치핵에 대한 Modified Whitedhead 치핵절제술

최승철(Sung Cheol),황용희(Yong Hee Hwang),최건필(Kun Pil Choi) 대한외과학회 1998 Annals of Surgical Treatment and Research Vol.54 No.2

여성 골반출구폐쇄성 변비 환자의 연령에 따른 아형 분석

이안젤라소은(Angela Soeun Lee),황용희(Yonghee Hwang),정용환(Yonghwan Jung) 대한임상노인의학회 2014 대한임상노인의학회지 Vol.15 No.1

연구배경: 고령환자에서의 특징을 중심으로 여성 골반출구 폐쇄성 변비 환자의 연령에 따른 아형과 치료를분석하고자 하였다. 방법: 2007년 7월부터 2010년 1월까지 배변장애 증상으로 삼육서울병원 대장항문 클리닉에 내원하였거나 타 과로부터 진료 의뢰된 여성 환자 중 대장경검사 혹은 바륨대장조영술 등으로 기질적 원인인 환자를 제외하고 직장항문생리기능검사에서 골반 출구 폐쇄성 변비로 진단되어 바이오피드백 치료를 받은 환자를 연구 대상으로 하였다. 환자는 나이에 따라 두 환자군으로 Group A는 65세 이상, Group B는 65세 미만으로 하였다. 결과: 총 106명의 대상 환자 중 65세 이상인 A군 환자는 23명, 65세 미만인 B군 환자는 83명이었다. 직장중첩증의 경우 A군에서는 30%, B군에서 10%로 통계적으로 유의하게 A군에서 더 발병율이 높았다(P<0.05). 직경 4 cm 이상의 직장류에서는 A군에서 26%, B군에서 16%로 A군에서 발병률이 유의하게 높았다(P<0.05). 회음부하강증에서는 A군에서 91%, B군에서 63%로 통계적으로 유의하게 A군에서 그 발병률이 더 높았다(P<0.01). 한편 치골직장근이완부전증의 경우에서는 A군에서 30%, B군에서 42%로 두 군간에 유의한 차이는 없었다(P=0.26). 2도 에스상 결장류의 경우에는 A군에서 9% (2/23), B군에서 0% (0/83)로 A군에서 통계적으로 유의하게 그 발병률이 더 높았다(P<0.01). 서행성 변비는 A군에서 17% (2/12), B군에서 9% (4/45)로 통계적으로 유의한 차이는 없었다(P=0.44). 한편 골반출구폐쇄증 환자에 대한 바이오피드백 치료의 결과는 증상의 소멸을 포함하여 증상의 호전을 보였다고 한 환자가 A군에서 91%, B군에서 77%로 통계적으로 유의한 차이가 없었으나(P=0.13) 바이오피드백 치료 후 증상이 소멸되었다고 한 환자는 통계적으로 유의하게 A군에서 더 많았다(A군:B군=52%:19%, P<0.005). 결론: 고령의 여성 변비 환자에서 직장중첩증, 큰 직장류, 회음부하강증, 2도에스상결장류의 발병 빈도가 젊은 여성환자보다 유의하게 더 높았다. 직장중첩증, 직장류, 회음부하강증, 2도 에스상 결장류의 경우에서 골반저의 변화를 초래하는 나이 먹음이 여성의 골반 출구 폐쇄성 변비의 원인에 영향을 미치는 요소가 될 것으로 사료된다. 한편 나이는 바이오피드백 치료 실패의 예보지표는 아니다. 고령의 여성 변비 환자에서 바이오피드백 치료는 좋은 치료 수단이 될 수 있을 것으로 생각된다. Background: The aim of this study was to assess clinical characteristics and treatment in aged females with pelvic outlet obstruction. Methods: From July 2007 to January 2010, all female patients who were diagnosed with pelvic outlet obstruction by cinedefecography had more than one biofeedback session. Patients were classified into 2 groups: group A: ≥65 years of age, group B; <65 years of age. Results: A hundred six patients (group A: 23, group B: 83) were analyzed. Incidence of rectal intussusceptions was significantly higher in group A (30%) than group B (12%) (P<0.05). Large rectocele was significantly higher in group A (26%) compared to group B (19%) (P<0.05). Perineal descending syndrome was significantly higher in group A (91%) than group B (63%) (P<0.01). Second degree sigmoidocele was significantly higher in group A (9%) than group B (0%) (P<0.01). There were no significant difference between the two groups comparing nonrelaxing puborectalis syndrome: group A (30%), group B (42%) (P=0.26); as well as the slow transit constipation incidence rate in group A (17%) and group B (9%) (P=0.44). Success rate of biofeedback therapy in group A (91%) and group B (77%) showed no significant difference (P=0.13). Conclusion: In aged females, rectal intussusception, large rectocele, descending perineal syndrome, 2nd degree sigmoidocele was common than in younger females. In case of rectal intussusception, rectocele, descending perineal syndrome, 2nd degree sigmoidocele, and aging was the factor influencing cause of idiopathic chronic constipation in female, possibly making a difference in the pelvic floor. However, age is not a predictor of failure of biofeedback therapy, and biofeedback is a favorable option for aged females with chronic constipation.

주부소비자의 준거집단 민감성과 자민족중심주의가 수입 가전제품 구매의향에 미치는 영향

황미진(Whang, Mee-jin),황용희(Hwang, Yong-hee),이완수(Lee, Wan-soo) 한국소비자원 2015 消費者問題硏究 Vol.46 No.1

만성 변비의 진단을 위한 배변조영술의 역할

신원철(Won Chul Shin),황용희(Yong Hee Hwang),정재은(Jae Eun Jung),오길선(Gil Sun Oh),심우성(Woo Sung Shim),임동성(Dong Sung Lim),박재근(Jae Keun Park),염귀종(Kui Jong Yeom) 대한영상의학기술학회 2005 대한영상의학기술학회 논문지 Vol.2005 No.1

To assess the role of Defecography and Cinedefecography for the diagnosis of chronic idiopathic constipation. A retrospective study of 122 constipated patients (33 male, 89 female) of mean age 49.5±1.5 (11-84) years who underwent defecography and cinedefecography was done. Non-relaxing puborectalis syndrome, rectocele, rectal intussusception, and sigmoidocele were observed in 43(35%), 38(31%), 22(18%), and 9(7%) of the patients, respectively. Normal cinedefecography finding was observed in 31(25%) patients. More than one abnormal finding was found in 20(16%) patients. Incidence of non-relaxing puborectalis syndrome in male was higher than that in female (M: F=55:28 %, P < 0.01). In younger female patients group( age < 40 years; 33 patients), incidence of rectocele(46%), and non-relaxing puborectalis syndrome (36%) were higher than incidences of rectal intussusception (12 %) and sigmoidocele (6 %) (P < 0.005). In older female patients group( age ≥ 40 years; 56 patients), incidences of rectocele, non-relaxing puborectalis syndrome, rectal intussusception and sigmoidocele were 41, 23, 23, and 9 percents, respectively (P < 0.05). Defecography and cinedefecography were effective diagnostic tool for idiopathic constipation, so the radiological technologist should be interested in the knowledge and technique of this study.

노인 환자에서 만성 변비의 임상적 특징 및 진단

신경수(Kyung Soo Shin),황용희(Yong Hee Hwang),정용환(Yong Hwan Jung) 대한임상노인의학회 2012 대한임상노인의학회지 Vol.13 No.2

연구배경: 노인에게 있어 만성변비는 흔한 증상이기는 하나 그에 대한 정의는 확실하지 않으며 원인과 진단 수단의 효용성에 대한 연구는 부족한 실정이다. 이에 본 연구에서는 노인환자들을 대상으로 만성변비의 원인과 그 진단 수단의 효용성을 알아보고자 하였다. 방법: 대장내시경, 바륨 조영술 및 직장수지검사를 통해 기질적 원인이 배제된 평균 연령 71.2±5.4(65∼83)의 32명의 변비 환자(남자 9명, 여자 23명)에 대해 후향적 연구를 시행하였다. 32명의 환자에서 배변조영술을 시행하였고 이중 21명에서 항문압 측정술을, 20명의 환자에서 대장통과시간 측정술을, 30명에서 항문 근전도 검사를 시행하였다. 결과: 배변조영술 및 배변영화촬영술을 시행한 32예에서 치골직장근 이완 부전증, 직장류, 직장중첩증, 항문성 배변 곤란증, 에스 결장류가 각각 14예(44%), 15예(47%), 7예(22%), 1예(3.1%), 3예(9%) 관찰되었고 2예(6.3%)에서 정상 소견을 보였다. 11예(34.4%)에서는 한가지 이상의 이상 소견을 보였다. 대장통과시간 측정술을 시행한 20예에서 3예(15%)에서 대장 무력증 소견을 보였고 정상 대장통과시간을 보인 경우는 17예(85%)였다. 항문압 측정술을 시행한 21예에서 항문관 긴장 항진증 소견을 보인 경우가 2예(9.5%) 있었고 이들 중 배변 영화촬영술 시행시 항문과 이완 부전증을 보여 항문성 배변 곤란증으로 진단된 경우가 1예 있었다. 항문 근전도 검사는 모두 30명의 환자에서 시행되었고 이중 13예(43.3%)에서 치골직장근 이완 부전증 소견을 보였다. 치골직장근 이완 부전증 진단에서 배변조영술과 항문 근전도 검사, 배변조영술과 대장통과시간 측정술, 대장통과시간 측정술과 항문 근전도 검사 사이에서 각각 73.3%, 55%, 55.6%의 상관 관계를 보였다. 결론: 만성 변비의 증상을 보이는 노인 환자에서 대장 외적인 원인 및 기질적 원인을 배제한 후 대장 항문 생리기능검사(배변조영술 및 배변영화조영술, 항문압검사, 항문 근전도 검사, 대장통과시간 측정)를 시행하여 정확한 원인을 규명한 후 그 원인에 따른 선택적 치료를 시행하여야 할 것으로 생각된다. 배변조영술과 항문 근전도 검사를 동시에 시행한 경우 골반 출구 폐쇄, 특히 치골근 이완 부전증에서 상관관계가 높았으며 대장통과시간과는 그렇지 못하였다. Background: The aim of this investigation was to assess clinical characteristics and diagnostic tool of idiopathic chronic constipation in elderly patient. Methods: A retrospective study of 32 constipated patients (9 male, 23 female) of mean age 71.2±5.4(65∼83) years who had no abnormalities in colonoscopy, barium enema and rectal exam were done. 32 patients underwent defecography and cine-defecography, of which 21 patients underwent anal manometry, 20 patients underwent colonic transit time study (CTT), and 30 patients underwent anal plug electromyography (EMG). Results: Nonrelaxing puborectalis syndrome (NRPR), rectocele, rectal intussusception, anal dyschezia and sigmoidocele were observed in 14 (44%), 15 (47%), 7 (22%), 1 (3.1%) and 3 (9%) of the patients, respectively. Normal cine-defecography finding was observed in 2 (6.3%) patients. More than one abnormal finding was found in 11 (34.4%) patients. Abnormal findings included colonic inertia in 3 (15%) patients. Normal colonic transit time was observed in 17 (85%) patients. Anal hypertonia was observed in 2 (9.5%) patients by manometry, of which 1 (4.8%) patient was diagnosed with anal dyschezia in cine-defecography. 13 (43.3%) patients were diagnosed with NRPR in anal plug EMG. The correlation rate between cine-defecography/EMG, defecography/CTT, and CTT/EMG were 73.3%, 55%, and 55.6% respectively in the diagnosis of NRPR. Conclusion: Elderly patients with chronic constipation should be evaluated with physiological tests (defecography and cine-defecography, anal manometry, anal electromyography, colonic transit time test) after structural disorders and extracolonic causes have been excluded. Defecography and EMG were complements each of the other in diagnosis of pelvic outlet obstruction especially NRPR, but CTT has no role.

결장 및 직장암에 대한 임상적 고찰

나종근(Jong Geun Na),황용희(Yong Hee Hwang),최건필(Kun Pil Choi) 대한외과학회 1997 Annals of Surgical Treatment and Research Vol.53 No.5

복강경 담낭절제술 시행 받은 60세 이상 고령환자의 임상분석

이안젤라소은(Angela Soeun Lee),정용환(Yonghwan Jung),황용희(Yonghee Hwang),이은헌(Eunhun Lee) 대한임상노인의학회 2013 대한임상노인의학회지 Vol.14 No.2

Background: The aim was to evaluate the outcome of the clinical progress of patients 60 or older those who underwent laparoscopic cholecystectomy (LC) and determine the advantages of LC in elderly patients. Methods: Elderly patients age of 60 or over between Jan, 2005 to Jan 2012, were retrospectively analyzed. Patients were evaluated according to clinical progress such as symptoms, pre-operative diagnosis, underlying disease, previous abdominal operation history, conversion to open cholecystectomy (OC), complications and pathology. Results: One hundred seventy nine LC were performed, mean age of 69.6±6.7 (60∼88) years old, 84 male, 95 female showed a ratio of 1:1.13. Most common pre-operative diagnosis was 129 (72.1%) cases of gallbladder calculus. Most common underlying disease was hypertension found in 79 (44.1%) cases. Previous abdominal surgery of 33 (18.4%) cases included 12 appendectomy, 12 myomectomy, 2 gastric ulcer perforation. Operative time varied 35 to 250 minutes and operative time-mean was 68.6±27.1 minutes. Conversion to OC had to be done in 17 (9.5%) patients. Post-operative hospital stay varied 3 to 59 days; 36 (20.1%) cases stayed 5 days, mean of 7.4±4.7 days. Complications were found in 14 (7.8%). Most common post-operative pathological diagnosis was 160 (89.3%) cases of chronic cholecystitis, followed by 11 (6.1%) cases of acute cholecystitis. Conclusion: Though elderly patients show higher possibility of combined underlying diseases and acute cholecystitis, laparoscopic cholecystectomy could be done safely and should be considered first for shorter hospital days and less post-operative complication. 연구배경: 복강경하 담낭절제술 시행받은 60세 이상의 고령환자의 임상적 경과를 분석하여 그 유용성 및 안전성을 알아보고자 하였다. 방법: 2005년 1월부터 2012 1월 사이 삼육서울병원에서 복강경하 담낭절제술 시행받은 60세 이상의 환자를 후향적으로 분석하였다. 환자 대조군은 임상 양상, 수술 전 진단, 동반질환, 복부 수술력, 수술 형태, 수술 시간, 개복술로의 전환, 술 후 입원기간, 술 후 합병증, 병리학적 소견 등에 대해 임상분석을 하였다. 결과: 평균 연령 69.6±6.7세(60∼88)의 환자 179예의 복강경하 담낭절제술이 시행되었으며, 남자 84예, 여자 95예로 남녀의 성비는 1:1.13였다. 수술 전 증상으로 우상복부 동통이 105예(58.7%)로 가장 많았으며, 동반질환 중 고혈압이 79 (44.1%)예로 가장 많았다. 과거에 복부수술을 받았던 경우는 33예(18.4%)에 있었고, 그 중 충수돌기 절제술을 받았던 경우가 12예(6.7%) 있었고, 복식 자궁절제술이 12예(6.1%), 소화성 궤양 천공 3예(1.68%), 제왕절개술이 2예(1.1%) 등의 순이었으며, 위절제술을 받았던 경우도 2예도 있었다. 수술시간은 35분에서 250분까지였으며, 평균수술 시간은 68.6±27.1분 이었다. 개복수술로 전환한 경우는 17예(9.5%)이었으며, 수술 후 입원기간은 3일-59일까지로, 5일이 36예(20.1%)로 가장 많았으며, 평균입원 기간은 7.4±4.7 일이었다. 합병증은 14예(7.8%)에서 발생하였으며 병리조직검사 결과 만성 담낭염이 160예(89.3%)로 가장 많았고 급성 담낭염이 11(6.1%)예로 그 뒤를 따랐다. 결론: 동반 질환이 많고 담낭염의 비율이 높은 고령의 환자에 있어서 복강경 담낭절제술은 개복술로의 전환, 술 후 합병증 발생이나 입원 기간 등을 고려 할 때 우선적으로 적용될 수 있는 효과적이며 유용한 방법으로 생각되어 개복적 담낭절제술 보다는 일차적으로 복강경 담낭절제술을 시도하는 것이 유익 할 것으로 사료된다.

소비자가 지각한 제품사용상황이 하이테크제품 교체구매의향에 미치는 영향

이현민 ( Hyun Min Lee ),이완수 ( Wan Soo Lee ),황미진 ( Mee Jin Whang ),황용희 ( Yong Hee Hwang ) 한국소비자학회 2011 소비자학연구 Vol.22 No.3

기업 간 경쟁 심화와 소비자들의 교체구매가 높은 비중을 차지하는 성숙기 하이테크 제품 시장은 소비자의 사용경험이 교체구매의향을 형성하는 영향관계의 규명을 통한 대고객 전략의 제안이 중요한 시기이다. 본 연구는 하이테크 제품에 대한 소비자의 교체구매의향이 소비자의 지각된 제품사용상황(perceived product-usage situation)에서 발현되어 제품속성 중요도 및 소비자 추구편익간의 조절적 관계를 통해 형성됨을 검증하였다. Fennell(1978)의 제안을 토대로, 첫째 소비자에게 지각된 제품사용상황을 제품관련 문제점이 지각된 사용상황(perceived situation of the product-related problems)과 심리적 욕구불만이 지각된 사용상황(perceived situation of the psychological frustration)의 두 차원으로 구성하고, 둘째 각각의 문제 상황이 특정 제품속성 중요도 평가에 미치는 영향관계를 검증하였으며, 셋째 소비자의 교체구매의향 유발에 영향을 미치는 제품 속성이 무엇인지를 구조방정식 모형에 근거하여 규명하였다. 연구 결과 하이테크 제품에 있어 소비자가 지각하는 제품사용상황 중, 첫째 제품관련 문제를 지각한 상황은 디자인, 브랜드, 주기능, 부가기능의 제품속성 중요도 평가를 증가시키며, 특히 주기능과 디자인, 브랜드 중요도는 교체구매의향으로 연계됨을 확인하였다. 둘째, 심리적 욕구불만을 지각한 상황은 제품의 디자인과 브랜드 속성중요도를 각각 증가시키며, 이중 브랜드 속성중요도가 교체구매의향을 증가시킴을 규명하였다. 또한 지각한 제품사용상황이 제품속성 중요도 평가에 미치는 영향은 소비자가 추구하는 편익에 따라 차이를 보이는 것으로 확인되었다. 본 연구의 시사점은 기존의 사용상황 연구에서 다루어지지 않았던 제품관련 문제 상황과 심리적 욕구 불만 지각상황이 소비자의 교체구매의향 형성에 미치는 영향관계를 규명함으로써 향후 교체구매 행동 연구의 토대를 마련하는 탐색적 연구로서 의의를 지닌다. 또한 기업의 하이테크 신제품 개발 전략 수립시, 소비자의 교체구매의향 발현을 위한 제품 컨셉 설정 및 마케팅 전략방향을 제시하고 있다. Intense competition among companies and replacement purchasing for consumers are features of a mature high-tech product market. Currently, suggestions for consumer strategy from investigations of the relationship between consumer experience and the formation of replacement purchase intention has become increasingly important. Consumers` perception of product-usage situation illicits a desire to purchase products and creates buying motives. It is important since it decides the direction in choosing a product(Fennell 1978). In the maturity phase of the hi-tech product market, the required time for consumers to understand products and to determine purchase intention becomes shorter. Amid the severe competition in the market, companies are required to establish consumer-attracting strategies by understanding perceived product-usage situations and by investigating how perceived product-usage situations lead to the formation of replacement purchase intentions. Consumers will make after-use evaluation of products. Then, the product-usage situation is expected to serve as a constraint, helping consumers to find countermeasures and narrowing down the criteria of the consumer`s decision(Bransford and McCarrell 1974; Ratneshwar and Shocker 1991). Moreover, consumers assess future choice alternatives based on the consumption cycle from purchase to use. The perception of product-usage situation assists consumers to select appropriate alternative products by inducing the retrieval process and reminding consumers of the measures they already know of. The perception of product-usage situation defines the range of alternatives and thus, serves as a frame for problem solving, which help consumers to find the benefits of a product they seek(Warlop and Ratneshwar 1993). In this respect, consumers` after-use product evaluation can be one of the important motives for the formation of replacement purchase intention along with the product-usage situation (Gardial, Clemons, Woodruff, Schumann, and Burns 1994). Especially, the situations subjectively perceived by consumers can be major factors affecting decision-making and other consumer behaviors(Kakkar and Lutz 1975). In this regard, the problems and complaints that consumers have during the use of hi-tech products will definitely influence after-use evaluation and the formation of replacement of purchase intentions. Therefore, verification of the aforementioned relationship is expected to bring to light new strategic points for further discussion. In addition, based on the means-ends chain model that explains the relationship between the results of product use and buying intention(Woodruff 1997), replacement purchase intention is assumed to be derived from the product-usage situation where consumers constantly try to perceive the results from the use of the product and from the process of re-evaluating the features of the product. This study verifies that consumer purchasing intention for product replacement of high-tech products is manifested by the perceived product usage and formed by moderating the relationship between the important product attributes and the benefits sought by the consumer. This study investigated the formation process of the replacement purchase intention based on the meansends chain model, a mechanism that explains how consumers` after-use evaluation of product features is connected to the replacement purchase intention in consecutive buying decisions. An empirical analysis verified that, in perceived product-usage situations, replacement purchase intention is formed by the customers` evaluation with much importance placed on the features that they particularly hope to acquire from the product. Fennell(1978) suggested that, first, two perceived product use situations were created as the perceived situation of product related problems and the perceived situation of psychological frustration. Second, the affect of the problem situation on the evaluation of importance of product attributes was conducted. Third, the product attributes that affect intention for replacement purchase were investigated based on structural equation models. Our results showed that for high-tech products, from the perceived product use situations that are perceived with product related problems increased the importance of design, brand, main function, and additional functions in product attribute evaluation. It was confirmed that main function, design, and brand importance led to replacement purchase intention. In perceived situations of psychological frustration, the importance of design and brand attributes increased, and identified with brand attribute importance was increased by intentions of replacement purchase. In addition, the influence of perceived usage situation on product attribute importance evaluation indicated a difference from the benefits pursued by consumers. The implications of this study are the identification of the affective relationship between product related problems and those psychologically frustrating situations caused by replacement purchase intention of consumers. This has not been addressed by existing product usage research. An empirical analysis verified that, in perceived product-usage situations, replacement purchase intention is formed by the customers` evaluation with much importance placed on the features that they particularly hope to acquire from the product. The significance of this research is that it sheds new light on the importance of considering product features when analyzing replacement purchase intentions. Re-evaluation of the importance level of the product features was confirmed to be one of the factors explaining the motive behind the replacement purchase intention. In addition, the perceived product-usage situation was confirmed to be an influential variable in the evaluation of the importance level of the product features. Product features were the main motive in the process of making a replacement purchase decision, which has not been studied to date. This study examined perceived product-usage situations where consumers used high-tech products and perceived the results from the use of the product. The situations were broken down into a functional one and psychological one. It was also confirmed that the discrepancy in the psychological part of a situation had a significant influence on the evaluation of the importance of the product features just as the functional part also did. Of note, it was also confirmed that there is a significant influence from the strengthened moderating effect, which is one of the sought variables for the subjective benefits that is caused by the individual differences between consumers. The moderating effect was observed to influence the perceived situation of psychological frustration about brand image for products. The moderating effect was also found to influence the perceived situation of product-related problems on the importance of the main function of products. The results of this study confirmed that the interaction effect of the sought variables for the subjective benefits, which is caused by differences between situations and consumers, have more influence on a consumer`s behavior than the independent influence of the situation. The reason is that the consumers` behaviors constantly change according to the situations(Belk 1974; Dickson 1982; Quester and Smart 1998). Our research is meaningful as an explorative study to provide foundation for future research on consumer replacement purchase behavior. In addition, our study suggests better product concepts and marketing strategy directions to induce consumer replacement purchase intentions and for companies seeking to establish development strategies for new high-tech products.