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Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries -Comparison between the different surgical approaches- (폐동맥폐쇄와 주대동맥폐동맥혈관부행지를 동반한 활로씨사징증 -다양한 외과적 치료접근의 비교-)

  • 이정렬;양지혁;김용진;노준량
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.471-479
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    • 1999
  • Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

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Operative Treatment of Congenitally Corrected Transposition of the Great Arteries(CCTGA) (교정형 대혈관 전위증의 수술적 치료)

  • 이정렬;조광리;김용진;노준량;서결필
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.621-627
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    • 1999
  • Background: Sixty five cases with congenitally corrected transposition of the great arteries (CCTGA) indicated for biventricular repair were operated on between 1984 and september 1998. Comparison between the results of the conventional(classic) connection(LV-PA) and the anatomic repair was done. Material and Method: Retrospective review was carried out based on the medical records of the patients. Operative procedures, complications and the long-term results accoding to the combining anomalies were analysed. Result: Mean age was 5.5$\pm$4.8 years(range, 2 months to 18years). Thirty nine were male and 26 were female. Situs solitus {S,L,L} was in 53 and situs inversus{I,D,D} in 12. There was no left ventricular outflow tract obstruction(LVOTO) in 13(20%) cases. The LVOTO was resulted from pulmonary stenosis(PS) in 26(40%)patients and from pulmonary atresia(PA) in 26(40%) patients. Twenty-five(38.5%) patients had tricuspid valve regurgitation(TR) greater than the mild degree that was present preoperatively. Twenty two patients previously underwent 24 systemic- pulmonary shunts previously. In the 13 patients without LVOTO, 7 simple closure of VSD or ASD, 3 tricuspid valve replacements(TVR), and 3 anatomic corrections(3 double switch operations: 1 Senning+ Rastelli, 1 Senning+REV-type, and 1 Senning+Arterial switch opera tion) were performed. As to the 26 patients with CCTGA+VSD or ASD+LVOTO(PS), 24 classic repairs and 2 double switch operations(1 Senning+Rastelli, 1 Mustard+REV-type) were done. In the 26 cases with CCTGA+VSD+LVOTO(PA), 19 classic repairs(18 Rastelli, 1 REV-type), and 7 double switch operations(7 Senning+Rastelli) were done. The degree of tricuspid regurgitation increased during the follow-up periods from 1.3$\pm$1.4 to 2.2$\pm$1.0 in the classic repair group(p<0.05), but not in the double switch group. Two patients had complete AV block preoperatively, and additional 7(10.8%) had newly developed complete AV block after the operation. Other complications were recurrent LVOTO(10), thromboembolism(4), persistent chest tube drainage over 2 weeks(4), chylothorax(3), bleeding(3), acute renal failure(2), and mediastinitis(2). Mean follow-up was 54$\pm$49 months(0-177 months). Thirteen patients died after the operation(operative mortality rate: 20.0%(13/65)), and there were 3 additional deaths during the follow up period(overall mortality: 24.6%(16/65)). The operative mortality in patients underwent anatomic repair was 33.3%(4/12). The actuarial survival rates at 1, 5, and 10 years were 75.0$\pm$5.6%, 75.0$\pm$5.6%, and 69.2$\pm$7.6%. Common causes of death were low cardiac output syndrome(8) and heart failure from TR(5). Conclusion: Although our study could not demonstrate the superiority of each classic or anatomic repair, we found that the anatomic repair has a merit of preventing the deterioration of tricuspid valve regurgitations. Meticulous selection of the patients and longer follow-up terms are mandatory to establish the selective advantages of both strategies.

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Estimation of Genetic Variations and Selection of Superior Lines from Diallel Crosses in Layer Chicken (산란계종의 잡종강세 이용을 위한 유전학적 기초연구와 우량교배조합 선발에 관한 연구)

  • 오봉국;한재용;손시환;박태진
    • Korean Journal of Poultry Science
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    • v.13 no.1
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    • pp.1-14
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    • 1986
  • The subject of this study was to obtain some genetic information for developing superior layer chickens. Heterosis and combining ability effects were estimated with 5,759 progenies of full diallel crosses of 6 strains in White Leghorn. Fertility, hatchability, brooder-house viability, rearing- house viability, laying-house viability, age at 1st egg laying, body weight at 1st egg laying, average egg weight, hen-day egg production, hen-housed egg production, and feed conversion were investigated and analyzed into heterosis effect, general combining ability, specific combining ability and reciprocal effect by Grilling's model I. The results obtained were summarized as follows; 1. The general performance of each traits was 94.76% in fertility, 74.05% in hatchability, 97.47% in brooder-house viability, 99.72% in rearing-house viability, 93.81% in laying-house viability, 150 day in the age at 1st egg laying, 1,505g in the body weight at 1st egg laying, 60.08g in average egg weight, 77.11% in hen-day egg production, 269.8 eggs in hen-housed egg Production, and 2.44 in feed conversion. 2. The heterosis effects were estimated to -0.66%, 9.58%, 0.26%, 1.83%, -3.87%, 3.63%, 0.96%, 4.23%, 6.4%, and -0.8%, in fertility, hatchability, brooder-house viability, laying-house viability, the age at 1st egg laying, the body weight at 1st egg laying, average egg weight, hen-day egg Production, hen-housed egg production and feed conversion, respectively. 3. The results obtained from analysis of combining ability were as follows ; 1) Estimates of general combining ability, specific combining ability and reciprocal effects were not high in fertility. It was considered that fertility was mainly affected by environmental factors. In the hatchability, the general combining ability was more important than specific combining ability and reciprocal effects, and the superior strains were K and V which the additive genetic effects were very high. 2) In the brooder-house viability and laying-house viability, specific combining ability and reciprocal effects appeared to be important and the combinations of K${\times}$A and A${\times}$K were very superior. 3) In the feed conversion and average egg weight, general combining ability was more important compared with specific combining ability and reciprocal effects. On the basis of combining ability the superior strains were F, K and B in feed conversion, F and B in the average egg weight. 4) General combining ability, specific combining ability and reciprocal effects were important in the age at 1st egg laying and the combination of V ${\times}$F, F${\times}$K and B${\times}$F were very useful on the basis of these effects. In the body weight at 1st egg laying, general combining ability was more important than specific combining ability and reciprocal effects, relatively. The K, F and E strains were recommended to develop the light strain in the body weight at 1st egg laying. 5) General combining ability, specific combining ability and reciprocal effects were important in the hen-day egg production and hen-housed egg production. The combinations of F${\times}$K, A${\times}$K, and K${\times}$A were proper for developing these traits. 4. In general, high general combining ability effects were estimated for hatchability, body weight at 1st egg laying, average egg weight, hen-day egg production, hen-housed egg production, and feed conversion and high specific combining ability effects for brooder-house viability, laying house viability, age at 1st egg laying, hen-day egg production and hen-housed egg production, and high reciprocal effects for the age at 1st egg laying.

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The Risk of Onset of the Illnesses Based on Gender, Age, and Monthly Income;Focusing on cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders (성별, 연령별, 월소득차이에 따른 질병발생의 위험성 차이연구;암, 고혈압, 중풍, 당뇨병, 관절염, 심장병을 중심으로)

  • Lee, Jun-Oh;Kim, Se-Jin;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.1
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    • pp.19-48
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    • 2008
  • In order to verify the risk of onset of the illnesses based on gender, age, and monthly income 1,739 subjects from Hongcheon county, Gangwon province were selected. Questionnaire on demographic sociology, health condition, existence of illnesses(cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders), and usage of public health services was surveyed from October 1, 2006 to October 20, 2006. Following conclusions were reached on the basis of the questionnaire : - For demographic sociological peculiarities, gender, age, occupation, and education level were evenly distributed. Most were under normal marriage(67.38%), health insurance(86.39%), 494(36.0%) individuals with less than monthly income of 1 million won, 494(36.0%) individuals with monthly income between 1 and 2 million won, 219(16.0%) with monthly income between 2 and 3 million won, and 164(12.0%) individuals with more than 3 million won, thus showing relatively low income. - For health status, 1,199(70.28%) individuals are non-smokers, 209(45.63%) individuals smoke $10{\sim}20$ cigarettes a day, 754(44.02%) individuals exercise less than twice a week are the major sector of the population. 1,518(88.10%) individuals have regular checkup more than once and 1,131(65.49%) stated their health condition less than average. - For comparison of existence of illnesses between genders, there was no statistical significance on cancer, stroke, and diabetes. But statistical significance was shown on hypertension(P value 0.025), arthritis(P value 0.000), and cardiac disorders(P value 0.016). Statistical significance was seen in the age comparison, and OR(confidence interval) drastically increased with increase in age. - There was no difference between the primary health clinic(P value 0.000), most visited clinic(P value 0.000), selection criteria(P value 0.000), and satisfaction on efficacy(P value 0.000). There was a tendency preferring hospital than public health center with increase in income. - For correlation between the existence of illnesses among different income levels, except for cancer(P value 0.172), statistical significance was seen in hypertension(P value 0.000), stroke(P value 0.003), diabetes (P value 0.001), arthritis(P value 0.000), and cardiac disorders(P value 0.000). The number of individuals suffering from illnesses and ratio all decreased for all illnesses with increase in income. - After adjusting confounding factors(gender, age, income, marriage, occupation, education) and male (1) as the standard, OR (confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 0.47(0.11${\sim}$2.05), 1.27(0.89${\sim}$1.81), 0.58(0.21${\sim}$1.59), 0.71(0.41${\sim}$1.23), 1.79(1.34${\sim}$2.39, P<0.01), and 1.46(0.72${\sim}$2.96), respectively. Risk of arthritis is significantly high in female and 20's (1) as the standard, OR(confidence interval) of cancer, hypertension, stroke, diabetes, arthritis, cardiac disorders were 1.01(0.96${\sim}$1.07), 1.06(1.04${\sim}$1.07, P<0.01), 1.05(1.01${\sim}$1.10, P<0.01), 1.06(1.03${\sim}$1.08, P<0.01), 1.05(1.03${\sim}$1.06, P<0.01), and 1.06(1.04${\sim}$1.09, P<0.01), respectively. Risk of onset for illnesses significantly increased with yearly aging except for cancer. - For comparison between monthly income after adjusting confounding factors(gender, age, income, marriage, occupation, education), with less than 1 million won (1) as the standard, OR(confidence interval) of cancer for 1 to 2 million won, 2 to 3 million won, and more than 3 million won were 0.23(0.03${\sim}$2.16), 2.53(0.41${\sim}$15.43), and 1.73(0.15${\sim}$19.50), respectively. OR(confidence interval) of hypertension were 1.12(0.76 ${\sim}$1.66), 0.68(0.34${\sim}$1.34), and 2.04(1.08${\sim}$3.86, P<0.01), respectively. OR(confidence interval) of stroke were 0.96(0.30${\sim}$3.08) for 1 to 2 million won, and 0.80(0.08${\sim}$8.46) for 2 to 3 million won. OR(confidence interval) of diabetes were 0.73(0.38${\sim}$1.38), 0.65(0.24${\sim}$1.71), and 0.69(0.24${\sim}$2.01), respectively. The values were 0.76(0.55${\sim}$1.03), 1.14(0.75${\sim}$1.73), and 0.90(0.56${\sim}$1.46), respectively for arthritis. OR(confidence interval) of cardiac disorders were 1.15(0.53${\sim}$2.48), 0.63(0.13${\sim}$3.12), and 1.20(0.28${\sim}$5.14), respectively. Risks of cancer, hypertension, stroke, diabetes, arthritis, and cardiac disorders were dependent of monthly income, and stroke and diabetes decreased with increase in income. Summarizing above data, arthritis was significantly higher in women and increase in age by each year brought significant increase in the chance of onset in hypertension, stroke, diabetes, arthritis, and cardiac disorders except for cancer. Stroke and diabetes decreased with increase in income. Above findings can be applied and reflected in public health policies at the national level, and it can also be applied at the personal level for individual health maintenance and prevention.

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The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.

Security and Safety Assessment of the Small-scale Offshore CO2 Storage Demonstration Project in the Pohang Basin (포항분지 해상 중소규모 CO2 지중저장 실증연구 안전성 평가)

  • Kwon, Yi Kyun;Chang, Chandong;Shinn, Youngjae
    • The Journal of Engineering Geology
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    • v.28 no.2
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    • pp.217-246
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    • 2018
  • During the selection and characterization of target formations in the Small-scale Offshore $CO_2$ Storage Demonstration Project in the Pohang Basin, we have carefully investigated the possibility of induced earthquakes and leakage of $CO_2$ during the injection, and have designed the storage processes to minimize these effects. However, people in Pohang city have a great concern on $CO_2$-injection-intrigued seismicity, since they have greatly suffered from the 5.4 magnitude earthquake on Nov. 15, 2017. The research team of the project performed an extensive self-investigation on the safety issues, especially on the possible $CO_2$ leakage from the target formation and induced earthquakes. The target formation is 10 km apart from the epicenter of the Pohang earthquake and the depth is also quite shallow, only 750 to 800 m from the sea bottom. The project performed a pilot injection in the target formation from Jan. 12 to Mar. 12, 2017, which implies that there are no direct correlation of the Pohang earthquake on Nov. 15, 2017. In addition, the $CO_2$ injection of the storage project does not fracture rock formations, instead, the supercritical $CO_2$ fluid replaces formation water in the pore space gradually. The self-investigation results show that there is almost no chance for the injection to induce significant earthquakes unless injection lasts for a very long time to build a very high pore pressure, which can be easily monitored. The amount of injected $CO_2$ in the project was around 100 metric-tonne that is irrelevant to the Pohang earthquake. The investigation result on long-term safety also shows that the induced earthquakes or the reactivation of existing faults can be prevented successfully when the injection pressure is controlled not to demage cap-rock formation nor exceed Coulomb stresses of existing faults. The project has been performing extensive studies on critical stress for fracturing neighboring formations, reactivation stress of existing faults, well-completion processes to minimize possible leakage, transport/leakage monitoring of injected $CO_2$, and operation procedures for ensuring the storage safety. These extensive studies showed that there will be little chance in $CO_2$ leakage that affects human life. In conclusion, the Small-scale Offshore $CO_2$ Storage Demonstration Project in the Pohang Basin would not cause any induced earthquakes nor signifiant $CO_2$ leakage that people can sense. The research team will give every effort to secure the safety of the storage site.

Study of Animation 3-Dimensional Motion Picture (애니메이션 입체 영화에 대한 연구)

  • Min, Kyung-Mi
    • Cartoon and Animation Studies
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    • s.9
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    • pp.127-142
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    • 2005
  • Not only in Korea but throughout the entire world millions of people are in contact with images. Images have become a medium through which to transmit anything from simple visualizations of moving images to knowledge and information. The age of the internet has arisen thanks to scientific development, and the internet generation's acquisition of information is continuously becoming faster. The spectators, ufo must choose amongst the excessive amount of available information, are changing along with it just as quickly. The method of visual transmission has changed to match the demands of the fast-changing pace of the new generation. In order to receive an instantaneous selection amongst much information, the primary requisite is attracting one's attention, and then presenting a corresponding feeling of satisfaction. The early stages of film arose from the desire to capture one's actual situation as it realty is. Unsatisfied with the still picture, people developed the motion picture. Research has succeeded in reproducing 3-dimensional images more realistic than the actual image we perceive as a result of the difference in visual perspective of both eyes and their response to rays of light From color film to 3-dimensional pictures, people enjoy the magnificent results of this. All fields within the category of film are continuously studying the human desire to pursue their visual side, namely the pursuit of visual images with a maximum sense of reality. The images that millions of people around the world see now are flat. The screen's depth and optical illusions effectively give a sense of reality while conveying information. However, although the flat screen is able to create a sense of depth using the different visual perspective of each eye for the realization of a cubic effect, there are limitations. Entering the 21s1 century, there is a quickly-arising branch within the field of image media which seeks to overcome these limitations Although 3-dimensional images began in films, entering the latter half of the 20th century, due to development of 3-dimensional images using the mediums of the animation field, cellular phones, advertisement screens, television etc., without restriction is designated as 'image.'. With research having started around 1900 and continuing for over 100 years, we are now able to witness the popularization of 3-dimensional films happening before our very eyes. Within our own country, we can frequently see them at amusement parks and museums. In the future, through the popularization of HDTV etc., there is a good outlook for practical use of 3-dimensional images in televisions with advanced picture qualify as well as in other areas. Together with the international current, research on 3-dimensional films has been activated in Korea and is rising as a main current in the film industry. Within this context, the contents and understanding of 3-dimensional images must keep in step with the pace of technical advancements. In order to accelerate of development of film contents to keep in pace with technical developments, this dissertation presents the techniques and technical aspects of future developments, and shows the need to prepare in advance to make the field grow- and thereby avoid having a lack of experts and being conquered by other nations in the field - rather than only advancing the technical aspects and importing the contents. This dissertation aims to stimulate interest and continual research by progressive-thinking people related to the film industry. Part II looks into the definition and types of 3-dimensional motion pictures, the terminology, the fundamentals of image formation, current market fluctuations, and looks into 3-dimensional techniques which can be borrowed and introduced in 3-dimensional animations. Part III concerns 3-dimensional animated films. It analyzes 3-dimensional production techniques while using the introduction of specific animation techniques in the 2004 production Lee Sun Shin and Nelson - Naval Heroes 3-dimensional animation produced in 2004 by Clay & Puppet Stop-Motion Animation & Computer Graphic. Original Korean title: 해전영웅 이순신과 넬슨. as an example, and it also looks into how current film techniques used in animations can be applied in 3-dimensional films. Additionally, the actual stages of the various fields of 3-dimensional animations are presented. Given the current direction and advancement of 3-dimensional films making use of animations and the possible realization of this field, the author plans to weigh the development of this yet unexploited new market Not looking at the current progress of the field, but rather the direction of the hypothetical types of animation techniques, the author predicts the marketability and possibility of development of each area.

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Mature Market Sub-segmentation and Its Evaluation by the Degree of Homogeneity (동질도 평가를 통한 실버세대 세분군 분류 및 평가)

  • Bae, Jae-ho
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.27-35
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    • 2010
  • As the population, buying power, and intensity of self-expression of the elderly generation increase, its importance as a market segment is also growing. Therefore, the mass marketing strategy for the elderly generation must be changed to a micro-marketing strategy based on the results of sub-segmentation that suitably captures the characteristics of this generation. Furthermore, as a customer access strategy is decided by sub-segmentation, proper segmentation is one of the key success factors for micro-marketing. Segments or sub-segments are different from sectors, because segmentation or sub-segmentation for micro-marketing is based on the homogeneity of customer needs. Theoretically, complete segmentation would reveal a single voice. However, it is impossible to achieve complete segmentation because of economic factors, factors that affect effectiveness, etc. To obtain a single voice from a segment, we sometimes need to divide it into many individual cases. In such a case, there would be a many segments to deal with. On the other hand, to maximize market access performance, fewer segments are preferred. In this paper, we use the term "sub-segmentation" instead of "segmentation," because we divide a specific segment into more detailed segments. To sub-segment the elderly generation, this paper takes their lifestyles and life stages into consideration. In order to reflect these aspects, various surveys and several rounds of expert interviews and focused group interviews (FGIs) were performed. Using the results of these qualitative surveys, we can define six sub-segments of the elderly generation. This paper uses five rules to divide the elderly generation. The five rules are (1) mutually exclusive and collectively exhaustive (MECE) sub-segmentation, (2) important life stages, (3) notable lifestyles, (4) minimum number of and easy classifiable sub-segments, and (5) significant difference in voices among the sub-segments. The most critical point for dividing the elderly market is whether children are married. The other points are source of income, gender, and occupation. In this paper, the elderly market is divided into six sub-segments. As mentioned, the number of sub-segments is a very key point for a successful marketing approach. Too many sub-segments would lead to narrow substantiality or lack of actionability. On the other hand, too few sub-segments would have no effects. Therefore, the creation of the optimum number of sub-segments is a critical problem faced by marketers. This paper presents a method of evaluating the fitness of sub-segments that was deduced from the preceding surveys. The presented method uses the degree of homogeneity (DoH) to measure the adequacy of sub-segments. This measure uses quantitative survey questions to calculate adequacy. The ratio of significantly homogeneous questions to the total numbers of survey questions indicates the DoH. A significantly homogeneous question is defined as a question in which one case is selected significantly more often than others. To show whether a case is selected significantly more often than others, we use a hypothesis test. In this case, the null hypothesis (H0) would be that there is no significant difference between the selection of one case and that of the others. Thus, the total number of significantly homogeneous questions is the total number of cases in which the null hypothesis is rejected. To calculate the DoH, we conducted a quantitative survey (total sample size was 400, 60 questions, 4~5 cases for each question). The sample size of the first sub-segment-has no unmarried offspring and earns a living independently-is 113. The sample size of the second sub-segment-has no unmarried offspring and is economically supported by its offspring-is 57. The sample size of the third sub-segment-has unmarried offspring and is employed and male-is 70. The sample size of the fourth sub-segment-has unmarried offspring and is not employed and male-is 45. The sample size of the fifth sub-segment-has unmarried offspring and is female and employed (either the female herself or her husband)-is 63. The sample size of the last sub-segment-has unmarried offspring and is female and not employed (not even the husband)-is 52. Statistically, the sample size of each sub-segment is sufficiently large. Therefore, we use the z-test for testing hypotheses. When the significance level is 0.05, the DoHs of the six sub-segments are 1.00, 0.95, 0.95, 0.87, 0.93, and 1.00, respectively. When the significance level is 0.01, the DoHs of the six sub-segments are 0.95, 0.87, 0.85, 0.80, 0.88, and 0.87, respectively. These results show that the first sub-segment is the most homogeneous category, while the fourth has more variety in terms of its needs. If the sample size is sufficiently large, more segmentation would be better in a given sub-segment. However, as the fourth sub-segment is smaller than the others, more detailed segmentation is not proceeded. A very critical point for a successful micro-marketing strategy is measuring the fit of a sub-segment. However, until now, there have been no robust rules for measuring fit. This paper presents a method of evaluating the fit of sub-segments. This method will be very helpful for deciding the adequacy of sub-segmentation. However, it has some limitations that prevent it from being robust. These limitations include the following: (1) the method is restricted to only quantitative questions; (2) the type of questions that must be involved in calculation pose difficulties; (3) DoH values depend on content formation. Despite these limitations, this paper has presented a useful method for conducting adequate sub-segmentation. We believe that the present method can be applied widely in many areas. Furthermore, the results of the sub-segmentation of the elderly generation can serve as a reference for mature marketing.

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The Effect of Partially Used High Energy Photon on Intensity-modulated Radiation Therapy Plan for Head and Neck Cancer (두경부암 세기변조방사선치료 계획 시 부분적 고에너지 광자선 사용에 따른 치료계획 평가)

  • Chang, Nam Joon;Seok, Jin Yong;Won, Hui Su;Hong, Joo Wan;Choi, Ji Hun;Park, Jin Hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.1-8
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    • 2013
  • Purpose: A selection of proper energy in treatment planning is very important because of having different dose distribution in body as photon energy. In generally, the low energy photon has been used in intensity-modulated radiation therapy (IMRT) for head and neck (H&N) cancer. The aim of this study was to evaluate the effect of partially used high energy photon at posterior oblique fields on IMRT plan for H&N cancer. Materials and Methods: The study was carried out on 10 patients (nasopharyngeal cancer 5, tonsilar cancer 5) treated with IMRT in Seoul National University Bundang Hospital. CT images were acquired 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). Two plans were generated under same planing objectives, dose volume constraints, and eight fields setting: (1) The low energy plan (LEP) created using 6 MV beam alone, (2) the partially used high energy plan (PHEP) created partially using 15 MV beam at two posterior oblique fields with deeper penetration depths, while 6 MV beam was used at the rest of fields. The plans for LEP and PHEP were compared in terms of coverage, conformity index (CI) and homogeneity index (HI) for planning target volume (PTV). For organs at risk (OARs), $D_{mean}$ and $D_{50%}$ were analyzed on both parotid glands and $D_{max}$, $D_{1%}$ for spinal cord were analyzed. Integral dose (ID) and total monitor unit (MU) were compared as addition parameters. For the comparing dose to normal tissue of posterior neck, the posterior-normal tissue volume (P-NTV) was set on the patients respectively. The $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ for P-NTV were evaluated by using dose volume histogram (DVH). Results: The dose distributions were similar with regard to coverage, CI and HI for PTV between the LEP and PHEP. No evident difference was observed in the spinal cord. However, the $D_{mean}$, $D_{50%}$ for both parotid gland were slightly reduced by 0.6%, 0.7% in PHEP. The ID was reduced by 1.1% in PHEP, and total MU for PHEP was 1.8% lower than that for LEP. In the P-NTV, the $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ of the PHEP were 1.6%, 1.8% and 2.9% lower than those of LEP. Conclusion: Dose to some OARs and a normal tissue, total monitor unit were reduced in IMRT plan with partially used high energy photon. Although these reduction are unclear how have a clinical benefit to patient, application of the partially used high energy photon could improve the overall plan quality of IMRT for head and neck cancer.

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The Market Segmentation of Coffee Shops and the Difference Analysis of Consumer Behavior: A Case based on Caffe Bene (커피전문점의 시장세분화와 소비자행동 차이 분석 : 카페베네 사례를 중심으로)

  • Yu, Jong-Pil;Yoon, Nam-Soo
    • Journal of Distribution Science
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    • v.9 no.4
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    • pp.5-13
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    • 2011
  • This study provides analysis of the effectiveness of domestic marketing strategies of the Korean coffee shop "Caffe Bene". It bases its evaluation on statistical outputs of 'choice attributes,' "market segmentation," demographic characteristics," and "satisfaction differences." The results are summarized in four points. First, five choice attributes were extracted from factor analysis: price, atmosphere, comfort, taste, and location; these are related to coffee shop selection behavior. Based on these five factors, cluster analysis was conducted, with statistical results classifying customers into three major groups: atmosphere oriented; comfort oriented; and taste oriented. Second, discriminant analysis tested cluster analysis and showed two discriminant functions: location and atmosphere. Third, cross-tabulation analysis based on demographic characteristics showed distinctive demographic characteristics within the three groups. Atmosphere oriented group, early-20s, as women of all ages was found to be 'walking down the street 'and 'through acquaintances' in many cases, as the cognitive path, and mostly found the store through 'outdoor advertising', and 'introduction'. Comfort oriented group was mainly women who are students in their early twenties or professionals, and appeared as a group to be very loyal because of high recommendation to other customers compared to other groups. Taste oriented group, unlike the other group, was mainly late-20s' college graduates, and was confirmed, as low loyalty, with lower recommendation activity. Fourth, to analyze satisfaction differences, one-way ANOVA was conducted. It shows that groups which show high satisfaction in the five main factors also show high menu satisfaction and high overall satisfaction. This results show that segmented marketing strategies are necessary because customers are considering price, atmosphere, comfort, taste, location when they choose coffee shop and demographics show different attributes based on segmented groups. For example, atmosphere oriented group is satisfied with shop interior and comfort while dissatisfied with price because most of the customers in this group are early 20s and do not have great financial capability. Thus, price discounting marketing strategies based on individual situations through CRM system is critical. Comfort oriented group shows high satisfaction level about location and shop comfort. Also, in this group, there are many early 20s female customers, students, and self-employed people. This group customers show high word of mouth tendency, hence providing positive brand image to the customers would be important. In case of taste oriented group, while the scores of taste and location are high, word of mouth score is low. This group is mainly composed of educated and professional many late 20s customers, therefore, menu differentiation, increasing quality of coffee taste and price discrimination is critical to increase customers' satisfaction. However, it is hard to generalize the results of study to other coffee shop brand, because this study have researched only one domestic coffee shop, Caffe Bene. Thus if future study expand the scope of locations, brands, and occupations, the results of the study would provide more generalizable results. Finally, research of customer satisfactions of menu, trust, loyalty, and switching cost would be critical in the future study.

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