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      • 觀光호텔의 TQM戰略에 關한 硏究

        구경원,이상우 韓國食飮料經營硏究會 1996 食飮料經營硏究 Vol.6 No.-

        TQM is a whole process of systemizing, documenting and measuring of service quality scientifically to achieve zero defects in product quality and to continue to improve the body of the product quality by itself. To have this process be improved continuously, first of all it needs to prepare an ideal environment to understand and to conform to its internal and external customers', that is every guests' and employees' expectations and demands. Then it has to be followed by the next step removing some negative aspects that could be derived from the first mentioned process The third step is to cut the cost by suitable compensation rather than an attitude trying to solve the problems in an easy way. The last essential factor for setting up TQM system is to make good use of the outstanding feature or process as it is reviewed against the superior benchmark. The purpose of this study is meet the customers' expectations and to maximize the hotel 's profits by searching TQM(total quality management) strategy in hotels. To attain this research's objective, it follows these three details. Firstly, it defines TQM and its contents. Secondly, it provides the standard of hotel TQM throughout some case studies. Thirdly, it suggests TQM strategic plan in tourism hotel as one of professional management strategies. Two useful methods are used together to achieve the goal of this study. To confirm its theoretical consideration, descriptive studies by the research documents published in arid out of the country is used. The other is case studies of TQM execution in real hospitality industry, which present the cases of the airline, Jefferson Memorial and the hotel. This research is targeting to demonstrate the successful TQM's exercise ill a hotel industry by completing the theoretical studies and case studies on service product quality with an understanding of its importance. As it is said earlier, to lead to the successful TQM's practice, it is necessary to maintain a constant training of the employees. Secondly, it also must identify where it has to focus on to deliver a professional quality management. Thirdly, effective quality management organization needs to be build up. The manager's strong will to accomplish and the employee' active participations are the last condition to be succeed. Once again this study places an emphasis on the fact that TQM is critical to maximize the customers' satisfaction and the hotel's profitability. It is also very worthwhile to have every people working on front line recognize why the TQM is important and further more how they can contribute to improve their service quality by a positive participation and a careful observation of TQM 's operating in their property.

      • 가토에서의 삽입물 피막피판에 관한 실험적 연구

        구상환,김우경 고려대학교 의과대학 1995 고려대 의대 잡지 Vol.32 No.1

        Silicones are a group of inert and inorganic compounds that were introduced over three decades ago and can be prepared in many different forms, which vary from hard rubber to the liquid crystals. Use of the silicone is widely accepted in almost every medical and dental specialty, perhaps most commonly in reconstructive surgery. A silicone implant elicits a capsular response in surrounding soft tissue. This phenomenon is well documented since significant capsular contracture occurs commonly as a complication of breast implants. The capsules are built up of an extremely tough, tendon-like collagenous material, which is arranged in a layer and surrounds the prosthesis completely. Three to four weeks after insertion of the implant, the capsule is already formed and it is made of capillaries, larger blood vessels, active macrophages, fibroblasts and a small amount of collagen. Later the capsule becomes less vascularized, more and more collagen are laid down and macrophages become inactive. The aim of this study was to examine whether this side effect could be used as a new source of flaps since the capsule has a structure and texture similar to fascia. With this objective, capsule formation was induced in rabbits by implanting spherical tissue expanders under the skin vascularized by the inferior epigastric vessels. When expansion was completed and the capsule was formed, the expander was removed and the animals were categorized into three groups. In the first group, the roof of the capsule was simply everted as hinge flap. In the second group, a capsule island flap was raised and orthotopically placed. In the third group, a capsule flap was raised and transferred to the ipsilateral injured Achilles tendon area for evaluation of ability to provide gliding surface. Four months later, a tendon-capsule-skin unit was excised and microscopically studied for late changes of capsule flap. The inner side of the various flaps for the first and second experimental groups and the outer side of the island flaps for the third group were covered with autologous full thickness skin graft to find out whether a peri-implant capsule was an adequate recipient site and this might be a new source of flaps for use in reconstructive surgery and this might be a new source of flaps for use in reconstructive surgery. In the three experimental groups, there was complete 'take' of the skin grafts in 80% of the animals. In conclusion, island or free flaps of capsular tissue may be raised and transferred safely. And the capsular flap, which provides a good gliding surface without adhesion even in the late stage, can be very useful if it is used as a fascia-like tissue to cover tendons.

      • 뇌혈관질환을 동반한 당뇨병 환자에서 지속적 혈당측정의 유용성 평가

        정성훈,강인구,박철영,류미숙,우정택,김성운,김진우,김영설 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.2

        연구배경: 뇌혈관질환을 동반한 고령의 당뇨병환자는 이들의 신경학적 결손으로 경고 증상없이 심한 저혈당에 노출될 가능성이 크다. 실제로 하루 4번 정도의 자가 혈당 측정으로는 이를 감지하기 어려울 뿐 아니라 검사에 따른 고통으로 적극적인 혈당 조절에 제한이 따르게 된다. 이에 저자들은 Mini Med사의 지속적 혈당측정기(CGMS, continuous glucose monitoring system)를 이용하여 뇌혈관질환을 동반한 당뇨병 환자에서 24시간 혈당의 변동양상을 알아보고 각기 다른 인슐린 치료방침에 따른 혈당조절의 효율성을 비교하고자 하였다. 방법: 2001년 1월부터 6월까지 경희대학교 부속병원에 입원해 있는 10명의 뇌혈관질환을 동반한 제 2형 당뇨병환자를 대상으로 하였다. 이 들은 모두 튜브식이를 받고 있엇고 최소 1개월 이상 인슐린 치료를 시행 받았다. 지속적 혈당측정기를 착용하고 3일간의 연속적인 혈당을 측정하였고, 치료 첫 날은 NPH, 둘째 날은 속효성 인슐린과 NPH, 마지막 날은 혼합형 인슐린제제로 치료하여 그 효과를 비교하였다. 이들 각기 다른 인슐린 제재의 하루 총량에 차이는 없었다. 혈당치가 3.3mmol/L 미만이거나 7.8mmol/L를 초과하는 경우 그 차이값의 총합을 시간으로 나누어 이 값(△Glu)이 적을수록 치료효과가 우수한 것으로 판정하였다. 또한 당 수치가 3.3mmol/L 미만인 경우를 저혈당 event, 16.7mmol/L 초과한 경우를 고혈당 event로 임의로 정의하였고, 이를 통해 지속적 혈당측정의 유용성을 간접적으로 평가하고자 하였다. 결과: 평균 △Glu값은 첫째 날이 0.93 ± 0.43mmol/Lㆍmin?¹, 둘째날이 0.71 ± 0.29mmol/Lㆍmin?¹ 마지막 날이 0.58 ± 0.29mmol/Lㆍmin?¹로서 서로 다른 3가지 치료방침사이에 통계학적으로 유의한 차이는 없었다(p=0.115). 10명의 환자들 중 자가 혈당측정기로는 1명에서 저혈당 event, 2명에서 고혈당 event를 인지하였으나 지속적 혈당측정기로는 각각 9명에서 event를 확인하였다. 결론: 지속적 혈당측정기를 이용한 각각의 인슐린 치료방침에 따른 혈당조절 효율성의 차이는 없었으나, 자가혈당 측정기로는 알 수 없었던 일 중 혈당 변동사항을 정확하게 알 수 있어, 뇌혈관질환을 동반한 당뇨병 환자에서 보다 적극적인 인슐린 치료 및 관리를 할 수 있을 것으로 생각된다. Background: Diabetic stroke patients are susceptible to hypoglycemia. However, there are many limitations in detecting hypoglycemic events, even though glucoses levels are checked 3 to 4 times per day using the fingerstick method. Therefore, we investigated the glycemic excursions and pattern in diabetic stroke patients using the continuous glucose monitoring system (CGMS, MiniMed) and its clinical utility. The other objective was to compare the treatment dfficacy between insulin regimens. Methods: From jan 2001 to jun 2001, 10 adult type 2 diabetic stroke patients wore CGMS for consecutive 3 days, which continuously checked the glucose level. NPH insulin, multiple daily injection of regular insulin ± NPH and the mixed type(Novolet 30/70, Novo Nordisk) were used on the first, second and third days of the study, respectively. If the mean delta glucose(△Glu = A+B/time, A=∑(hlucose-7.8), glucose > 7.8 mmol/l, B=∑(3.3-glucose) if, glucose < 3.3 mmol/l) was calculated in order to recognize the degree of individual glycemic changes and to compare the efficacy of each treatment diverse insulin regimen. We arbitrarily defined a glucose level less than 3.3mmol/l, as a hypoglycemic event, and more than 16.7mmol/l as a hyperglycemic event. Results: Variable patterns of glycemic changes were observed among patients with the same dosage, but a different insulin regimen. The mean △Glu was 0.93±0.43 on the first day, 0.71±0.29 on the second day and 0.58±0.29 on the third. There was no significant difference in treatment efficacy between the 3 different insulin modalities(p=0.115). Of the 10 patients, a hypoglycemic event was detected in 1 with the fingerstick method, in contrast to 9 with CGMS, with hyperglycemic events being detedted in 2 and 9, respectively. Conclusion: Continuous glucose monitoring maybe useful in providing the information necessary for optimal glycemic control in the diabetic stroke patients.

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