• Title/Summary/Keyword: 2007

Search Result 77,428, Processing Time 0.103 seconds

An Analysis on the Curricula and Recognitions of the Home Economics Teachers who were the Participants of the First-Grade Home Economics Regular Teacher Qualification Program (중등 가정과 1급 정교사 자격 연수 프로그램 운영 실태 분석 및 연수 참여자의 인식)

  • Lim, Il-Young;Kweon, Li-Ra;Lee, Hye-Suk;Park, Mi-Jin;Ryu, Sang-Hee
    • Journal of Korean Home Economics Education Association
    • /
    • v.19 no.4
    • /
    • pp.37-56
    • /
    • 2007
  • The purpose of this study is to provide basic resources to the first-grade Home Economics Regular Teacher Qualification Program (FGHERTQP) in order to improve its operation plans. For the study, the three methods were carried out: an analysis on the curricula of FGHERTQP over six years since 2000, a questionnaire asking their satisfaction degrees and needs on the programs which was answered by the home economics teachers who were the participants of FGHERTQP, and several statistical analyses such as a descriptive-test, a $X^2$-test, a t-test, and one way ANOVA by using SPSS Win ver 10.0. The results of the study were as follows; Firstly, FGHERTQP has been operated ten times by five training centers during resent six years. Subject matters ($1{\sim}7$), whole numbers of lectures ($11{\sim}29$), and their allotted working hours ($111{\sim}136$) vary with individual training centers and operation years. Secondly, when using 5 point likert scales, Contents and Methods of evaluation marked 3.08 which were the lowest scores, and Qualification Training in General marked 3.72 which was the highest score among five fields of Qualification Training in General, Contents, Organizations, Methods and Evaluation. The overall scores were low. Thirdly, in needs analysis on offering subject matters, the participants wanted to study the field of home economics education more than that of subject contents. Looking about the highest needs classified by domains, Food Principles & Meal Management showed the highest in Foods. And Consumer Issues in Clothing & Textiles in Textiles, Upcoming Housing Cultures in Housing, Family Relationship in Child Development & Family Relationship, Juveniles and their daily life as a consumer in Family & Consumer Resources Management. Fourthly, training centers' lectures available had a significant influence on the satisfaction degrees according to general characteristic variations of the participants. That is, as a training center offers more lectures in the field of subject education than those of subject contents, the participants showed higher satisfaction degrees (p<.05).

  • PDF

Measuring Consumer-Brand Relationship Quality (소비자-브랜드 관계 품질 측정에 관한 연구)

  • Kang, Myung-Soo;Kim, Byoung-Jai;Shin, Jong-Chil
    • Journal of Global Scholars of Marketing Science
    • /
    • v.17 no.2
    • /
    • pp.111-131
    • /
    • 2007
  • As a brand becomes a core asset in creating a corporation's value, brand marketing has become one of core strategies that corporations pursue. Recently, for customer relationship management, possession and consumption of goods were centered on brand for the management. Thus, management related to this matter was developed. The main reason of the increased interest on the relationship between the brand and the consumer is due to acquisition of individual consumers and development of relationship with those consumers. Along with the development of relationship, a corporation is able to establish long-term relationships. This has become a competitive advantage for the corporation. All of these processes became the strategic assets of corporations. The importance and the increase of interest of a brand have also become a big issue academically. Brand equity, brand extension, brand identity, brand relationship, and brand community are the results derived from the interest of a brand. More specifically, in marketing, the study of brands has been led to the study of factors related to building of powerful brands and the process of building the brand. Recently, studies concentrated primarily on the consumer-brand relationship. The reason is that brand loyalty can not explain the dynamic quality aspects of loyalty, the consumer-brand relationship building process, and especially interactions between the brands and the consumers. In the studies of consumer-brand relationship, a brand is not just limited to possession or consumption objectives, but rather conceptualized as partners. Most of the studies from the past concentrated on the results of qualitative analysis of consumer-brand relationship to show the depth and width of the performance of consumer-brand relationship. Studies in Korea have been the same. Recently, studies of consumer-brand relationship started to concentrate on quantitative analysis rather than qualitative analysis or even go further with quantitative analysis to show effecting factors of consumer-brand relationship. Studies of new quantitative approaches show the possibilities of using the results as a new concept of viewing consumer-brand relationship and possibilities of applying these new concepts on marketing. Studies of consumer-brand relationship with quantitative approach already exist, but none of them include sub-dimensions of consumer-brand relationship, which presents theoretical proofs for measurement. In other words, most studies add up or average out the sub-dimensions of consumer-brand relationship. However, to do these kind of studies, precondition of sub-dimensions being in identical constructs is necessary. Therefore, most of the studies from the past do not meet conditions of sub-dimensions being as one dimension construct. From this, we question the validity of past studies and their limits. The main purpose of this paper is to overcome the limits shown from the past studies by practical use of previous studies on sub-dimensions in a one-dimensional construct (Naver & Slater, 1990; Cronin & Taylor, 1992; Chang & Chen, 1998). In this study, two arbitrary groups were classified to evaluate reliability of the measurements and reliability analyses were pursued on each group. For convergent validity, correlations, Cronbach's, one-factor solution exploratory analysis were used. For discriminant validity correlation of consumer-brand relationship was compared with that of an involvement, which is a similar concept with consumer-based relationship. It also indicated dependent correlations by Cohen and Cohen (1975, p.35) and results showed that it was different constructs from 6 sub-dimensions of consumer-brand relationship. Through the results of studies mentioned above, we were able to finalize that sub-dimensions of consumer-brand relationship can viewed from one-dimensional constructs. This means that the one-dimensional construct of consumer-brand relationship can be viewed with reliability and validity. The result of this research is theoretically meaningful in that it assumes consumer-brand relationship in a one-dimensional construct and provides the basis of methodologies which are previously preformed. It is thought that this research also provides the possibility of new research on consumer-brand relationship in that it gives root to the fact that it is possible to manipulate one-dimensional constructs consisting of consumer-brand relationship. In the case of previous research on consumer-brand relationship, consumer-brand relationship is classified into several types on the basis of components consisting of consumer-brand relationship and a number of studies have been performed with priority given to the types. However, as we can possibly manipulate a one-dimensional construct through this research, it is expected that various studies which make the level or strength of consumer-brand relationship practical application of construct will be performed, and not research focused on separate types of consumer-brand relationship. Additionally, we have the theoretical basis of probability in which to manipulate the consumer-brand relationship with one-dimensional constructs. It is anticipated that studies using this construct, which is consumer-brand relationship, practical use of dependent variables, parameters, mediators, and so on, will be performed.

  • PDF

The Effects of Environmental Dynamism on Supply Chain Commitment in the High-tech Industry: The Roles of Flexibility and Dependence (첨단산업의 환경동태성이 공급체인의 결속에 미치는 영향: 유연성과 의존성의 역할)

  • Kim, Sang-Deok;Ji, Seong-Goo
    • Journal of Global Scholars of Marketing Science
    • /
    • v.17 no.2
    • /
    • pp.31-54
    • /
    • 2007
  • The exchange between buyers and sellers in the industrial market is changing from short-term to long-term relationships. Long-term relationships are governed mainly by formal contracts or informal agreements, but many scholars are now asserting that controlling relationship by using formal contracts under environmental dynamism is inappropriate. In this case, partners will depend on each other's flexibility or interdependence. The former, flexibility, provides a general frame of reference, order, and standards against which to guide and assess appropriate behavior in dynamic and ambiguous situations, thus motivating the value-oriented performance goals shared between partners. It is based on social sacrifices, which can potentially minimize any opportunistic behaviors. The later, interdependence, means that each firm possesses a high level of dependence in an dynamic channel relationship. When interdependence is high in magnitude and symmetric, each firm enjoys a high level of power and the bonds between the firms should be reasonably strong. Strong shared power is likely to promote commitment because of the common interests, attention, and support found in such channel relationships. This study deals with environmental dynamism in high-tech industry. Firms in the high-tech industry regard it as a key success factor to successfully cope with environmental changes. However, due to the lack of studies dealing with environmental dynamism and supply chain commitment in the high-tech industry, it is very difficult to find effective strategies to cope with them. This paper presents the results of an empirical study on the relationship between environmental dynamism and supply chain commitment in the high-tech industry. We examined the effects of consumer, competitor, and technological dynamism on supply chain commitment. Additionally, we examined the moderating effects of flexibility and dependence of supply chains. This study was confined to the type of high-tech industry which has the characteristics of rapid technology change and short product lifecycle. Flexibility among the firms of this industry, having the characteristic of hard and fast growth, is more important here than among any other industry. Thus, a variety of environmental dynamism can affect a supply chain relationship. The industries targeted industries were electronic parts, metal product, computer, electric machine, automobile, and medical precision manufacturing industries. Data was collected as follows. During the survey, the researchers managed to obtain the list of parts suppliers of 2 companies, N and L, with an international competitiveness in the mobile phone manufacturing industry; and of the suppliers in a business relationship with S company, a semiconductor manufacturing company. They were asked to respond to the survey via telephone and e-mail. During the two month period of February-April 2006, we were able to collect data from 44 companies. The respondents were restricted to direct dealing authorities and subcontractor company (the supplier) staff with at least three months of dealing experience with a manufacture (an industrial material buyer). The measurement validation procedures included scale reliability; discriminant and convergent validity were used to validate measures. Also, the reliability measurements traditionally employed, such as the Cronbach's alpha, were used. All the reliabilities were greater than.70. A series of exploratory factor analyses was conducted. We conducted confirmatory factor analyses to assess the validity of our measurements. A series of chi-square difference tests were conducted so that the discriminant validity could be ensured. For each pair, we estimated two models-an unconstrained model and a constrained model-and compared the two model fits. All these tests supported discriminant validity. Also, all items loaded significantly on their respective constructs, providing support for convergent validity. We then examined composite reliability and average variance extracted (AVE). The composite reliability of each construct was greater than.70. The AVE of each construct was greater than.50. According to the multiple regression analysis, customer dynamism had a negative effect and competitor dynamism had a positive effect on a supplier's commitment. In addition, flexibility and dependence had significant moderating effects on customer and competitor dynamism. On the other hand, all hypotheses about technological dynamism had no significant effects on commitment. In other words, technological dynamism had no direct effect on supplier's commitment and was not moderated by the flexibility and dependence of the supply chain. This study makes its contribution in the point of view that this is a rare study on environmental dynamism and supply chain commitment in the field of high-tech industry. Especially, this study verified the effects of three sectors of environmental dynamism on supplier's commitment. Also, it empirically tested how the effects were moderated by flexibility and dependence. The results showed that flexibility and interdependence had a role to strengthen supplier's commitment under environmental dynamism in high-tech industry. Thus relationship managers in high-tech industry should make supply chain relationship flexible and interdependent. The limitations of the study are as follows; First, about the research setting, the study was conducted with high-tech industry, in which the direction of the change in the power balance of supply chain dyads is usually determined by manufacturers. So we have a difficulty with generalization. We need to control the power structure between partners in a future study. Secondly, about flexibility, we treated it throughout the paper as positive, but it can also be negative, i.e. violating an agreement or moving, but in the wrong direction, etc. Therefore we need to investigate the multi-dimensionality of flexibility in future research.

  • PDF

The Effects of Evaluation Attributes of Cultural Tourism Festivals on Satisfaction and Behavioral Intention (문화관광축제 방문객의 평가속성 만족과 행동의도에 관한 연구 - 2006 광주김치대축제를 중심으로 -)

  • Kim, Jung-Hoon
    • Journal of Global Scholars of Marketing Science
    • /
    • v.17 no.2
    • /
    • pp.55-73
    • /
    • 2007
  • Festivals are an indispensable feature of cultural tourism(Formica & Uysal, 1998). Cultural tourism festivals are increasingly being used as instruments promoting tourism and boosting the regional economy. So much research related to festivals is undertaken from a variety of perspectives. Plans to revisit a particular festival have been viewed as an important research topic both in academia and the tourism industry. Therefore festivals have frequently been leveled as cultural events. Cultural tourism festivals have become a crucial component in constituting the attractiveness of tourism destinations(Prentice, 2001). As a result, a considerable number of tourist studies have been carried out in diverse cultural tourism festivals(Backman et al., 1995; Crompton & Mckay, 1997; Park, 1998; Clawson & Knetch, 1996). Much of previous literature empirically shows the close linkage between tourist satisfaction and behavioral intention in festivals. The main objective of this study is to investigate the effects of evaluation attributes of cultural tourism festivals on satisfaction and behavioral intention. accomplish the research objective, to find out evaluation items of cultural tourism festivals through the literature study an empirical study. Using a varimax rotation with Kaiser normalization, the research obtained four factors in the 18 evaluation attributes of cultural tourism festivals. Some empirical studies have examined the relationship between behavioral intention and actual behavior. To understand between tourist satisfaction and behavioral intention, this study suggests five hypotheses and hypothesized model. In this study, the analysis is based on primary data collected from visitors who participated in '2006 Gwangju Kimchi Festival'. In total, 700 self-administered questionnaires were distributed and 561 usable questionnaires were obtained. Respondents were presented with the 18 satisfactions item on a scale from 1(strongly disagree) to 7(strongly agree). Dimensionality and stability of the scale were evaluated by a factor analysis with varimax rotation. Four factors emerged with eigenvalues greater than 1, which explained 66.40% of the total variance and Cronbach' alpha raging from 0.876 to 0.774. And four factors named: advertisement and guides, programs, food and souvenirs, and convenient facilities. To test and estimate the hypothesized model, a two-step approach with an initial measurement model and a subsequent structural model for Structural Equation Modeling was used. The AMOS 4.0 analysis package was used to conduct the analysis. In estimating the model, the maximum likelihood procedure was used.In this study Chi-square test is used, which is the most common model goodness-of-fit test. In addition, considering the literature about the Structural Equation Modeling, this study used, besides Chi-square test, more model fit indexes to determine the tangibility of the suggested model: goodness-of-fit index(GFI) and root mean square error of approximation(RMSEA) as absolute fit indexes; normed-fit index(NFI) and non-normed-fit index(NNFI) as incremental fit indexes. The results of T-test and ANOVAs revealed significant differences(0.05 level), therefore H1(Tourist Satisfaction level should be different from Demographic traits) are supported. According to the multiple Regressions analysis and AMOS, H2(Tourist Satisfaction positively influences on revisit intention), H3(Tourist Satisfaction positively influences on word of mouth), H4(Evaluation Attributes of cultural tourism festivals influences on Tourist Satisfaction), and H5(Tourist Satisfaction positively influences on Behavioral Intention) are also supported. As the conclusion of this study are as following: First, there were differences in satisfaction levels in accordance with the demographic information of visitors. Not all visitors had the same degree of satisfaction with their cultural tourism festival experience. Therefore it is necessary to understand the satisfaction of tourists if the experiences that are provided are to meet their expectations. So, in making festival plans, the organizer should consider the demographic variables in explaining and segmenting visitors to cultural tourism festival. Second, satisfaction with attributes of evaluation cultural tourism festivals had a significant direct impact on visitors' intention to revisit such festivals and the word of mouth publicity they shared. The results indicated that visitor satisfaction is a significant antecedent of their intention to revisit such festivals. Festival organizers should strive to forge long-term relationships with the visitors. In addition, it is also necessary to understand how the intention to revisit a festival changes over time and identify the critical satisfaction factors. Third, it is confirmed that behavioral intention was enhanced by satisfaction. The strong link between satisfaction and behavioral intentions of visitors areensured by high quality advertisement and guides, programs, food and souvenirs, and convenient facilities. Thus, examining revisit intention from a time viewpoint may be of a great significance for both practical and theoretical reasons. Additionally, festival organizers should give special attention to visitor satisfaction, as satisfied visitors are more likely to return sooner. The findings of this research have several practical implications for the festivals managers. The promotion of cultural festivals should be based on the understanding of tourist satisfaction for the long- term success of tourism. And this study can help managers carry out this task in a more informed and strategic manner by examining the effects of demographic traits on the level of tourist satisfaction and the behavioral intention. In other words, differentiated marketing strategies should be stressed and executed by relevant parties. The limitations of this study are as follows; the results of this study cannot be generalized to other cultural tourism festivals because we have not explored the many different kinds of festivals. A future study should be a comparative analysis of other festivals of different visitor segments. Also, further efforts should be directed toward developing more comprehensive temporal models that can explain behavioral intentions of tourists.

  • PDF

Diagnostic Value of ADA Multiplied by Lymphocyte to Neutrophil Ratio in Tuberculous Pleurisy (결핵성 흉막염에서 ADA 활성도와 림프구/중성구 비의 곱의 진단적 유용성)

  • Jeon, Eun Ju;Kwak, Hee Won;Song, Ju Han;Lee, Young Woo;Jeong, Jae Woo;Choi, Jae Cheol;Shin, Jong Wook;Kim, Jae Yeol;Park, In Won;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
    • /
    • v.63 no.1
    • /
    • pp.17-23
    • /
    • 2007
  • Background: Many diagnostic approaches for defining the definitive cause of pleurisy should be included due to the large variety of diseases resulting in pleural effusion. Although ADA is a useful diagnostic tool for making a differential diagnosis of pleural effusion, particularly for tuberculous pleural effusion, a definitive diagnostic cut-off value remains problematic in Korea. It was hypothesized that ADA multiplied by the Lymphocyte/Neutrophil ratio(L/N ratio) might be more powerful for making a differential diagnosis of pleural effusion. Methods: One hundred and ninety patients, who underwent thoracentesis and treatment in Chung-Ang University Hospital from January, 2005 through to February 2006, were evaluated. The clinical characteristics, radiologic data and the examination of the pleural effusion were analyzed retrospectively. Results: 1. Among the 190 patients, 59 patients (31.1%) were diagnosed with tuberculous pleurisy, 45 patients(23.7%) with parapneumonic effusion, 42 patients(22.1%) with malignant effusions, 36 patients(18.9%) with transudate, and 8 patients(4.2%) with empyema. One hundred and twenty one patients were found to have an ADA activity of 1 to 39 IU/L(63.7%). Twenty-nine were found to have an ADA activity of 40 to 75 IU/L(15.3%) and 40 were found to have an ADA activity of 75 IU/L or greater(21.0%). 2. Among the patients with tuberculous pleurisy, 5(8%), 18(30%) and 36 patients(60%) had an ADA activity ranging from 1 to 39 IU/L, 40 to 75 IU/L, and 75 IU/L or greater, respectively. In those with an ADA activitiy 40 to 75 IU/L, 18 patients(62%) had tuberculous pleurisy, 9(31%) had parapneumonic effusion and empyema, and 1(3.4%) had a malignant effusion. 3. In those with an ADA activity of 40 to 75 IU/L, there was no significant difference between tuberculous pleurisy and non-tuberculous pleural effusion(tuberculous pleurisy : 61.3 ${\pm}$ 9.2 IU/L, non-tuberculous pleural effusion : 53.3${\pm}$10.5 IU/L). 4. The mean L/N ratio of those with tuberculous pleurisy was 39.1 ${\pm}$ 44.6, which was significantly higher than nontuberculous pleural effusion patients (p<0.05). The mean ADA x L/N ratio of the tuberculous pleurisy patients was 2,445.7 ${\pm}$ 2,818.5, which was significantly higher than the non-tuberculous pleural effusion patients (level p<0.05). 5. ROC analysis showed that the ADA x L/N ratio had a higher diagnostic value than the ADA alone in the group with an ADA between 40-75 IU/L. Conclusion: The ADA multiplied by the lymphocyte-to-neutrophil ratio might provide a more definitive diagnosis of tuberculous pleurisy.

Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
    • /
    • v.8 no.2
    • /
    • pp.89-99
    • /
    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

Influence of Change of Atmospheric Pressure and Temperature on the Occurrence of Spontaneous Pneumothorax (기압과 기온변화가 자발성 기흉 발생에 미치는 영향)

  • Lee, Gun;Lim, Chang-Young;Lee, Hyeon-Jae
    • Journal of Chest Surgery
    • /
    • v.40 no.2 s.271
    • /
    • pp.122-127
    • /
    • 2007
  • Background: Spontaneous pneumothorax is a common respiratory condition and has been postulated that it develops because of rupture of subpleural blebs. Although the morphology and ultrastructure of causative lesions are well known, the reason for rupture of sbupleural blebs is not absolutely clear. Broad consensus concerning the role of meteorological factors in spontaneous pneumothorax dose not exist. The aim of the study was to examine the influence of change of atmospheric pressure and temperature on the occurrence of spontaneous pneumothorax. Material and Method: One hundred twenty eight consecutive spontaneous pnemothorax events that occurred between January 2003 and December 2004 were selected. Changes of meteorological factors of particular days from the day before for 5 consecutive days were calculated and compared between the days with pneumothorax occurrence (SP days) and the days without pneumothorax occurrence (Non SP days). The correation between change of pressure and temperature and the occurrence of SP was evaluated. Result: SP occurred on 117 days (16.0%) in the 2-year period. Although there was no significant differences in change of pressure factors prior 4 days of SP occurrence compare to the 4 days prior Non SP day, change of mean pressure was higher (+0.934 vs. -0.191hPa, RR 1.042, Cl $1.003{\sim}1.082$, p=0.033), and change of maximum pressure fall was lower (3.280 vs. 4.791 hPa, RR 1.051, Cl $1.013{\sim}l.090$, p=0.009) on the 4 days prior SP day. There were significant differences in change of temperature factors prior 2 days and the day of SP, Changes of mean temperature (-0.576 vs.+$0.099^{\circ}C$, RR 0.886, 95% Cl $0.817{\sim}0.962$, p=0.004) and maximum temperature rise (7.231 vs. $8.079^{\circ}C$, RR 0.943 Cl $0.896{\sim}0.993$, p=0.027) were lower on the 2 days prior SP. But changes of mean temperature (0.533 vs. $-0.103^{\circ}C$, RR 1.141, Cl $1.038{\sim}l.255$, p=0.006) and maximum temperature rise (9.209 vs. $7.754^{\circ}C$, RR 1.123, Cl $1.061{\sim}1.190$, p=0.006) and maximum temperature rise (9.209 vs. $7.754^{\circ}C$ RR 1.123, Cl $1.061{\sim}l.190$, p=0.000) were higher on the SP days. Conclusion: Charge of atmospheric pressure and temperature seems to influence the chance of occurrence of SP. Meteorological phenomena that pressure rise 4 day prior to SP and following temperature fall and rise might explain the occurrence of SP. Further studies should be continued in the future.

Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암에 대한 기관지 소매 절제술의 성적)

  • Kim, Dae-Hyun;Youn, Hyo-Chul;Kim, Soo-Cheol;Kim, Bum-Shik;Cho, Kyu-Seok;Kwak, Young-Tae;Hwang, En-Gu;Kim, Dong-Won;Park, Joo-Chul
    • Journal of Chest Surgery
    • /
    • v.40 no.1 s.270
    • /
    • pp.37-44
    • /
    • 2007
  • Background: It is known that long-term survival rate in patients underwent bronchial sleeve lobectomy for primary lung cancer is at least equal to that in patients underwent pneumonectomy, and bronchial sleeve lobectomy is performed in patients with suitable tumor location even in patients have adequate pulmonary function. Sleeve pneumonectomy is performed when carina was invaded by tumor or tumor location was near to the carina. We performed this study to know our results of sleeve resection for primary lung cancer. Material and Method: We analyzed retrospectively the medical records of 45 patients who underwent sleeve lobectomy or sleeve pneumonectomy for primary lung cancer by one thoracic surgeon from May 1990 to July 2003 in Department of Thoracic & Cardiovascular Surgery, College of Medicine, Kyung Hee University. Follow-up loss was absent and last follow-up was performed in April 5, 2005. Kaplan-Meyer method and log-lank test were used to know long-term survival rate and p-value. Result: Mean age was 60 years old and male to female ratio 41:1. Histologic types were squamous cell carcinoma were 39, adenocarcinoma were 4, and others were 2 patients. Pathologic stages were I 14, II 14, and III 17 patients. Nodal stages were N0 23, N1 13, and N2 9 patients. Types of operation were sleeve lobectomy 40 and sleeve pneumonectomy 5 patients. Operative mortality was 3 patients and its cause was respiratory complications. Early complications were pneumonia 4, atelectasis 8, air leakage more than 7 days 6, and atrial fibrillation 4 patients. In 19 patients tumor was recurred. Local recurrence was 10 and systemic metastasis was 9 patients. Overall 5, 10-year survival rate were 54.2%, 42.5%. The 5, 10-year survival rates according to the pathologic stage were 83.9%, 67.1% in stage I, 55%, 47.1% in II, 33.3%, 25% in III, and significance difference was present between stage I and III. The 5, 10-year survival rate according to the lymph node involvement were 63.9%, 54.6% in N0, 53,8%, 46.5% in N1, 28.5%, 14.2% in N2, and significance difference was present between N0 and N2. Conclusion: Because bronchial sleeve lobectomy for primary lung cancer could be performed safely and shows acceptable long-term survival rate, it could be considered primary in case of suitable tumor location if complete resection is possible. Although sleeve pneumonectomy for primary lung cancer shows somewhat high operative mortality rate, it could be considered in view of curative treatment.

Comparison of Left Ventricular Volume and Function between 46 Channel Multi-detector Computed Tomography (MDCT) and Echocardiography (16 채널 Multi-detector 컴퓨터 단층촬영과 심초음파를 이용한 좌심실 용적과 기능의 비교)

  • Park, Chan-Beom;Cho, Min-Seob;Moon, Mi-Hyoung;Cho, Eun-Ju;Lee, Bae-Young;Kim, Chi-Kyung;Jin, Ung
    • Journal of Chest Surgery
    • /
    • v.40 no.1 s.270
    • /
    • pp.45-51
    • /
    • 2007
  • Background: Although echocardiography is usually used for quantitative assessment of left ventricular function, the recently developed 16-slice multidetector computed tomography (MDCT) is not only capable of evaluating the coronary arteries but also left ventricular function. Therefore, the objective of our study was to compare the values of left ventricular function quantified by MDCT to those by echocardiography for evaluation of its regards to clinical applications. Material and Method: From 49 patients who underwent MDCT in our hospital from November 1, 2003 to January 31, 2005, we enrolled 20 patients who underwent echocardiography during the same period for this study. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), stroke volume index (SVI), left ventricular mass index (LVMI), and ejection fraction (EF) were analyzed. Result: Average LVEDVI ($80.86{\pm}34.69mL$ for MDCT vs $60.23{\pm}29.06mL$ for Echocardiography, p<0.01), average LVESVI ($37.96{\pm}24.52mL$ for MDCT vs $25.68{\pm}16.57mL$ for Echocardiography, p<0.01), average SVI ($42.90{\pm}15.86mL$ for MDCT vs $34.54{\pm}17.94mL$ for Echocardiography, p<0.01), average LVMI ($72.14{\pm}25.35mL$ for MDCT vs $130.35{\pm}53.10mL$ for Echocardiography, p<0.01), and average EF ($55.63{\pm}12.91mL$ for MOCT vs $59.95{\pm}12.75ml$ for Echocardiography, p<0.05) showed significant difference between both groups. Average LVEDVI, average LVESVI, and average SVI were higher in MDCT, and average LVMI and average EF were higher in echocardiogram. Comparing correlation for each parameters between both groups, LVEDVI $(r^2=0.74,\;p<0.0001)$, LVESVI $(r^2=0.69,\;p<0.0001)$ and SVI $(r^2=0.55,\;p<0.0001)$ showed high relevance, LVMI $(r^2=0.84,\;p<0.0001)$ showed very high relevance, and $EF (r^2=0.45,\;p=0.0002)$ showed relatively high relevance. Conclusion: Quantitative assessment of left ventricular volume and function using 16-slice MDCT showed high relevance compared with echocardiography, therefore may be a feasible assessment method. However, because the average of each parameters showed significant difference, the absolute values between both studies may not be appropriate for clinical applications. Furthermore, considering the future development of MDCT, we expect to be able to easily evaluate the assessment of coronary artery stenosis along with left ventricular function in coronary artery disease patients.

Changes of Brain Natriuretic Peptide Levels according to Right Ventricular HemodynaMics after a Pulmonary Resection (폐절제술 후 우심실의 혈역학적 변화에 따른 BNP의 변화)

  • Na, Myung-Hoon;Han, Jong-Hee;Kang, Min-Woong;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Choi, Jae-Sung;Yoon, Seok-Hwa;Choi, Si-Wan
    • Journal of Chest Surgery
    • /
    • v.40 no.9
    • /
    • pp.593-599
    • /
    • 2007
  • Background: The correlation between levels of brain natriuretic peptide (BNP) and the effect of pulmonary resection on the right ventricle of the heart is not yet widely known. This study aims to assess the relationship between the change in hemodynamic values of the right ventricle and increased BNP levels as a compensatory mechanism for right heart failure following pulmonary resection and to evaluate the role of the BNP level as an index of right heart failure after pulmonary resection. Material and Method: In 12 non small cell lung cancer patients that had received a lobectomy or pnemonectomy, the level of NT-proBNP was measured using the immunochemical method (Elecsys $1010^{(R)}$, Roche, Germany) which was compared with hemodynamic variables determined through the use of a Swan-Garz catheter prior to and following the surgery. Echocardiography was performed prior to and following the surgery, to measure changes in right ventricular and left ventricular pressures. For statistical analysis, the Wilcoxon rank sum test and linear regression analysis were conducted using SPSSWIN (version, 11.5). Result: The level of postoperative NT-proBNP (pg/mL) significantly increased for 6 hours, then for 1 day, 2 days, 3 days and 7 days after the surgery (p=0.003, 0.002, 0.002, 0.006, 0.004). Of the hemodynamic variables measured using the Swan-Ganz catheter, the mean pulmonary artery pressure after the surgery when compared with the pressure prior to surgery significantly increased at 0 hours, 6 hours, then 1 day, 2 days, and 3 days after the surgery (p=0.002, 0,002, 0.006, 0.007, 0.008). The right ventricular pressure significantly increased at 0 hours, 6 hours, then 1 day, and 3 days after the surgery (p=0.000, 0.009, 0.044, 0.032). The pulmonary vascular resistance index [pulmonary vascular resistance index=(mean pulmonary artery pressure-mean pulmonary capillary wedge pressure)/cardiac output index] significantly increased at 6 hours, then 2 days after the surgery (p=0.008, 0.028). When a regression analysis was conducted for changes in the mean pulmonary artery pressure and NT-proBNP levels after the surgery, significance was evident after 6 hours (r=0.602, p=0.038) and there was no significance thereafter. Echocardiography displayed no significant changes after the surgery. Conclusion: There was a significant correlation between changes in the mean pulmonary artery pressure and the NT-proBNP level 6 hours after a pulmonary resection. Therefore, it can be concluded that changes in NT-proBNP level after a pulmonary resection can serve as an index that reflects early hemodynamic changes in the right ventricle after a pulmonary resection.