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Chest CT Finding and Its Comparison with Bronchoscopic Finding in Endobronchial Tuberculosis (기관지결핵의 흉부전산화단층촬영소견 및 기관지경소견과의 비교)

  • Lee, Jae-Ho;Yoon, Hye-Kyung;Song, Jae-Woo;Yoo, Chul-Gyu;Chung, Hee-Soon;Kim, Young-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.742-755
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    • 1997
  • Background : Endobronchial tuberculosis(ET) is still relatively common disease in Korea. We intended to evaluate the length of endobronchial lesion, peribronchial thickness, luminal irregularity and associated mediastinal lymph node enlargement with Chest CT to get information for such aggressive treatment as electrocautery, laser therapy and so on of bronchial stricture in ET, and also to compare the change of Chest CT finding with that of bronchoscopic finding after one month of anti-tuberculosis treatment. Method : We performed CT in 26 patients who were diagnosed as ET by bronchoscopy at Boramae Hospital from November 1991 to March 1996. After classifying ET into seven subtypes according to bronchoscopic finding, we analyzed the CT finding of each subtype. And we followed up the bronchoscopy, CT, and PIT after one month of anti-tuberculosis treatment, and compared the change of CT findings with those of bronchoscopic findings in nine patients. Results : Age of the patients was from 17 to 73 years old, and the ratio of male to female was 1 : 25 with absolute female predominance. The site(s) of bronchial involvement by tuberculosis is one in 14 cases, two in nine cases and three in one case, respectively, and the left main bronchus was the most frequently involved site (13 cases for multiple involvements and 7 cases for single involvement among 26 cases). The length of bronchial involvement by tuberculosis which was measured by CT was from 10 to 55 mm, and there was a tendency that the length of involved lesion in fibrostenotic type was shorter than that of actively caseating type. Bronchial stricture on CT was noticed in 25 (96%) cases and the range of severity was from total occlusion to near-normal and also showed wide variation even though the subtype of ET was same. The increase of peribronchial thickness which was measured by CT, was noticed in 21 cases (91%) among 23 cases (in which the measurement was possible), and there was no improvement of peribronchial thickness in those cases which showed little improvement in bronchial stricture despite anti-tuberculosis treatment. There was no difference in the luminal irregularity of involved bronchi on CT in relation to bronchoscopic subtypes. The mediastinal lymph node enlargement, defined as the diameter of lymph node was larger than 1cm on CT, was detected in 20 cases (77%), and right side was more frequently involved (L : R = 1 : 5.2). The CT finding usually showed extrinsic bronchial compression but showed direct invasion in two cases which were bronchoscopically classified as tumorous type. When follow-up bronchoscopy and CT was performed after one month of anti-tuberculosis treatment in nine patients, CT showed significant improvement in peribronchial thickness and mediastinal lymph node enlargement. Bronchial stricture was also improved in 6 cases but aggravated in 3 cases despite anti-tuberculosis therapy. In two cases which were classified as fibrostenotic type by bronchoscopy, CT showed significant improvement in bronchial stricture, interestingly. Conclusion : We concluded that the role of Chest CT was complimentary to bronchoscopy in ET, since CT was useful in evaluating the length of bronchial involvement, peribronchial thickness, and mediastinal lymph node enlargement.

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Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

6-Month Short-Course Chemotherapy for Tuberculous Pleural Effusion (결핵성 흉막염에서의 6개월 단기 치료)

  • Kim, Tae-Hyung;Kim, Kyoung-A;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.509-518
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    • 1998
  • Background: Short-course chemotherapy for 6 months is well established for pulmonary tuberculosis. However, little is known about the efficacy of the short-course chemotherapy for tuberculous pleural effusion. Tuberculous pleural effusion itself may be self-limiting without any treatment, but about two thirds of the patients with tuberculous pleural effusion may subsequently develop pulmonary tuberculosis within 5 years. After completing treatment for tuberculous pleural effusion. prolonged follow-up is necessary for evaluating the efficacy of the treatment There is still no report on the efficacy of 6-month regimens for tuberculous pleural effusion in Korea, where the incidence of tuberculous disease and drug resistance is high. We studied the efficacy of 6 month short-course chemotherapy comparing with 9 month chemotherapy. Method : Retrospective study was done through medical record review in 238 patients with tuberculous pleural effusion who admitted to Asan Medical Center during May 1989-May 1993. The diagnosis of tuberculous pleural effusion was made by bacteriologic or histopathologic study. Results: Among 238 patients, 38 patients were dropped out during follow-up period. In 2 patients, second line drugs were prescribed according to known drug resistance results. And, in 23 patients, treatment longer than 9 months was done due to accompanying extrapulmonary tuberculosis or durg resistance. In 8 patients, treatment regimen was changed due to hepatotoxicity. Remaining 167 cases (70.2%) completed the treatment as scheduled ; 6 month chemotherapy in 88 cases and 9 month chemotherapy in 79 cases. In 60 patients (35.9%) with pleural effusion only in chest X-ray finding, sputum smear or culture for M.tuberculosis was positive in 6 cases (10.0%), and in 63 patients (37.7%) with radiologically inactive pulmonary tuberculosis, sputum smear or culture was positive in 18 cases (28.6%). In 44 patients (26.3%) with radiologically active pulmonary tuberculosis, the sputum smear or culture was positive in 24 cases (54.5%). In 6-month chemotherapy group (n=88), during mean 23 months (range; 1~61months) follow-up period, pulmonary tuberculosis developed in 1 case (1.4%). In 9-month chemotherapy group(n=79), during mean 23 months (range; 3~70months) follow-up period, pulmonary tuberculosis developed in 2 cases (2.5%). All the cases who developed pulmonary tuberculosis also showed active pulmonary tuberculosis on initial chest X-ray before treatment Conclusion: In patients with tuberculous pleural effusion, the incidence of pulmonary tuberculosis after 6 month chemotherapy showed no difference from that after 9 month chemotherapy. Thus, 6 month short-course chemotherapy seems to be an effective treatment for tuberculous pleural effusion.

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A Study of Nutritional Intake, Eating Habit, Iron Status of Urban and Rural Middle School Girls (도시와 농촌 여중생의 영양섭취상태, 식습관 및 철영양상태 연구)

  • Hong, Soon-Myung;Seo, Yeong-Eun;Hwang, Hye-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.10
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    • pp.1634-1640
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    • 2004
  • This study was designed to compare the nutritional intake and iron nutritional status between urban and rural middle school girls. Along with a questionnaire, blood samples were obtained from 311 middle school girls (urban 129 girls, rural 182 girls). Nutrient intakes were measured with a convenient method, and clinical symptoms relating anemia was investigated by 4-point Likert scale. For the nutrient intake, the total energy intake was 1722.2 kcal (82.0% of RDA) for the urban group and 1649.5 kcal (78.6% of RDA) for rural group. The rural group showed significantly lower level than the urban group in all nutrients except fat, carbohydrate and total energy intake. Regarding the food frequency, students from the rural group marked significantly lower intake of milk (p<0.00l), kimchi (p<0.05), fruit (p<0.05), tofu, bean (p<0.00l) than the urban group. For every clinical finding regarding anemia, the rural group marked higher value than the urban group but the difference was not significant. The hemoglobin concentration of urban group was 13.28 g/dL, and rural group showed 12.51 g/dL which was significantly lower than urban group (p<0.00l). The hematocrit rate was 37.82% for the urban group and 38.13% for the rural group and there was no significant difference between two groups. The red blood cell (RBC) count of the rural group was significantly lower than the urban group (p<0.00l). Evaluating with the iron deficiency standard which is less than 12 g/dL, the urban group was 6.2% and the rural group was 34.6% thus the deficiency rate was significantly higher in the rural group. This study showed that nutrient and iron status of the girls of rural group is not as good as the urban group. As middle school girls require high level of iron absorption due to blood loss which occurs during abrupt physical growth and menstruation, dietary counselling is required to enhance the iron status. When iron deficiency is serious, they need to take more positive action such as iron supplement in addition to food-iron fortification.

Nutrition Survey in Koje Island (거제도(巨濟島) 주민(住民)의 영양실태조사(營養實態調査))

  • Oh, Seoung-Ho;Chang, Soo-Kyung;Park, Michael Myung-Yun
    • Journal of Nutrition and Health
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    • v.10 no.4
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    • pp.43-58
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    • 1977
  • Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

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Development and Research into Functional Foods from Hydrolyzed Whey Protein Powder with Sialic Acid as Its Index Component - I. Repeated 90-day Oral Administration Toxicity Test using Rats Administered Hydrolyzed Whey Protein Powder containing Normal Concentration of Sialic Acid (7%) with Enzyme Separation Method - (Sialic Acid를 지표성분으로 하는 유청가수분해단백분말의 기능성식품 개발연구 - I. 효소분리로 7% Siailc Acid가 표준적으로 함유된 유청가수분해단백분말(7%)의 랫드를 이용한 90일 반복경구투여 독성시험 평가 연구 -)

  • Noh, Hye-Ji;Cho, Hyang-Hyun;Kim, Hee-Kyong
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.2
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    • pp.99-116
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    • 2016
  • We herein performed animal safety assessment in accordance with Good Laboratory Practice (GLP) regulations with the aim of developing sialic acid from glycomacropeptide (hereafter referred to as "GMP") as an index ingredient and functional component in functional foods. GMP is a type of whey protein derived from milk and a safe food, with multiple functions, such as antiviral activity. A test substance was produced containing 7% (w/w) sialic acid and mostly-hydrolyzed whey protein (hereafter referred to as "7%-GNANA") by enzymatic treatment of substrate GMP. The maximum intake test dose level was selected based on 5,000 mg/kg/day dose set for male NOEL (no-observed-effect-level) and female NOAEL (no-observed-adverse-effect-level) determined by a dose-range finding (DRF) test (GLP Center of Catholic University of Daegu, Report No. 15-NREO-001) that was previously conducted with the same test substance. To evaluate the toxicity of a repeated oral dose of the test substance in connection with the previous DRF study, 1,250, 2,500, and 5,000 mg/kg of the substance were administered by a probe into the stomachs of 6-week-old SPF Sprague-Dawley male and female rats for 90 d. Each test group consisted of 10 male and 10 female rats. To determine the toxicity index, all parameters, such as observation of common signs; measurements of body weight and food consumption; ophthalmic examination; urinalysis, electrolyte, hematological, and serum biochemical examination; measurement of organ weights during autopsy; and visual and histopathological examinations were conducted according to GLP standards. After evaluating the results based on the test toxicity assessment criteria, it was determined that NOAEL of the test substance, 7%-GNANA, was 5,000 mg/kg/day, for both male and female rats. No animal death was noted in any of the test groups, including the control group, during the study period, and there was no significant difference associated with test substance, as compared with the control group, with respect to general symptoms, body weight changes, food consumption, ophthalmic examination, urinalysis, hematological and serum biochemical examination, and electrolyte and blood coagulation tests during the administration period (P<0.05). As assessed by the effects of the test substance on organ weights, food consumption, autopsy, and histopathological safety, change in kidney weight as an indicator of male NOAEL revealed up to 20% kidney weight increase in the high-dose group (5,000 mg/kg/day) compared with the change in the control group. However, it was concluded that this effect of the test substance was minor. In the case of female rats, reduction of food consumption, increase of kidney weight, and decrease of thymus weight were observed in the high-dose group. The kidney weight increased by 10.2% (left) and 8.9% (right) in the high-dose group, with a slight dose-dependency compared with that of the control group. It was observed that the thymus weight decreased by 25.3% in the high-dose group, but it was a minor test substance-associated effect. During the autopsy, botryoid tumor was detected on the ribs of one subject in the high-dose group, but we concluded that the tumor has been caused by a naturally occurring (non-test) substance. Histopathological examination revealed lesions on the kidney, liver, spleen, and other organs in the low-dose test group. Since these lesions were considered a separate phenomenon, or naturally occurring and associated with aging, it was checked whether any target organ showed clear symptoms caused by the test substance. In conclusion, different concentrations of the test substance were fed to rats and, consequently, it was verified that only a minor effect was associated with the test substance in the high-dose (5,000 mg/kg/day) group of both male and female rats, without any other significant effects associated with the test substance. Therefore, it was concluded that NOAEL of 7%-GNANA (product name: Helicobactrol) with male and female rats as test animals was 5,000 mg/kg/day, and it thus was determined that the substance is safe for the ultimate use as an ingredient of health functional foods.

Efficacy and Safety of Early Bronchoscopy in Patients with Hemoptysis (객혈환자에서 조기기관지경의 유용성 몇 안정성)

  • Kim, Ho-Cheol;Cheon, Eun-Mee;Chung, Man-Pyo;Kim, Ho-Joong;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.391-400
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    • 1997
  • Background : Bronchoscopy is an essential procedure for identifying the bleeding site and evaluating cause of hemoptysis. However, it is controversial regarding to the timing of bronchoscopy in patients with hemoptysis. Early bronchoscopy, which was performed during hemoptysis or with 48hour after cessation of bleeding, was better for identifying the site of bleeding compared with delayed bronchoscopy, which was performed 48 hours after cessation of bleeding. The diagnostic yield of identifying the bleeding site by bronchoscopy was variable in reported literature and the safety of early bronchoscopy was not mentioned in previous literature. Therefore, we evaluated the efficacy and safety of early bronchoscopy in patients with hemoptysis. Method : From October 1994 to August 1996 in Samsung Medical Center, bronchoscopy was performed in patients with hemoptysis. Early bronchoscopy was performed prospectively during hemoptysis or within 48 hours after cessation of bleeding from May 1995 to August 1996. Delayed bronchoscopy group included patients who did not received early bronchoscopy at the same period or in whom bronchoscopy was performed 48 hour after cessation of bleeding from October 1994 to May 1995. Results : Early bronchoscopy group was performed 73 times in 71 patients. Delayed bronchoscopy was performed in 57 times in 55 patients. There was no difference as to amount and underlying cause of hemoptysis between both groups. Indentification of bleeding site by visualizing active bleeding was significantly higher in early bronchoscopy (38.3%) than delayed bronchoscopy group (8.7%)(p < 0.05). Indentification of bleeding site by bleeding after clot removal was 8 in early and 10 in delayed bronchoscopy. Indentification of bleeding site by visualizing active bleeding and bleeding after clot removal was 36 in early and 15 patients in delayed bronchoscopy(p > 0.05). Causes of hemoptysis was found in 18 patients in early and 16 patients in delayed bronchoscopy group. patients who had early bronchoscopy underwent surgery. We diagnosed the site of bleeding in 4 patients preoperatively. In 3 patients we made a treatment plan promptly right after bronchoscopy. Among early bronchoscopy group, bleeding over 100cc during bronchoscopy occurred in 2 patients. In early bronchoscopy group there was no other major complication during bronchoscopy. Conclusion : In patients with hemoptysis, early bronchoscopy which performed within 48 hours after cessation of bleeding was more effective procedure for identifying the bleeding site than delayed bronchoscopy which was performed after 48 hour cessation of bleeding.

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Incidence of Hypertension in a Cohort of an Adult Population (성인코호트에서 고혈압 발생률)

  • Kam, Sin;Oh, Hee-Sook;Lee, Sang-Won;Woo, Kook-Hyeun;Ahn, Moon-Young;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.141-146
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    • 2002
  • Objectives : This study was peformed in order to assess the incidence of hypertension based on two-years follow-up of a rural hypertension-free cohort in Korea. Methods : The study cohen comprised 2,580 subjects aged above 20 (1,107 men and 1,473 women) of Chung-Song County in Kyungpook Province judged to be hypertensive-free at the baseline examination in 1996. For each of two examinations in the two-year follow-up, those subjects free of hypertension were followed for the development of hypertension to the next examination one year (1997) and two years later (1998). The drop-out rate was 24.7% in men and 19.6% in women. Hypertension was defined as follows 1) above mild hypertension as a SBP above 140 mmHg or a DBP above 90 mmMg,2) above moderate hypertension as a SBP above 160 mmHg or a DBP above 100 mmHg or when the participant reported having used antihypertensive medication after beginning this survey. Results : The age-standardized incidence of above mild hypertension was 6 per 100 person years (PYS) in men and that of above moderate hypertension was 1.2. In women, the age-standardized rate for above mild hypertension was 5.7 and 1.5 for above mild and moderate hypertension, respectively. However, the rates of incidence as calculated by the risk method were 4.8% and 1.0% in men and 4.6%, 1.2% in women, respectively. In both genders, incidence was significantly associated with advancing age(p<0.01), In men, the incidences of above moderate hypertension by age group were 0.5 per 100 PYS aged 20-39, 0.7 aged 40-49, 1.7 aged 50-59, 3.6 aged 60-69, and 5.8 aged above 70(p<0.01). In women, those the incidence measured 0.6 per 100 PYS aged 20-39, 1.8 aged 40-49, 1.3 aged 50-59, 3.3 aged 60-69, and 5.6 aged above 70(p<0.01). After age 60, the incidence of hypertension increased rapidly. Conclusions : The incidence data of hypertension reported in this study may serve as a reference data for evaluating the impact of future public efforts in the primary prevention of hypertension in Korea.

The Effect of Price Promotional Information about Brand on Consumer's Quality Perception: Conditioning on Pretrial Brand (품패개격촉소신식대소비자질량인지적영향(品牌价格促销信息对消费者质量认知的影响))

  • Lee, Min-Hoon;Lim, Hang-Seop
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.17-27
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    • 2009
  • Price promotion typically reduces the price for a given quantity or increases the quantity available at the same price, thereby enhancing value and creating an economic incentive to purchase. It often is used to encourage product or service trial among nonusers of products or services. Thus, it is important to understand the effects of price promotions on quality perception made by consumer who do not have prior experience with the promoted brand. However, if consumers associate a price promotion itself with inferior brand quality, the promotion may not achieve the sales increase the economic incentives otherwise might have produced. More specifically, low qualitative perception through price promotion will undercut the economic and psychological incentives and reduce the likelihood of purchase. Thus, it is important for marketers to understand how price promotional informations about a brand have impact on consumer's unfavorable quality perception of the brand. Previous literatures on the effects of price promotions on quality perception reveal inconsistent explanations. Some focused on the unfavorable effect of price promotion on consumer's perception. But others showed that price promotions didn't raise unfavorable perception on the brand. Prior researches found these inconsistent results related to the timing of the price promotion's exposure and quality evaluation relative to trial. And, whether the consumer has been experienced with the product promotions in the past or not may moderate the effects. A few studies considered differences among product categories as fundamental factors. The purpose of this research is to investigate the effect of price promotional informations on consumer's unfavorable quality perception under the different conditions. The author controlled the timing of the promotional exposure and varied past promotional patterns and information presenting patterns. Unlike previous researches, the author examined the effects of price promotions setting limit to pretrial situation by controlling potentially moderating effects of prior personal experience with the brand. This manipulations enable to resolve possible controversies in relation to this issue. And this manipulation is meaningful for the work sector. Price promotion is not only used to target existing consumers but also to encourage product or service trial among nonusers of products or services. Thus, it is important for marketers to understand how price promotional informations about a brand have impact on consumer's unfavorable quality perception of the brand. If consumers associate a price promotion itself with inferior quality about unused brand, the promotion may not achieve the sales increase the economic incentives otherwise might have produced. In addition, if the price promotion ends, the consumer that have purchased that certain brand will likely to display sharply decreased repurchasing behavior. Through a literature review, hypothesis 1 was set as follows to investigate the adjustive effect of past price promotion on quality perception made by consumers; The influence that price promotion of unused brand have on quality perception made by consumers will be adjusted by past price promotion activity of the brand. In other words, a price promotion of an unused brand that have not done a price promotion in the past will have a unfavorable effect on quality perception made by consumer. Hypothesis 2-1 was set as follows : When an unused brand undertakes price promotion for the first time, the information presenting pattern of price promotion will have an effect on the consumer's attribution for the cause of the price promotion. Hypothesis 2-2 was set as follows : The more consumer dispositionally attribute the cause of price promotion, the more unfavorable the quality perception made by consumer will be. Through test 1, the subjects were given a brief explanation of the product and the brand before they were provided with a $2{\times}2$ factorial design that has 4 patterns of price promotion (presence or absence of past price promotion * presence or absence of current price promotion) and the explanation describing the price promotion pattern of each cell. Then the perceived quality of imaginary brand WAVEX was evaluated in the scale of 7. The reason tennis racket was chosen is because the selected product group must have had almost no past price promotions to eliminate the influence of average frequency of promotion on the value of price promotional information as Raghubir and Corfman (1999) pointed out. Test 2 was also carried out on students of the same management faculty of test 1 with tennis racket as the product group. As with test 1, subjects with average familiarity for the product group and low familiarity for the brand was selected. Each subjects were assigned to one of the two cells representing two different information presenting patterns of price promotion of WAVEX (case where the reason behind price promotion was provided/case where the reason behind price promotion was not provided). Subjects looked at each promotional information before evaluating the perceived quality of the brand WAVEX in the scale of 7. The effect of price promotion for unfamiliar pretrial brand on consumer's perceived quality was proved to be moderated with the presence or absence of past price promotion. The consistency with past promotional behavior is important variable that makes unfavorable effect on brand evaluations get worse. If the price promotion for the brand has never been carried out before, price promotion activity may have more unfavorable effects on consumer's quality perception. Second, when the price promotion of unfamiliar pretrial brand was executed for the first time, presenting method of informations has impact on consumer's attribution for the cause of firm's promotion. And the unfavorable effect of quality perception is higher when the consumer does dispositional attribution comparing with situational attribution. Unlike the previous studies where the main focus was the absence or presence of favorable or unfavorable motivation from situational/dispositional attribution, the focus of this study was exaus ing the fact that a situational attribution can be inferred even if the consumer employs a dispositional attribution on the price promotional behavior, if the company provides a persuasive reason. Such approach, in academic perspectih sis a large significance in that it explained the anchoring and adjng ch approcedures by applying it to a non-mathematical problem unlike the previous studies where it wis ionaly explained by applying it to a mathematical problem. In other wordn, there is a highrspedency tmatispositionally attribute other's behaviors according to the fuedach aal attribution errors and when this is applied to the situation of price promotions, we can infer that consumers are likely tmatispositionally attribute the company's price promotion behaviors. Ha ever, even ueder these circumstances, the company can adjng the consumer's anchoring tmareduce the po wibiliute thdispositional attribution. Furthermore, unlike majority of previous researches on short/long-term effects of price promotion that only considered the effect of price promotions on consumer's purchasing behaviors, this research measured the effect on perceived quality, one of man elements that affects the purchasing behavior of consumers. These results carry useful implications for the work sector. A guideline of effectively providing promotional informations for a new brand can be suggested through the outcomes of this research. If the brand is to avoid false implications such as inferior quality while implementing a price promotion strategy, it must provide a clear and acceptable reasons behind the promotion. Especially it is more important for the company with no past price promotion to provide a clear reason. An inconsistent behavior can be the cause of consumer's distrust and anxiety. This is also one of the most important factor of risk of endless price wars. Price promotions without prior notice can buy doubt from consumers not market share.

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The Study of Characteristics of Consumer Purchasing Private Brand Products at Large-Scale Mart (국내 대형마트의 유통업체 브랜드 상품 구매 소비자의 특성 분석에 관한 연구)

  • Hwang, Seong-Huyk;Lee, Jung-Hee;Roh, Eun-Jung
    • Journal of Distribution Research
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    • v.15 no.4
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    • pp.1-19
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    • 2010
  • As having the movement of developing private brand (PB) goods, domestic big retailers are facing up with new problems. Thus, it is required studies of PB products, and how consumers recognize PB products as a consideration commodity set. Also, it is worthy in order that it gives us the important meaning on the marketing strategy with focusing on evaluating the differences between customers buying PB grocery goods with respect to demographic characteristics and purchasing behaviors. PB has some advantages for customers and retailers. However, according to AC Nielson's report (2005), Asian and emerging market has 1/5 sales relatively to Western countries. But we can assume that the emerging market has the most potential growth through this result. As a result from several other studies, it becomes necessary to not only increase the rate of selling composition of PB product temporarily, but also analyze the characteristics of customers using big retailers and segmenting customer groups to make PB product as a consideration commodity set for them. In addition, it is needed to have a variety of acts of marketing. From studies related to PB, there is a prejudice - cheap products have low quality - but, evaluation by customers who have used those products shows neutral stand, and there is a study representing that it is the most important to accumulate the belief between the retailers selling PB products and consumers using those for the accurate evaluation and intention on purchasing. Also, by the result from analyzing the characteristics of customers buying PB products, we could assume that higher income and higher education level, more preference on PB products. Especially, according to TNS's research, the primary targets of PB product are 30's who seeks value for money and planned spending habits, and 40's who have teenager children, and are interested in encouraging themselves. This paper used Probit model to analyze the characteristics of consumers. This model helps us to analyze with the variables representing the demographic characteristics of consumers (gender, age, educational level, occupation, income level, living area), and variables related to purchasing behavior (visiting frequency on big retailers, the average amount that they pay for goods in there, and check-up which brand made those goods). The method we used in this study is by man to man interview and survey on-line with the rate of 89% and 11% in Seoul and Gyunggi Province, respectively, for about one month from the beginning of February, 2008. As a result of this, under the assumption that people buy PB products more as long as they go shopping more, it was not meaningful for target groups which we pointed out as frequently visiting customers to be. Although, we have expected women buy more PB products than men do, gender doesn't mean anything for the result. And, it has inferred that married people buy more PB goods than singles do. It was also meaningless with variables related to occupation. Because housewives are often exposed to any kind of supermarket than workers are, we could not get any relatives. Moreover, we couldn't proof that younger generation prefer big retailers more than older people who 50~60's. Education levels doesn't affect on the purchase of PB product as well. Related to living area, the result is statistically not similar as we expected whether living in Seoul or not. It shows there is no relationship with the preference on retail brands and PB products, and it is similar with the study researched by TNS(2008) that customers tend to buy PB product impulsively no matter which brand it is and where they are even though their shopping place is the big market where customers are often using. Variables on which we had meaningful results are income level and living place. That is, customers who have 3,000,000~6,000,000 WON every month on average are more willing to buy PB products than other customers whose income is over 6,000,000 WON, and residents not living in Seoul prefer PB goods than those who are living in Seoul. To explain more about what we got, if there is only one condition about customer's visiting frequency on big retails, we could come up with this result that more exposed to PB products, more purchasing frequency. Consequently, it brings the important insight that large retailers have to prepare something to make customers visit them often to increase selling rate of PB products. To demonstrate the result of analyzing more, what is more efficient variables are demographically including marital status, income level, and residential area to buy items that affect the PB products and could include the frequency of visiting large markets by the purchase habits. Specifically, then, married couples rather than singles, middle-income customers than high-income customers, and local residents not living in Seoul than customers in Seoul are more likely to purchase PB goods. In addition, as long as a customer visits two times more, then the purchasing rate of PB products is to increase over 5.3%. Therefore, it seems that retailers are better to make a shopping place as fun and comfortable places. With overwhelming the idea that PB products are just cheap, one-time purchase goods, it is needed to increase the loyalty on those goods like NB products, try to make PB products as a consideration products set, and occur to sustainable sales. Especially, as suggested by this paper, it seems like it strongly needs to identify the characteristics of customers who prefer PB, to segment those customers, and to select the main target, and to do positioning with well-planned marketing strategies. Then, it is able to give us a meaningful point on marketing strategy by developing the field of PB study, identifying the difference of life style and shopping habits of customers.

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