• Title/Summary/Keyword: Evaluation Criteria

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Assessment for the Utility of Treatment Plan QA System according to Dosimetric Leaf Gap in Multileaf Collimator (다엽콜리메이터의 선량학적엽간격에 따른 치료계획 정도관리시스템의 효용성 평가)

  • Lee, Soon Sung;Choi, Sang Hyoun;Min, Chul Kee;Kim, Woo Chul;Ji, Young Hoon;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Kim, Kum Bae
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.168-177
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    • 2015
  • For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.

The Usefulness of B-type Natriuretic Peptide test in Critically Ill, Noncardiac Patients (심질환 병력이 없었던 중환자에서 B-type Natriuretic Peptide 검사의 유용성)

  • Kim, Kang Ho;Park, Hong-Hoon;Kim, Esther;Cheon, Seok-Cheol;Lee, Ji Hyun;Lee, Stephen YongGu;Lee, Ji-Hyun;Kim, In Jai;Cha, Dong-Hoon;Kim, Sehyun;Choi, Jeongeun;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.311-319
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    • 2003
  • Background : Previous studies have suggested that a B-type natriuretic peptide(BNP) test can provide important information on diagnosis, as well as predicting the severity and prognosis of heart failure. Myocardial dysfunction is often observed in critically ill noncardiac patients admitted to the Intensive Care Unit, and the prognosis of the myocardial dysfunction needs to be determined. This study evaluated the predictability of BNP on the prognosis of critically ill noncardiac patients. Methods : 32 ICU patients, who were hospitalized from June to October 2002 and in whom the BNP test was evaluated, were enrolled in this study. The exclusion criteria included the conditions that could increase the BNP levels irrespective of the severity, such as congestive heart failure, atrial fibrillation, ischemic heart disease, and renal insufficiencies. A triage B-Type Natriuretic Peptide test with a RIA-kit was used for the fluorescence immunoassay of BNP test. In addition, the acute physiology and the chronic health evaluation (APACHE) II score and mortality were recorded. Results : There were 16 males and 16 females enrolled in this study. The mean age was 59 years old. The mean BNP levels between the ICU patients and control were significantly different ($186.7{\pm}274.1$ pg/mL vs. $19.9{\pm}21.3$ pg/mL, p=0.033). Among the ICU patients, there were 14(44----) patients with BNP levels above 100 pg/mL. The APACHE II score was $16.5{\pm}7.6$. In addition, there were 11 mortalities reported. The correlation between the BNP and APACHE II score, between the BNP and mortality were significant (r=0.443, p=0.011 & r=0.530, p=0.002). The mean BNP levels between the dead and alive groups were significantly different ($384.1{\pm}401.7$ pg/mL vs. $83.2{\pm}55.8$ pg/mL p=0.033). However, the $PaO_2/FiO_2$ did not significantly correlate with the BNP level. Conclusion : This study evaluated the BNP level was elevated in critically ill, noncardiac patients. The BNP level could be a useful, noninvasive tool for predicting the prognosis of the critically ill, noncardiac patients.

The Alignment Evaluation for Patient Positioning System(PPS) of Gamma Knife PerfexionTM (감마나이프 퍼펙션의 자동환자이송장치에 대한 정렬됨 평가)

  • Jin, Seong Jin;Kim, Gyeong Rip;Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.203-209
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    • 2020
  • The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

Major Characteristics Related to Eating Quality in Waxy Corn Hybrids (찰옥수수 교잡종의 식미관련 주요 특성)

  • Jung Tae wook;Kim Sun Lim;Moon Hyeon Gui;Son Beom Young;Kim Si Ju;Kim Soon Kwon
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.50 no.spc1
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    • pp.152-160
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    • 2005
  • This study was carried out to investigate selectable criteria in evaluating waxy corn $F_1$ hybrids for developing good eating quality waxy corn variety. The physicochemical property analysis of 6 waxy corn $F_1$ hybrids - Chalok1, Chalok2, Heugjeomchal, Yeonnongl, Chalok4, and Suwon45- showed a range of $11.2\~13.1\%$ for crude protein, $5.1\~6.0\%$ for crude fat, $91.8\~92.6\%$ for amylopectin, and $4.5\~6.6\%$ for free sugar content. The pericarp thickness which is one of the most important characteristics related to tenderness in waxy corn was ranged $34\~47{\mu}m$ in 4 waxy corn hybrids - Yeonnongl, Chalok4, Suwon45, and Heugjeomchal. On the other hand, it was ranged $64\~81{\mu}m$ in Chalok1 and Chalok2. The amylogram analysis by rapid visco analyzer showed that in fresh waxy corn hybrid (DAP25), all amylogram properties except setback were higher in Yeonnongl, Chalok4, and Suwon45 compared to those of Chalokl, Chnlok2, and Heugjeomchal. However, in matured waxy corn hybyids (DAP45), the result was the opposite - the amylogram properties were higher in Chalokl, Chalok2, and Heugjeomchal than those of Yeonnongl, Chalok4, and Suwon45. The texture analysis showed that gumminess, chewiness, and hardness increased dramatically with the time after the cooking in Chalokl and Beugjeomchal. On the other hand, these above pyoperties did not change as rapidly with the time in Yeonnongl, Chalok4, and Suwon45. Gumminess, chewiness, and hardness did not increase much within 6 hours after steamingr but increased significantly 32 hours after steaming. Therefore, we have reached a conclusion that texture analysis of cooked waxy corn should be carried out 6 hours after steaming. In the sensory evaluation, Yeonnongl, Chalok4, and Suwon45 revealed higher palatability -6.8, 7.1, and 6.9 respectively - than. that of Chnlokl, Chalok2, and Heugjeomchal. The palatability analysis of 6 waxy corn hybrids showed palatability positively correlating with free sugar content,100-kernel weight, kernel length, kernet width, and consistency, but negatively correlating with pericarp thickness, hardness, gumminess, and chewiness.

A New Exploratory Research on Franchisor's Provision of Exclusive Territories (가맹본부의 배타적 영업지역보호에 대한 탐색적 연구)

  • Lim, Young-Kyun;Lee, Su-Dong;Kim, Ju-Young
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.37-63
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    • 2012
  • In franchise business, exclusive sales territory (sometimes EST in table) protection is a very important issue from an economic, social and political point of view. It affects the growth and survival of both franchisor and franchisee and often raises issues of social and political conflicts. When franchisee is not familiar with related laws and regulations, franchisor has high chance to utilize it. Exclusive sales territory protection by the manufacturer and distributors (wholesalers or retailers) means sales area restriction by which only certain distributors have right to sell products or services. The distributor, who has been granted exclusive sales territories, can protect its own territory, whereas he may be prohibited from entering in other regions. Even though exclusive sales territory is a quite critical problem in franchise business, there is not much rigorous research about the reason, results, evaluation, and future direction based on empirical data. This paper tries to address this problem not only from logical and nomological validity, but from empirical validation. While we purse an empirical analysis, we take into account the difficulties of real data collection and statistical analysis techniques. We use a set of disclosure document data collected by Korea Fair Trade Commission, instead of conventional survey method which is usually criticized for its measurement error. Existing theories about exclusive sales territory can be summarized into two groups as shown in the table below. The first one is about the effectiveness of exclusive sales territory from both franchisor and franchisee point of view. In fact, output of exclusive sales territory can be positive for franchisors but negative for franchisees. Also, it can be positive in terms of sales but negative in terms of profit. Therefore, variables and viewpoints should be set properly. The other one is about the motive or reason why exclusive sales territory is protected. The reasons can be classified into four groups - industry characteristics, franchise systems characteristics, capability to maintain exclusive sales territory, and strategic decision. Within four groups of reasons, there are more specific variables and theories as below. Based on these theories, we develop nine hypotheses which are briefly shown in the last table below with the results. In order to validate the hypothesis, data is collected from government (FTC) homepage which is open source. The sample consists of 1,896 franchisors and it contains about three year operation data, from 2006 to 2008. Within the samples, 627 have exclusive sales territory protection policy and the one with exclusive sales territory policy is not evenly distributed over 19 representative industries. Additional data are also collected from another government agency homepage, like Statistics Korea. Also, we combine data from various secondary sources to create meaningful variables as shown in the table below. All variables are dichotomized by mean or median split if they are not inherently dichotomized by its definition, since each hypothesis is composed by multiple variables and there is no solid statistical technique to incorporate all these conditions to test the hypotheses. This paper uses a simple chi-square test because hypotheses and theories are built upon quite specific conditions such as industry type, economic condition, company history and various strategic purposes. It is almost impossible to find all those samples to satisfy them and it can't be manipulated in experimental settings. However, more advanced statistical techniques are very good on clean data without exogenous variables, but not good with real complex data. The chi-square test is applied in a way that samples are grouped into four with two criteria, whether they use exclusive sales territory protection or not, and whether they satisfy conditions of each hypothesis. So the proportion of sample franchisors which satisfy conditions and protect exclusive sales territory, does significantly exceed the proportion of samples that satisfy condition and do not protect. In fact, chi-square test is equivalent with the Poisson regression which allows more flexible application. As results, only three hypotheses are accepted. When attitude toward the risk is high so loyalty fee is determined according to sales performance, EST protection makes poor results as expected. And when franchisor protects EST in order to recruit franchisee easily, EST protection makes better results. Also, when EST protection is to improve the efficiency of franchise system as a whole, it shows better performances. High efficiency is achieved as EST prohibits the free riding of franchisee who exploits other's marketing efforts, and it encourages proper investments and distributes franchisee into multiple regions evenly. Other hypotheses are not supported in the results of significance testing. Exclusive sales territory should be protected from proper motives and administered for mutual benefits. Legal restrictions driven by the government agency like FTC could be misused and cause mis-understandings. So there need more careful monitoring on real practices and more rigorous studies by both academicians and practitioners.

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Interlaboratory Comparison of Blood Lead Determination in Some Occupational Health Laboratories in Korea (일부 산업보건기관들의 혈중연 분석치 비교)

  • Ahn, Kyu Dong;Lee, Byung Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.5 no.1
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    • pp.8-15
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    • 1995
  • The reliable measurement of metal in biological media in human body is one of critical indicators for the proper evaluation of its toxic effect on human health. Recently in Korea the necessity of quality assurance of measurement in occupational health and occupational hygiene fields brought out regulatory quality control program. Lead is often used as a standard metal for the program in both fields of occupational health and hygiene. During last 20 years lead poisoning was prevalent in Korea and still is one of main heavy metal poisoning and the capability of the measurement of blood lead is one of prerequisites for institute of specialized occupational health in Korea. Furthermore blood lead is most important indicator to evaluate lead burden of human exposure to lead and the reliable and accurate analysis is most needed whenever possible. To evaluate the extent of the interlaboratory differences of blood lead measurement in several well-known institute specialized in occupational health in Korea, authors prepared 68 blood samples from two storage battery industries and all samples were divided into samples with 2 ml. One set of 68 samples were analyzed by authors's laboratory(Soonchunhyang University Institute of Industrial Medicine: SIIM) and 40 samples of other set were analyzed by C University Institute of Industrial Medicine(CIIM) and the rest 28 samples of other set were analyzed by Japanese institute(K Occupational Health Center:KOHC). Authors also prepared test bovine samples which were obtained from Japanese Federation of Occupational Health Organization (JFOHO) for quality control. Authors selected 2 other well-known occupational health laboratories and one laboratory specialized for instrumental analysis. A total of 6 laboratories joined the interlaboratory comparison of blood lead measurement and the results obtained were as follows: 1. There was no significant difference in average blood lead between SIIM and CIIM in different group of blood lead concentration, and the relative standard deviation of two laboratories was less than 3.0%. On the other hand, there was also no significant difference of average blood lead between SIIM and KOHC with relative standard deviation of 6.84% as maximum. 2. Taking less than 15% difference of mean or less than 6 ug/dl difference in below 40 ug/dl in whole blood as a criteria of agreement of measurement between two laboratories, agreement rates were 87.5%(35/40) and 78.6%(22/28) between SIIM and CIIM, SIIM and KOHC respectively. 3. The correlation of blood lead between SIIM and CIIM was 0.975 (p=0.0001) and the regression equation was SIIM = 2.19 + 0.9243 ClIM, whereas the correlation between SUM and KOHC was O.965(p=0.0001) with the equation of SIIM = 1.91 + 0.9794 KOHC. 4. Taking the reference value as a dependent variable and each of 6 laboratories's measurement value as a independent variable, the determination coefficient($R^2$) of simple regression equations of blood lead measurement for bovine test samples were very high($R^2>0.99$), and the regression coefficient(${\beta}$) was between 0.972 and 1.15 which indicated fairly good agreement of measurement results.

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Chinese Communist Party's Management of Records & Archives during the Chinese Revolution Period (혁명시기 중국공산당의 문서당안관리)

  • Lee, Won-Kyu
    • The Korean Journal of Archival Studies
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    • no.22
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    • pp.157-199
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    • 2009
  • The organization for managing records and archives did not emerge together with the founding of the Chinese Communist Party. Such management became active with the establishment of the Department of Documents (文書科) and its affiliated offices overseeing reading and safekeeping of official papers, after the formation of the Central Secretariat(中央秘書處) in 1926. Improving the work of the Secretariat's organization became the focus of critical discussions in the early 1930s. The main criticism was that the Secretariat had failed to be cognizant of its political role and degenerated into a mere "functional organization." The solution to this was the "politicization of the Secretariat's work." Moreover, influenced by the "Rectification Movement" in the 1940s, the party emphasized the responsibility of the Resources Department (材料科) that extended beyond managing documents to collecting, organizing and providing various kinds of important information data. In the mean time, maintaining security with regard to composing documents continued to be emphasized through such methods as using different names for figures and organizations or employing special inks for document production. In addition, communications between the central political organs and regional offices were emphasized through regular reports on work activities and situations of the local areas. The General Secretary not only composed the drafts of the major official documents but also handled the reading and examination of all documents, and thus played a central role in record processing. The records, called archives after undergoing document processing, were placed in safekeeping. This function was handled by the "Document Safekeeping Office(文件保管處)" of the Central Secretariat's Department of Documents. Although the Document Safekeeping Office, also called the "Central Repository(中央文庫)", could no longer accept, beginning in the early 1930s, additional archive transfers, the Resources Department continued to strengthen throughout the 1940s its role of safekeeping and providing documents and publication materials. In particular, collections of materials for research and study were carried out, and with the recovery of regions which had been under the Japanese rule, massive amounts of archive and document materials were collected. After being stipulated by rules in 1931, the archive classification and cataloguing methods became actively systematized, especially in the 1940s. Basically, "subject" classification methods and fundamental cataloguing techniques were adopted. The principle of assuming "importance" and "confidentiality" as the criteria of management emerged from a relatively early period, but the concept or process of evaluation that differentiated preservation and discarding of documents was not clear. While implementing a system of secure management and restricted access for confidential information, the critical view on providing use of archive materials was very strong, as can be seen in the slogan, "the unification of preservation and use." Even during the revolutionary movement and wars, the Chinese Communist Party continued their efforts to strengthen management and preservation of records & archives. The results were not always desirable nor were there any reasons for such experiences to lead to stable development. The historical conditions in which the Chinese Communist Party found itself probably made it inevitable. The most pronounced characteristics of this process can be found in the fact that they not only pursued efficiency of records & archives management at the functional level but, while strengthening their self-awareness of the political significance impacting the Chinese Communist Party's revolution movement, they also paid attention to the value possessed by archive materials as actual evidence for revolutionary policy research and as historical evidence of the Chinese Communist Party.

A Study on Traditional Ideology and the 'Tradition' of the Theatre company Minye in 1970s (1970년대 전통 이념과 극단 민예극장의 '전통')

  • Kim, Ki-Ran
    • Journal of Popular Narrative
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    • v.26 no.3
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    • pp.45-86
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    • 2020
  • In this article, the "modernization of the tradition" constructed on the cultural politics and the way in which it appropriated in the korean theatre in the 1970s were analyzed. It is trying to reveal its implications. It is also a work to critically review the aspects of self-censorship in the korean theatre in the 70s. To that end, we looked at the theatre company Minye Theatre, which preoccupied the traditional discussions in the 1970s by creating national dramas. Until now, the evaluation of the theatre company Minye Theatre in the 1970s has focused on the achievement on the directing of Heo Gyu, who promoted the succession and transformation of tradition. However, the traditional ideology constructed in the state-led cultural politics in the 70s and the way in which it was operated cannot be evaluated only in terms of artistic achievement. The ideology of tradition is selected according to the selective criteria of the subject to appropriate tradition. What's important is that certain objects are excluded, discarded, re-elected, re-interpreted and re-recognized in the selection process of selected traditional ideology. This is the situation in the '70s, when tradition was constantly re-recognized amid differences between the decadent and the disorder that were then designated as non-cultural, and led to a new way of appropriate. The nation-led traditional discussion of the '70s legalized the tradition with stable values, one of the its way was the national literary and artistic support. Under the banner of modernization of tradition, theatre company Minye preoccupied the discussions on the tradition and presented folk drama as a new theatre. As an alternative to the crisis of korean theatre at the time, the Minye chose the method of inheriting and transforming tradition. It is noteworthy that Heo Gyu, the representative director of the theatre company Minye, recognized the succession and transformation of traditional performance as both a calling and an experiment. For Heo Gyu, tradition was accepted as an irresistible stable value and an unquestionable calling, and as a result, his performance, filled with excessive traditional practices, became overambitious, especially when it failed to reflect the present-here reality, the repeated use of traditional expression tools resulted in skilled craftsmanship, not artistic creation. The traditional ideology of the 70s unfolds in a new aspect of appropriation in the 80s. In 1986, Son Jin-Cheok, Kim Seong-nyeo, and Yoon Mun-sik, who were key members of the theatre company Minye Theatre, left the theatre to create the theatre company Michu, and secured popularity through Madangnori(popular folk yard theatre). Son Jin-Cheok's Madangnori is overbearing through satire and humor. It gained popularity by criticizing and mocking state power. On the other hand, not only the form of traditional performance, but also the university-centered Madanggeuk movement, which appropriated on the spirit of resistance from the people to its traditional values, has rapidly grown. In the field of traditional discussions of the 70s, Madanggeuk was self-born through appropriation in which the spirit of resistance of the people is used as a traditional value. Madanggeuk as well as Michu that achieved the popularization of Madangnori cannot be discussed solely by the artistic achievement of the modernization of tradition. Critics of korean theatre in response to state-led traditional discussions in the 70s was focused only on the qualitative achievement of performing arts based on artistry. I am very sorry for that. As a result, the popular resistance of the Madanggeuk and the Madangnori were established in the 'difference' with the traditions of the theatre company Minye Theatre. Theatre company Minye Theatre was an opportunity for the modernization of tradition, but the fact that it did not continuously produce significant differences. This is the meaning and limitation of the "tradition" of the theatre company Minye Theatre in the history of korean theatre in the 1970s.

Chronic HBV Infection in Children: The histopathologic classification and its correlation with clinical findings (소아의 만성 B형 간염: 새로운 병리조직학적 분류와 임상 소견의 상관 분석)

  • Lee, Seon-Young;Ko, Jae-Sung;Kim, Chong-Jai;Jang, Ja-June;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.56-78
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    • 1998
  • Objective: Chronic hepatitis B infection (CHB) occurs in 6% to 10% of population in Korea. In ethinic communities where prevalence of chronic infection is high such as Korea, transmission of hepatitis B infection is either vertical (ie, by perinatal infection) or by close family contact (usually from mothers or siblings) during the first 5 years of life. The development of chronic hepatitis B infection is increasingly more common the earlier a person is exposed to the virus, particularly in fetal and neonatal life. And it progress to cirrhosis and hepatocellular carcinoma, especially in severe liver damage and perinatal infection. Histopathology of CHB is important when evaluating the final outcomes. A numerical scoring system which is a semiquantitatively assessed objective reproducible classification of chronic viral hepatitis, is a valuable tool for statistical analysis when predicting the outcome and evaluating antiviral and other therapies. In this study, a numerical scoring system (Ludwig system) was applied and compared with the conventional histological classification of De Groute. And the comparative analysis of cinical findings, family history, serology, and liver function test by histopathological findings in chronic hepatitis B of children was done. Methods: Ninety nine patients [mean age=9 years (range=17 months to 16 years)] with clinical, biochemical, serological and histological patterns of chronic HBV infection included in this study. Five of these children had hepatocelluar carcinoma. They were 83 male and 16 female children. They all underwent liver biopsies and histologic evaluation was performed by one pathologist. The biopsy specimens were classified, according to the standard criteria of De Groute as follows: normal, chronic lobular hepatitis (CLH), chronic persistent hepatitis (CPH), mild to severe chronic active hepatitis (CAH), or active cirrhosis, inactive cirrhosis, hepatocellular carcinoma (HCC). And the biopsy specimens were also assessed and scored semiquantitatively by the numerical scoring Ludwig system. Serum HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc (IgG, IgM), and HDV were measured by radioimunoassays. Results: Male predominated in a proportion of 5.2:1 for all patients. Of 99 patients, 2 cases had normal, 2 cases had CLH, 22 cases had CPH, 40 cases had mild CAH, 19 cases had moderate CAH, 1 case had severe CAH, 7 cases had active cirrhosis, 1 case had inactive cirrhosis, and 5 cases had HCC. The mean age, sex distribution, symptoms, signs, and family history did not differ statistically among the different histologic groups. The numerical scoring system was correlated well with the conventional histological classification. The histological activity evaluated by both the conventional classification and the scoring system was more severe as the levels of serum aminotransferases were higher. In contrast, the levels of serum aminotransferases were not useful for predicting the degree of histologic activity because of its wide range overlapping. When the histological activity was more severe and especially the cirrhosis more progressing, the prothrombin time was more prolonged. The histological severity was inversely related with the duration of seroconversion of HBeAg. Conclusions: The histological activity could not be accurately predicted by clinical and biochemical findings, but by the proper histological classification of the numerical scoring system for the biopsy specimen. The numerical scoring system was correlated well with the conventional histological classification, and it seems to be a valuable tool for the statistical analysis when predicting the outcome and evaluating effects of antiviral and other therapies in chronic hepatitis B in children.

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The Effects of Consumer Value Cognition on Benefits and Attributes of Culture-Art Products (문화예술상품 소비자의 가치인식이 추구혜택과 상품속성에 미치는 영향)

  • Shin, Eun Joo;Rhee, Young Sun
    • Asia Marketing Journal
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    • v.14 no.2
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    • pp.177-207
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    • 2012
  • Today's consumers perceive consumption as a representation of themselves. It is not simply an act that fulfills a consumer's physical and practical needs. Even in terms of life quality, consumers increasingly want to achieve an emotional and sensible experience through consumption. Consumers now make decisions based on their need to express their position in relation to other people, pursue emotional satisfaction, and try to improve the quality of life. Culture-art products that meet such internal and external demands of consumers have made significant improvements in both quantity and quality, because of the social interest and policy support. The recognition of personal and social values of culture and arts has brought about interest in and need for culture-art products. Businesses have agilely embraced such change and actively implemented various marketing strategies utilizing culture and arts. For example, businesses began to sponsor artists who produce culture-art products while building facilities for cultural and art performances or exhibitions. Businesses have also provided performances and exhibitions free-of-charge or at affordable prices. As a result, the supply in the market has started to exceed its demand as is often the case in many of other markets. However, such imbalance has occurred not because of over-supply but because of a lack of demand. Given these circumstances, the government and culture and art related organizations, which had mainly concentrated on the supply side, started to recognize the importance of creating personal and social values in culture and arts. As a result, the government and various organizations are now creating various strategies that include policy measures to achieve their new found goal. Unfortunately however, such efforts are not meeting the expectations. Focusing on above-mentioned circumstances and problems, this study aims to find measures to create demand for culture-art products in the internal conditions of those who consume culture-art products. In other words, given that the demand for culture-art products has not increased despite all external conditions to encourage consumption, this study aims to find the reasons in consumers' value judgment on culture-art products. Though there were recent studies on culture-art products that applied consumer behavior on marketing theories, most of them focused on peripheral aspects such as people's motivation for or satisfaction from watching culture-art events. Hence, there is a need to understand what kind of value consumers perceive from culture-art products and how such value cognition leads to consumption in a comprehensive manner. This study acts as follow-up to a separate study entitled "Qualitative Study about Value Cognition and Benefits of Consumer on Culture-Art Products". The current study aims to extend practical implications that enhance the effectiveness of marketing strategies among the producing and policy agencies in the industry. The purpose of this study is to investigate dimensions of value cognition, benefits and attributes of culture-art products, and identify the effects of consumer value cognition on benefits and attributes. The questionnaire was developed based on the conceptual structure of qualitative research and previous researches. It was composed of value cognition, benefits, attributes of culture-art products and demographic variables. This survey was conducted on-line and off-line among a total of 662 persons ranging from their teens to their 50's who were living in Seoul, Gyeonggi-do, various metropolitan cities, and small and medium-sized cities. The data collected was analyzed by factor analysis and path analysis using SPSS WIN 18.0 and AMOS 16.0. This empirical study found that the dimensions of value cognition of culture-art products were categorized into personal goods, aesthetic goods and public property. This shows that the consumers perceive culture-art products as products that are worthy enough to pay the costs not just for personal benefits but also for their social values. Also the formation of value cognition for culture-art products requires special conditions unlike that for physical consumer goods and services, which simply require marketing stimuli. The dimensions of benefits pursued by consuming culture-art products were found to be composed of four types - pursuit of aesthetic benefits, pursuit of actual benefits, pursuit of emotional benefits, and pursuit of conspicuous character. This result implies that people consume culture-art products not just to pursue pleasure from emotional and intelligent satisfaction as well as social relations, but also to seek the needs and benefits embodied at a social level. The dimensions of attributes of culture-art products had seven different factors, - environmental, price, evaluation, people, artwork, composition, and personal relations - which is plentiful. This is because the attributes of culture-art products are very complicated compared to other consumer goods or services. Since culture-art products include not just cultural or artistic works but also all physical, human, environmental, and systemic elements of the products in a comprehensive manner, consumers perceive everything they experience in the process of consuming culture-art products as part of the products. The dimensions of value cognition was found to affect attributes of the products, mostly using pursued benefits as a mediating factors. This result is consistent with the result of qualitative research, and proves that applying the means-end chain theory in the reverse direction is reasonable. The result can be interpreted that consumers' value cognitions for culture-art products turns into actual benefits leading to consumers' decisions. Furthermore, this result reveals that when consumers choose culture-art products, they take into account the attributes of culture-art products depending on the benefits they pursue. These results confirm that despite their conceptual and abstract attributes, culture-art products have values that contribute to actual benefits for individual consumers and society. Hence, value cognition generates benefits to be pursued and this in turn affects the consumers' choices of attributes on products. Based on the conceptual structure of consumers' value cognitions on culture-art products and its dimensions, it is possible to find detailed methods to provide opportunities for education and training to form and reinforce positive value cognition on culture-art products. And through those methods, it will be possible to develop attributes of culture-art products according to the dimensions of pursued benefits, and allow conceptual products become the subject to valuable consumption in real life. These results provide theoretical understanding of consumer behavior in culture marketing and useful information to culture-art producers, companies that use culture and art, and government agencies that use culture-art as a mean to improve the public perception of quality of life. As a follow up on this study, there should be experimental studies that can develop criteria visualizing the demands of consumers who purchase culture-art products and identify their detailed attributes. Studies that compare characteristics of different areas within the culture-art product category and in-depth studies on a specific area or genre will also be needed. In order to develop marketing strategies for culture-art products, studies on the formation and reinforcement of positive value cognition on culture-art products and education for the development of consumer demand as well as on the development and differentiation of attributes of culture-art products depending on types of consumer groups should also follow.

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