• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

• Health Policy and Management
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• v.14 no.1
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• pp.65-88
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• 2004

In general, empowerment is defined as the motivational concept of autonomy and self-efficacy. Recently, the concept of empowerment is applied to improve organizational staff's job satisfaction and organizational commitment in many organizations. Empower-ment in service organizations, i.e., hospitals, has certainly generated more publicity than any other organizations. The objectives of this study are, first, to measure the degree of hospital employees' empowerment using Spreitzer(1995)'s empowerment theory, second, to analyze the causal relationship of organizational and job characteristics, a degree of empowerment, and organizational performance(job satisfaction and organizational commitment), and third, to offer the strategy for the improvement of job satisfaction and organizational commitment. Spreitzer insists that the empowerment is composed of 4 dimensions(meaning, competence, self-determination, and impact). And he argues that various work-related characteristics is a direct cause of empowerment and the indirect cause of job satisfaction and organizational commitment, mediated by the empowerment latent variable. In order to perform this study, data were collected by self-administered questionnaires from hospital employees working in administrative department of 3 university hospitals in Inchon and Kyunggi-Do region. The number of cases is 181(response rate; 86%). The Collected data were analyzed with SPSS Ver. 10.0 and AMOSV Ver. 4.0. First, to test validity of variables, the factor analysis was used. Second, to test reliability, Cronbach's alpha coefficients was calculated. Cronbach's alpha of empowerment variable is 0.8323 showing that there's no problem in regard to the internal consistency. Also the Cronbach's alpha of other variables are 0.8301 of the degree of perceived control, 0.6705 of job characteristics, O.8787 of compensation, 0.9254 of job satisfaction, and 0.8389 of organizational commitment, respectively. Among the questions of job characteristics, two survey questions are deleted due to lowering the reliability. Third, to test multicollinearity and correlation of variables, the correlation analysis was performed. There was no problem of multicollinearity. Finally structural equation modelling (SEM) analysis was conducted to find the causal relationship of organizational and job Characteristics, empowerment, job satisfaction and organizational commitment. The 16 variables are included for the SEM analysis. The major results of this study are as follows: First, in the case of model fitness, the condition of x$^2$ statistic(92.187) is not fully satisfied, but the indices of GFI(0.912), AGFI(0.863), NFI(0.917) and CFI(0.928) are partially satisfied, which needs to upper 0.90. Second, in the result of hypotheses testing, all hypotheses are accepted and have a positive effect in 95% or 99% confidence interval(P<0.05 or P<0.001) except the effect of compensation variable on empowerment(P=0.082). Third, in regard to the direct, indirect, and total effect of variables, the direct effect of perceived control, task characteristics, and compensation on job satisfaction are 0.728, 2.264, 0.328 and on organizational commitment are 0.094, 1.411, 0.418, respectively. Also the indirect effect of perceived control, task characteristics, and compensation on job satisfaction are 0.311, 0.196, 0.028 and on organizational commitment are 0.210, 0.132, 0.019, respectively. Thus, these findings imply that various work-related factors are direct effect of empowerment and indirect effect of result variables, job satisfaction and organizational commitment. Also These results showed that the workplace empowerment is significant mediating factor of employee's job satisfaction and organizational commitment.

• Korean journal of communication and information
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• v.17
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• pp.112-144
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• 2001

This study attempts to analyze how and why Chosun Ilbo and Hankyoreh Shinmun produce particular social discourses about the media reform in different ways. In doing so, this paper attempts to disclose the ideological nature of media reform discourses in social contexts. For the purpose, a content analysis method was applied to the analysis of straight news, while an interpretive discourse analysis was appled to analyze both editorials and columns in newspapers. As a theoretical framework, an articulation theory was applied to explain the relationships among social forces, ideological elements, discourse practices and subjects to produce the media reform discourses. In doing so, I attempted to understand the overall conjuncture of the media reform aspects in social contexts. The period for the analysis was limited from January 10th to August 10th this year. Newspaper articles related to the media reform were obtained from the database of newspaper articles, "KINDS," produced by Korean Press Foundation, in searching the key word, "media reform". Total articles to be analyzed were 765, 429 from Hankyoreh Sinmun and 236 from Chosun Ilbo. The research results, first of all, empirically show that both Chosun Ilbo and Hankure Synmun used straight news for their firms' interests and value judgement, in selecting and excluding events related to media reform or in exaggerating and reducing the meanings of the events, although there are differences in a greater or less degree between two newspaper companies. Accordingly, this paper argues that the monopoly of newspaper subscriber by three major newspapers in Korean society could result in the forming of one-sided social consensus about various social issues through the distorting and unequal reporting by them. Second, this paper's discourse analysis related to the media reform indicates that the discourse of ideology confrontation between the right and the left produced by Chosen Ilbo functioned as a mechanism to realize law enforcement of the right in articulating the request of media reform and the anti-communist ideology. It resulted in the discursive effect of suppressing the request of media reform by civic groups and scholars and made many people to consider the media reform as a ideological matter in Korean society.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Journal of the Korea Concrete Institute
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• v.19 no.1
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• pp.121-130
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• 2007

To investigate the enhancement in strength and deformation capacities of concrete confined by FRP composites, tests under axial loads were carried out on three groups of thirty six short columns in circular section with diverse GFRP confining reinforcement. The major test variables considered include fiber content or orientation, wrap or tube type by varying the end loading condition, and continuous or discontinuous confinement depending on the presence of vortical spices between its two halves. The circumferential FRP strains at failure for different types of confinements were also investigated with emphasis. Various analytical models capable of predicting the ultimate strength and strain of the confined concrete were examined by comparing to observed results. Tests results showed that FRP wraps or tubes provide the substantial increase in strength and deformation, while partial wraps comprising the vertical discontinuities fail in an explosive manner with less increase in strength, particularly in deformation. A bilinear stress-strain response was observed throughout all tests with some variations of strain hardening. The failure hoop strains measured on the FRP surface were less than those obtained from the tensile coupons in all tests with a high degree of variation. In overall, existing predictive equations overestimated ultimate strengths and strains observed in present tests, with a much larger scatter related to the latter. For more accuracy, two simple design- oriented equations correlated with present tests are proposed. The strength equation was derived using the Mohr-Coulomb failure criterion, whereas the strain equation was based on entirely fitting of test data including the unconfined concrete strength as one of governing factors.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.4
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• pp.627-635
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• 2003

This study was performed to investigate the relations between dietary habit and academic achievement, subjective health judgement, and physical status. The subjects consisted of freshmen in university and answered to questionnaires through the Internet. The questionnaire consists of the dietary habit, academic achievement (College Scholastic Ability Test), subjective health judgement, and physical status during their 3$^{rd}$ grade in high school days. Data were collected from 3,612 people. Over 33% of respondents had their breakfast daily. Subjects who had breakfast below twice per week were 37.9%. The major reason of skipping breakfast was lack of time to eat breakfast (62.8%). The subjects who recognized the importance of breakfast were 80.6% (p＜0.001). More than half (52.7%) thought that dinner was most tasty. People who ate breakfast regularly had a tendency to recognize their health state were in good health (p＜0.01). There was no significant difference of BMI (body mass index) according to the frequency of breakfast per week. The subjects who had their breakfast regularly and well-balanced dietary habit reported higher marks in the College Scholastic Ability Test. In contrast, the subjects who rarely had breakfast showed poor marks of academic achievement and subjective health judgement. According to these results, a good dietary habit is considered to be important to academic achievement and confidence in health. Therefore we suggest the school breakfast program and nutrition education program should be required for teenagers. In addition, the findings from this study would provide the basic information for nutrition education in Korean teenagers..

• Journal of The Korean Association For Science Education
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• v.20 no.1
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• pp.52-76
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• 2000

Following the previous study focused on the period until the middle of the 20th century, this study tried to show how STS-related ideas have been developed historically in British science education, particularly focused on the period of the 2nd half of the 20th century. Like the USA, the UK witnessed the development of numerous academically-oriented programs, such as Nuffield projects, during the 1950-60s. However, during the 1970s, there had been growing criticism against the discipline-centered science education and some new noticeable approaches had been made to compensate the contemporary trend. For example, although its main focus was on the integrated approach in school science, the SCISP was quite successful to illustrate the importance of the relationship between science and society. Following this example, Science in Society and SISCON-in-Schools were more ambitious in developing genuine STS programs. These two projects were developed simultaneously and took the form of modules, rather than of textbooks. Nevertheless, Science in Society was more concerned with the applied and industrial aspects of science while SISCON-in-Schools was more inclined to the historical, philosophical and social aspects of science. During the 1980s, far more ambitious attempts had been made to develop full-scale STS programs, i.e. Salters' Chemistry/Science and SATIS. These two programs have been developed with the active corporation from the ASE and soon became the typical examples of the STS approach across the world. Besides the similarities between them, Salters' approach is more application-oriented, subject-oriented, and textbook-like while SATIS is more socially-oriented, issue-oriented and module-style. In summary, the history of STS approach in school science shows that the STS programs were developed under the different social backgrounds and initiated by different groups of the people who have different views towards the purposes of school science and that the STS approach is certainly not the exclusive characteristic of the last period of the 20th century. Finally, the features of the major STS programs developed in Britain during the 20th century are summarized and compared in relation to the Ziman's criteria of the possible approaches in STS education. And some general conclusion are drown based on the study of the history of the STS approaches in Britain.

• Journal of The Korean Association For Science Education
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• v.34 no.3
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• pp.285-294
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• 2014

This study investigates the effects of formative assessment utilizing mobile applications on interest and self-directedness in science instruction. The study subjects are two 6th grade classes from H elementary school located in Incheon, and the experimental group and the comparative group are composed of 21 students, respectively. The students from the experimental group have been taught with mobile devices while the comparative group has been taught in methods consistent with the current teaching standards. For the sake of research, the results of the method applied to the mobile device focus group have been edited using Google Drive Forms, entered as QR codes and stored in order for them to later be utilized for teaching and learning process. In the process, the teacher has provided the students with feedback based on their answers. The students of comparative group are to solve the same formative assessment in paper. As a result, the teacher of the mobile device focus group has been able to go through twenty-nine questions on formative assessment in the teaching and learning process, confirm the correct answers five times and provide feedback twenty-five times for additional explanation. In the inquiry about interest, the mobile device group scored 4.64 points and the standard one scored just 1.99 points (p<0.01). Fifteen students answered in the interview that and the major reason why they scored high has been because it was fun to study with mobile devices. When it comes to self-directedness over the process of teaching and learning, the mobile device focus group has answered positively but the standard group has scored relatively low (p<0.01).

• Culinary science and hospitality research
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• v.18 no.2
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• pp.182-196
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• 2012

This study investigates the optimal application of perilla leaves to fresh noodles in terms of a variety of beneficial effects and functions such as the anti-microbial function of the leaves. First, we measured the water contents of the fresh noodles and found that the ones added with 7% lyophilized perilla leaf extract showed the maximum water contents whereas the control noodles without perilla leaf extract the minimum. Increasing amount of raw perilla leaf extract or lysophilzed perilla leaves in the fresh noodles elevated the L value and significantly reduced the A value. The mass and volume of the fresh noodles were gradually decreased with raw perilla leaves added. Addition of raw perilla leaf extract and lyophilized perilla leaves decreased the turbidity of the fresh noodles. Hardness of the fresh noodles was increased by the addition of lyophilized Perilla leaves. Next, we tested the effect of the addition of sesame leaves on microbial growth. No microbes were found in the fresh noodles in the absence or presence of sesame leaves at day 0. When the noodles were stored for 3 days, the greatest number of bacteria was detected in the noodles without perilla leaves while addition of perilla leaves lowered the amount of bacteria in the noodles. We then performed the sensory test. For the raw perilla leaf extract addition, the noodles with 9% of extract exhibited the highest in appearance, flavor, color (6.47), texture (6.60), and overall acceptability (7.67). Texture was the highest in the ones with 3% (6.87) and 5% (6.20) of extracts added. Overall acceptability (7.07) was the best when 3% perilla leaves were added. Overall, 9% addition of raw perilla leaf extract or 3% addition of lysophilized perilla leaves showed optimal tastes.