• Asia Marketing Journal
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• v.12 no.2
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• pp.83-110
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• 2010

Dissatisfied customers may express their dissatisfaction behaviorally. These behavioral responses may impact the firms' profitability. How do we model the impact of self regulatory orientation on emotions and subsequent customer behaviors? Obviously, the positive and negative emotions experienced in these situations will influence the overall degree of satisfaction or dissatisfaction with the service(Zeelenberg and Pieters 1999). Most likely, these specific emotions will also partly determine the subsequent behavior in relation to the service and service provider, such as the likelihood of complaining, the degree to which customers will switch or repurchase, and the extent of word of mouth communication they will engage in(Zeelenberg and Pieters 2004). This study investigates the antecedents, consequences of negative consumption emotion and the moderate effect of attribution processing in an integrated model(self regulatory mode → specific emotions → behavioral responses). We focused on the fact that regret and disappointment have effects on consumer behavior. Especially, There are essentially two approaches in this research: the valence based approach and the specific emotions approach. The authors indicate theoretically and show empirically that it matters to distinguish these approaches in services research. and The present studies examined the influence of two regulatory mode concerns(Locomotion orientation and Assessment orientation) with making comparisons on experiencing post decisional regret and disappointment(Pierro, Kruglanski, and Higgins 2006; Pierro et al. 2008). When contemplating a decision with a negative outcome, it was predicted that high (vs low) locomotion would induce more disappointment than regret, whereas high (vs low) assessment would induce more regret than disappointment. The validity of the measurement scales was also confirmed by evaluations provided by the participating respondents and an independent advisory panel; samples provided recommendations throughout the primary, exploratory phases of the study. The resulting goodness of fit statistics were RMR or RMSEA of 0.05, GFI and AGFI greater than 0.9, and a chi-square with a 175.11. The indicators of the each constructs were very good measures of variables and had high convergent validity as evidenced by the reliability with a more than 0.9. Some items were deleted leaving those that reflected the cognitive dimension of importance rather than the dimension. The indicators were very good measures and had convergent validity as evidenced by the reliability of 0.9. These results for all constructs indicate the measurement fits the sample data well and is adequate for use. The scale for each factor was set by fixing the factor loading to one of its indicator variables and then applying the maximum likelihood estimation method. The results of the analysis showed that directions of the effects in the model are ultimately supported by the theory underpinning the causal linkages of the model. This research proposed 6 hypotheses on 6 latent variables and tested through structural equation modeling. 6 alternative measurements were compared through statistical significance test of the paths of research model and the overall fitting level of structural equation model and the result was successful. Also, Locomotion orientation more positively influences disappointment when internal attribution is high than low and Assessment orientation more positively influences regret when external attribution is high than low. In sum, The results of our studies suggest that assessment and locomotion concerns, both as chronic individual predispositions and as situationally induced states, influence the amount of people's experienced regret and disappointment. These findings contribute to our understanding of regulatory mode, regret, and disappointment. In previous studies of regulatory mode, relatively little attention has been paid to the post actional evaluative phase of self regulation. The present findings indicate that assessment concerns and locomotion concerns are clearly distinct in this phase, with individuals higher in assessment delving more into possible alternatives to past actions and individuals higher in locomotion engaging less in such reflective thought. What this suggests is that, separate from decreasing the amount of counterfactual thinking per se, individuals with locomotion concerns want to move on, to get on with it. Regret is about the past and not the future. Thus, individuals with locomotion concerns are less likely to experience regret. The results supported our predictions. We discuss the implications of these findings for the nature of regret and disappointment from the perspective of their relation to regulatory mode. Also, self regulatory mode and the specific emotions(disappointment and regret) were assessed and their influence on customers' behavioral responses(inaction, word of mouth) was examined, using a sample of 275 customers. It was found that emotions have a direct impact on behavior over and above the effects of negative emotions and customer behavior. Hence, We argue against incorporating emotions such as regret and disappointment into a specific response measure and in favor of a specific emotions approach on self regulation. Implications for services marketing practice and theory are discussed.

• Sim-seong Yeon-gu
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• v.26 no.1
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• pp.36-66
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• 2011

The goal of this article is to examine the connection between creativity of unconscious and religion. Jung criticized how Freud's approach in studying the unconscious as a scientific inquiry focuses on the unconscious as reflecting only those which is repressed by the ego. Jung conceived of the unconscious as encompassing not only the repressed but also the variety of other psychic materials that have not reached the threshold of the consciousness in its range. Moreover, since human psyche is as individualistic as is a collective phenomenon, the collective psyche is thought to be pervasive at the bottom of the psychic functioning and the conscious and the personal unconscious comprising the upper level of the psychic functioning. Through clinical and personal experience, Jung had come to a realization that the unconscious has the self-regulatory function. The unconscious can make "demands" and also can retract its demands. Jung saw this as the autonomous function of the unconscious. And this autonomous unconscious creates, through dreams and fantasies, images that include an abundance of ideas and feelings. These creative images the unconscious produces assist and lead the "individuation process" which leads to the discovery of the Self. Because this unconscious process compensates the conscious ego, it has the necessary ingredients for self-regulation and can function in a creative and autonomous fashion. Jung saw religion as a special attitude of human psyche, which can be explained by careful and diligent observation about a dynamic being or action, which Rudolph Otto called the Numinosum. This kind of being or action does not get elicited by artificial or willful action. On the contrary, it takes a hold and dominates the human subject. Jung distinguished between religion and religious sector or denomination. He explained religious sector as reflecting the contents of sanctified and indoctrinated religious experiences. It is fixated in the complex organization of ritualized thoughts. And this ritualization gives rise to a system that is fixated. There is a clear goal in the religious sector to replace intellectual experiences with firmly established dogma and rituals. Religion as Jung experienced is the attitude of contemplation about Numinosum, which is formed by the images of the collective unconscious that is propelled by the creativity and autonomy of the unconscious. Religious sector is a religious community that is formed by these images that are ritualized. Jung saw religion as the relationship with the best or the uttermost value. And this relationship has a duality of being involuntary and reflecting free will. Therefore people can be influenced by one value, overcome with the unconscious being charged with psychic energy, or could accept it on a conscious level. Jung saw God as the dominating psychic element among humans or that psychic reality itself. Although Jung grew up in the atmosphere of the traditional Swiss reformed church, it does not seem that he considered himself to be a devoted Christian. To Jung, Christianity is a habitual, ritualized institution, which lacked vitality because it did not have the intellectual honesty or spiritual energy. However, Jung's encounter with the dramatic religious experience at age 12 through hallucination led him to perceive the existence of living god in his unconscious. This is why the theological questions and religious problems in everyday life became Jung's life-long interest. To this author, the reason why Jung delved into problems with religion has to do with his personal interest and love for the revival of the Christian church which had lost its spiritual vitality and depth and had become heavily ritualized.

• Sim-seong Yeon-gu
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• v.28 no.1
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• pp.1-49
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• 2013

This article started with 'encounter'. Both authors met around the middle of February and discussed the subject for the inhospital conference presentation scheduled at the break of June. Having conversation like "Movies similar to fairytales heard from childhood are standing out conspicuously among commercial films which are attracting audiences and receiving fervent response these days. This phenomenon is marvelous and mysterious." together, and sharing this and that, the conversation turned naturally to 'Bram Stoker's Dracula', 'Series of Twilight', and 'Warm Bodies', both authors found out the fact that we saw these movies in common with propound impression. Feeling our hearts beating high, bit of fear and hesitation followed simultaneously at the moment when both of us encountered the idea to choose subject of conference presentation related to this and expressed one in words. While preparing for the conference, presenting to others, and having discussion with the audience, our hearts have been filled with Presentation was finished after active discussion beyond fixed hour and it also brought audience (among those present) to show strong emotional response both positively and negatively. At first, we just had a thought to put aside the content of presentation, but we felt lack of something else, lingering in our minds. We finally decided to accomplish our work into an article leading to submission, based on the advice and recommendation from one of the audience. This article is a small 'creative writing' born by sharing both authors' passion and enthusiasm. In the first part of this article, we have introduced the dream of 31-year-old woman's which led to the 'creative writing' and spotlighted her personal life, before and after the dream. In the second part, we have examined the consequence (way of realization) and meaning of creative impulse shown from or experienced from personal unconsciousness (dream, fantasy) together. Creative impulse shown from the individual appeared to bring creative transformation of individual personality through the process of 'introversion'. Otherwise it also appeared to be delivered as a masterpiece through 'creative writing' or from the process of 'extroversion'. Sometimes both consequences happened at once. We tried to examine and interpret the dream of 31-year-old woman's, which was introduced in the first part of this article, that is to say, the dream of 'Stephenie Meyer's, the author of the 'love between vampire boy and ordinary human girl' themed novel 'Twilight Series', in a psychoanalytic perspective. In the third part, highlighting individual dreams and three different movies 'Bram Stoker's Dracula', 'Twilight Series', and 'Warm Bodies', we found the transformation of symbol 'Man of Darkness, vampire' seen in each individual dreams and in some specific popular arts, such as novels and movies, receiving fervent response from people. We also found love between this symbol and humane woman, bearing fruit together with very impressive change shown in the attitude of 'Man of Darkness' (vampire)'s conscious ego and mutual relationship pattern. We contemplated this phenomenon, the reason why these events happen, and what kind of association presents among these events, individual, and this era and discussed the effects on individuals and this era, at present. 'Creative impulse', originated in the deep structure of human mind is realized as a 'transformation of individual personality' or masterpiece through artistic creation. If it has a chance to make a match with this era, shared by a lot of contemporary people, it also appears to bring positive effect as healing and salvation to each individual or to each era. From this article, we mainly highlighted positive and healing aspects of individual 'creative impulse'. We hope to deal with the negative consequences and their reason coming from 'creative impulse', if the occasion arises, in the future with a new article.

• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.39-46
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• 1989

Kimura's Disease is a chronic inflammatory and proliferative condition producing subcutaneous masses especially in the head and neck area. This report of our experience with 5 patients with this disease is the first in the Korean surgical literature. Kimura's Disease is thought to be part of the larger spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). It is characterized pathologically by hyperplastic lymphoid follicles, eosinophilic infiltration, and vase 비 ar proliferation. It produces masses which are most common in the area of the parotid, submandibular gland and upper neck. These masses occupy the subcutaneous tissues but also extend into salivary tissue and into upper neck nodes. One of our patients had masses in the groin. The tumors are extremely vascular due to the presence of new proliferative vessels and sinusoids. The average age of our 5 patients was 35, but all but one case were younger than 38 years of age. The male: female ratio was 3 : 2, and the average duration of symptoms was 5,2years. All patients had peripheral blood eosinophilia. All had multiple masses, sometimes symmetrical. The management was surgery alone in one case, surgery and steroids in one case, surgery and radiotherapy in two cases, and all three modalities in one case. The relationship of this entity to ALHE and our experience in the management of this disease are presented. A clinicopathological discrepancy alerted us to the existence of Kimura's Disease. A nineteen-year old male presented with subcutaneous masses over both mastoid areas present for 3 years (Case III). When biopsy on each side was reported as 'eosinophilic granuloma' we submitted the slides to an internationally expert pathologist. Symmetrically occurring tumors in the peri-parotid subcutaneous areas did not fit any category of neoplasm or granuloma known to us. The diagnosis, made by Dr. Gist Fan at the Ochsner Clinic, was Kimura's Disease. We found two additional cases in a review of soft tissue eosinophilic granuloma previously reported at Presbyterian Medical Center, and since then have diagnosed two new cases. These five cases constitute the basis for this, the largest series to be reported in Korea. These vascular, tumor-like lesions of the skin, subcutaneous areas and subjacent structures of the head and neck have been a variety of names, such as angiolymphoid hyperplasia with eosinophilia, eosinophilic hyperplastic lymphogranuloma, angioblastic lymphoid hyperplasia with eosinophilia, histioid hemangioma, and epithelioid hemangioma. The history of this disease spectrum dates back to 1937 when Kimm and Szeto (1) reported 7 cases of 'eosinophilic hyperplastic lymphogranuloma' in the Proceedings of the Chinese Medical Journal. In 1948 Kimura and his associates(2) reported additional cases in Japan under the title 'On the unusual granulation combined with hyperplastic changes of lymphatic tissue.' From then until 1966 several hundred cases were reported in China and Japan. The first report from the West was by Wells and Whimster(3) in the British Journal of Dermatology, in 1969. These authors coined the term, angiolymphoid hyperplasia with eosinophilia (ALHE). Since that time a debate has ensued as to whether Kimura's Disease and ALHE are distinct entities, or whether Kimura's is part of the larger spectrum of ALHE, perhaps a later or advanced phase. From the clinical perspective, surgeons should be aware of the diagnosis of Kimura's Disease not only as part of the differential diagnosis of head and neck tumors but also because these lesions are indolent, and generally require conservative surgical removal as part of the management program. CASE I. A 37-year-old female company employee presented in August 1982 with submental swelling of 12 years' duration and with inguinal swelling of 7 years' duration. The submental mass measured 5x5cm. and the inguinal mass was 8x4cm. in size. Peripheral eosinophilia varying from 14% to 40% was found. On August 20, 1982, the submental mass was removed and a superficial groin dissection was done. In May 1983 an intraoral lesion of the palate was removed. The patient is free of disease. CASE II. A 23-year-old unemployed man visited this hospital for the first time in July, 1984, with swelling of the right cheek present for 6 years. The mass was soft and ill-defined but measured 10x20cm. and extended from the submandibular upper neck to the zygomatic arch, and from the mastoid to the cheek, over the parotid gland. Eosinophilia varying from 27% to 29% was noted in the peripheral blood. On March 21, 1986, the lesion was resected. The procedure comprised an extended superficial parotidectomy from the temporalis fascia to the upper neck. Post-operatively radiotherapy 3000 rad tissue dose was administered using the 6 MeV linear accelerator. The patient remains free of disease. CASE III. A 19-year-old student came to the clinic with masses over both mastoid areas, present 3 years. On the right there were two adjacent lesions, one over the mastoid, the other in the upper jugular level of the neck. On the left it was a single mass over the mastoid. Eosinophilia varied from 13 to 32% in the peripheral blood, and 11.6% in the bone marrow. Incisional biopsy revealed 'eosinophilic granuloma' and a trial of predisolone was employed. The mass increased in size so a small dose of radiation (600 rads) was used, with substantial regression,. The lesion on the left was excised and follwed by 1000 rads radiotherapy. Finally recurrent tumor on the right side was removed on November 5, 1985. The patient remains free of disease. CASE N. A 29-year-old local merchant had had swelling of both upper necks since childhood. At the time of his first visit on March 17, 1986, the right submandibular mass measured 5x3.5cm. and the ,right upper neck and parotid tail mass measured 2.5cm. On the left there were masses in the upper neck, the largest of which measured 2.5cm, and of the parotid tail, 2.0cm. in size.(See Fig. 1) Peripheral eosinophilia of 39% was recorded. Left side partial parotidectomy and resection of the upper neck and subdigstric mases was done on May 2, 1986. The mass involving the right parotid tail and upper neck nodes was removed on Angust 7,1986. Postoperatively the patient was placed on prednisolone 30 mg. per day. No definite masses are palpable. CASE V. A 66-year-old housewife informed us, at the time of her first visit in May, 1986, that she had had multiple neck masses since 10 years ago. On the right side there was a 2.5cm. subcutaneous mass of the upper neck, over the upper jugular chain. On the left there was a 9x4.5cm. mass involving the entire parotid, the post-auricular area and the upper neck. A third mass presented in the submental area and measured 3.5cm. (See Fig. 2) Eosinophilia of 51% was noted in the peripheral blood. partial excision of the left upper neck lesion and complete excision of the submental mass were performed on june 6, 1986. post-operatively she was placed on 20 mg. of prednisolone daily, but when the mass re-grew after two months she was referred to Radiation Therapy for a 2500 rad course of treatment. A barely palpable thickening remains.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.1
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• pp.63-73
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• 2014

This study was intended to analyze the correlation between the builder's intentions and the colors that are revealed through the analysis of the manifestation of symbolic colors as the signs and symbols that are shown in the traditional space of Soshaewon as one of the representative retreating villa gardens of Chosun Dynasty and the interpretation of the meanings. The research on the traditional colors and the intended background of Soshaewon and so on was conducted by examining the relative literature and the contents as the objects for the empirical analysis were the scenic beauties and spatial elemnts that are shown in the plan of Soshewon and the poems about Soshewon 48 scenes as well as the contents of the poems related to Five Primary Colors that are used based on "the Ideology of Five Elements of the Positive and Negative". Espectially, this study was conducted by dividing the spatial elements shown in Soswaewon broadly into the visual, synesthetic and symbolic & cognitive spaces in order to classify the locations and directions of the spaces and natural objects as the visual space, the seasons, the points of times and the five sensory organs as the synesthetic space and the "Four Moral Begginings" & the "Seven Emotions" of New Confucianism as the symbolic and cognitive space and by analyzing if there are any correlation between the decided intentions and the spatial meanings that are revealed by analyzing the system of five primary colors which are used in each spatial element.7) As a result from the analysis of the colors that are used based on the three spatial components of Soshaewon, it was found that one of Five Primary Colors were used 74 times in total. First, in the visual spatial component, one of the colors was used 18 times in total including 2 times of blue, 1 time of red, 6 times of yellow, 4 times of white and 5 times of black. The fact that yellow symbolizing the source of everything and white symoblizing cleanness and pureness are used relatively more often than blue and red symbolizing nature and life respectively can be interpreted that the builder, Mr. San-bo Yang's intention to build Soshaewon is related to the meaning symbolizing the pure will of the builder who wanted to seclude himself from society rather than to give priority to enjoying nature. Second, in the synesthetic spatial component which are selected from the 48 scenes of Soshaewon, one of Five Primary Colors was used 38 times in total including 11 times of blue, 8 times of red, 4 times of yellow, 5 times of white and 10 times of black. Since blue and red symbolizing nature and life respectively are used more often than yellow and black symbolizing the source of the world and pureness & knowledge respectively, it was interpreted that the builder means to be faithful to the unique basic functions of the retreating villa with which the builder wanted to enjoy his passion for enjoying nature and exploring knowledge even though the builder built the villa garden for the purpose of keeping himself pure while being unstained by the world. Finally, it was analyzed that one of Five Primary Colors was used 18 times in total including 4 times of blue, 5 times of red and 9 times of white in the symbolic and cognitive spatial components of the 48 scenes. Since it was found that white symbolizing the builder's political pureness is used at the same frequency as blue and red symbolizing nature and life respectively are used as a result from the analysis, it was interpreted that the intention of creating Soshaewon was emotionally revealed at the same percentage in the aspects of his political pureness and enjoyment of nature through his poems. Especially, as a result from such 3 kinds of analyses regarding to the frequency of using Five Primary Colors, it was found that the number of times using Five Primary Colors in the synesthetic spatial component was 38 as the highest percentage, around 51% followed by each 18 times as the24.5% respectively in the visual and cognitive & symbolic spatial spaces. Based on such results, it can be interpreted that the builder, Mr. San-bo Yang's intention of creating Soshaewon sympolizes that his intention for enjoying the basic nature and the vitality of nature within the retreating villa garden is hidden at the same proportion as his intention for keeping himself pure from the unrightful world. It was intended to reveal the traditional colors which are hidden in a traditional retreating villa by analyzing the correlation between the symbolic meanings and the spatial components of Soshaewon based on the Five Primary Colors which are originated from the "Ideology of the Five Natural Elements of the Positive and Negative", but it is thought that it is possible to explore whether such a theory can be generally applied to other kinds of retreating villa gardens or not through a study on other retreating villa gardens as other examples in which the builder's apparent pure intentions, such as enjoyment of nature and persuit of study, etc., unlike Soshaewon are hidden.

• Journal of dental hygiene science
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• v.5 no.4
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• pp.211-220
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• 2005

The purpose of this study was to examine the job performance of dental coordinators and their perception of their job to lay the groundwork for utilizing dental personnels more efficiently. The subjects in this study were dental coordinators who worked at selected dental hospitals and clinics in Seoul, Gyeonggi province and Incheon. A survey was conducted to gather data from May 1 to August 8, 2005 and answer sheets from 108 respondents were analyzed. The findings of the study were as follows: 1. As for the length of service, 43.5 percent of the dental coordinators investigated had worked at dental institutes for five years or more, which was followed by less than two years(19.5%) and three years to less than five years(19.4%). Concerning the length of service as dental coordinators, 39.8 percent had served for less than two years, and 19.4 percent had worked for two years to less than three years and for five years or more respectively. Regarding the name of position, 38 percent were called team leaders, and 30.6 percent were called coordinators. As to duties, the largest group of them that stood at 30.6 percent were in charge of receiving, and in regard to department, the largest group, 57.4 percent, belonged to the treatment backup department. 2. Concerning education, the greatest number of them, 45.4 percent, had received education at private institutes, and 73.1 percent found it necessary for dental coordinators to take an authorized qualification test. 43.5 percent, the largest group, looked upon the central government as the best organization to authorize their qualifications and 70.8 percent believed that what they learned enabled them to perform their job successfully. As to the necessity of follow-up education as a means to improve job performance, 96.3 percent consented to it. As for the reason, 63.9 percent considered that necessary to enhance their own ability and 22.2 percent were in want of systematic education. Regarding educational expenses, 29.6 percent were subsidized by the dental institutes where they had worked and 25.9 percent had totally been responsible for that. Regarding a required course, medical service and marketing was most widely pointed out(66.7%), followed by theory and practice(65.7%) and introduction to dentistry(57.4%). As to what sort of education they wanted to receive more, dental service and marketing was selected the most, followed by practical health insurance(35.2%). 3. In regard to what type of job they performed as dental coordinators, 88.9 percent were in charge of appointment in the field of customer service, and 87.9 percent paid attention to having good manners as service providers in the area of self-management. In the field of hospital affairs, 81.3 percent were in charge of receiving. 4. As to their awareness of dental coordinator job, the largest group took pride in the job they performed ($3.99{\pm}0.76$), and the second largest group believed that dental coordinators made a great contribution to hospital management ($3.92{\pm}0.70$). The third largest group gave a great weight to their own job ($3.91{\pm}0.84$) in light of overall dental duties and the fourth largest group found themselves to get along with other employees regardless of position ($3.86{\pm}0.74$). The fifth largest group believed their job was of great use for promoting the oral health of patients ($3.76{\pm}0.75$), and the sixth largest group thought the future of dental coordinators was promising($3.74{\pm}0.86$). 5. In regard to their perception by age group, those who were older had a better opinion on every item of their job in general. Their age made a statistically significant difference to their view of the weight of dental coordinator job(P < 0.001) in light of overall dental duties, of being approved and trusted by managers(P < 0.01), of social awareness of dental coordinator, and of being understood and approved by other employees and dentists. Their pride in current job and their satisfaction with the name of their position were statistically significantly different according to their age as well. Besides, their age made a statistically significant difference to their opinion about whether or not there was an age limit to their occupation and about their contribution to hospital management (P < 0.05). 6. As for their perception by type of job, the dental hygienists were generally most satisfied with their job, followed by nursing aids and others. There was a statistically significant gap among their opinions about whether to make a job-related decision on their own(P < 0.001). the weight of their job in terms of overall dental duties, whether their job improved their ability, whether their job made a great contribution to enhancing the oral health of patients, whether their job was understood and approved by other employees(P < 0.01), social awareness of their job, whether they conflicted with other employees during job performance, and whether dental hospitals or clinics offered a self-development opportunity for them to take their ability to another level(P < 0.05). And their satisfaction with current pay was statistically significantly different as well.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.452-461
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• 1994

Background: Tumor necrosis factor(TNF)-$\alpha$ and Interleukin(lL)-$1{\beta}$ are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-$\alpha$ in the pathogenesis of ARDS, including human studies, it has been reported that TNF-$\alpha$ is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-$\alpha$ and IL-$1{\beta}$ as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. Methods: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood samples were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-$\alpha$ and IL-$1{\beta}$ was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. Results: 1) Plama TNF-$\alpha$ levels: Plasma TNF-$\beta$ levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the $mean{\pm}2SD$, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-$\alpha$ levels from patients with ARDS were 10.26pg/mL(median; <10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-$\alpha$ levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (p<0.01). There was no statistical significance between survivors(<10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-$\alpha$ levels. 2) Plasma IL-$1{\beta}$ levels: Plasma IL-$1{\beta}$ levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-$1{\beta}$ levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ngfmL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-$1{\beta}$ levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). Conclusion: Plasma TNF-$\alpha$ and IL-$1{\beta}$ level are not a predictable marker for development of ARDS. But TNF-$\alpha$ is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-$\alpha$ and IL-$1{\beta}$ in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.69-87
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• 2003

Background : LB20304(gemifloxacin) is a new fluoroquinolone antibacterial agent with excellent activity against both Gram-negative and Gram-positive organisms. In vitro studies using clinical isolates have shown gemifloxacin to be highly active against penicillin-resistant strains of S. pneumoniae and in contrast to other reference quinolones, gemifloxacin retained good activity against clinical isolates of S. pneumoniae that were resistant to other members of the quinolone class. Therefore, gemifloxacin is thought to be effective in treating acute bacterial exacerbation of chronic bronchitis(AECB). The objective of this study was to evaluate the efficacy and safety of oral gemifloxacin at doses of 160mg or 320mg once daily for 7 days for the treatment of AECB in Korean adult population. Methods : This was a randomized, multicenter, double-blind, parallel group Phase II study to assess the clinical and antibacterial efficacy and safety of oral gemifloxacin for the treatment of AECB. Treatment Group A (67 patients) took oral gemifloxacin 160mg once daily for seven days and treatment Group B (70 patients) took oral gemifloxacin 320mg once daily for seven days. Results : The demographic profiles of the two treatment groups were similar. The clinical response at follow-up was 84.2% in the gemifloxacin 160-mg group, and 88.7% in the gemifloxacin-320 mg group, showing no statistically significant difference between two treatment groups(p=0.49). The clinical response at the end of therapy was 96.5% in the 160-mg group, and 96.4% in the 320-mg group. The bacteriological response at the end of therapy and follow-up were 81.8% and 78.9%, respectively, in the 160-mg group, and 86.4% and 84.2%, respectively, in the 320-mg group, showing no statistically significant difference between two treatment groups(p=0.68 and 0.68, respectively). S. pneumoniae(12 isolates) and H. influenzae(10 isolates) were the most prevalent pathogens. The MICs were lower for gemifloxacin than other quinolones against these key pathogens, and for S. pneumoniae, the MICs for gemifloxacin were considerably lower(${\leq}0.03$ ug/mL) than those for other quinolones, beta-lactams and macrolides. In the period on-therapy plus 30 days post-therapy, a total of 18 patients(26.9%) in the gemifloxacin 160mg group and 22 patients(31.4%) in the 320mg group reported at least one adverse event(AE). The most frequently reported AE was abdominal pain(3/67 patients, 4.5%) in the gemifloxacin 160mg group and increased level of hepatic enzyme(5/70 patients, 7.1%) in the 320mg group. The overall AE profiles for the two treatment groups were similar. Two out of 67 patients(3.0%) in the gemifloxacin 160mg group and 1/70 patients(1.4%) in the 320mg group reported at least one serious AE, however, none of which was considered by the investigator to be of suspected or probable relationship to study medication. Conclusion : The results of this study showed that gemifloxacin at doses of 160mg or 320mg once daily for 7 days in the treatment of acute exacerbations of chronic bronchitis(AECB) in adult Koreans was a very effective and safe treatment both clinically and bacteriologically.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.143-151
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• 2005

Purpose: Bereavement Memorial Service has been held every year by the hospice team at St. Vincent's Hospital for the purpose of supporting the bereaved family who feel grief and mourning. The purpose of this study is to find out the attitude of the bereaved attending at bereavement memorial service (BMS) and to find out the areas needing improvements to set up better memorial service. Methods: Hospice team sent invitation card to 180 families of patients who admitted and passed away at hospice ward Nov., 2003${\sim}$Oct., 2004. Among them 22 families attended the BMS meeting, which was held on 26th Nov., 2004. The researcher collected data from 22 families with 'Questionnaire' survey. Except identifying data and 2 dichotomy questions, we used open-ended questionnaire. 1 researcher conducted a telephone interview survey in 18 families who couldn't attend at BMS meeting. Results: The median age was 56 (range $16{\sim}19$) and there were 37 females and 3 males. They were patient's wife (22), mother (4), husband (5), daughter (4), mother-in-law (1), siblings (1), brothers wife (1). Duration after bereavement, $1{\sim}3$ months (17) was the highest frequency. 36 families agreed 'the dead experienced the death with dignity'. The reason of agreement to the death with dignity was 'the patient died in preparation' (16). 'the patient died in well-being condition spiritually' (9), 'the patient died in comfort physically (7). 4. persons thought the dead died with indignity. The bereaved defined 'the death with dignity' as follows: 'acceptance of death & death in spiritual well-being' (9), 'death in physical comfort condition' (7), 'the death in psycho-social well-being' (3), non-respondents (10). Most families (21) were still in difficulty to overcome bereavement grief. The answer regarding the method to overcome the difficulty was 'with spiritual sublimation' (13), 'with devotion of oneself in daily life' (10), 'with devotion to mourning as it is' (3). With regard to their attitude to invitation, 'having joy and thanks from hospice team' (21), 'grief' (4), 'suffering' (4). Toward the existence of hesitation about attendance at BMS meeting, the result as follows. Nonexistence of hesitation respondent (34), existence respondent (6), the reason for hesitation was various; 'the meeting reminds me of the suffering times', 'the meeting makes me to recall, and it will be likely to cry', and so on. The needs and feelings to memorial service meeting were various; 'it was meaningful time', 'it was good to recall about the dead', 'more meeting annually' and so on. In respect of the most difficulty after bereavement, in attendant family, 'depression' (10) was the highest frequency, whereas, in non-attendant family, the most difficult thing was 'financial problem/role difficulty (6). Conclusion: This study shows the rate of attendance was high in bereaved whose bereavement duration $1{\sim}3$ month. Most of bereaved were still suffering from bereavement grief within 1 year. Although most families didn't hesitate and felt positive mood to invitation, the rate of attendance was low. Comparing with two groups between attendant family and non-attendant, the latter felt more difficulty in 'financial problem/role difficulty, on the other hand, the former felt difficulty in 'depression'. Hereafter, the additional study about the factor relating to these attitude and needs of the bereaved relating to memorial service will be necessary.

• Korean Journal of Veterinary Research
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• v.35 no.2
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• pp.337-345
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• 1995

To evaluate the pathogenicity and immunogenicity of Eimeria tenella to the chicken treated with dexamethasone(DEX) and testosterone propionate (TES), we administered 0.1ml/chicken of dexamethasone and 40mg/chicken of testosterone propionate at 1-, 2-, and 7-days old, respectively. We also immunized with ND oil-emulsion vaccine at 2 weeks old. After that, we immunized and challenged with 100 and $1{\times}10^5$ oocysts/chicken of E tenella at 2 and 4 weeks old, respectively. And then we investigated the HI titers for ND virus, survival rate, body weight gain, lesion score and the weight of the bursa of Fabricius and thymus. The titers for ND virus in the groups treated with TES were higher than those in the groups treated with DEX and CON during 3 to 6 weeks. After challenge, the survival rate of testosterone propionate treated-challenged(TES-CHA) and TES-immunized and challenged(TES-V&C) groups were 61.5 and 83.3% and those of the other groups were all 100%. At 1 week after challenge, the lesion scores of TES-CHA group(4.0) was the highest of all experimental groups. Those of DEX and controlchallenged( CON-CHA) groups were 2.8, and those of all V&C groups were 2.4. During 1 and 2 weeks after immunization, the body weight gains of TES groups were severe low(61.6-82.2g and 189.6-260.4g). During 1 and 2 weeks after challenge, the body weight gains of all CHA groups were lower than those of not challenged groups. But, those of all V AC groups were not different from those of not immunized groups. At 4- and 6-weeks old, the weight of the bursa of Fabricius and thymus in the chicken of all TES groups were lower than those of all control (CON) and DEX groups. Therefore, testosterone propionate acted as immunosuppressive drug. Also, it was thought that the chicken affected a little humoral immunity to E tenella.