위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

서비스 접점에서의 쇼핑고객 경험이 긍정적 감정과 브랜드 태도가 구매의 의도에 미치는 영향

이성우 ; 김순희 ; 배인호 김천대학교 2013 김천대학교 논문집 Vol.34 No.-

The customer experience management includes two things which are the practice of active management and service differentiation strategy to derive a company's branding from the customer experience. Existing researches about shopping customers have limited details and obscurely overlapped parts, so a research in united level and universal aspects will be needed. This study, searching for a new research dimension, researches how positive emotions in the customer's shopping experience and brand attitude in services at the point influence purchase intention. Eventually, this study is expected to be able to provide strategic and practical implications in the service at the point shopping store managers

제주지역 특성을 도입한 병원설계 사례에 대한 연구 : 제주대학병원 현상설계안을 중심으로

임성보,김치헌,박순희 한국의료복지시설학회 2003 의료·복지 건축 Vol.9 No.2

The recent project has been progressed from focusing on the establishment of an international sense and making a symbclic building in Cheju Island. Its purpose is to provide the best medical services to the inhabitants, and to reflect the local feelings and the entire design concept based upon the role of the health promotion. This study is to explain the process of a traditional architecture method of Cheju applied to the modern design element and re-composition into the layout plan, the composition diagram of the exterior. the elevations etc. of the drawings of the project.

구연산을 첨가한 오디 설기떡의 품질 특성

홍정희,안상희,김미지,박금순,최상원,이순재 한국조리과학회 2003 한국식품조리과학회지 Vol.19 No.6

This study was carried out to investigate the characteristics of mulberry fruit seolgidduk. Four percent additions of mulberry were evaluated as the most suitable concentration for seolgidduk, in order to improve the color of gum metal gray and sour smell. Therefore, in order to improve the preference, citric acid was added. The acidity of mulberry fruit seolgidduk increased and its pH decreased significantly by increasing amount of citric acid. The moisture content of mulberry fruit seolgidduk showed no significant difference between the groups with added citric acid and the control of group. The L value decreased as the citric acid concentration increased. Color a and b (Ed-define 'a' and 'b') values increased significantly by increasing the amount of citric acid. The hardness, cohesiveness, springiness, gumminess and brittleness decreased as the citric acid was added. From the sensory evaluation, mulberry fruit seolgidduk with 0.01% citric acid added was the most preferred in taste, chewiness and overall acceptability. These results indicated that mulberry fruit seologidduk with 0.01% citric acid added showed the best quality.

반응표면분석법에 의한 동충하초 첨가 증편 제조의 최적화

박금순,윤광섭,황성희,조현정,김정숙 한국조리과학회 2003 한국식품조리과학회지 Vol.19 No.4

To optimize the preparation process of Jeung-Pyun, an experiment was derived, using a central composite design, to find the optimal mixing conditions. The addition of Paecilomyces japonica powder, the volume of Tak-Ju and the second fermentation time were independent variables, with the pH, volume, color, sensory and texture properties of the Jeung-Pyun selected as response variables. As the Paecilomyces japonica powder and fermentation time were increased, the b values and volume after the second fermentation also increased. The color of the Jeung-Pyun became deeper with increases in the Paecilomyces japonica powder and fermentation time, and was deepest on the addition of 30% Tak-Ju. The pH increased with increasing fermentation time of the Jeung-Pyun, and on the addition of 3% Paecilomyces japonica rapidly increased more than with the other groups. The optimal mixing conditions for the best quality Jeung-Pyun, with restricted conditions above a b value of 3, a color intensity above 3, and a volume of 40㎖ and a pH of 4.02~4.04 after the second fermentation, were 4.0%, 20% and 45 mins for the Paecilomyces japonica powder, Tak-Ju and second fermentation time, respectively.

가정과 LT협동학습이 중학생의 학습태도 및 학업성취도에 미치는 효과

황순하,류상희 이화여자대학교 교과교육연구소 2004 교과교육학연구 Vol.8 No.3

본 연구는 LT협동학습이 중학교 가정과 교육에서 보이는 변화를 경험적으로 밝혀 보는 데 목적을 두었다. 이를 위해 다음과 같은 세 가지 연구문제를 가지고 수행하였다. 첫째, Learning Together 협동학습과 전통적 강의식 학습에 따라 중학생들의 학습태도는 어떠한 차이가 있는가? 둘째, Learning Together 협동학습과 전통적 강의식 학습에 따라 중학생들의 가정과 학업성취는 어떠한 차이가 있는가? 셋째,Learning Together 협동학습에 대한 중학생들의 인식은 어떠한가? 본 연구에는 중학교 2학년 4개 학급 남·여 학생 총 144명이 참여 하였다. 그 중 2개 반 72명은 실험집단으로, 2개 반 72명은 통제집단으로 구성하였고, 실험집단에는 협동학습의 LT모형을, 그리고 통제집단에는 전통적인 경쟁학습 방법을 적용하였다. 본 실험연구에서는 사전-사후 검사가 집단 사용되었다. 연구의 결과는 실험처치 후 수립된 사후검사점수를 대상으로 SPSS Win을 사용하여 통계 처리되었다. 본 연구를 통해 얻어진 주요 결과는 다음과 같다. 첫째, 협동학습의 LT모형 집단의 학습태도 사후검사 평균점수가 전통적 강의식 학습 집단에 비해 통계적으로 유의미한 수준에서 높게 나타났다. 둘째, 협동학습의 LT모형 집단의 학업성취 사후검사 평균점수가 경쟁학습 집단에 비해 의미 있게 높은 수준으로 나타났다. 셋째, Learning Together 협동학습을 받은 학생 집단의 협동학습에 대한 인식조사에서는 전통적 강의식 학습에 비해 수업에 적극적으로 참여할 수 있고, 토의하면서 공부하므로 이해가 잘되며, 지루하지 않고 흥미가 있다 등의 좋은 점이 있으나, 참여하는 사람만 참여하고, 수준별 능력차가 있어 서로에게 부담을 주며, 소란하고 분위기가 산만하다 등의 단점이 있었다. 전반적으로 볼 때 본 연구의 결과는 가정과 수업전략으로서 협동학습이 갖는 가능성을 보여주었다. 본 연구를 바탕으로 앞으로의 연구 과제를 제시하면 다음과 같다. 첫째, 중학교 가정과 교실에서 유사한 실험연구가 계속되어 가정과 협동학 습의 교육적 변화를 입증 할 수 있는 연구가 지속되어야 할 것이다. 둘째, 학생의 발달상황, 학생의 학업수준, 교육환경특성 등을 고려한 적합한 협동학습 모형의 검증이 필요하다. 셋째, 좁은 교실과 다인수 학급 등의 우리의 교육 여건에 맞는 협동학습 방안을 위한 포괄적이고 체계적인 연구가 필요하다. The purpose of this study was to investigate experimentally the educational effects of LT cooperative learning on learning attitude and academic achievement in middle school home economics classes. The major results of the study were as follows. First, According to students responses, cooperative learning allows more active participation and interesting. Second, the post-test average score on learning attitude of experimental group(LT cooperative learning group) appeared to be significantly higher than that of control group(traditional learning group). Third, the post-test average score on academic achievement of experimental group appeared to be significantly higher than that of the control group. Therefore, it could be said that cooperative learning has positive effect on promotion of students' learning attitude and academic achievement, and the results of this study support the possibility that cooperative learning has the potential as the alternative strategy for teaching middle school Home Economics Education.

신원방우황청심원액의 심혈관계에 관한 약효

조태순,이선미,김낙두,허인회,안형수,권광일,박석기,심상호,신대희,박대규 충남대학교 약학대학 의약품개발연구소 1999 藥學論文集 Vol.15 No.-

In order to investigate the pharmacological properties of New Wonbang Woohwangchungsimwon Liquid (NSCL), effects of Wonbang Woohwangchungsimwon Liquid (SCL) and NSCL were compared. In isolated rat aorta, NSCL and SCL showed the relaxation of blood vessels in maximum contractile response to phenylephrine (10^-6M) regardless to intact endothelium or denuded rings of the rat aorta. Furthermore, the presences of the inhibitor of NO synthase and guanylate cyclase did not affect the relaxing effect of NSCL and SCL. NSCL and SCL inhibited the vascular contractions induced by acetylcholine, prostaglandin endoperoxide or peroxide in a dose-dependent manner. In conscious spontaneously hypertensive rats (SHRs), NSCL and SCL significantly decreased heart rate. NSCL and SCL, at high doses, had a negative inotropic effect that was a decrease of left ventricular developed pressure and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In excised guinea-pig papillary muscle, NSCL and SCL had no effects on parameters of action potential such as resting membrane potential, action potential amplitude, APD_90 and V_max at low doses, whereas inhibited the cardiac contractility at high doses. These results suggested that NSCL and SCL have weak cardiovascular effects with relaxation of blood vessels and decrease of heart rate, and that this effect is no significant differences between cardiovascular effects of two preparations.

지방산의 산화에 미치는 양조간장과 Glucose-Lysine Model melanoidin의 영향

류승희,최경미,문갑순 인제대학교 1996 仁濟論叢 Vol.12 No.2

To observe the antioxidative effect of Maillard rection products(MRPs) to fatty acid compositions, corn oil and sardine oil emulsion were prepared and detected the changes of fatty acid compositions by gas chromatography with or without soybean sauce or glucose-lysine model melanoidin as MRPs during 10days at 40℃ incubation. The main fatty acid composition in corn oil made by J company in Korea was linoleic acid (54.94%), oleic acid (28.63%) and palmitic acid (11.95%), respectively, which is very similar with other references about corn oil. The composition of sardine oil contained major 6-7 fatty acids. The major saturated acids were palmitic (22.44%) and myristic (9.12%). Monoethylenic fatty acids were composed mainly of palmitoleic acid (14.37%) and oleic acid (18.51%). The major polyenoic acids are eicosapentaenoic acid (9.77%) and docosahexaenoic acid (5.47%), which is the most characteristic feature of marline oils. The fatty acid composition in corn oil was very stable during 10days at 40℃ incubation because of its tocopherol contained in corn oil. So MRPs no effected the fatty acid composition in corn oil during incubatuon epriod. But fatty acid composition of sardine oil severe changed during 10days at 40℃ incubation, especially in polyenoic acids. When added glucose-lysine model melanoidin and soybean sauce to sardine oil, the polyenoic acid decomposition protected effectively. Especially soybean sauce stabilize fatty acid composition than model melanoidin in sardine oil.

신원방우황청심원의 심혈관계에 관한 약효

조태순,이선미,김낙두,허인회,안형수,권광일,박석기,심상호,신대희,박대규 성균관대학교 약학연구소 1999 成均藥硏論文集 Vol.11 No.-

Abstract-In order to investigate the phamacological properties of New Wonbang Woohwangchungsimwon Pill (NSCH), effects of Wonbang Woohwangchungsimwon Pill (SCH) and NSCH were compared using various experimental models. In rat aorta, NSCH and SCH made the relaxation of blood vessels in maximum contractile response to phenylephrine (10^-6 M) regardless to endothelium containing or denuded rings of the rat aorta. Furthermore, the presence of the inhibitors of NO synthase and guanylate cyclase did not aftect significantly the relaxing effects of NSCH and SCH, NSCH and SCH inhibited the vascular contractions induced by acetylcholine, prostaglandin endoperoxide or peroxide in a dose-dependent manner. In conscious spontaneously hypertensive rats (SHRs). NSCH and SCH decreased significantly heart rate. These, at high doses, had a negative inotropic effect that was a decrease of left ventricular developed pressure and (-dp/dt)/(+dp/dt) in the isolated perfused rat hearts, and also decreased the contractile force and heart rate in the isolated rat right atria. In guinea-pig papillary muscle, these had no effects on parameters of action potential such as action potential amplitude (APA). V_max and resting membrane potential (RMP) at low doses, whereas inhibited the cardiac contractility at high doses. Furthermore, these had a significant inhibitory effects on palpitation of the heart in normotensive rats and SHRs. These results suggest that NSCH and SCH have weak cardiovascular effects, and that there is no significant differences between cardiovascular effects of two preparations.

장애,비장애인 휠체어 농구선수의 유산소 능력

김성수,이동희,황부근,신말순,배종진,윤진환,지용석,안희구 한국특수체육학회 2002 한국특수체육학회지 Vol.10 No.2

The purpose of this study was to analyzed the aerobic capacity of disability· able-bodied wheelchair basketball players. Cardiorespiratory parameters were measured during graded maximal exercise test. Exercise time, HRpeak, oxygen uptake(VO_2, L·min^-1, ml·min^-1·kg^-1), carbon dioxide production(VCO_2, L·min^-1), ventilation(L·min^-1) were examined in disability national elite male wheelchair basketball at letes(DA, N = 10), able-bodied wheelchair basketball athletes(AA, N = 10). All data were expressed in means and standard deviation. Exercise time, HRpeak, oxygen uptake, carbon dioxide production, ventilation were not different between groups. In conclusion, aerobic capacity of disability national elite male wheelchair basketball athletes is the same able-bodied wheelchair basketball athletes. These finding suggest that chronic wheelchair basketball training produce local adaptations in the functional upper body musculature.