• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.653-662
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• 2006

Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

• 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 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.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.351-360
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• 1995

Background: Pressure support(PS) is becomimg a widely accepted method of mechanical ventilation either for total unloading or for partial unloading of respiratory muscle. The aim of the study was to find out if PS exert different effects on respiratory mechanics in synchronized intermittent mandatory ventilation(SIMV) and continuous positive airway pressure (CPAP) modes. Methods: 5, 10 and 15 cm $H_2O$ of PS were sequentially applied in 14 patients($69{\pm}12$ yrs, M:F=9:5) and respiratory rate (RR), tidal volume($V_T$), work of breathing(WOB), pressure time product(PTP), $P_{0.1}$, and $T_1/T_{TOT}$ were measured using the CP-100 pulmonary monitor(Bicore, USA) in SIMV and CPAP modes respectively. Results: 1) Common effects of PS on respiratory mechanics in both CPAP and SIMV modes As the level of PS was increased(0, 5, 10, 15 cm $H_2O$), $V_T$ was increased in CPAP mode($0.28{\pm}0.09$, $0.29{\pm}0.09$, $0.31{\pm}0.11$, $0.34{\pm}0.12\;L$, respectively, p=0.001), and also in SIMV mode($0.31{\pm}0.15$, $0.32{\pm}0.09$, $0.34{\pm}0.16$, $0.36{\pm}0.15\;L$, respectively, p=0.0215). WOB was decreased in CPAP mode($1.40{\pm}1.02$, $1.01{\pm}0.80$, $0.80{\pm}0.85$, $0.68{\pm}0.76$ joule/L, respectively, p=0.0001), and in SIMV mode($0.97{\pm}0.77$, $0.76{\pm}0.64$, $0.57{\pm}0.55$, $0.49{\pm}0.49$ joule/L, respectively, p=0.0001). PTP was also decreased in CPAP mode($300{\pm}216$, $217{\pm}165$, $179{\pm}187$, $122{\pm}114cm$ $H_2O{\cdot}sec/min$, respectively, p=0.0001), and in SIMV mode($218{\pm}181$, $178{\pm}157$, $130{\pm}147$, $108{\pm}129cm$ $H_2O{\cdot}sec/min$, respectively, p=0.0017). 2) Different effects of PS on respiratory mechanics in CP AP and SIMV modes By application of PS (0, 5, 10, 15 cm $H_2O$), RR was not changed in CPAP mode($27.9{\pm}6.7$, $30.0{\pm}6.6$, $26.1{\pm}9.1$, $27.5{\pm}5.7/min$, respectively, p=0.505), but it was decreased in SIMV mode ($27.4{\pm}5.1$, $27.8{\pm}6.5$, $27.6{\pm}6.2$, $25.1{\pm}5.4/min$, respectively, p=0.0001). $P_{0.1}$ was reduced in CPAP mode($6.2{\pm}3.5$, $4.8{\pm}2.8$, $4.8{\pm}3.8$, $3.9{\pm}2.5\;cm$ $H_2O$, respectively, p=0.0061), but not in SIMV mode($4.3{\pm}2.1$, $4.0{\pm}1.8$, $3.5{\pm}1.6$, $3.5{\pm}1.9\;cm$ $H_2O$, respectively, p=0.054). $T_1/T_{TOT}$ was decreased in CPAP mode($0.40{\pm}0.05$, $0.39{\pm}0.04$, $0.37{\pm}0.04$, $0.35{\pm}0.04$, respectively, p=0.0004), but not in SIMV mode($0.40{\pm}0.08$, $0.35{\pm}0.07$, $0.38{\pm}0.10$, $0.37{\pm}0.10$, respectively, p=0.287). 3) Comparison of respiratory mechanics between CPAP+PS and SIMV alone at same tidal volume. The tidal volume in CPAP+PS 10 cm $H_2O$ was comparable to that of SIMV alone. Under this condition, the RR($26.1{\pm}9.1$, $27.4{\pm}5.1/min$, respectively, p=0.516), WOB($0.80{\pm}0.85$, 0.97+0.77 joule/L, respectively, p=0.485), $P_{0.1}$($3.9{\pm}2.5$, $4.3{\pm}2.1\;cm$ $H_2O$, respectively, p=0.481) were not different between the two methods, but PTP($179{\pm}187$, $218{\pm}181 cmH_2O{\cdot}sec/min$, respectively, p=0.042) and $T_1/T_{TOT}$($0.37{\pm}0.04$, $0.40{\pm}0.08$, respectively, p=0.026) were significantly lower in CPAP+PS than in SIMV alone. Conclusion: PS up to 15 cm $H_2O$ increased tidal volume, decreased work of breathing and pressure time product in both SIMV and CPAP modes. PS decreased respiration rate in SIMV mode but not in CPAP mode, while it reduced central respiratory drive($P_{0.1}$) and shortened duty cycle ($T_1/T_{TOT}$) in CPAP mode but not in SIMV mode. By 10 em $H_2O$ of PS in CPAP mode, same tidal volume was obtained as in SIMV mode, and both methods were comparable in respect to RR, WOB, $P_{0.1}$, but CPAP+PS was superior in respect to the efficiency of the respiratory muscle work (PTP) and duty cycle($T_1/T_{TOT}$).

• Journal of Global Scholars of Marketing Science
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• v.18 no.2
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• pp.19-45
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• 2008

This study is to empirically examine the primary dimensions of visual merchandising (VMD) of internet shopping mall, namely store design, merchandise, and merchandising cues, to be a attractive virtual store to the shoppers. The authors reviewed the literature related to the major components of VMD from the perspective of the AIDA model, which has been mainly applied to the offline store settings. The major purposes of the study are as follows; first, tries to derive the variables related with the components of visual merchandising through reviewing the existing literatures, establish the hypotheses, and test it empirically. Second, examines the relationships between the components of VMD and the attitude toward the VMD, however, putting more emphasis on finding out the component structure of the VMD. VMD needs to be examined with the perspective that an online shopping mall is a virtual self-service or clerkless store, which could reduce the number of employees, help the shoppers search, evaluate and purchase for themselves, and to be explored in terms of the in-store persuasion processes of customers. This study reviewed the literatures related to store design, merchandise, and merchandising cues which might be relevant to the store, product, and promotion respectively. VMD is a total communication tool, and AIDA model could explain the in-store consumer behavior of online shopping. Store design has to do with triggering a consumer attention to the online mall, merchandise with a product related interest, and merchandising cues with promotions such as recommendation and links that induce the desire to pruchase. These three steps might be seen as the processes for purchase actions. The theoretical rationale for the relationship between VMD and AIDA could be found in Tyagi(2005) that the three steps of consumer-oriented merchandising are a store, a product assortment, and placement, in Omar(1999) that three types of interior display are a architectural design display, commodity display, and point-of-sales(POS) display, and in Davies and Ward(2005) that the retail store interior image is related to an atmosphere, merchandise, and in-store promotion. Lee et al(2000) suggested as the web merchandising components a merchandising cues, a shopping metaphor which is an assistant tool for search, a store design, a layout(web design), and a product assortment. The store design which includes differentiation, simplicity and navigation is supposed to be related to the attention to the virtual store. Second, the merchandise dimensions comprising product assortments, visual information and product reputation have to do with the interest in the product offerings. Finally, the merchandising cues that refer to merchandiser(MD)'s recommendation of products and providing the hyperlinks to relevant goods for the shopper is concerned with attempt to induce the desire to purchase. The questionnaire survey was carried out to collect the data about the consumers who would shop at internet shopping malls frequently. To select the subject malls, the mall ranking data announced by a mall rating agency was used to differentiate the most popular and least popular five mall each. The subjects was instructed to answer the questions after navigating the designated mall for five minutes. The 300 questionnaire was distributed to the consumers, 166 samples were used in the final analysis. The empirical testing focused on identifying and confirming the dimensionality of VMD and its subdimensions using a structural equation modeling method. The confirmatory factor analysis for the endogeneous and exogeneous variables was carried out in four parts. The second-order factor analysis was done for a store design, a merchandise, and a merchandising cues, and first-order confirmatory factor analysis for the attitude toward the VMD. The model test results shows that the chi-square value of structural equation is 144.39(d.f 49), significant at 0.01 level which means the proposed model was rejected. But, judging from the ratio of chi-square value vs. degree of freedom, the ratio was 2.94 which smaller than an acceptable level of 3.0, RMR is 0.087 which is higher than a generally acceptable level of 0.08. GFI and AGFI is turned out to be 0.90 and 0.84 respectively. Both NFI and NNFI is 0.94, and CFI 0.95. The major test results are as follows; first, the second-order factor analysis and structural equational modeling reveals that the differentiation, simplicity and ease of identifying current status of the transaction are confirmed to be subdimensions of store design and to be a significant predictors of the dependent variable. This result implies that when designing an online shopping mall, it is necessary to differentiate visually from other malls to improve the effectiveness of the communications of store design. That is, the differentiated store design raise the contrast stimulus to sensory organs to promote the memory of the store and to have a favorable attitude toward the VMD of a store. The results that navigation which means the easiness of identifying current status of shopping affects the attitude to VMD could be interpreted that the navigating processes via the hyperlinks which is characteristics of an internet shopping is a complex and cognitive process and shoppers are likely to lack the sense of overall structure of the store. Consequently, shoppers are likely to be alost amid shopping not knowing where to go. The orientation tool enhance the accessibility of information to raise the perceptive power about the store environment.(Titus & Everett 1995) Second, the primary dimension of merchandise and its subdimensions was confirmed to be unidimensional respectively, have a construct validity, and nomological validity which the VMD dimensions supposed to have a positive correlation with the dependent variable. The subdimensions of product assortment, brand fame and information provision proved to have a positive effect on the attitude toward the VMD. It could be interpreted that the more plentiful the product and brand assortment of the mall is, the more likely the shoppers to favor it. Brand fame and information provision as well affect the VMD attitude, which means that the more famous the brand, the more likely the shoppers would trust and feel familiar with the mall, and the plentifully and visually presented information could have the shopper have a favorable attitude toward the store VMD. Third, it turned out to be that merchandising cue of product recommendation and hyperlinks affect the VMD attitude. This could be interpreted that recommended products could reduce the uncertainty related with the purchase decision, and the hyperlinks to relevant products would help the shopper save the cognitive effort exerted into the information search and gathering, which could lead to a favorable attitude to the VMD. This study tried to sheds some new light on the VMD of online store by reviewing the variables mentioned to be relevant with offline VMD in the existing literatures, and tried to link the VMD components from the perspective of AIDA model. The effect size of the VMD dimensions on the attitude was in the order of the merchandise, the store design and the merchandising cues.It is said that an internet has an unlimited place for display, however, the virtual store is not unlimited since the consumer has a limited amount of cognitive ability to process the external information and internal memory. Particularly, the shoppers are likely to face some difficulties in decision making on account of too many alternative and information overloads. Therefore, the internet shopping mall manager should take into consideration the cost of information search on the part of the consumer, to establish the optimal product placements and search routes. An efficient store composition would be possible by reducing the psychological burdens and cognitive efforts exerted to information search and alternatives evaluation. The store image is in most part determined by the product category and its brand it deals in. The results of this study support this proposition that the merchandise is most important to the VMD attitude than other components, the manager is required to take a strategic approach to VMD. The internet users are getting more accustomed and more knowledgeable about the internet media and more likely to accept the internet as a shopping channel as the period of time during which they use the internet to shop become longer. The web merchandiser should be aware that the product introduction using a moving pictures and a bulletin board become more important in order to present the interactive product information visually and communicate with customers more actively, therefore leading to making the quantity and quality of product information more rich.