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A Inquiry of the Perception of Death in School Age (학령기 아동의 죽음인식에 관한 탐색적 연구)

  • Joun, Young-Ran
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.13-28
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    • 2008
  • Purpose: This paper aims to examine the subjective structures and types of school age children's perception of death through an investigative study on their perception of death in order to provide a basic material for them to understand death, and develop and carry out an effective death education program. Methods: The study method used the Q Methodology which can investigate the subjective structures and types of school age children's perception of death. For Q-population, 20 school age children were used as subjects for neutral interviews and open surveys, and through documentary research, a total of 132 statements were collected, For Q-samples, 23 statements (Q-samples) were derived through a non-structural method. P-samples were 31 school age children (8-13 year olds), Q-sorting was carried out using Q-cards, and the collected data was analyzed using the PC QUANL program. Results: As a result of the study, children's perception of death was divided into five types. The first type was functional type, characterized by prominent subjective perception regarding the elements of death, such as non-reversibility, universality, non-functionality, and causality. The second was after-life type, characterized by a strong, focus on life after death in one's perception of death, and it included children with Christian background and those who had experienced death in their immediate family. The third was religious type, characterized by a strong belief in being able to still watch over one's family and friends after one's death, resulting in a positive faith in the after-life. The fourth was fearful type, characterized by a deeper fear of death in comparison to other types. The fifth was realistic type, characterized by a strong and positive assent to the perception of good death. Conclusion: The significance of the results of this paper's study to Nursing is as follows. In terms of understanding the subjectivity of school age children's perception of death in nursing practice, and understanding the compositional elements of death presented with strong emphasis in existing literature and studies, the results will expand these understandings and allow us to understand the level of perception in school age children regarding the definition of death, after-life, and good death, be utilized as useful material in developing an effective death education program for them according to their type characteristics, and become the fertilizer for enabling the children to live a proper life and preventing the tendency to make light of death that occur in adolescence and the spread of suicides. In terms of nursing theory, the description and examination of the subjective structures and the characteristics of the different, types of school age children's perception of death can be utilized as useful material for building a model of school age children's perception of death, and be further used for teaching respect for life. In terms of nursing research, the results can contribute to research describing the effects of nursing intervention strategies and developing tools for providing psychosocial nursing in terms of giving school age children a positive perception of death according to their types as well respect for life.

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Optimization of DME Reforming using Steam Plasma (수증기 플라즈마를 이용한 DME 개질의 최적화 방안 연구)

  • Jung, Kyeongsoo;Chae, U-Ri;Chae, Ho Keun;Chung, Myeong-Sug;Lee, Joo-Yeoun
    • Journal of Korea Society of Industrial Information Systems
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    • v.24 no.5
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    • pp.9-16
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    • 2019
  • In today's global energy market, the importance of green energy is emerging. Hydrogen energy is the future clean energy source and one of the pollution-free energy sources. In particular, the fuel cell method using hydrogen enhances the flexibility of renewable energy and enables energy storage and conversion for a long time. Therefore, it is considered to be a solution that can solve environmental problems caused by the use of fossil resources and energy problems caused by exhaustion of resources simultaneously. The purpose of this study is to efficiently produce hydrogen using plasma, and to study the optimization of DME reforming by checking the reforming reaction and yield according to temperature. The research method uses a 2.45 GHz electromagnetic plasma torch to produce hydrogen by reforming DME(Di Methyl Ether), a clean fuel. Gasification analysis was performed under low temperature conditions ($T3=1100^{\circ}C$), low temperature peroxygen conditions ($T3=1100^{\circ}C$), and high temperature conditions ($T3=1376^{\circ}C$). The low temperature gasification analysis showed that methane is generated due to unstable reforming reaction near $1100^{\circ}C$. The low temperature peroxygen gasification analysis showed less hydrogen but more carbon dioxide than the low temperature gasification analysis. Gasification analysis at high temperature indicated that methane was generated from about $1150^{\circ}C$, but it was not generated above $1200^{\circ}C$. In conclusion, the higher the temperature during the reforming reaction, the higher the proportion of hydrogen, but the higher the proportion of CO. However, it was confirmed that the problem of heat loss and reforming occurred due to the structural problem of the gasifier. In future developments, there is a need to reduce incomplete combustion by improving gasifiers to obtain high yields of hydrogen and to reduce the generation of gases such as carbon monoxide and methane. The optimization plan to produce hydrogen by steam plasma reforming of DME proposed in this study is expected to make a meaningful contribution to producing eco-friendly and renewable energy in the future.

Improvement of Fatigue Life with Local Reinforcement for Offshore Topside Module during Marine Transportation (해양플랫폼 탑사이드 모듈의 해상 운송 시 국부 보강을 통한 피로 수명 개선에 관한 연구)

  • Jang, Ho-Yun;Seo, Kwang-Cheol;Park, Joo-Shin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.27 no.2
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    • pp.387-393
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    • 2021
  • In this study, finite element analysis was performed to evaluate a method of increasing the fatigue life of the pipe connection structure commonly used in the topside structure of offshore platforms. MSC Patran/Nastran, a commercial analysis program, was used, and the critical structural model was selected from the global analysis. To realize the stress concentration phenomenon according to the load, modeling using 8-node solid elements was implemented. The main loads were considered to be two lateral loads and a tensile load on a diagonal pipe. To check the hotspot stress at the main location, a 0.01 mm dummy shell element was applied. After calculating the main stress at the 0.5-t and 1.5-t locations, the stress generated in the weld was estimated through extrapolation. In some sections, this stress was observed to be below the fatigue life that should be satisfied, and reinforcement was required. For reinforcement, a bracket was added to reduce the stress concentration factor where the fatigue life was insufficient without changing the thickness or diameter of the previously designed pipe. Regarding the tensile load, the stress in the bracket toe increased by 23 %, whereas the stress inside and outside of the pipe, which was a problem, decreased by approximately 8 %. Regarding the flexural load, the stress at the bracket toe increased by 3 %, whereas the stress inside and outside of the pipe, which was also a problem, decreased by approximately 48 %. Owing to the new bracket reinforcement, the stress in the bracket toe increased, but the S-N curve itself was better than that of the pipe joint, so it was not a significant problem. The improvement method of fatigue life is expected to be useful; it can efficiently increase the fatigue life while minimizing changes to the initial design.

A Study on Forming 'Body Schema' for Role Creating (역할 창조를 위한 '몸틀(body schema)' 형성 연구)

  • Song, Hyo-sook
    • Journal of Korean Theatre Studies Association
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    • no.52
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    • pp.319-357
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    • 2014
  • Formation of 'body schema' is the start for actor to create role and becomes the root and the foundation of existing as a role on the stage. For this, an actor needs to form 'scheme of role' with escaping from own 'body schema.' 'Schema of role' is formed by acquiring through synthesizing daily basic actions, namely, walking, standing, sitting, hand stretching, bending, and touching. The body schema, which was made with simple and usual actions, has fundamental significance in a sense of becoming the body in which the past traces in a role are habituated while energy as a role flows. As for the process of forming body schema, an actor first needs to obtain the visualized materials like photo, magazine, picture and image available for seeing a role specifically and clearly based on what analyzed a character. An actor needs to have three-dimensional image available for always recalling it in the head during acting. To do this, image data available for fundamentally capturing routine actions along with body structure are still more useful. Next, the body schema is formed by interaction with environment. Thus, there is a need of passing through the two-time process of forming body schema. Firstly, the body schema is made on routine actions in a role as physical condition of a role in actor's own everyday life. Secondly, the body schema is made on routine actions available for moving efficiently and economically in line with the environment of performance. A theatrical stage is the temporal space of rhythm and rule different from routine space. What forms body schema immediately in the second phase without body schema in the first phase ultimately becomes what exists as actor's own body, not the body of a role. The body schema, which was formed as the second process, is what truly has identity as a role in the ontological aspect, comes to experience the oppositional force in muscle, a qualitative change in energy, and emotional agitation in the physical aspect, and experiences perception, thinking, volition, and even consciousness with the entire body in the cognitive dimension. Thus, the formation of body schema can be known to be just a method of changing even spiritual and emotional layer. Body schema cannot be made if there is no process of embodiment and habit. Embodiment and habit are not simply the repeated, empty and mechanical action in the body. But, habit itself has very important meanings for forming body schema for role creating. First, habit allows the body itself to learn and understand a meaning. Second, habit relies upon environment, thereby allowing an actor of making the habituated body schema to recognize environment. Third, habit makes the mind. The habituated body schema is just the mind and the ego of a person who possesses the body schema. Fourth, habit comes to experience the expansion in energy and the expansion in existence. It may be experienced through interrelation among actor's body, tool, and environment. Fifth, habit makes identity of the body. Hence, this just becomes what secures identity of a role. These implications of habit are the formation of body schema, which is maintained with the body of being remembered firmly through being closely connected with the process of neural adaptation. Finally, it sought for possibility of practice as one method of forming body schema for role creating through Deleuze's '-becoming' theory. As 'actual animal-becoming' is real '-becoming' of forming structural transformation in the physical dimension, it meets with what the formation of body schema pursues actuality and reality. This was explained with a concept as saying of 'all '-becoming' molecular' by Deleuze/Guattari. 'Animal of having imitated animal's characteristic- becoming' is formed by which the body schema relies upon environment. In this way, relationship among the body, tool and environment has influence even upon a change in consciousness, thinking, and emotion, thereby being able to be useful for forming body schema in a sense of possibly experiencing ultimately expansion in role, namely, expansion in existence.

A Study on the Development Direction of Medical Image Information System Using Big Data and AI (빅데이터와 AI를 활용한 의료영상 정보 시스템 발전 방향에 대한 연구)

  • Yoo, Se Jong;Han, Seong Soo;Jeon, Mi-Hyang;Han, Man Seok
    • KIPS Transactions on Computer and Communication Systems
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    • v.11 no.9
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    • pp.317-322
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    • 2022
  • The rapid development of information technology is also bringing about many changes in the medical environment. In particular, it is leading the rapid change of medical image information systems using big data and artificial intelligence (AI). The prescription delivery system (OCS), which consists of an electronic medical record (EMR) and a medical image storage and transmission system (PACS), has rapidly changed the medical environment from analog to digital. When combined with multiple solutions, PACS represents a new direction for advancement in security, interoperability, efficiency and automation. Among them, the combination with artificial intelligence (AI) using big data that can improve the quality of images is actively progressing. In particular, AI PACS, a system that can assist in reading medical images using deep learning technology, was developed in cooperation with universities and industries and is being used in hospitals. As such, in line with the rapid changes in the medical image information system in the medical environment, structural changes in the medical market and changes in medical policies to cope with them are also necessary. On the other hand, medical image information is based on a digital medical image transmission device (DICOM) format method, and is divided into a tomographic volume image, a volume image, and a cross-sectional image, a two-dimensional image, according to a generation method. In addition, recently, many medical institutions are rushing to introduce the next-generation integrated medical information system by promoting smart hospital services. The next-generation integrated medical information system is built as a solution that integrates EMR, electronic consent, big data, AI, precision medicine, and interworking with external institutions. It aims to realize research. Korea's medical image information system is at a world-class level thanks to advanced IT technology and government policies. In particular, the PACS solution is the only field exporting medical information technology to the world. In this study, along with the analysis of the medical image information system using big data, the current trend was grasped based on the historical background of the introduction of the medical image information system in Korea, and the future development direction was predicted. In the future, based on DICOM big data accumulated over 20 years, we plan to conduct research that can increase the image read rate by using AI and deep learning algorithms.

Development and Experimental Performance Evaluation of Steel Composite Girder by Turn Over Process (단면회전방법을 적용한 강합성 소수주거더 개발 및 실험적 성능 평가)

  • Kim, Sung Jae;Yi, Na Hyun;Kim, Sung Bae;Kim, Jang-Ho Jay
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.30 no.5A
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    • pp.407-415
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    • 2010
  • In Korea, more than 90% of the total number of steel bridges built for 40~70 m span length is a steel box-girder bridge type. A steel box-girder bridge is suitable for long span or curved bridges with outstanding flexural and torsional rigidity as well as good constructability and safety. However, a steel box-girder bridge is uneconomical, requiring many secondary members and workmanship such as stiffeners and ribs requiring welding attachments to flanges or webs. Therefore, in US and Japan, a plate girder bridge, which is relatively cheap and easy to construct is generally used. One type of the plate girder bridge is the two- or three-main girder plate bridge, which is a composite plate girder bridge that minimizes the number of required main girders by increasing the distance between the adjacent girders. Also, for the simplification of girder section, the stiffener which requires attachment to the web is not required. The two-main steel girder plate bridge is a representative type of plate girder bridges, which is suitable for bridges with 10 m effective width and has been developed in the early 1960s in France. To ensure greater safety of two- or three-main girder plate bridges, a larger steel section is used in the bridge domestically than in Europe or Japan. Also, the total number of two- or three-main girder plate bridge constructed in Korea is significantly less than the steel box girder bridge due to a lack of designers' familiarity with more complex design detailing of the bridge compare to that of a steel box girder bridge design. In this study, a new construction method called Turn Over method is proposed to minimize the steel section size used in a two- or three-main girder plate bridge by applying prestressing force to the member using confining concrete section's weight to reduce construction cost. Also, a full scale 20 m Turn Over girder specimen and a Turn Over girder bridge specimen were tested to evaluate constructability and structural safety of the members constructed using Turn Over process.

Effects of Storytelling in Advertising on Consumers' Empathy

  • Park, Myungjin;Lee, Doo-Hee
    • Asia Marketing Journal
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    • v.15 no.4
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    • pp.103-129
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    • 2014
  • Differentiated positioning becomes increasingly difficult when brand salience weakens. Also, the daily increase in new media use and information load has led to a social climate that regards advertising stimuli as spamming. For these reasons, the focus of advertisement-related communication is shifting from persuading consumers through the direct delivery of information to an emphasis on appealing to their emotions using matching stimuli to enhance persuasion effects. Recently, both academia and industry have increasingly shown an interest in storytelling methods that can generate positive emotional responses and attitude changes by arousing consumers' narrative processing. The purpose of storytelling is to elicit consumers' emotional experience to meet the objectives of advertisement producers. Therefore, the most important requirement for storytelling in advertising is that it evokes consumers' sympathy for the main character in the advertisement. This does not involve advertisements directly persuading consumers, but rather, consumers themselves finding an answer through the advertisement's story. Thus, consumers have an indirect experience regarding the product features and usage through empathy with the advertisement's main character. In this study, we took the results of a precedent study as the starting point, according to which consumers' emotional response can be altered depending on the storytelling methods adopted for storytelling ads. Previous studies have reported that drama-type and vignette-type storytelling methods have a considerably different impact on the emotional responses of advertising audiences, due to their different structural characteristics. Thus, this study aims to verify that emotional response aroused by different types of advertisement storytelling (drama ads vs. vignette ads) can be controlled by the socio-psychological gender difference of advertising audiences and that the interaction effects between the socio-psychological gender differences of the audience and the gender stereotype of emotions to which advertisements appeal can exert an influence on emotional responses to types of storytelling in advertising. To achieve this, an experiment was conducted employing a between-group design consisting of 2 (storytelling type: drama ads vs. vignette ads) × 2 (socio-psychological gender of the audience: masculinity vs. femininity) × 2 (advertising appeal emotion type: male stereotype emotion vs. female stereotype emotion). The experiment revealed that the femininity group displayed a strong and consistent empathy for drama ads regardless of whether the ads appealed to masculine or feminine emotions, whereas the masculinity group displayed a stronger empathy for drama ads appealing to the emotional types matching its own gender as well as for vignette ads. The theoretical contribution of this study is significant in that it sheds light on the controllability of the audiences' emotional responses to advertisement storytelling depending on their socio-psychological gender and gender stereotype of emotions appealed to through advertising. Specifically, its considerable practical contribution consists in easing unnecessary creative constraints by comprehensively analyzing essential advertising strategic factors such as the target consumers' gender and the objective of the advertisement, in contrast to the oversimplified view of previous studies that considered emotional responses to storytelling ads were determined by the different types of production techniques used. This study revealed that emotional response to advertisement storytelling varies depending on the target gender of and emotion type appealed to by the advertisement. This suggests that an understanding of the targeted gender is necessary prior to producing an advertisement and that in deciding on an advertisement storytelling type, strategic attention should be directed to the advertisement's appeal concept or emotion type. Thus, it is safe to use drama-type storytelling that expresses masculine emotions (ex. fun, happy, encouraged) when the advertisement target, like Bacchus, includes both men and women. For brands and advertisements targeting only women (ex. female clothes), it is more effective to use a drama-type storytelling method that expresses feminine emotions (lovely, romantic, sad). The drama method can be still more effective than the vignette when women are the main target and a masculine concept-based creative is to be produced. However, when male consumers are targeted and the brand concept or advertisement concept is focused on feminine emotions (ex. romantic), vignette ads can more effectively induce empathy than drama ads.

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Factors Influencing the Social and Economic Performance of High-Tech Social Ventures (하이테크 소셜벤처의 사회적·경제적성과에 미치는 영향요인)

  • Kim, Hyeong Min;Kim, Jin Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.1
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    • pp.121-137
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    • 2022
  • The purpose of this study is to present the necessary success factors and strategies for high-tech social ventures and stakeholders in the related ecosystem by empirically identifying factors that affect their sustainable performance. Based on prior research, the dimensions of three performance factors were presented: core technology competency, core business competency, and social mission orientation. Then, such sub-dimensions such as technology innovation orientation, R&D capability, business model, customer orientation, social network, and social mission pursuit were derived. For empirical analysis, a survey was conducted on domestic high-tech social ventures, and the significance of the hypothesis was tested through PLS-structural equation analysis of the collected 243 valid data. As a result, it was found that the technology innovation orientation was embedded as an abstract organizational and cultural characteristic in the high-tech social venture, which is a research sample, and thus did not significantly affect the dependent variable. In other words, aiming for the latest cutting-edge technology alone cannot affect performance, and it is a result of proving the need for substantial influencing factors that can strengthen it. On the other hand, the business model had a significant effect only on social performance, which is presumed to be the limitation of measurement tools developed for social enterprises, and the results of additional multi-group analysis to determine the cause also supported the basis for this estimation. Excluding the previous two performance factors, R&D competency, customer orientation, social network, and social mission pursuit were all found to have a significant positive (+) effect on social and economic performance. This study laid a foundation for related research by identifying high-tech social ventures emerging in the ecosystem of a social economy and expanded empirical research models related to the performance of existing social enterprises and social ventures. However, in the research method or process, there were limitations such as factor derivation or verification for balance of dual performance, subjective measurement method, and sample representativeness. It is expected that more in-depth follow-up studies will continue by supplementing future limitations and designing improved research models.

An Exploratory Study on the Components of Visual Merchandising of Internet Shopping Mall (인터넷쇼핑몰의 VMD 구성요인에 대한 탐색적 연구)

  • Kim, Kwang-Seok;Shin, Jong-Kuk;Koo, Dong-Mo
    • 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.

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Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.