On the triviality of fiber bundles

성영희 조선대학교 1990 국내석사

<玩月會盟宴>의 서사 구조와 의미

성영희 부산대학교 대학원 2002 국내석사

This study classified the construction of a large volume of <Wanwolhoemaengyeon> into two parts from a spatial view. The study saw disguise and drugs as motifs of incidents illustrated in the volume and greed as the most basic source of conflicts critically representing those incidents. Discussions by the chapters of the study can be summarized as below. Chapter Ⅱ dealt with two spaces, power acquisition and the recognition and overcoming of realistic problems. The space of power acquisition contains stories of wars as outside activities not inside ones. The space is significant as punishing intruders and settling family dignity. The other space is about inside disputes and their solutions. It is a space where women may appeal their current situations and where conflicts among people are repeated and aggravated. Chapter Ⅲ suggested that the epic structure of <Wanwolhoemaengyeon> was maintained by repetitions between conflicts andoverturns. The chapter attributed similar conflicts and their upturns to drugs use and disguising. Drugs(Kaeyongdan, Miyongdan and so on) were regarded most contributing to the triggering of incidents. And disguising was referred to as the most important means connecting between incidents, necessary for incidental turns. Disguising means a purported change into another appearance through hiding oneself or cheating others. Ways of disguisingillustrated in <Wanwolhoemaengyeon> make possible the maintenance of the volume's epic quality and play a useful role in providing cues of incidents. Such ways themselves become incidents sometimes. Nevertheless, disguising would be a starting point of incidental turns because it could not be permanent essentially and finally exposed in some time. Chapter Ⅴ regarded greed as the most fundamental source that causes and connects incidents. Then the chapter examined howthe source is implied in the volume mentioned above. Sokyowan is the main character of <Wanwolhoemaengyeon>. She always plots to do harm to others and wants to meet his needsthrough others' sacrifice. Her brutality is largely attributed to ignorance by people of her family. Bur it cannot explain her evildoing sufficiently. It is ambiguous to see Sokyowan as merely a vicious character because she is very beautiful, well-educated and highly skillful. Sometimes she is even illustrated as a good wife and wise mother sincerely respect her husband Jungjam and her mother-in-law. It is suggested that her evil deeds are because of her mind and demands beyond control. She could not objectify herself and regulate her own behaviors to commit such vicious things. Her greed becomes a primary cause of incidents and plays a critical role in maintaining such incidents. Consequently, <Wanwolhoemaengyeon> is the most perfect work of the late Chosun with a epic structure that pursues the restoration of human oder and realization of a more desirable world through figuring conflicts among many different characters.

고종 친정기(高宗 親政期, 1873-1907) 궁중행사도(宮中行事圖) 연구

성영희 서울대학교 대학원 2019 국내석사

This thesis aims to explore the court ceremonial paintings produced during the period of King Gojong's direct rule (1873-1907) by examining how the king and his royal court used the paintings for their political purposes. Given that the court ceremonial paintings strongly reflect the nature of each royal event, this study focuses on analyzing the paintings based on the close relationship between the painting and the event. Main themes of the court ceremonial paintings drawn during King Gojong's reign are jinchan (進饌 court banquet), jinyeon (進宴 royal banquet), and jinha (進賀 congratulatory ceremony); the former two are the royal ceremonies held to commemorate a congratulable event for the king and the royal family members while the latter is a royal ritual to pay felicitation to the king by his retainers. Whereas most royal events organized in the Joseon dynasty dealt with the solid and faithful relationship between the king and his courtiers, the nineteenth-century court banquets such as jinyeon served as a platform where the king regulated the hierarchial structure in bureaucracy and exercised his power to control over the court. This shift was demonstrated in the paintings on which the king and the crown prince were distinctively depicted. In these paintings, the participating officials were depicted as insignificant figures in comparison to the royal family members in terms of their location, representation, thematic focus, and visual elements such as juryeom (珠簾 blind), bogye (補階 temporary seat) and chail (遮日 umbrella). The jinha paintings had been made according to the king's order and direct selection on the theme. These paintings were devised to enhance the political influence of the king and the crown prince, not to accurately document the event. King Gojong particularly chose the themes through which the transcendence of the king and the crown prince can be declared such as the crown prince's birth, complete recovery of smallpox, and acting for the king. King Gojong used these paintings as a means of proclaiming his son's legitimacy and authority in visual terms. Despite financial burden caused by the painting production, King Gojong continued holding the royal events and creating the paintings for the purpose of seizing the political hegemony and securing legitimacy in the turbulent era of the late nineteenth century. King Gojong's intention was displayed in many other court-sponsored visual materials made during the period of his direct rule. Court ceremonial paintings created during this period are of great importance because they clearly indicate how the Joseon royal court produced and utilized the visual arts in the transitional period to the modern era in Korea. King Gojong has effectively expressed and disseminated his will to strengthen the royal authority by establishing a new tradition in the court banquet painting of the Joseon dynasty. 본 논문은 고종 친정기(高宗 親政期, 1873-1907)에 제작된 궁중행사도(宮中行事圖)에 대한 연구이다. 본 논문의 목표는 동 시기 왕실에서 궁중행사도를 능동적으로 제작하고 활용하였던 모습을 살펴보고 그 의의를 논하는 것이다. 궁중행사도는 국가 의례의 모습을 도회(圖繪)한 그림이기 때문에 그림에 의례의 성격이 강하게 반영되어 있다. 따라서 각각의 의례가 궁중행사도를 이해하는 데 결정적인 근거를 제공한다. 이 점에 유념하여 본 논문은 국가 의례와 그림의 관계에 기반하여 궁중행사도를 분석하는 것에 초점을 맞추었다. 우선 필자는 진연 의례(進宴儀禮)가 어떻게 19세기에 변하게 되었으며 그 변화가 진찬진연도 제작에 어떤 영향을 주었는지를 검토하였다. 고종 친정기 진연 의례는 대왕대비, 왕, 왕세자, 종친(宗親), 척신(戚臣), 명부(命婦), 관료 등 다양한 정치 참여 세력의 위계를 국왕 입장에서 규정하고 이들을 포섭하기 위해 기획된 것이었다. 고종 친정기 진찬진연도의 변화는 이러한 의례의 변화와 궤를 같이 하고 있었다. 고종 친정기 진찬진연도에서 가장 강조되었던 것은 왕과 왕세자였다. 왕과 왕세자는 한 화면에서 여러 차례 모습을 드러내었으며 그림의 정중앙에 차비(差備)들에게 둘러싸여 그림에서 가장 중요한 주인공으로 등장하였다. 반면 실제 의례와 그림에서 왕실 친족이 아닌 일반 관료들의 지위는 축소되었고 명부, 종친, 척신, 의빈 등 왕실 친족이 관료들보다 높은 비중을 차지하게 되었다. 이들 왕실 구성원의 위계는 그림의 주제, 인물들의 위치와 표현, 배경의 묘사, 주렴(珠簾), 보계(補階), 차일(遮日) 등의 시각 요소로 구현되고 차별화되었다. 또한 필자는 진하 의례(陳賀儀禮)의 성격을 살피고 이를 기반으로 진하도의 성격을 검토하였다. 진하례의 가장 큰 특징은 위계성(位階性)과 유동성이었다. 진하례를 바탕으로 한 진하도는 국왕과 관료 사이의 위계를 보여주는 것이 특징이며 국왕에 의해 제작 계기가 특별히 선택되어 그려진다는 점에서 유동성을 지녔다. 따라서 진하도는 해당 의례의 절차를 정확히 기록하기 위해 제작된 것이 아니라 왕과 왕세자의 권위를 높이기 위한 화목(畵目)으로 고안되었다. 이 시기 왕실에서는 왕과 왕세자의 초월성을 보여줄 수 있는 계기를 특별히 지목하여 이것을 진하도로 제작하였다. 고종 친정기 진하도는 왕세자의 탄생, 천연두 완치, 국왕 업무 대행 등을 기념해 제작되었다. 이를 통해 고종은 자신의 후계자인 왕세자의 위상을 공고히 하고자 하였다. 아울러 고종은 진하도를 통해 왕세자가 천명(天命)에 의해 대권을 이을 인물로 성장하는 과정을 보여줌으로써 왕실의 초월성을 강조하고자 하였다. 17세기까지 지속되었던 관료들의 계회도(契會圖) 전통은 18세기 이후 왕실 주도의 계병(稧屛) 제작 체계로 변화되어 고종 친정기에 적극적으로 활용되었다. 고종 친정기 궁중 행사 계병의 주제, 형식, 좌목(座目) 기술(記述) 방법 등을 살펴보면 조선 시대 계회도 전통이 왕실로 전용(轉用)되었던 모습이 포착된다. 이와 더불어 계병 제작의 주체가 명백하게 왕실이었기 때문에 궁중행사도 제작을 위한 재원(財源) 마련도 왕실 주도로 이루어지게 되었다. 이를 검토하는 과정에서 고종 친정기 진찬진연 의궤에 기재된 소요 재원 내역이 형식적으로 기입되었을 가능성과 실제 소요 재원이 의궤에 기재된 내역을 훨씬 초과하였을 가능성이 제기되었다. 이를 통해 고종 친정기 궁중행사도가 많은 이들에게 경제적 부담을 지우며 무리하게 제작된 것이었음이 드러났다. 고종 친정기 왕실에서 궁중 행사 설행(設行)과 궁중행사도 제작을 지속하였던 의도로는 다음 두 가지 사항이 주목된다. 첫째, 고종은 궁중 행사를 통해 새롭게 정치 주체로 등장한 종친, 척신, 명부 등 왕실 구성원들을 적극적으로 포섭함과 동시에 국왕 입장에서 이들의 지위를 규정하고자 하였다. 둘째, 고종은 만민 평등을 지향했던 근대화의 흐름에 맞서 왕과 왕세자의 존재에 초월성과 정당성을 부여하고자 하였다. 이러한 의도는 고종 친정기 왕실에서 생산된 왕실 이미지 전반에서 발견된다. 이를 구체화하기 위해 필자는 궁중행사도와 함께 왕과 왕세자가 직접 화면에 드러난 장르인 어진(御眞)과 어사진(御寫眞)을 비교 분석하였다. 고종 친정기 궁중행사도는 근대 전환기 왕실에서 시각 매체를 제작하고 활용했던 방식을 보여주는 미술사적으로 매우 중요한 자료이다. 본 논문은 고종 친정기 궁중행사도가 조선 왕실 미술 전통에 의거하면서도 당시 왕실의 정치적 목적에 맞추어 변화된 모습에 주목하여 근대 전환기 왕실 미술 전반에 대한 이해를 새롭게 하는 데 기여하고자 하였다.

다면평가제도의 개선방안에 관한 연구 : 경남교육청 소속 지방공무원에 대한 인식조사를 중심으로

성영희 경상대학교 행정대학원 2009 국내석사

Traditional civil servant appraisal system based on performance rating is limited to top-down evaluation in which a superior evaluates people under his supervision, so it has been criticized for excessive reliance on the superior's subjective opinion and limitation in reflecting people's abilities and qualities objectively and fairly. The introduction of multi-source assessment into the public office society shows the necessity for fair assessment of civil servants' capabilities and efficient personnel management. Thus, multi-source assessment was adopted in the Executive Order on Civil Servant Appointment from the promotion screening in December 1998, and the guidelines for multi-source assessment began to be enforced from August 2008. In order to survey the current state of improvement in multi-source assessment among local civil servants at the Gyeongsangnam-do office of Education, this study conducted a questionnaire survey of 6th-grade or lower local civil servants. The questionnaire was designed to survey the respondents' perception of the assessment process with regard to the adequacy of assessors and assessment methods. In addition, the survey purposed to understand the participants' satisfaction with multi-source assessment and derive plans to improve the assessment system. For this study, the theoretical background of multi-source assessment was examined through previous research and literature review. In addition, we investigated the operation of multi-source assessment at the departments of the central government and local education institutions. Problems and improvement plans derived from this study are summarized as follows. First, with regard to problems in assessors and assessment methods, multi-source assessment was being performed without knowing details on the persons to be assessed. In addition, the characteristics of works and job performance were not reflected in multi-source assessment. Furthermore, the anonymity of multi-source assessors should be thoroughly guaranteed. Also, with regard to assessment methods, it was required to diversify assessment methods and to set reasonable assessment criteria and the weight of each assessor's evaluation according to position. To solve the problem that multi-source assessment is executed without knowing the persons to be assessed, preliminary education before multi-source assessment should be reinforced. Education and training can emphasize the profits and effects of multi-source assessment, and resolve anxiety about multi-source assessment. In addition, with regard to assessment methods, it is necessary to reach an agreement on multi-source assessment design reflecting the weight of multi-source assessment and the characteristics of works. Furthermore, there should a device for adjusting evaluation results to correct intentional or unintentional errors happening in the assessment process. Second, a problem related to assessment results was dissatisfaction with the operation of multi-source assessment. In order to solve this problem, it appeared very important to educate multi-source assessment participants. Third, a problem related to the use of assessment results was that the use of the results was limited to promotion screening and the payment of performance-based bonus. As to how to improve multi-source assessment, the most frequently mentioned suggestion was the activation of the job performance add-point system. In addition, they suggested the maintenance of the current system but its electronic operation (e-human). The results of multi-source assessment should be utilized not limitedly to personnel management but in various areas including the development of abilities. In the personnel management of civil servant organizations, multi-source assessment is very critical and should be utilized intensively in the future. A limitation of this study is that positive changes brought to organizations by multi-source assessment were not approached from different sides due to lack of time and effort for preliminary study for surveying and analyzing efficient alternatives to improve the operation of multi-source assessment. In addition, because this study derived plans to improve multi-source assessment from 6th-grade or lower local civil servants at the Gyeongsangnam-do Office of Education, further multi-sided research is necessary with the entire population of local civil servants.

파킨슨병 환자의 인지기능 저하의 선별검사도구의 유용성에 관한 연구

성영희 가천의과학대학교 대학원 2011 국내석사

Objective: Dementia is an important and increasingly recognized problem in Parkinson’s disease (PD). Tests such as the mini-mental state examination (MMSE) are insensitive to cognitive impairment in PD and the length of neurophychologic batteries is an obstacle to more widespread use. The Montreal cognitive assessment (MoCA) is brief tool developed to detect mild cognitive impairment that assesses a broader range of domains frequently affected in PD. The objective of this study was comparing MMSE to MoCA socre in patients with PD. Furthermore, we sought to identify demographic and clinical correlates of cognitive dysfunction in PD. Methods: This was a prospective study of patients attending the Neurologic department of the Gil Hospital between September 1, 2009 and June 30, 2010. The clinical diagnosis of PD was based on UK Brain Bank criteria. Patients underwent a neuropsychological assessment, including MMSE, MoCA and Back depression inventory(BDI), quantitative ratings of motor symptom severity and functional status. Results: There are no significant difference among PD-ND, PDD and control group in the age, sex and education. However, there are significant differences in the K-MMSE. That is there are difference between PD-ND and PDD and difference between PD-ND and control which were confirmed by post-hoc analysis. There are significant differences in the K-MoCA between PD-ND and PDD but no difference between PD-ND and control. In the ROC curve analysis, AUC of the MMSE is .685 and AUC of the MoCA is .654. There are no significant difference between MMSE and MoCA (p=0.379). Conclusion: There are no significant differences to identify PDD in MoCA and MMSE. 목적 : 파킨슨병 환자의 약 90%가 병의 진행과정에서 이러한 비운동증상을 경험하며 이로 인한 삶의 질 저하를 호소하고 있다. 이중 인지장애는 인지장애는 가장 흔한 증상의 하나도 대략 40%에서 치매로 진행하는 것으로 알려져 있다. 본 연구에서는 파킨슨병 환자에서 MMSE와 MoCA를 비교분석하여 파킨슨치매 진단도구의 유용성과 타당성을 밝히고 환자의 운동척도 및 임상양상과 인지기능 저하와의 연관성에 대하여 알아보고자 하였다. 방법 : 가천의과대학교 길병원 신경과 외래를 내원하여 특발성 파킨슨병(idiopathic Parkinson’e disesas)으로 진단 받고 경과 관찰중인 환자중 CDR 점수가 0.5인 환자를 “Parkinson Disease No Dementia (PD-ND)”집단으로, 인지기능장애와 함께 일상생활의 장애까지 확인된 CDR 점수가 1점 이상인 환자를 “Parkinson Disease Dementia (PDD)”집단으로 분류하였다. 또한 나이와 교육정도가 환자군과 일치하는 정상대조군을 선정하였다. 모든 환자를 대상으로 기본적인 인구학적 정보(성별, 연령, 교육정도 등), 특발성 파킨슨병의 증상 발생 시기와 발병 기간, UPDRS (Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr stage, SEADL (Schwab and England Activities of Daily Living Scale)와 인지 기능의 정도를 알기 위해 K-MMSE와 K-MoCA 를 시행하여 인지장애의 특성을 조사하였다. 결과 : PD-ND, PDD 및 대조군, 세 집단의 나이, 교육년수 및 성별 구성에 있어서의 차이는 발견되지 않았다. 그러나 K-MMSE 점수에서 뚜렷한 집단차이가 발견되었으며 이는 사후분석 결과 PD-ND와 PDD, PD-ND와 대조군간에도 유의한 차이가 있음이 밝혀졌다. K-MoCA 점수에서는 PD-ND와 PDD간에는 유의한 차이가 있음이 확인되었으나 PD-ND와 대조군간에는 점수 차이는 발견되지 않았다. K-MMSE와 K-MOCA가 파킨슨 환자군과 정상 대조군의 판별에 대한 ROC curve 분석 결과, MMSE의 AUC는 .685, MOCA의 AUC는 .654로 나타났으며, 유의한 차이는 없는 것으로 나타났다(p=0.379). 또한 파킨슨 환자군내에서 PD-ND군과 PDD군간의 판별에 대한 ROC curve 분석 결과, K-MMSE 의 AUC는 .899, K-MOCA의 AUC는 .887로 나타났으며, 유의한 차이는 없는 것으로 나타났다(p=0.682). 결론 : 본 연구에서는 파킨슨병 환자에서 외래에서 평가할 수 있는 간단한 인지평가도구로 K-MMSE와 K-MoCA를 비교분석한 결과 두 도구간의 판별력은 유의한 차이가 없는 것으로 도출이 되었다.

ON THE TRIVIALITY OF FIBRE BUNDLES : 파이버束의 自明性에 관한 연구

성영희 조선대학교 대학원 1991 국내석사

Fibre束의 이론은 接束 이외에도 Lie群 및 等質空間, 被覆空間이나 일반적인 Vector束등에 응용되고 Fibre束의 Homology 구조에 대한 연구는 그 스펙톨 系列의 이론에 의해 발전하고 Cohomology 作用素의 연구 전진과 함께 K-Theory도 발전이 기대된다. Fibre bundle의 연구에서 주된 의문은 Fibre bundle의 어떤 Cross section이 존재하는가에 있다. Principal G-bundle의 自明性은 Principal G-bundle이 cross section을 가지느냐는 판정조건을 준다. 이 논문의 목적은 Principal G-bundle과 Fibre bundle의 自明性을 증명하는데 있다. 2장은 bundle의 일반적인 槪念을 기술한다. 3장은 Principal G-bundle의 기본개념을 나열하고 Principal G-bundle의 自明性을 증명한다. 4장은 종합적인 Fibre bundle을 정의하고 Fibre bundle의 自明性을 증명한다.

환자사례관리모형 개발 및 적용 효과 : 척추후궁절제술 환자 중심으로

성영희 中央大學校 2000 국내박사

As a result of the recent problems of increased medical expenses and ineffective utilization of medical resources, related to an increase in the people's medical needs, the medical reform has made by the government. Medical facilities have therefore been searching for a medical delivery system, one that could make a quality improvement and one that is at the same time cost effective. In order to meet these demands, it was also seen necessary to develop a new nursing delivery system, that is able to improve nursing productivity. The purpose of this study was to develop a case management model for patients who have undergone laminectomy, then to analyze the outcomes after the clinical application of the developed case management model. In order to develop a case management model, the case management team was constituted with the members of a neurosurgeon, rehabilitation doctor, nurse manager, and nurses, who were involved in the care of laminectomy patients and a staff member of the QA team, department of the medical records and the billing and finance. Pre-admission program, CP to be used during hospitalization and the form to be used to record variances, were developed by reviewing various domestic and international literature, bench-marking of leading hospitals with successful programs and also by reviewing medical records and case manager's role was defined. Subjects of this study were consisted of patients who have admitted and received laminectomy during 13 months period, from May 1998 to May 1999. Those patients who agreed to be managed under a case management model was used for the experimental group, previously used nursing care methods were used for the control group. The results are as follows 1. Development of case management model Once the patient was selected as an experimental group patient, he(or she) is admitted through the pre-admission program. The pre-admission program included visiting the neuro-surgical outpatient department twice prior to the admission. The outpatient case manager then performed pre-operative tests and reviewed the results of the tests, did any measurements necessary for the operation, filled out the patient information form, performed procedures and specific instructions regarding the operation. The patient was admitted to the inpatient unit directly on the day of surgery, and was received preparations and instructions on the day of surgery, then got transferred to the operating room. The standardized CP, to be applied from the moment the patient is admitted to the ward after the operation, until he(or she) was discharged. The standardized CP was developed through 4 phases. During the first phase, the conceptual framework was constructed by putting assessment and observation, activity, diet, treatment, drainage, consultation, tests, medications, patient teaching, emotional support and remarks to evaluate daily treatment and nursing care on the vertical axis, and by putting the time frame which has operational date as a center on the horizontal axis. During the second phase, the preliminary CP was developed after analysis of the medical record of 27 patients , who were discharged after receiving laminectomy from February to April 1998, based on the developed conceptual framework. The third phase consisted of correction of the preliminary CP by the professional groups consisting of neurosurgeons, nurses working in the neurosurgical nursing unit. and the final form of CP was confirmed by the case management team. In this model, instead of assigning a full time case manager, the unit nurse manager, the nurses in the neurosurgical inpatient unit and the outpatient department, were all taught to assume this role. Variance sheets were then developed to record all variance. 2. Outcomes of the case management model 1) Outcomes from the patient's perspective ⑴ Nursing Quality Evaluation Score(NQES) The mean NQES for the experimental group(1.96) was higher than that for the control group(1.81). ⑵ Hours of direct nursing care provided to each patient in one day The average direct nursing care hour for a patient in one day for the experimental group(82.71 min) was higher than that for the control group(73.71 min). ⑶ Surgical outcomes ① The degree of lower back pain postoperatively The mean score of lower back pain of the experimental group(2.61) was lower than that of the control group, but no significant difference was noted between the two groups when compared pre and post operatively. ② The degree of lower extremities pain postoperatively The mean score of lower extremities pain of the experimental group(1.67) was lower than that of the control group(3.12), and statistically significant difference was noted between the experimental group(6.21) and the control group(4.15) when compared the lower extremities pain pre and post operatively. ③ Post-operative complications The experimental group was seen to have one wound problem, and one minor problem related to impairment of elimination and urination postoperatively. However these problems were minimal and rather insignificant. The degree of decreased ambulatory discomfort after the surgery for the experimental group(4.42) was higher than that for the control group(3.65). ⑷ Medical expense per patient The mean medical expense for the experimental group(1,833,163￦) was lower than for that of the control group(2,589,065￦). ⑸ Level of patient satisfaction No significant difference was seen between the experimental group(4.35) and the control group(4.17), in terms of patient satisfaction. 2) Outcomes from the perspective of hospital management ⑴ Length of stay(LOS) The mean LOS for the experimental group(6.06 day) was shorter than that for the control group(10.04 day). ⑵ Nursing cost The mean cost of nursing for the experimental group(262,387￦) was lower than that for the control group(418,070￦). 3) Outcomes from the medical care providers' perspective No statistically significant difference was found between the experimental group(3.26) and the control group(3.18) in terms of nurses' job satisfaction. 3. Analysis of variances There were 125 variances with 43 cases(35.25%) in patients/family factor, 79 cases(63.2%) in medical care providers factor and 3 cases(2.4%) in hospital factor. When the variance were classified by 3 grades, grade 1 was seen with no change or minimal variances from CP, grade 2 was seen with some variances from CP, but still able to apply CP, grade 3 was seen to be unable to apply CP. There were 111 cases(88.8%) of grade 1, 14 cases(11.2%) of grade 2, and no case of grade 3. In conclusion, through effective activation activities by the case management team, as a result of active participation of medical doctors, the outpatient management program, CP during hospitalization, and forms to record the variances were all developed successfully, and the standard of evaluations which could systematically and comprehensively test the outcomes of case management was also selected. This research has shown that it may be necessary to consider a full time case manager in developing future patient case management model, since there was no positive outcomes from the medical care providers' perspective, by giving dual assignments to the staff nurses in this study. The case management model has been seen to be a cost-effective nursing delivery system, that could improve the level of nursing care quality and reduce the patient's burden for medical expense from the patient's perspective, and that could reduce the length of stay and the nursing cost from the perspective of hospital management. 현재 의료계는 국민의 의료수요의 증가, 인구의 노령화 및 질병구조의 만성화에 따른 의료비 상승문제, 의료자원의 비효율적인 활용의 문제를 안고 있어, 정부차원의 의료개혁이 시도되고 있다. 1997년 포괄수가제 도입을 위시하여 여러 가지 의료정책의 변화는 의료서비스의 질을 향상시키면서도 비용효과를 가져올 수 있는 혁신적인 의료전달체계를 모색하게 되었고, 이에 따라 간호계에서도 간호생산성을 향상시킬 수 있는 새로운 간호전달체계의 개발을 필요로 하게 되었다. 본 연구의 목적은 일개 종합병원의 척추후궁절제술 환자를 대상으로 사례관리모형을 개발하고 이를 임상에 적용하여 환자 측면의 효과로는 진료와 간호의 질 수준, 진료비 부담수준 및 만족도를, 병원운영 측면의 효과는 재원일수와 간호원가를, 의료제공자 측면의 효과로는 직무만족도를 분석하는데 있으며, 이를 바탕으로 효율적인 간호전달체계를 수립하고 진료 및 간호의 생산성을 향상시키기 위한 기초자료를 제공하는데 있다. 관련 의료진과 환자사례관리팀에게 환자사례관리에 대한 교육을 시행한 후, 1998년 5월부터 1999년 5월까지 13개월동안 환자사례관리모형을 적용한 실험군 33명과 기존의 진료 및 간호를 받은 대조군 26명을 대상으로 환자사례관리의 효과를 평가하였다.

Initial diagnostic workup of Parkinsonism : dopamine transporter positron emission tomography versus susceptibility map-weighted imaging at 3T

성영희 Hallym University 2019 국내박사

연구배경: 뇌자공명영상에서 흑질 치밀질의 후부에서 보이는 고음영 평가가 흑질선조체 퇴화를 진단하는데 도움이 될 수 있다. 본 연구는 파킨슨증의 초기 진단도구로서 자화지도강조영상과 도파민 운반체 영상의 진단 성능을 비교하고자 하였다. 연구방법: 본 연구는 병원 윤리위원회에서 승인을 받은 후 3T 감수성 맵 가중 영상과 도파민 운반체 영상을 시행한 파킨슨증 환자 233 명과 15 명의 건강한 피험자 (평균 연령, 69.5 세, 135 명의 여성)를 후향적으로 등록하였다. 흑질선조체 퇴화를 반영을 평가하는 두 검사간의 진단율은 DTComPair 패키지를 사용에서 제공하는 R을 사용하였고, 두 검사 사이의 차이의 90 % 신뢰 구간 (CI)로 비교하였다. 일치율 평가는 Cohen 's kappa를 사용하였다. 결과: 자화지도강조영상과 도파민 운반체 영상의 진단 민감도는 흑질 당 94.6 %와 100 %, 참가자 당 100 %와 100 %였다. 특이도는 흑질 당 95.3 %와 87.6 % 였고 참가자 당 94.7 %와 85.0 %였다. 진단 민감도는 흑질 당과 참가자 당의 테스트에서 유사했지만 특이도 차이는 90 % CI가 흑질 당 -0.115, 참가자 당 -0.158로 자화지도강조영의 진단 특이성이 도파민 운반체 영상보다 높게 나타났다. 기저핵에 병변이 있는 20명의 환자군을 제외 시켰을 때, 두 가지 검사는 유사한 진단 성능을 나타내었고 우수한 일치도를 보였다 (흑질 당 k = 0.899, 참가자 당 k = 0.947). 결론: 파킨슨증 환자에서 자화지도강조영상과 도파민 운반체 영상은 유사한 진단 성능을 보인다. Background: Evaluation of dorsal nigral hyperintensity on MRI can help detect nigrostriatal degeneration. We aimed to compare the diagnostic performance between susceptibility map-weighted imaging (SMWI) and N-3-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane (18F-FP-CIT) positron emission tomography (PET) as an initial diagnostic tool of parkinsonism. Materials and Methods: This local ethics committee-approved retrospective study enrolled 233 patients with parkinsonism and 15 healthy subjects (mean age, 69.5 years; 135 females) who underwent both SMWI at 3T and 18F-FP-CIT PET. The diagnostic performances of the two tests for nigrostriatal degeneration were compared by evaluating whether the 90% confidence interval (CI) of the difference between the two tests was within the equivalence margin by using the DTComPair package of R. The concordance rate was tested by Cohen’s kappa. Results: The diagnostic sensitivities of SMWI and 18F-FP-CIT PET were 94.6% and 100% per SN and 100% and 100% per participant, respectively; their specificities were 95.3% and 87.6% per SN and 94.7% and 85.0% per participant, respectively. While the diagnostic sensitivity was comparable between the two tests per SN and per participant, the lower 90% CIs of the differences in the specificity were -0.115 per SN and -0.158 per participant, indicating a higher diagnostic specificity of SMWI than that of 18F-FP-CIT PET. When excluding 20 participants with basal ganglia lesions, the two tests exhibited similar diagnostic performance and had excellent agreement (k=0.899 per SN; k=0.947 per participant). Conclusion: For patients with parkinsonism, SMWI and 18F-FP-CIT PET exhibit similar diagnostic performance.

Benjamin Britten의 Cantata rejoice in the lamb op. 30에 대한 작품분석과 지휘법 : 합창곡 1, 2, 3곡을 중심으로

성영희 장로회신학대학교 교회음악대학원 2007 국내석사

지금까지 브리튼의 칸타타 Rejoice in the lamb op.30(주안에서 기뻐하라)을 살펴본 결과 18세기의 시인 크리스토퍼 스마트의 Jubilate Agno(어린양을 기뻐하라)라는 긴 종교적인 시에서 브리튼이 자유롭게 선택하여 정리해서 가사로 사용하였는데 가사를 중요시여기는 가사그리기의 기법을 사용하여 그림을 그리듯 생생하게 가사를 묘사하는 선율로 작곡하였다. 복잡하고 어려운 선율이 아닌 단순한 선율에 리듬과 박자의 변화를 통해 변주시키며 아름답고 경쾌한 음악으로 만들어 주고 있다. 여기에 2도과 4도의 비화성음을 이용한 불협화음과 오르간 포인트, 오스티나토, 극적인 악상의 대조 등을 사용하여 음악을 장식해 주어 신비스럽고 화려한 음색으로 음악에 옷을 입혀 주고 있다. 현대음악임에도 뚜렷이 나타나고 있는 조성으로 인해 우리의 귀에 친숙하게 들리도록 해 주고 있으며 현대기법인 복조성을 이용하여 현대음악의 야릇함도 느끼게 해 준다. 합창과 오르간은 같은 선율을 이용하여 곡의 통일성을 주며 선율을 다양한 리듬과 박자로 변화시켜 합창과 오르간이 각각 따로 작곡된 것이 아닐까 하는 느낌을 주지만 하나로 신비스럽고 아름답게 합쳐지는 음악으로 천재적인 능력을 발휘하고 있다. 브리튼은 과거의 전통적인 음악기법에 새로운 현대적 기법을 접목시켜 새로운 음악으로 만들어 내는 작곡자로 Rejoice in the lamb op.30(주안에서 기뻐하라)을 통해 그의 독특한 음악색채를 보여주고 있다.

문(門)의 유형에 관한 사진적 연구 : <오래>展을 중심으로

성영희 상명대학교 예술디자인대학원 2013 국내석사