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Usefulness of Troponin-I, Lactate, C-reactive protein as a Prognostic Markers in Critically Ill Non-cardiac Patients (비 순환기계 중환자의 예후 인자로서의 Troponin-I, Lactate, C-reactive protein의 유용성)

  • Cho, Yu Ji;Ham, Hyeon Seok;Kim, Hwi Jong;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.562-569
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    • 2005
  • Background : The severity scoring system is useful for predicting the outcome of critically ill patients. However, the system is quite complicated and cost-ineffective. Simple serologic markers have been proposed to predict the outcome, which include troponin-I, lactate and C-reactive protein(CRP). The aim of this study was to evaluate the prognostic values of troponin-I, lactate and CRP in critically ill non-cardiac patients. Methods : From September 2003 to June 2004, 139 patients(Age: $63.3{\pm}14.7$, M:F = 88:51), who were admitted to the MICU with non-cardiac critical illness at Gyeongsang National University Hospital, were enrolled in this study. This study evaluated the severity of the illness and the multi-organ failure score (Acute Physiologic and Chronic Health EvaluationII, Simplified Acute Physiologic ScoreII and Sequential Organ Failure Assessment) and measured the troponin-I, lactate and CRP within 24 hours after admission in the MICU. Each value in the survivors and non-survivors was compared at the 10th and 30th day after ICU admission. The mortality rate was compared at 10th and 30th day in normal and abnormal group. In addition, the correlations between each value and the severity score were assessed. Results : There were significantly higher troponin-I and CRP levels, not lactate, in the non-survivors than in the survivors at 10th day($1.018{\pm}2.58ng/ml$, $98.48{\pm}69.24mg/L$ vs. $4.208{\pm}10.23ng/ml$, $137.69{\pm}70.18mg/L$) (p<0.05). There were significantly higher troponin-I, lactate and CRP levels in the non-survivors than in the survivors on the 30th day ($0.99{\pm}2.66ng/ml$, $8.02{\pm}9.54ng/dl$, $96.87{\pm}68.83mg/L$ vs. $3.36{\pm}8.74ng/ml$, $15.42{\pm}20.57ng/dl$, $131.28{\pm}71.23mg/L$) (p<0.05). The mortality rate was significantly higher in the abnormal group of troponin-I, lactate and CRP than in the normal group of troponin-I, lactate and CRP at 10th day(28.1%, 31.6%, 18.9% vs. 11.0%, 15.8 %, 0%) and 30th day(38.6%, 47.4%, 25.8% vs. 15.9%, 21.7%, 14.3%) (p<0.05). Troponin-I and lactate were significantly correlated with the SAPS II score($r^2=0.254$, 0.365, p<0.05). Conclusion : Measuring the troponin-I, lactate and CRP levels upon admission may be useful for predicting the outcome of critically ill non-cardiac patients.

The Recent Outcomes after Repair of Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries (폐동맥폐쇄와 주대동맥폐동맥부행혈관을 동반한 활로씨사징증 교정의 최근 결과)

  • Kim Jin-Hyun;Kim Woong-Han;Kim Dong-Jung;Jung Eui-Suk;Jeon Jae-Hyun;Min Sun-Kyung;Hong Jang-Mee;Lee Jeong-Ryul;Rho Joon-Ryuang;Kim Yong-Jin
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.269-274
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    • 2006
  • Background: Tetralogy of Fallot (TOF) with pulmonary atresia and major aortopulmonary collateral arteries (MAPCAS) is complex lesion with marked heterogeneity of pulmonary blood supply and arborization anomalies. Patients with TOF with PA and MAPCAS have traditionally required multiple staged unifocalization of pulmonary blood supply before undergoing complete repair. In this report, we describe recent change of strategy and the results in our institution. Material and Method: We established surgical stratagies: early correction, central mediastinal approach, initial RV-PA conduit interposition, and aggressive intervention. Between July 1998 and August 2004, 23 patients were surgically treated at our institution. We divided them into 3 groups by initial operation method; group I: one stage total correction, group II: RV-PA conduit and unifocalization, group III: RV-PA conduit interposition only. Result: Mean ages at initial operation in each group were $13.9{\pm}16.0$ months (group 1), $10.4{\pm}15.6$ months (group II), and $7.9{\pm}7.7$ months (group III). True pulmonary arteries were not present in f patient and the pulmonary arteries were confluent in 22 patients. The balloon angioplasty was done in average 1.3 times (range: $1{\sim}6$). There were 4 early deaths relating initial operation, and 1 late death due to incracranial hemorrhage after definitive repair. The operative mortalities of initial procedures in each group were 25.0% (1/4: group I), 20.0% (2/10: group II), and 12.2% (1/9: group III). The causes of operative mortality were hypoxia (2), low cardiac output (1) and sudden cardiac arrest (1). Definitive repair rates in each group were 75% (3/4) in group I, 20% (2/10, fenestration: 2) in group II, and 55.0% (5/9, fenestration: 1) in group III. Conclusion: In patients of TOF with PA and MAPCAS, RV-PA connection as a initial procedure could be performed with relatively low risk, and high rate of definitive repair can be obtained in the help of balloon pulmonary angioplasty. One stage RV-PA connection and unifocalization appeared to be successful in selected patients.

Quantitative Differences between X-Ray CT-Based and $^{137}Cs$-Based Attenuation Correction in Philips Gemini PET/CT (GEMINI PET/CT의 X-ray CT, $^{137}Cs$ 기반 511 keV 광자 감쇠계수의 정량적 차이)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Dong-Soo;Park, Eun-Kyung;Kim, Jong-Hyo;Kim, Jae-Il;Lee, Hong-Jae;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.3
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    • pp.182-190
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    • 2005
  • Purpose: There are differences between Standard Uptake Value (SUV) of CT attenuation corrected PET and that of $^{137}Cs$. Since various causes lead to difference of SUV, it is important to know what is the cause of these difference. Since only the X-ray CT and $^{137}Cs$ transmission data are used for the attenuation correction, in Philips GEMINI PET/CT scanner, proper transformation of these data into usable attenuation coefficients for 511 keV photon has to be ascertained. The aim of this study was to evaluate the accuracy in the CT measurement and compare the CT and $^{137}Cs$-based attenuation correction in this scanner. Methods: For all the experiments, CT was set to 40 keV (120 kVp) and 50 mAs. To evaluate the accuracy of the CT measurement, CT performance phantom was scanned and Hounsfield units (HU) for those regions were compared to the true values. For the comparison of CT and $^{137}Cs$-based attenuation corrections, transmission scans of the elliptical lung-spine-body phantom and electron density CT phantom composed of various components, such as water, bone, brain and adipose, were performed using CT and $^{137}Cs$. Transformed attenuation coefficients from these data were compared to each other and true 511 keV attenuation coefficient acquired using $^{68}Ge$ and ECAT EXACT 47 scanner. In addition, CT and $^{137}Cs$-derived attenuation coefficients and SUV values for $^{18}F$-FDG measured from the regions with normal and pathological uptake in patients' data were also compared. Results: HU of all the regions in CT performance phantom measured using GEMINI PET/CT were equivalent to the known true values. CT based attenuation coefficients were lower than those of $^{68}Ge$ about 10% in bony region of NEMA ECT phantom. Attenuation coefficients derived from $^{137}Cs$ data was slightly higher than those from CT data also in the images of electron density CT phantom and patients' body with electron density. However, the SUV values in attenuation corrected images using $^{137}Cs$ were lower than images corrected using CT. Percent difference between SUV values was about 15%. Conclusion: Although the HU measured using this scanner was accurate, accuracy in the conversion from CT data into the 511 keV attenuation coefficients was limited in the bony region. Discrepancy in the transformed attenuation coefficients and SUV values between CT and $^{137}Cs$-based data shown in this study suggests that further optimization of various parameters in data acquisition and processing would be necessary for this scanner.

Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan (분화 갑상선암 수술 후 최초 고용량 방사성옥소 치료시 투여용량 결정: 병리적 병기, 혈청 갑상선글로불린치와 I-123 전신 스캔의 유용성 비교)

  • Jeong, Hwan-Jeong;Lim, Seok-Tae;Youn, Hyun-Jo;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.301-306
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    • 2008
  • Purpose: Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Materials and Methods: Fifty eight patients (M:F=13;45, age $44.5{\pm}11.5\;yrs$) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. Results: All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, fourty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were $154{\pm}25\;mCi$ in stage I (n=9), $175{\pm}50\;mCi$ in stage II (n=4), $149{\pm}21\;mCi$ in stage III (n=38), and $161{\pm}20\;mCi$ in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with $149{\pm}26\;mCi$ of I-131, 9 patients (17.3%) having $2{\leq}\;sTG\;<5\;ng/mL$ with $156{\pm}17\;mCi$, 5 patients (9.6%) having $5{\leq}\;sTG\;<10\;ng/mL$ with $156{\pm}13\;mCi$, 7 patients (13.5%) having $10{\leq}sTG\;<50\;ng/mL$ with $147{\pm}24\;mCi$, and 6 patients (11.5%) having above 50 ng/mL with $175{\pm}42\;mCi$. The statistical significance between sTG level and TD (p=0.252) was not shown. Conclusion: In conclusion, PS and sTG could not replace the determination of TD using I-123 scan for first HD-RAI in patients with differentiated thyroid cancer.

Evaluation of the Radioimmunotherapy Using I-131 labeled Vascular Endothelial Growth Factor Receptor2 Antibody in Melanoma Xenograft Murine Model (흑색종에서의 I-131표지 혈관내피세포성장인자 수용체2항체를 이용한 방사면역치료 평가)

  • Kim, Eun-Mi;Jeong, Hwan-Jeong;Park, Eun-Hye;Cheong, Su-Jin;Lee, Chang-Moon;Jang, Kyu-Yun;Kim, Dong-Wook;Lim, Seok-Tae;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.307-313
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    • 2008
  • Purpose: Vascular endothelial growth factor (VEGF) and its receptor, fetal liver kinase 1 (Flk-1), play an important role in vascular permeability and tumor angiogenesis. The aim of this study is to evaluate the therapeutic efficacy of $^{131}I$ labeled anti-Flk-1 monoclonal antibody (DC101) on the growth of melanoma tumor, which is known to be very aggressive in vivo. Materials and Methods: Balb/c nude mice were injected subcutaneously with melanoma cells in the right flank. Tumors were allowed to grow up to $200-250\;mm^3$ in volume. Gamma camera imaging and biodistribution studies were performed to identify an uptake of $^{131}I$-DC101 in various organs. Mice with tumor were randomly divided into five groups (10 mice per group) and injected intravenously; control PBS (group 1), $^{131}I$-DC101 $50\;{\mu}g/mouse$ (group 2), non-labeled DC101 $50\;{\mu}g/mouse$ (group 3), $^{131}I$-DC101 $30\;{\mu}g/mouse$ (group 4) and $15\;{\mu}g/mouse$ (group 5) every 3 or 4 days for 20 days. Tumor volume was measured with caliper twice a week. Results: In gamma camera images, the uptake of $^{131}I$-DC101 into tumor and thyroid was increased with time. Biodistribution results showed that the radioactivity of blood and other major organ was gradually decreased with time whereas tumor uptake was increased up to 48 hr and then decreased. After 4th injection of $^{131}I$-DC101, tumor volume of group 2 and 4 was significantly smaller than that group 1. After 5th injection, the tumor volume of group 5 also significantly reduced. Conclusion: These results indicated that delivery of $^{131}I$ to tumor using FlK-1 antibody, DC101, effectively blocks tumor growth in aggressive melanoma xenograft model.

Studies on the Fatty Acid Composition of Lipids from Some Seeds of the Cucurbitaceae Family (박과식물(科植物) 종자유(種子油)의 지방산(脂肪酸) 조성(組成))

  • Kim, Seong-Jin;Joh, Yong-Goe
    • Journal of the Korean Applied Science and Technology
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    • v.13 no.1
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    • pp.21-29
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    • 1996
  • Levels of total, neutral and polar lipids from the seeds of eight species of the Cucurbitaceae f Cucurbita moschata, Lufa cylindrica, Citrullus vulgari, Cucumis melo var. makuwa, Cucumis satvus, Lag leucantha. Trichosanthes kirilowii and Momordica charantia, were determinded, and their fatty compositions were also analyzed by gas-liquid chromatography. The results were summarized as foll. Lipid contents of the seeds range from 21.9 to 50.7%, which contained 98% up of neutral lipi the fatty acid compositon of ottal lipids from the seeds of Cucurbita moschata, Lufa cylindrica, Ci vulgari, Cucumis melo var. makuwa, Cucumis sativus and Lagenaria leucantha, linoleic acid is the mos dominant component(56.8${\sim}$84.0%) followed by oleic acid(5.7${\sim}$22.2%) and palmitic acid(6.1${\sim}$1) with a trace amount of ${\alpha}-linolenic$ acid(below 0.6%). On the contrary, the seed oils of Tricho kirilowii and Momordica charantia are characterized by presence of considerable amounts of con trienoic acid such as punicic acid($_{9c.11t.13c-}C_{18:3}$) and ${\alpha}-eleostearic$ acid($_{9c.11t.13c-}C_{18:3}$). For example total lipids of T. kirilowii seeds were mainly composed of linoleic acid(40.5%) and punicic acid(3) in the fatty acid composition, while those of M. charantia seeds predominantly comprised ${\alpha}-eleos$ acid as a main component(66.9%), accompanied by oleic acid(11.7%) and linoleic acid(10.4%). oil ${\beta}-eleostearic$ acid($_{9t.11t.13c-}C_{18:3}$) was checked as a trace. Fatty acid profiles of neutral lipids close resemblance to those of total lipids in all the seed oils, but are different from those of polar In particular, conjugate trienoic acids including punicic acid and ${\alpha}-eleostearic$ acid which are oc as the most abundant component in both neutral lipids of T. kirilowii and M. charantia seed oils, ar ent in a extremely small amount in both polar lipids. The fatty acid distribution in the polar lipid the samples except for T. kirilowii and M. charantia seed oils, showed a tendency of consid increased level of saturated fatty acids(25.0${\sim}$29.4%) compared with that in the neutral lipids(9.9%). The results obtained in this experiment suggest us that the seed oils of the Cucurbitaceae

Genetic Diversity of Korean Native Chicken Populations in DAD-IS Database Using 25 Microsatellite Markers (초위성체 마커를 활용한 가축다양성정보시스템(DAD-IS) 등재 재래닭 집단의 유전적 다양성 분석)

  • Roh, Hee-Jong;Kim, Kwan-Woo;Lee, Jinwook;Jeon, Dayeon;Kim, Seung-Chang;Ko, Yeoung-Gyu;Mun, Seong-Sil;Lee, Hyun-Jung;Lee, Jun-Heon;Oh, Dong-Yep;Byeon, Jae-Hyun;Cho, Chang-Yeon
    • Korean Journal of Poultry Science
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    • v.46 no.2
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    • pp.65-75
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    • 2019
  • A number of Korean native chicken(KNC) populations were registered in FAO (Food and Agriculture Organization) DAD-IS (Domestic Animal Diversity Information Systems, http://www.fao.org/dad-is). But there is a lack of scientific basis to prove that they are unique population of Korea. For this reason, this study was conducted to prove KNC's uniqueness using 25 Microsatellite markers. A total of 548 chickens from 11 KNC populations (KNG, KNB, KNR, KNW, KNY, KNO, HIC, HYD, HBC, JJC, LTC) and 7 introduced populations (ARA: Araucana, RRC and RRD: Rhode Island Red C and D, LGF and LGK: White Leghorn F and K, COS and COH: Cornish brown and Cornish black) were used. Allele size per locus was decided using GeneMapper Software (v 5.0). A total of 195 alleles were observed and the range was 3 to 14 per locus. The MNA, $H_{\exp}$, $H_{obs}$, PIC value within population were the highest in KNY (4.60, 0.627, 0.648, 0.563 respectively) and the lowest in HYD (1.84, 0.297, 0.286, 0.236 respectively). The results of genetic uniformity analysis suggested 15 cluster (${\Delta}K=66.22$). Excluding JJC, the others were grouped in certain cluster with high genetic uniformity. JJC was not grouped in certain cluster but grouped in cluster 2 (44.3%), cluster 3 (17.7%) and cluster8 (19.1%). As a results of this study, we can secure a scientific basis about KNC's uniqueness and these results can be use to basic data for the genetic evaluation and management of KNC breeds.

Importance and Satisfaction Analysis for Vitalization of River Estuary - Focused on the Nakdong Estuary - (강 하구역 활성화를 위한 자원의 중요도·만족도 분석 - 낙동강 하구역의 사례를 중심으로 -)

  • An, Byung-Chul;Kwon, Jin-Wook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.6
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    • pp.49-59
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    • 2018
  • The purpose of this study was to analyze the importance and satisfaction of resources in the mouth of Nakdong River. A Pearson's chi-square test was performed in SPSS 24.0 for statistical analysis and the result of the study was summarized by three points. First, the results of importance analysis on resources in Nakdong estuary found that the importance of ecology resources was the highest with 27.1%, followed by landscape resources (18.5%), waterside leisure resources (6.5%), complex cultural resources (5.4%), and historic and cultural resources (3.3%). The probability values (p-value) of each group had shown significant differences depending on gender, age, and the location of the survey. For instance, women respondents reported a higher preference to ecology resources and complex cultural resources such as museums than men respondents as much as two times and three times, respectively. Meanwhile, men respondents showed a higher preference to waterside leisure resources in three times as much as women respondents. As for the analysis by age, the respondents in their 20s and 30s recorded a higher value than those in other age groups, and people in their 30s reported a higher preference to waterside leisure resources than those in different age groups by three times. Lastly, no significant differences were found in the preference analysis by occupation (p>.05). With regard to the results of satisfaction analysis, the average level of satisfaction on landscape resources was 6.01, and that of ecology resources and complex cultural resource were 5.65 and 5.15, respectively. Also, significant differences were found between landscape and ecology resources in the satisfaction analysis by age, landscape resources by age, ecology resources by region, and between landscape resources and ecology resources by occupation. The p-value of complex cultural resources was p=0.012, although the satisfaction level of landscape resources and ecology resources were reported to have no significant differences by age. As for the level of satisfaction in landscape resources, respondents in their 40s and 50s showed a high level of satisfaction. However, those in their 20s showed a relatively low level of satisfaction in the same category. The survey respondents living in Busan and South Gyeongsang Province and those living outside the regions revealed no significant differences in terms of satisfaction in landscape resources and complex cultural resources. However, the two same groups were found to show significant differences in the satisfaction analysis on ecology resources. In the satisfaction analysis of landscape resources and ecology resources by occupation, significant differences were found among college students, government employees, ordinary citizens, and expert groups. However, they showed no significant differences in the level of satisfaction to complex cultural resources. Third, the results of importance-satisfaction analysis on Nakdong estuary found that the average levels of satisfaction to landscape resources for each group of respondents who considered landscape, ecology, and cultural resources as important was 6.19, 6.08, and 5.67, respectively. Their levels of satisfaction on ecology resources were 5.95, 5.57, and 5.41 for each. Its correlation to the importance was insignificant. However, it was confirmed that the correlation to the level of satisfaction on complex cultural resources had a significant difference (p=0.025). In addition, the results of the analysis on 15 detailed items that was carried out with the aim to improving values and vitalizing resources in the mouth of Nakdong River found that respondents considered that the vitalization of eco-tourism (49.5%) and restoration of reed marsh (47.5%) were important. The results of detailed analysis revealed respondents' high awareness on the need of enhancing values on ecology resources. Also, improving infrastructure nearby the mouth, creating cycling routes, walkways, waterside leisure facilities, and others were considered as the requirements for the vitalization of Nakdong estuary.

A Study on Practical Curriculum Development of the Education for Love based on the Understanding of Psychoanalytic 'Desire of Subject' (정신분석학적 '욕망의 주체' 이해에 기초한 사랑의 교육 교육과정 개발)

  • Kim, Sun Ah
    • Journal of Christian Education in Korea
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    • v.68
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    • pp.77-112
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    • 2021
  • This study is based on the research of the first year, which is the National Research Foundation of Korea's R&D subject for middle-grade researchers. In this study, the practical curriculum development of the education for love - an according to the psychoanalytic perspectives of F. Dolto(1908-1988) - is suggested as follows. The first is 'the reconstruction of the directions of curriculum and its specific aims in accordance with such directions.' The reconstruction of the directions of curriculum aims at leading our future generation to live as a subject of desire through the mutual-communication of love. The second is 'the reconstruction of the tasks of curriculum and its specific contents in accordance with such tasks.' The reconstruction of the tasks of curriculum pursuit to help our future generation through the converting the education for love into the paradigm of desire of Agape to live as a subject of desire forming a whole personality and practicing the desire of Agape in daily life. as a source of desire. According to these aims, the reconstruction of directions of curriculum are presented as following: firstly, 'curriculum for the mutual-communication between subjects of love' and secondly, 'curriculum for the subject of desire'. The reconstruction of tasks of curriculum are like these: firstly, 'converting the education for love into the paradigm of desire of Agape', and secondly, 'forming a whole personality through the education for love'. Thus, with respect to two specific aims in accordance with the reconstruction of directions are suggested like these: Firstly, 'constructing a subject as a speaking existence' and secondly, 'realizing the subject as the autonomous source of desire'. In the two specific contents in accordance with the reconstruction of tasks are presented as following: Firstly, 'realizing the truth of the desire of Agape'.' Secondly, 'practicing the desire of Agape in daily life.' The third is 'the reconstruction of curriculum by life cycle' are suggested. They include the fetal life, infants and preschool children life, and childhood life. In further study, it is required to contain adolescent period. It will be useful to help them to recover their self-esteem with the experience of true love, especially, out-of-school young generation overcome negative perspectives and prejudice in the society, and challenges to their dreams and future through proper utilization of the study outcome. The outcome of this study, which presented practical curriculum development of the education for love based on the understanding of psychoanalytic 'desire of subject' can be used as basic teaching materials for our future generations. Furthermore, the results can be used as a resource for educating ministers and lay leaders in the religious world to build capabilities to heal their inner side as well as the society that is tainted with various forms of conflict. These include general conflicts, anger, pleasure and addiction, depression and suicide, violence and murder, etc. The study outcome can contribute to the prevention of antisocial incidents against humanity that have recently been occurring in our free-semester system implemented in all middle schools across the country to be operated effectively. For example, it is possible to provide the study results as lecture and teaching materials for 'character camp' (self-examination and self-esteem improvement training) and 'family healing camp' (solution of a communication gap between family members and love communication training), which help students participate in field trip activities and career exploration activities voluntarily, independently, and creatively. Ultimately, it can visibly present the convergent research performance by providing the study outcome as preliminary data for the development of lecture videos and materials including infant care and preschool education, parental education, family consultation education, and holistic healing education. Support from the religious world, including the central government and local governments, are urgently required in order for such educational possibilities to be fulfilled both in the society and the fields of church education and to be actively linked to follow-up studies.

The Effect of Customer Satisfaction on Corporate Credit Ratings (고객만족이 기업의 신용평가에 미치는 영향)

  • Jeon, In-soo;Chun, Myung-hoon;Yu, Jung-su
    • Asia Marketing Journal
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    • v.14 no.1
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    • pp.1-24
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    • 2012
  • Nowadays, customer satisfaction has been one of company's major objectives, and the index to measure and communicate customer satisfaction has been generally accepted among business practices. The major issues of CSI(customer satisfaction index) are three questions, as follows: (a)what level of customer satisfaction is tolerable, (b)whether customer satisfaction and company performance has positive causality, and (c)what to do to improve customer satisfaction. Among these, the second issue is recently attracting academic research in several perspectives. On this study, the second issue will be addressed. Many researchers including Anderson have regarded customer satisfaction as core competencies, such as brand equity, customer equity. They want to verify following causality "customer satisfaction → market performance(market share, sales growth rate) → financial performance(operating margin, profitability) → corporate value performance(stock price, credit ratings)" based on the process model of marketing performance. On the other hand, Insoo Jeon and Aeju Jeong(2009) verified sequential causality based on the process model by the domestic data. According to the rejection of several hypotheses, they suggested the balance model of marketing performance as an alternative. The objective of this study, based on the existing process model, is to examine the causal relationship between customer satisfaction and corporate value performance. Anderson and Mansi(2009) proved the relationship between ACSI(American Customer Satisfaction Index) and credit ratings using 2,574 samples from 1994 to 2004 on the assumption that credit rating could be an indicator of a corporate value performance. The similar study(Sangwoon Yoon, 2010) was processed in Korean data, but it didn't confirm the relationship between KCSI(Korean CSI) and credit ratings, unlike the results of Anderson and Mansi(2009). The summary of these studies is in the Table 1. Two studies analyzing the relationship between customer satisfaction and credit ratings weren't consistent results. So, in this study we are to test the conflicting results of the relationship between customer satisfaction and credit ratings based on the research model considering Korean credit ratings. To prove the hypothesis, we suggest the research model as follows. Two important features of this model are the inclusion of important variables in the existing Korean credit rating system and government support. To control their influences on credit ratings, we included three important variables of Korean credit rating system and government support, in case of financial institutions including banks. ROA, ER, TA, these three variables are chosen among various kinds of financial indicators since they are the most frequent variables in many previous studies. The results of the research model are relatively favorable : R2, F-value and p-value is .631, 233.15 and .000 respectively. Thus, the explanatory power of the research model as a whole is good and the model is statistically significant. The research model has good explanatory power, the regression coefficients of the KCSI is .096 as positive(+) and t-value and p-value is 2.220 and .0135 respectively. As a results, we can say the hypothesis is supported. Meanwhile, all other explanatory variables including ROA, ER, log(TA), GS_DV are identified as significant and each variables has a positive(+) relationship with CRS. In particular, the t-value of log(TA) is 23.557 and log(TA) as an explanatory variables of the corporate credit ratings shows very high level of statistical significance. Considering interrelationship between financial indicators such as ROA, ER which include total asset in their formula, we can expect multicollinearity problem. But indicators like VIF and tolerance limits that shows whether multicollinearity exists or not, say that there is no statistically significant multicollinearity in all the explanatory variables. KCSI, the main subject of this study, is a statistically significant level even though the standardized regression coefficients and t-value of KCSI is .055 and 2.220 respectively and a relatively low level among explanatory variables. Considering that we chose other explanatory variables based on the level of explanatory power out of many indicators in the previous studies, KCSI is validated as one of the most significant explanatory variables for credit rating score. And this result can provide new insights on the determinants of credit ratings. However, KCSI has relatively lower impact than main financial indicators like log(TA), ER. Therefore, KCSI is one of the determinants of credit ratings, but don't have an exceedingly significant influence. In addition, this study found that customer satisfaction had more meaningful impact on corporations of small asset size than those of big asset size, and on service companies than manufacturers. The findings of this study is consistent with Anderson and Mansi(2009), but different from Sangwoon Yoon(2010). Although research model of this study is a bit different from Anderson and Mansi(2009), we can conclude that customer satisfaction has a significant influence on company's credit ratings either Korea or the United State. In addition, this paper found that customer satisfaction had more meaningful impact on corporations of small asset size than those of big asset size and on service companies than manufacturers. Until now there are a few of researches about the relationship between customer satisfaction and various business performance, some of which were supported, some weren't. The contribution of this study is that credit rating is applied as a corporate value performance in addition to stock price. It is somewhat important, because credit ratings determine the cost of debt. But so far it doesn't get attention of marketing researches. Based on this study, we can say that customer satisfaction is partially related to all indicators of corporate business performances. Practical meanings for customer satisfaction department are that it needs to actively invest in the customer satisfaction, because active investment also contributes to higher credit ratings and other business performances. A suggestion for credit evaluators is that they need to design new credit rating model which reflect qualitative customer satisfaction as well as existing variables like ROA, ER, TA.

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