• 제목/요약/키워드: Painful experience

검색결과 107건 처리시간 0.025초

Baxter $Infusor^{(R)}$를 이용한 경막외 진통제 지속 주입 (Clinical Experience of Continuous Epidural Analgesia Using Baxter $Infusor^{(R)}$)

  • 배상철;이장원;김일호;송후빈;박욱;김성열
    • The Korean Journal of Pain
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    • 제4권2호
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    • pp.127-132
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    • 1991
  • Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

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효율적인 돌발성 암 통증 관리를 위한 자가 진단 알고리즘 설계 (The Design of the Self-diagnosis Algorithm for the Efficient Control of Sudden Cancer Pain)

  • 정은영;은성종;정병희;이용준;박동균
    • 한국콘텐츠학회논문지
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    • 제14권5호
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    • pp.458-467
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    • 2014
  • 통증은 암 환자들이 겪는 가장 흔하며 고통스러운 증상중의 하나이며, 암의 진단 초기에 있거나 적극적인 항암 치료를 받고 있는 환자의 30~50%, 진행성인 경우에는 약 60~70%, 말기의 경우에는 80~90% 정도가 통증으로 고통 받고 있는 것으로 알려져 있다. 그러나 이러한 암 환자들에게 있어 체계적이고 사용하기 쉬운 통증 관리 프로그램이 없어 이에 대한 필요성이 요구되고 있다. 본 논문은 암 수술 생존자 및 퇴원 환자가 겪는 통증의 관리에 있어 돌발성 통증 발생 시 신속히 통증을 완화할 수 있는 서비스를 위한 암 통증 자가 관리 알고리즘을 제안한다. 제안 알고리즘은 타당한 가이드라인 정립을 위해 조사지와 평가지, 그리고 NCCN(National Comprehensive Cancer Network) 가이드라인을 참조하였으며, 설계된 알고리즘의 평가를 위해 20명의 암 환자 실험군을 대상으로 한 달간 시범 서비스를 수행하였다. 제안 알고리즘을 평가하기 위하여 시범 서비스 결과를 전문 의료진을 통해 검토한 결과, 90%의 적합성 판단을 도출하여 제안 알고리즘의 실효성을 검증하였다. 의료 전문의 결과 부적합 판단의 경우 통증 일기의 관리에서 적합한 결과를 도출하지 못했으며 이에 대한 향후 연구로 사용자 맞춤형의 통증 일기 알고리즘을 추가로 연구하고자 한다.

관절경을 이용한 주관절 활막 추벽의 제거 (Arthroscopic Resection of Synovial Plica in Elbow)

  • 유연식
    • Clinics in Shoulder and Elbow
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    • 제10권1호
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    • pp.50-58
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    • 2007
  • 목적: 주관절의 후외측 동통과 탄발음을 유발할 수 있는 주관절의 활막추벽 9예에 대한 관절경적 경험과 해부학적 특징을 보고하고자 하였다. 대상 및 방법: 1999년 5월부터 2004년 1월까지 주관절 관절경을 받은 43명의 환자 중 활막추벽으로 진단되었거나 제거 받은 12개월 이상 추시가 가능했던 8명의 환자 9예를 대상으로 조사하였다. 양측 성을 보인 1명 2예를 포함한 남자가 8예 여자가 1예이었고 평균 연령은 29세 이었다. 모든 환자는 수술 전까지 최소 6개월의 보존적 치료를 받았으며 술 전 활막 추벽이라고 진단했던 경우가 6예, 외상과 염으로 진단했거나 진단이 처음부터 불분명하여 수술 중에 발견했던 경우가 3예이었다. 수술 직 후 관절경 소견으로 추벽의 형태를 분류하였고 최종 추시시점에서 통증 및 탄발음 소실 여부와 함께 Visual Analogue Scale (VAS)의 변화와 환자의 만족도를 조사였다. 결과: 관절경 소견상 전 예에서 외측 활막 추벽과 함께 전 외측에서 국한된 국소적 활막염의 소견이 관찰되었으며 7예에서 요골 두의 연골 연화증 또는 미란 소견을 보였다. 그러나 소두변화는 1예에서만 보였다. 2예를 제외한 7예에서 수술 직후부터 통증과 탄발음이 소실 또는 완화되었으며(VAS<1) 최종 추시 상에의 통증지수는 평균 6.8 에서 0.9로 감소하였다. 그 중 미약한 탄발음이 지속되었던 1예는 불완전한 제거로 판단하여 재수술을 시행하였다. 결론: 주관절의 활막 추벽은 주관절의 잠김 또는 외측 동통을 일으키는 주 진단범주에 포함시켜야할 것이며 특히 오랫동안 지속된 저항성 외 상과염이라면 활막 추벽을 고려해 봐야 할 것이다. 관절경을 통한 추벽의 제거는 매우 안전하고 효과적이었으며 단기 추시에서 매우 우수한 결과를 보였다.

가토 편측 악관절원판 제거 후 하악 과두 변화에 관한 실험적 연구 (THE EXPERIMENTAL STUDY ON THE CHANGES OF CONDYLAR HEAD FOLLOWING UNILATERAL DISCECTOMY IN RABBIT)

  • 박광진;김경욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.758-770
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    • 1996
  • Discectomy is the oldest and most commonly performed operation for the painful temporomandibular joint with internal derangement. It is the one operation for which there are longest follow-up study, with Eriksson, Silver, and Tolvanen et al reporting good results in patients about 30 years after discectomy. About 80% to 90% of patients clinically experience relief from pain and dysfunction after discectomy, and interestingly, the results may improve with time. However such as Myrhaug found headache and Poswillo supposed pain and limitation of movement as postoperative complications, even though this operation had the longest follow-up term, several aspects of discectomy remain unclear. The controversies to discectomy for TMJ with pain and dysfunction have laid emphasis only upon clinical results, and then the histomorphological study was planned to evaluate the morphologic change of TMJ after discectomy. To clarify the nature of the change through an observation on the morphologic changes of articular cartilage and subchondral bone of the condyle resulting from experimental unilateral discectomy in rabbit, the author excised the left articular discs of 12 male rabbits(control 4 rabbits), weighing about 3kg, and at 1, 3, 6, 9 weeks following surgery, harvested both(left surgical site and right nonsurgical sits) TMJ. The specimens were examined with light microscope after H-E and MT stain and the obtained results were as follows. 1. Histopathological features showed thickening of articular zone and active proliferation of fibrocartilaginous zone associated with slight proliferative zone in surgical site than control group. Also replacement of chondrocytes in calcified cartilaginous zone into bone cells was observed. 2. There were thinning of thickness of each zone of articular cartilage except calcified cartilagnous zone was observed in nonsurgical site. 3. In MT stain of condylar trabeculae, there was increased calcification in nonsurgical site than control and surgical site and the degree of calcification was similar in surgical site and control group. 4. In both site of experimental group no features of degenerative changes were observed. From the above results, it is presumed that the morphologic changes of surgical site discectomy are compensatory remodeling process characterized by an hyperplastic reaction of the articular zone and fibrocartilaginous zone filling the void created by removing the disc, and the bone changes are secondary to changes in the cartilage. Increased degree of calcification seen in condylar trabeculae of nonsurgical site results from the excessive use of condyle of that site.

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보툴리눔 톡신을 이용한 구강하악 근긴장이상증의 치료 증례 (Case Report : Botulinum Toxin Treatment in Oromandibular Dystonia)

  • 유지원;홍성주;배국진;윤창륙;안종모
    • Journal of Oral Medicine and Pain
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    • 제34권4호
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    • pp.421-427
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    • 2009
  • 구강하악 근긴장이상증(oromandibular dystonia)은 국소적인 근긴장이상증의 한 형태로, 저작근, 안면근 또는 혀 근육의 지속적이고 반복적인 근경련이 발생하여 불수의적인 개구 및 폐구, 악골의 측방 및 후퇴운동이 나타나는 것으로 정의내릴 수 있다. 구강하악 근긴장이상증에 이환된 환자의 경우, 저작, 연하 및 발음을 하는데 불편감을 가지게 되고, 그 결과 하악 운동에 지장을 초래하게 된다. 현재까지는 근긴장이상증에 대한 병태생리가 뚜렷히 입증된 바가 없어, 원인에 관련한 치료는 이루어지지 않고 있는 상태이다. 약물요법, 행동요법, 외과적 처치 등 다양한 방법이 구강하악 근긴장이상증의 치료법으로 제시되고 있으나, 성공률이 그리 높은 편은 아니며, 많은 부작용을 초래할 수 있다. 최근 들어 근긴장이상증에 이환된 근육에 보툴리눔 톡신을 이용한 치료법이 주목을 받고 있는 추세이다. 본 증례를 통해 구강하악 근긴장이상증을 중심으로 한 구강안면 운동장애에 대하여 전반적으로 고찰을 시행하고 해당 질환에서의 보툴리눔 톡신 치료법에 대하여 알아보고자 한다.

사전연명의료의향서 작성 동기에 관한 연구 (A Study on the Motivation to Write Signing Advance Medical Directives)

  • 장경희;강경희;김두리;임효남;김광환
    • 한국산학기술학회논문지
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    • 제20권10호
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    • pp.243-249
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    • 2019
  • 본 연구의 목적은 호스피스 완화의료와 임종과정에 있는 환자에게 최선의 이익을 보장하고 자기결정을 존중하여 인간으로서의 존엄과 가치를 보호하기 위하여 S시 소재의 C 기독교 종교시설을 방문하여 사전연명의료의향서를 작성한 노인을 대상으로 사전연명의료의향서 작성의 동기를 알아보기 위해 시행되었다. 조사 기간은 2019년 7월 1일부터 10일간 진행하였다. 연구 결과 사전 연명의료 의향서 작성 동기에 관해 4개 주제와 8개의 하위주제가 도출되었다. 주제는 '자식들을 위해서', '고통스러울 것 같아서', '내 삶을 잘 정리하고 싶어서', '필요성을 느껴서' 등의 4가지 주제가 도출되었으며, 하부주제로 '자식들 고생시키고 싶지 않아서', '자식들에게 의료비 부담주고 싶지 않아서', '고통에 대한 두려움이 있어서', '고통스러워하는 가족의 임종을 돌본 경험이 있어서', '편안한 마음을 위해서', '자기결정권의 중요성을 느껴서', '그전부터 알고는 있었지만 이번에 결심하게 되어서', '정보를 처음 알게 되었는데 결심하게 되어서'였다. 본 연구결과는 노인들의 좋은 죽음을 위한 웰다잉 교육 프로그램 개선과 사전연명의료의향서 작성을 위한 효과적 제도를 보완하기 위한 기초자료가 될 수 있다는 점에서 의의가 있다.

Photobiomodulation and Miescher's cheilitis granulomatosa: case report

  • Porrini, Massimo;Garagiola, Umberto;Rossi, Margherita;Bosotti, Moreno;Marino, Sonia;Gianni, Aldo Bruno;Runza, Letterio;Spadari, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.35.1-35.6
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    • 2020
  • Background: Miescher's cheilitis granulomatosa (MCG) is a rare chronic inflammatory disease and is known as the monosymptomatic clinical form of Melkersson-Rosenthal syndrome (MRS). It is characterised by swelling of one or both lips and more frequently affects the upper lip. Histopathological findings show the presence of numerous inflammatory infiltrates and granuloma formations. Pharmacological treatments and surgery have provided results that are positive yet insufficiently stable in the long term. The clinical case described is of a 68-year-old female patient with a diagnosis of MCG of the upper lip. Case presentation: The patient was diagnosed and treated at the Oral Medicine and Oral Pathology outpatient clinic of Maxillofacial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico. The patient was recommended localised treatments of photobiomodulation (PBM) using a diode laser with a 635 nm and 980 nm dual-wavelength (λ) approach, a 600-micron fibre, and a handpiece with a 1-cm-diameter lens at 300 mW. Three treatments a week were administered for four weeks for a total of 12 treatment sessions (T1-T12). After that, the patient had a long follow-up period of about 2 years. The therapeutic results were clear from the initial stages of treatment. There was an immediate, gradual, and consistent reduction in labial swelling. A reduction in the size of the lip by about 35% at T10-T12 was observed, returning the size and volume of the upper lip within the normal clinical range. The painful symptoms subsided after the seventh treatment (T7). The histopathological check at 3 months and the follow-up in particular confirmed the disease was in remission with satisfactorily stable treatment results. Moreover, the patient did not use any other treatments on the area from the early laser treatments through to the end of the follow-up period. Conclusions: Our experience describes a clinical case of MCG treated with PBM and effectively resolved with a reduction of the lip swelling. The real success of the treatment emerged over time, showing that the tissue healing was stable. In absence of any collateral phenomena, this confirms the effective and documented therapeutic potential of PBM for chronic inflammatory infiltrates.

대순진리회 고통론의 유형화와 특징 (A Study on the Classification and Characteristic of Sufferings in Daesoonjinrihoe)

  • 차선근
    • 대순사상논총
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    • 제25_2집
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    • pp.1-43
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    • 2015
  • Daesoonjinrihoe perceives that human suffering is caused not only by mental factors but also by the cosmic principle of Mutual Overcoming more fundamentally. The relationship influenced among all things in the universe is Mutual Beneficence and Mutual Overcoming. If these relations are properly cooperated in harmony, all things will reveal their energetic existence in a balanced state, however, if one side, particularly, Mutual Overcoming becomes excessive, indeed, it will cause trouble. That is, the sentient beings that are inclined to excessive Mutual Overcoming rather than indispensable Mutual Overcoming make grievances among themselves and cumulate them. In the end, heaven and earth lose its constant Way[常道], leading the sentient beings to all kinds of agonies. However, it may be a problem if every agony is depicted with Mutual Overcoming, that is, one single fixed frame, because Mutual Overcoming has to be interpreted diversely according to the circumstances. Thus, it is not possible to explain precisely about the agony if not understanding its spectrum. This study analyzed the ways how Daesoonjinrihoe explains the aspects of reasons and solutions to a variety of agonies. In the Supreme Scripture of Daesoonjinrihoe, the reasons for agony vary: first, it is caused by Mutual Overcoming of the cosmos itself, which is irrelevant to human beings. Secondly, man can be victimized because of Mutual Overcoming caused by man. Thirdly, there is a case of a victim who is damaged due to Mutual Overcoming caused by the other. Fourthly, man can be victimized because of Mutual Overcoming caused by someone else's unintended deeds. Fifthly, there is a case of man having agony in return when he, as a perpetrator, hurt others or resolve his inappropriate desires. Sixthly, man's deed unintendedly became a sin and have agony in return. Seventhly, man can be a self-perpetrator, conceiving vain desire, obsession and grievance. Eightly, there is a case of man having agony during enforcement of the law or practice of justice. Ninthly, man needs to endure agony during self-cultivation, enacting Reordering of the Universe(天地公事), ritual practice, promotion of fortune, and test. However, it is important to make sure that the reason for agony can interact with not only one but also diverse models in real situation. These nine models are included in the category of Mutual Overcoming; but, these cannot be classified in a single term, Mutual Overcoming because much information will be hidden, only to make it difficult to explain about agony more precisely. There are some characteristic observed in the concept of agony in Daesoonjinrihoe as follows: first, reasons for agony are caused by Mutual Overcoming although Mutual Overcoming can be interpreted differently according to the circumstances. Secondly, Daesoonjinrihoe makes a positive valuation for some agony. Thirdly, the solution to overcome a agony is brought to a conclusion, that is cultivation practice of Daesoonjinrihoe. Fourthly, the experience of agony and solution in Daesoonjinrihoe sometimes lie in the unit of family beyond individual. Fifthly, in the painful situation resulted from vain desire and obsession, Daesoonjinrihoe suggests a solution called Mutual Beneficence. That is, it emphasizes not only self-control but also active practice of considering others.

그림형제 동화 '황금 새'의 분석심리학적 해석 (An Interpretation of "Golden Bird" from the Perspective of Analytical Psychology)

  • 박상학
    • 심성연구
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    • 제31권2호
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    • pp.177-214
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    • 2016
  • 그림형제가 수집한 민담 <황금 새>를 분석심리학적 관점에서 해석하였다. 민담의 제시부에 나타난 문제점은 왕과 아들 세 명의 치우친 남성적 구조 속에서 이 왕국은 여성성이 결핍되어 있다. 황금 사과의 상실은 균형을 이루기 위해 더욱 더 여성적 요소를 보충할 필요성을 느낀다. 가장 어리고 바보스러운 막내의 모험과 여행은 분석심리학에서 말하는 새로운 자아의 개성화 과정으로 볼 수 있다. 자아는 여행의 경과 중에 단계마다 새로운 왕국이라는 특정 집단의식의 지배에 사로잡히고 죽음의 위기에서 어려운 과제를 수행한 후에 해방되어 다음 단계로 나아간다. 이 과정은 성인화 과정으로 자아의 높아진 의식성의 회복 뒤에 여성성의 보충이라 하는 공주와의 결혼 즉 대극의 합일이 가능한 수준으로 발전할 수 있다. 여성성의 보충으로 보이는 새, 말, 공주는 독립되어 있는 것처럼 보이지만 그들은 서로 하나로 연결되어 있다. 이들을 만난 자아가 아직은 온전한 성공에 이른 것은 아니다. 집단 지배의식의 지시에 따라 출발하는 두 형들의 실패 뒤에 주관적 의식이 적극적으로 개입한 새로운 자아(막내)가 나섰다고는 하지만 아직도 페르소나의 구분과 버림은 쉽지 않은 난관이다. 반복된 고난에 이어 형들을 사형에 처한 다음에 즉 지적인 능력이 제물로 바쳐진 다음에 상위의 의식성을 획득하고 그의 아니마인 공주와 일차적 결혼을 한다. 대개의 이야기는 결혼으로 끝나지만 여기서는 다음 단계가 남아있다. 여우가 자신을 죽여 머리와 발을 잘라 달라는 간절한 부탁을 주인공이 마지못해 행하자 여우는 마법이 풀려 왕자가 된다. 여우가 공주의 오빠로 변신한 것은 동물이 인간화한 것으로 또 다른 의식화를 경험한다. 비로소 대극의 합일이 이루어지고, 신성한 결합이 전체성을 획득하고 즉 개성화의 완성을 이루게 된다.

쇼핑 가치 추구 성향에 따른 쇼핑 목표와 공유 의도 차이에 관한 연구 - 전자제품 구매고객을 중심으로 (Shopping Value, Shopping Goal and WOM - Focused on Electronic-goods Buyers)

  • 박경원;박주영
    • 마케팅과학연구
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    • 제19권2호
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    • pp.68-79
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    • 2009
  • The interplay between hedonic and utilitarian attributes has assumed special significance in recent years; it has been proposed that consumption offerings should be viewed as experiences that stimulate both cognitions and feelings rather than as mere products or services. This research builds on previous work on hedonic versus utilitarian benefits, regulatory focus theory, customer satisfaction to address two question: (1) Is the shopping goal at the point of purchase different from the shopping value? and (2) Is the customer loyalty after the use different from the shopping value and shopping goal? We surveyed 345 peoples those who have bought the electronic-goods within 6 months. This research dealt with the shopping value which is consisted of 2 types, hedonic and utilitarian. Those who pursue the hedonic shopping value may prefer the pleasure of purchasing experience to the product itself. They tend to prefer atmosphere, arousal of the shopping experience. Consistent with previous research, we use the term "hedonic" to refer to their aesthetic, experiential and enjoyment-related value. On the contrary, Those who pursue the utilitarian shopping value may prefer the reasonable buying. It may be more functional. Consistent with previous research, we use the term "utilitarian" to refer to the functional, instrumental, and practical value of consumption offerings. Holbrook(1999) notes that consumer value is an experience that results from the consumption of such benefits. In the context of cell phones for example, the phone's battery life and sound volume are utilitarian benefits, whereas aesthetic appeal from its shape and color are hedonic benefits. Likewise, in the case of a car, fuel economics and safety are utilitarian benefits whereas the sunroof and the luxurious interior are hedonic benefits. The shopping goals are consisted of the promotion focus goal and the prevention focus goal, based on the self-regulatory focus theory. The promotion focus is characterized into focusing ideal self because they are oriented to wishes and vision. The promotion focused individuals are tend to be more risk taking. They are more sensitive to hope and achievement. On the contrary, the prevention focused individuals are characterized into focusing the responsibilities because they are oriented to safety. The prevention focused individuals are tend to be more risk avoiding. We wanted to test the relation among the shopping value, shopping goal and customer loyalty. Customers show the positive or negative feelings comparing with the expectation level which customers have at the point of the purchase. If the result were bigger than the expectation, customers may feel positive feeling such as delight or satisfaction and they would want to share their feelings with other people. And they want to buy those products again in the future time. There is converging evidence that the types of goals consumers expect to be fulfilled by the utilitarian dimension of a product are different from those they seek from the hedonic dimension (Chernev 2004). Specifically, whereas consumers expect the fulfillment of product prevention goals on the utilitarian dimension, they expect the fulfillment of promotion goals on the hedonic dimension (Chernev 2004; Chitturi, Raghunathan, and Majahan 2007; Higgins 1997, 2001) According to the regulatory focus theory, prevention goals are those that ought to be met. Fulfillment of prevention goals in the context of product consumption eliminates or significantly reduces the probability of a painful experience, thus making consumers experience emotions that result from fulfillment of prevention goals such as confidence and securities. On the contrary, fulfillment of promotion goals are those that a person aspires to meet, such as "looking cool" or "being sophisticated." Fulfillment of promotion goals in the context of product consumption significantly increases the probability of a pleasurable experience, thus enabling consumers to experience emotions that result from the fulfillment of promotion goals. The proposed conceptual framework captures that the relationships among hedonic versus utilitarian shopping values and promotion versus prevention shopping goals respectively. An analysis of the consequence of the fulfillment and frustration of utilitarian and hedonic value is theoretically worthwhile. It is also substantively relevant because it helps predict post-consumption behavior such as the promotion versus prevention shopping goals orientation. Because our primary goal is to understand how the post consumption feelings influence the variable customer loyalty: word of mouth (Jacoby and Chestnut 1978). This research result is that the utilitarian shopping value gives the positive influence to both of the promotion and prevention goal. However the influence to the prevention goal is stronger. On the contrary, hedonic shopping value gives influence to the promotion focus goal only. Additionally, both of the promotion and prevention goal show the positive relation with customer loyalty. However, the positive relation with promotion goal and customer loyalty is much stronger. The promotion focus goal gives the influence to the customer loyalty. On the contrary, the prevention focus goal relates at the low level of relation with customer loyalty than that of the promotion goal. It could be explained that it is apt to get framed the compliment of people into 'gain-non gain' situation. As the result, for those who have the promotion focus are motivated to deliver their own feeling to other people eagerly. Conversely the prevention focused individual are more sensitive to the 'loss-non loss' situation. The research result is consistent with pre-existent researches. There is a conceptual parallel between necessities-needs-utilitarian benefits and luxuries-wants-hedonic benefits (Chernev 2004; Chitturi, Raghunathan and Majaha 2007; Higginns 1997; Kivetz and Simonson 2002b). In addition, Maslow's hierarchy of needs and the precedence principle contends luxuries-wants-hedonic benefits higher than necessities-needs-utilitarian benefits. Chitturi, Raghunathan and Majaha (2007) show that consumers are focused more on the utilitarian benefits than on the hedonic benefits of a product until their minimum expectation of fulfilling prevention goals are met. Furthermore, a utilitarian benefit is a promise of a certain level of functionality by the manufacturer or the retailer. When the promise is not fulfilled, customers blame the retailer and/or the manufacturer. When negative feelings are attributable to an entity, customers feel angry. However in the case of hedonic benefit, the customer, not the manufacturer, determines at the time of purchase whether the product is stylish and attractive. Under such circumstances, customers are more likely to blame themselves than the manufacturer if their friends do not find the product stylish and attractive. Therefore, not meeting minimum utilitarian expectations of functionality generates a much more intense negative feelings, such as anger than a less intense feeling such as disappointment or dissatisfactions. The additional multi group analysis of this research shows the same result. Those who are unsatisfactory customers who have the prevention focused goal shows higher relation with WOM, comparing with satisfactory customers. The research findings in this article could have significant implication for the personal selling fields to increase the effectiveness and the efficiency of the sales such that they can develop the sales presentation strategy for the customers. For those who are the hedonic customers may be apt to show more interest to the promotion goal. Therefore it may work to strengthen the design, style or new technology of the products to the hedonic customers. On the contrary for the utilitarian customers, it may work to strengthen the price competitiveness. On the basis of the result from our studies, we demonstrated a correspondence among hedonic versus utilitarian and promotion versus prevention goal, WOM. Similarly, we also found evidence of the moderator effects of satisfaction after use, between the prevention goal and WOM. Even though the prevention goal has the low level of relation to WOM, those who are not satisfied show higher relation to WOM. The relation between the prevention goal and WOM is significantly different according to the satisfaction versus unsatisfaction. In addition, improving the promotion emotions of cheerfulness and excitement and the prevention emotion of confidence and security will further improve customer loyalty. A related potential further research could be to examine whether hedonic versus utilitarian, promotion versus prevention goals improve customer loyalty for services as well. Under the budget and time constraints, designers and managers are often compelling to choose among various attributes. If there is no budget or time constraints, perhaps the best solution is to maximize both hedonic and utilitarian dimension of benefits. However, they have to make trad-off process between various attributes. For the designers and managers have to keep in mind that without hedonic benefit satisfaction of the product it may hard to lead the customers to the customer loyalty.

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