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The Usefulness of Noninvasive Positive Pressure Ventilation in Patients With Acute Respiratory Failure after Extubation (기관내 관 제거 후 발생한 급성 호흡부전에서 비침습적 양압 환기법의 유용성)

  • Na, Joo-Ock;Lim, Chae-Man;Shim, Tae-Sun;Park, Joo-Hun;Lee, Ki-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.350-362
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    • 1999
  • Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

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Acute and Chronic Eosinophilic Pneumonia; Clinical and Laboratory Findings (급성 및 만성 호산구성 폐렴의 임상적 고찰)

  • Hyun, D.S.;Yeo, D.S.;Kim, J.W.;Lee, S.H.;Lee, S.Y.;Kim, S.C.;Seo, J.Y.;Song, S.H.;Kim, C.H.;Moon, H.S.;Song, J.S.;Park, S.H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.795-804
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    • 1998
  • Background: Chronic eosinophilic pneumonia(CEP) is interstitial lung disease characterized by multiple infiltration on radiographic study, accumulation of eosinophils in the alveolar space and interstitium of the lung, chronic persistent symptoms and possible relapse. Acute eosinophilic pneumonia(AEP) is a recently described illness, characterized by rapid clinical course, acute respiratory insufficiency and no relapse. Method : To better characterize acute and chronic eosinophilic pneumonia, we studied the clinical and laboratory features of 16 patients(AEP : 7 patients, CEP : 9 patients), which were clinico-pathohistologically diagnosed and not to be associated with organic disorders producing peripheral blood eosinophilia. Results: The mean age was higher for patients with CEP than for patients with AEP ($55.4{\pm}15.1$ vs. $24.6{\pm}7.9$ years, p<0.05). High fever(above $38^{\circ}C$) was presented in all patients of AEP and in one patient(11%) of CEP. All patients of AEP and eight patients (89%) of CEP showed bilateral pulmonary infiltrates, and 6 patients(86%) of AEP and 2 patients(22%) of CEP showed pleural effusion in chest radiograph. The mean white blood cell count of AEP and CEP were $17,186/mm^3$ and $12,867/mm^3$, respectively. The mean peripheral blood eosinophil count of AEP and CEP were $939/mm^3$ and $2,104/mm^3$, respectively. The mean eosinophil fraction of BAL fluid of AEP and CEP were 32.4% (range: 18~47%) and 35.8% (range: 15.3~88.2%), respectively. The mean $PaO_2$ was lower for patients with AEP than for patients with CEP ($44.1{\pm}15.5$ vs. $62.7{\pm}6.9$mmHg, p<0.05). All patients of AEP and CEP were initially treated with antibiotics. All patients of CEP and one patients of AEP were finally required systemic steroid therapy. 6 patients of AEP were improved without steroid therapy. Relapse was observed in 3 patients(33%) of CEP. Conclusion : Compair with of chronic eosinophilic pneumonia, acute eosinophilic pneumonia was characterized by relatively young age, acute onset, high fever, severe hypoxemia, diffuse pulmonary infiltrates with pleural effusion, steroid therapy is effective but spontaneous improvement with conservative therapy was frequent.

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The Diagnostic Yield and Complications of Percutaneous Needle Aspiration Biopsy for the Intrathoracic Lesions (경피적 폐생검의 진단성적 및 합병증)

  • Jang, Seung Hun;Kim, Cheal Hyeon;Koh, Won Jung;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.916-924
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    • 1996
  • Bacground : Percutaneous needle aspiration biopsy (PCNA) is one of the most frequently used diagnostic methcxJs for intrathoracic lesions. Previous studies have reponed wide range of diagnostic yield from 28 to 98%. However, diagnostic yield has been increased by accumulation of experience, improvement of needle and the image guiding systems. We analysed the results of PCNA performed for one year to evaluate the diagnostic yield, the rate and severity of complications and factors affecting the diagnostic yield. Method : 287 PCNAs undergone in 236 patients from January, 1994 to December, 1994 were analysed retrospectively. The intrathoracic lesions was targeted and aspirated with 21 - 23 G Chiba needle under fluoroscopic guiding system. Occasionally, 19 - 20 G Biopsy gun was used for core tissue specimen. The specimen was requested for microbiologic, cytologic and histopathologic examination in the case of obtained core tissue. Diagnostic yields and complication rate of benign and malignant lesions were ca1culaled based on patients' chans. The comparison for the diagnostic yields according to size and shape of the lesions was analysed with chi square test (p<0.05). Results : There are 19.9% of consolidative lesion and 80.1% of nodular or mass lesion, and the lesion is located at the right upper lobe in 26.3% of cases, the right middle lobe in 6.4%, the right lower lobe 21.2%, the left upper lobe in 16.8%, the left lower lobe in 10.6%, and mediastinum in 1.3%. The lesion distributed over 2 lobes is as many as 17.4% of cases. There are 74 patients with benign lesions, 142 patients with malignant lesions in final diagnosis and confirmative diagnosis was not made in 22 patients despite of all available diagnostic methods. 2 patients have lung cancer and pulmonary tuberculosis concomittantly. Experience with 236 patients showed that PCNA can diagnose benign lesions in 62.2% (42 patients) of patients with such lesions and malignant lesions in 82.4% (117 patients) of patients. For the patients in whom the first PCNA failed to make diagnosis, the procedure was repeated and the cumulative diagnostic yield was increased as 44.6%, 60.8%, 62.2% in benign lesions and as 73.4%, 81.7%, 82.4% in malignant lesions through serial PCNA. Thoracotomy was performed in 9 patients with benign lesions and in 43 patients with malignant lesions. PCNA and thoracotomy showed the same pathologic result in 44.4% (4 patients) of benign lesions and 58.1% (25 patients) of malignant lesions. Thoracotomy confirmed 4 patients with malignat lesions against benign result of PCNA and 2 patients with benign lesions against malignant result of PCNA. There are 1.0% (3 cases) of hemoptysis, 19.2% (55 cases) of blood tinged sputum, 12.5% (36 cases) of pneumothorax and 1.0% (3 cases) of fever through 287 times of PCNA. Hemoptysis and blood tinged sputum didn't need therapy. 8 cases of pneumothorax needed insertion of classical chest tube or pig-tail catheter. Fever subsided within 48 hours in all cases. There was no difference between size and shape of lesion with diagnostic yield. Conclusion: PCNA shows relatively high diagnostic yield and mild degree complications but the accuracy of histologic diagnosis has to be improved.

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Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule (고립성폐결절의 진단시 FDG-PET의 임상적 유용성에 관한 연구)

  • Cheon, Eun Mee;Kim, Byung-Tae;Kwon, O. Jung;Kim, Hojoong;Chung, Man Pyo;Rhee, Chong H.;Han, Yong Chol;Lee, Kyung Soo;Shim, Young Mog;Kim, Jhingook;Han, Jungho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.882-893
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    • 1996
  • Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

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A Study on Nutritional Intake Status and Health-related Behaviors of the Elderly People in Gyeongsan Area (경산시 노인의 영양섭취상태 및 건강관련인자에 관한 연구)

  • Yang, Kyung-Mi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.7
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    • pp.1018-1027
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    • 2005
  • The purpose of this study was to investigate nutrients intake and health-related behaviors in elderly people residing in Gyeongsan-si, Gyeongbuk who have no problem in daily living. Information on general characteristics of the elderly, health-related behaviors and dietary habits were obtained by interview based on questionnare. Dietary nutrients intake data were obtained through the 24 recall method. The subject group of this study was composed of 113 males and 112 females, the average age being $73.1\pm6.06$ years old. In health related factors, $76.9\%$ of subjects exercised regularly. The rates of alcohol drinking and smoking showed to be $38.2\%\;and\;22.2\%$, respectively. There were many elderly with neuralgia, hypertension, and gastrointestinal disease, especially female were worse. Average heights of the subjects were lower than the standard established in the Korean Recommended Dietary Allowances, and average weights were similar to the standards. The mean BMI and WHR were 24.8 (male 23.7, female 25.7) and 0.92 (male 0.92, female 0.89), respectively. Most of the subjects had a regular meal pattern comsuming three meals a day, and many elderly, especially more than $79.5\%$ of female, prepared the meals for themselves. Mean daily energy intakes and RDA percentage of energy intakes of the male and female subjects were estimated as 1426.9kcal $(79.3\%)$ and 1381.3 kcal $(86.3\%)$, respectively. Mean daily intakes of nutrients were estimatied as 48.1g for protein, 411.3mg for calcium, 8.05mg for iron, 541.8 R.E. for vitamin A, 0.84mg for vitamin $B_1$, and 0.79mg for vitamin $B_2$. Most nutrients except protein, clacium, iron and vitamin $B_2$ were consumed over $75\%$ of the RDA. Female elderly showed significant lower intakes (p<0.05) for most of the nutrients except calcium, phosphorus and vitamin ethan the elderly male.

Fatty Acid Composition of Achatina fucica Bowdich and Ampullarius insularus (식용달팽이와 왕우렁이의 지방산 조성)

  • Park, Il-Woong;Kim, Choong-Ki
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.21 no.1
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    • pp.36-42
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    • 1992
  • The lipid compositions of total lipid extracted from the flesh divided into albinic type and melanic type of culture shellfishes, i.e. Achatina fucica Bowdich, Ampullarius insularus were compared. Total lipid contents of shellfishes were $1.11{\sim}3.25%$, the levels were appeared higher in Ampullarius insularus than Achatina fucica Bowdich, and in albinic type than melanic type. It was found that the contents of neutral lipids $(31.79{\sim}40.60%)$ and phospholipids $(50.95{\sim}62.12%)$ were high, while that of glycolipids $(4.84{\sim}9.47%)$ were low. The major fatty acids in total lipid of each sample were $C_{18:2}(11.92{\sim}14.37%)$, $C_{18:1}(12.34{\sim}13.64%)$, $C_{20:4}(11.03{\sim}13.74%)$, $C_{16:0}(7.45{\sim}15.39%)$ and $C_{18:0}(7.34{\sim}11.80%)$ and additionally $C_{20:2}(9.62{\sim}10.19%)$ in Achatina fucica Bowdich, and the major fatty acid composition in total lipids of each sample showed no significant differences between albinic type and melanic type, respectively. Particularly the content of $C_{16:0}$ in total lipids was shown more abundant in Ampullarius insularus and that of $C_{18:0}$, C_{20:2}$ in Achatina fucica Bowdich. The content of polyene acids in total lipids occupied higher level in Achatina fucica Bowdich but $C_{22:6}$ was almost detected, and observed relatively higher amounts in Ampullarius insularus. The main fatty acids in neutral lipid of Achatina fucica Bowdich were $C_{18:2}(16.80{\sim}17.74%)$, $C_{20:2}(12.15{\sim}12.59%)$, $C_{18:1}(9.79{\sim}10.37%)$, $C_{18:0}(7.71{\sim}12.43%)$ and C_{16:0},\;C_{20:4}$ and additionally $C_{18:3} (20.90%)$ was shown predominant in melanic type and the level of polyene acid highest in neutral lipids. The neutral lipids in each type of Ampullarius insularus were mainly composed of $C_{16:0}(16.96{\sim}17.46%)$, $C_{18:1}(13.79{\sim}13.95%)$ and $C_{18:2} (12.90{\sim}15.70%)$ and additionally it chiefly consisted of $C_{18:1}$, $C_{20:4}$and$C_{22:6}$. The major fatty acids in each type of glycolipids were $C_{18:2}(19.01{\sim}19.72)$, $C_{16:0}(12.89{\sim}18.76%)$ and $C_{18:0}(12.68{\sim}17.52%)$ and additionally $C_{18:1}$ in Achatina fucica Bowdich, but $C_{22:1}$ was detected in relatively higher level by 6.95% in albinic type only. The major fatty acids in glycolipids were $C_{18:2}(12.46{\sim}18.21%)$, $C_{16:0}(10.43{\sim}18.48%)$, $C_{20:1}(10.51{\sim}14.59%)$, $C_{20:4}(8.24{\sim}12.34%)$ and additionally it chiefly consisted of $C_{18:0}\;and\;C_{18:1}$ in Ampullarius insularus. The fatty acid composition in phospholipids of each sample was very resembled to total lipids, respectively.

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A Study on the Preservation of Citrus Mandarin by Irradiation (방사선조사(放射線照射)에 의(依)한 감귤(柑橘) 저장(貯藏)에 관(關)한 연구(硏究))

  • Chung, Chang Cho;Kim, Jai Ha;Kim, Soo Hyun;Cho, Han Ok
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.12 no.2
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    • pp.116-121
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    • 1983
  • A study was conducted to evaluate the effect of $^{60}CO-{\gamma}$ irradiation on the preservation on Satauma mandarin in Cheju Island. Four varieties (S. m. early, S. m. Komezawa, S. m. Hayashi and S. m. Aoshima) were irradiated using 10,000Ci, $^{60}CO-{\gamma}$ ray with dosages of 0, 50, 100 and 150Krad. During 92 days of storage the effects of irradiation on mandarin porperties were as follows: At the end of storage period the accumulated fruit rotting percentage were S. m. Komezawa($T_2$);74.32%, S. m. early($T_1$);69.67%, S. m. Aoshima($T_4$);64.33% and S. m. Hayashi ($T_3$);61.79%. The rottings steadily increased from the early stage of storage and rapid spoilage continued after 59 days of irradiation. A high corelation existed between fruit rotting and varieties ($T_3$;Y=0.78x-15.30, $T_4$;Y=0.79x-12.29, $T_1$;Y=0.93x-9.01 and $T_2$;Y=0.79x-13.49) High dosages(100 and 150 Krad)improved fruit preservation during the mid storage stage. However 76 days after high dose irradiation there was no significant difference a rotting between irradiated fruit and the control. Irradiation decreased acidity of fruit during storage (p<0.01). The mean acidities of examined varieties were $T_1$;1.01%, $T_3$;1.01%, $T_4$;0.84% and $T_2$;0.77%. A significant differences were observed in acidity between varieties and dosages(P<0.01) With one exception in all treatments. the increase in free and total sugar content was not statestically significant. The exception was the 50 Krad treatment where the total sugar content decreased. $T_1$ and $T_4$ showed slightly higher value of than Brix $T_2$ and $T_3$, and were significantly(P<0.01) decreased by higher dosage. The ascorbic acid content in all treatments decreased with length of storage and also decreased significantly with a higher dosage.

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Effects of Molecular Weight of Polyethylene Glycol on the Dimensional Stabilization of Wood (Polyethylene Glycol의 분자량(分子量)이 목재(木材)의 치수 안정화(安定化)에 미치는 영향(影響))

  • Cheon, Cheol;Oh, Joung Soo
    • Journal of Korean Society of Forest Science
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    • v.71 no.1
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    • pp.14-21
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    • 1985
  • This study was carried out in order to prevent the devaluation of wood itself and wood products causing by anisotropy, hygroscopicity, shrinkage and swelling - properties that wood itself only have, in order to improve utility of wood, by emphasizing the natural beautiful figures of wood, to develop the dimensional stabilization techniques of wood with PEG that it is a cheap, non-toxic and the impregnation treatment is not difficult, on the effects of PEG molecular weights (200, 400, 600, 1000, 1500, 2000, 4000, 6000) and species (Pinus densiflora S. et Z., Larix leptolepis Gordon., Cryptomeria japonica D. Don., Cornus controversa Hemsl., Quercus variabilis Blume., Prunus sargentii Rehder.). The results were as follows; 1) PEG loading showed the maximum value (137.22%, Pinus densiflora, in PEG 400), the others showed that relatively slow decrease. The lower specific gravity, the more polymer loading. 2) Bulking coefficient didn't particularly show the correlation with specific gravity, for the most part, indicated the maximum values in PEG 600, except that the bulking coefficient of Quercus variabilis distributed between the range of 12-18% in PEG 400-2000. In general, the bulking coefficient of hardwood was higher than that of softwood. 3) Although there was more or less an exception according to species, volumetric swelling reduction was the greatest in PEG 400. That is, its value of Cryptomeria japonica was the greatest value with 95.0%, the others indicated more than 80% except for Prunus sargentii, while volumetric swelling reduction was decreased less than 70% as the molecular weight increase more than 1000. 4) The relative effectiveness of hardwood with high specific gravity was outstandingly higher than softwood. In general, the relative effectiveness of low molecular weight PEG was superior to those of high molecular weight PEG except that Quercus variabilis showed more than 1.6 to the total molecular weight range, while it was no significant difference as the molecular weight increase more than 4000. 5) According to the analysis of the results mentioned above, the dimensional stabilization of hardwood was more effective than softwood. Although volumetric swelling reduction was the greatest at a molecular weight of 400. In the view of polymer loading, bulking coefficiency reduction of swelling and relative effectiveness, it is desirable to use the mixture of PEG of molecular weight in the range of 200-1500. To practical use, it is recommended to study about the effects on the mixed ratio on the bulking coefficient, reduction of swelling and relative effectiveness.

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Electronic Word-of-Mouth in B2C Virtual Communities: An Empirical Study from CTrip.com (B2C허의사구중적전자구비(B2C虚拟社区中的电子口碑): 관우휴정려유망적실증연구(关于携程旅游网的实证研究))

  • Li, Guoxin;Elliot, Statia;Choi, Chris
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.262-268
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    • 2010
  • Virtual communities (VCs) have developed rapidly, with more and more people participating in them to exchange information and opinions. A virtual community is a group of people who may or may not meet one another face to face, and who exchange words and ideas through the mediation of computer bulletin boards and networks. A business-to-consumer virtual community (B2CVC) is a commercial group that creates a trustworthy environment intended to motivate consumers to be more willing to buy from an online store. B2CVCs create a social atmosphere through information contribution such as recommendations, reviews, and ratings of buyers and sellers. Although the importance of B2CVCs has been recognized, few studies have been conducted to examine members' word-of-mouth behavior within these communities. This study proposes a model of involvement, statistics, trust, "stickiness," and word-of-mouth in a B2CVC and explores the relationships among these elements based on empirical data. The objectives are threefold: (i) to empirically test a B2CVC model that integrates measures of beliefs, attitudes, and behaviors; (ii) to better understand the nature of these relationships, specifically through word-of-mouth as a measure of revenue generation; and (iii) to better understand the role of stickiness of B2CVC in CRM marketing. The model incorporates three key elements concerning community members: (i) their beliefs, measured in terms of their involvement assessment; (ii) their attitudes, measured in terms of their satisfaction and trust; and, (iii) their behavior, measured in terms of site stickiness and their word-of-mouth. Involvement is considered the motivation for consumers to participate in a virtual community. For B2CVC members, information searching and posting have been proposed as the main purpose for their involvement. Satisfaction has been reviewed as an important indicator of a member's overall community evaluation, and conceptualized by different levels of member interactions with their VC. The formation and expansion of a VC depends on the willingness of members to share information and services. Researchers have found that trust is a core component facilitating the anonymous interaction in VCs and e-commerce, and therefore trust-building in VCs has been a common research topic. It is clear that the success of a B2CVC depends on the stickiness of its members to enhance purchasing potential. Opinions communicated and information exchanged between members may represent a type of written word-of-mouth. Therefore, word-of-mouth is one of the primary factors driving the diffusion of B2CVCs across the Internet. Figure 1 presents the research model and hypotheses. The model was tested through the implementation of an online survey of CTrip Travel VC members. A total of 243 collected questionnaires was reduced to 204 usable questionnaires through an empirical process of data cleaning. The study's hypotheses examined the extent to which involvement, satisfaction, and trust influence B2CVC stickiness and members' word-of-mouth. Structural Equation Modeling tested the hypotheses in the analysis, and the structural model fit indices were within accepted thresholds: ${\chi}^2^$/df was 2.76, NFI was .904, IFI was .931, CFI was .930, and RMSEA was .017. Results indicated that involvement has a significant influence on satisfaction (p<0.001, ${\beta}$=0.809). The proportion of variance in satisfaction explained by members' involvement was over half (adjusted $R^2$=0.654), reflecting a strong association. The effect of involvement on trust was also statistically significant (p<0.001, ${\beta}$=0.751), with 57 percent of the variance in trust explained by involvement (adjusted $R^2$=0.563). When the construct "stickiness" was treated as a dependent variable, the proportion of variance explained by the variables of trust and satisfaction was relatively low (adjusted $R^2$=0.331). Satisfaction did have a significant influence on stickiness, with ${\beta}$=0.514. However, unexpectedly, the influence of trust was not even significant (p=0.231, t=1.197), rejecting that proposed hypothesis. The importance of stickiness in the model was more significant because of its effect on e-WOM with ${\beta}$=0.920 (p<0.001). Here, the measures of Stickiness explain over eighty of the variance in e-WOM (Adjusted $R^2$=0.846). Overall, the results of the study supported the hypothesized relationships between members' involvement in a B2CVC and their satisfaction with and trust of it. However, trust, as a traditional measure in behavioral models, has no significant influence on stickiness in the B2CVC environment. This study contributes to the growing body of literature on B2CVCs, specifically addressing gaps in the academic research by integrating measures of beliefs, attitudes, and behaviors in one model. The results provide additional insights to behavioral factors in a B2CVC environment, helping to sort out relationships between traditional measures and relatively new measures. For practitioners, the identification of factors, such as member involvement, that strongly influence B2CVC member satisfaction can help focus technological resources in key areas. Global e-marketers can develop marketing strategies directly targeting B2CVC members. In the global tourism business, they can target Chinese members of a B2CVC by providing special discounts for active community members or developing early adopter programs to encourage stickiness in the community. Future studies are called for, and more sophisticated modeling, to expand the measurement of B2CVC member behavior and to conduct experiments across industries, communities, and cultures.

A Study on the Various Attributes of E-Sport Influencing Flow and Identification (e-스포츠의 다양한 속성이 유동(flow)과 동일시에 미치는 영향에 관한 연구)

  • Suh, Mun-Shik;Ahn, Jin-Woo;Kim, Eun-Young;Um, Seong-Won
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.59-80
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    • 2008
  • Recently, e-sports are growing with potentiality as a new industry with conspicuous profit model. But studies that dealing with e-sports are not enough. Hence, proposes of this paper are both to establish basic model that is for the design of e-sport marketing strategy and to contribute toward future studies which are related to e-sports. Recently, the researches to explain sports-sponsorship through the identification theory have been discovered. Many researches say that somewhat proper identification is a requirement for most sponsors to improve the their images which is essential to sponsorship activity. Consequently, the research for sponsorship associated with identification in the e-sports, not in the physical sports is the core sector of this study. We extracted the variables from online's major characteristics and existing sport sponsorship researches. First, because e-sports mean the tournaments or leagues in the use of online game, the main event of the game is likely to call it online game. Online media's attributes are distinguished from those of offline. Especially, interactivity, anonymity, and expandibility as a e-sport game attributes are able to be mentioned. So, these inherent online attributes are examined on the relationship with flow. Second, in physical sports games, Fisher(1998) revealed that team similarity and team attractivity were positively related to team identification. Wann(1996) said that the result of former game influenced the evaluation of the next game, then in turn has an effect on the identification of team supporters. Considering these results in the e-sports side, e-sports gamer' attractivity, similarity, and match result seem to be important precedent variables of the identification with a gamer. So, these e-sport gamer attributes are examined on the relationship with both flow and identification with a gamer. Csikszentmihalyi(1988) defined the term flow as feeling status for him to be making current positive experience optimally. Hoffman and Novak(1996) also said that if a user experienced the flow he would visit a website without any reward. Therefore flow might be positively associated with user's identification with a gamer. And, Swanson(2003) disclosed that team identification influenced the positive results of sponsorship, which included attitude toward sponsors, sponsor patronage, and satisfaction with sponsors. That is, identification with a gamer expect to be connected with corporation identification significantly. According to the above, we can design the following research model. All variables used in this study(interactivity, anonymity, expandibility, attractivity, similarity, match result, flow, identification with a gamer, and identification with a sponsor) definitely were defined operationally underlying precedent researches. Sample collection was carried out to the person who has an experience to have enjoyed e-sports during June 2006. Much portion of samples is men because much more men than women enjoy e-sports in general. Two-step approach was used to test the hypotheses. First, confirmatory factor analysis was committed to guarantee the validity and reliability of variables. The results showed that all variables had not only intensive and discriminant validity, but also reliability. Then, research model was examined with fully structural equation using LISREL 8.3 version. The fitness of the suggested model mostly was at the acceptable level. Shortly speaking about the results, first of all, in e-sports game attributes, only interactivity which is called a basic feature in online situation affected flow positively. Secondly, in e-sports gamer's attributes, similarity with a gamer and match result influenced flow positively, but there was no significant effect in the relationship between the attractivity of a gamer and flow. And as expected, similarity had an effect on identification with a gamer significantly. But unexpectedly attractivity and match result did not influence identification with a gamer significantly. Just the same as the fact verified in the many precedent researches, flow greatly influenced identification with a gamer, and identification with a gamer continually had an influence on the identification with a sponsor significantly. There are some implications in these results. If the sponsor of e-sports supports the pro-game player who absolutely should have the superior ability to others and is similar to the user enjoying e-sports, many amateur gamers will feel much of the flow and identification with a pro-gamer, and then after all, feel the identification with a sponsor. Such identification with a sponsor leads people enjoying e-sports to have purchasing intention for products produced by the sponsor and to make a positive word-of-mouth for those products or the sponsor. For the future studies, we recommend a few ideas. Based on the results of this study, it is necessary to find new variables relating to the e-sports, which is not mentioned in this study. For this work to be possible, qualitative research seems to be needed to consider the inherent e-sport attributes. Finally, to generalize the results related to e-sports, a wide range of generations not a specific generation should be researched.

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