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The Role of Tumor Necrosis Factor-$\alpha$ and Interleukin-$1{\beta}$ as Predictable Markers for Development of Adult Respiratory Distress Syndrome in Septic Syndrome (패혈증 증후군환자에서 성인성 호흡곤란 증후군 발생의 예측 지표서의 혈중 Tumor Necrosis Factor-$\alpha$와 Interleukin-$1{\beta}$에 관한 연구)

  • Koh, Youn-Suck;Jang, Yun-Hae;Kim, Woo-Sung;Lee, Jae-Dam;Oh, Soon-Hwan;Kim, Won-Dong
    • 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.

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A Study on the Classification and Research Trends of Articles in The Korean Journal of Rural Medicine (한국농촌의학회지(韓國農村醫學會誌)에 게재된 연구논문의 분류 및 연구동향)

  • Wee, You-Mee;Kim, Suk-Il;Park, Hyang;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.231-244
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    • 2000
  • Classification and research trends were studied to analyze a total of 240 original articles that have been published in 34 volumes of The Korean Journal of Rural Medicine from 1976 to 1999. The results were as follows: 1. A total of 337 articles were published. Among them, 240(71.2%) articles were classified as original articles. This number has been increasing significantly over the years as the number of the articles was 13 in the 1970s, 73 in the 1980s, and 154 in the 1990s. 2. There were 10 authors in the original articles and 55(22.9%) of them were written by 3 of them. There were five research institutions involved in the articles, and 106(44.2%) of the articles were done by one research group. 3. In the original articles. 24(10.0%) were noted to be done using research funds, and only 6(2.5%) were written in English. 4. In the view of the research styles of the original articles, 115(47.9%) used analytical study, 92(38.3%) used technical study, 21(9.2%) used experimental study, and 6(2.5%) used case reports. In the 1970s, 13(100.0%) articles used technical study, and in the 1980s, 47(64.4%) used technical studies and 19(26.0%) used analytical studies. However, in the 1990s, 96(62.8%) articles used analytical studies and 32(20.9%) used technical studies. The statistical methods most commonly used in the articles were technical statistics, the ${\chi}^2$-test, and the t-test respectively. 5. On the classification into three different research fields, 105(43.8%) articles were classified as health management, 96(40.0%) as disease epidemiology, and 39(16.3%) as rural environment and rural occupational disorders. In the 1970s, 12 (92.3 %) of the articles were on disease epidemiology and 1(7.7%) on health management were published. In the 1980s, 33(45.2%) articles on disease epidemiology, 29(39.7%) on health control, and 11(15.1%) on rural environment and rural occupational disorders were recorded. In the 1990s, however, 75(48.7%) articles were on health control, 51(33.1%) on disease control, and 28(18.2%) on the rural environment and rural occupational disorders. 6. According to the research subjects in each research field, the 39 articles in rural environment and rural occupational disorders were composed of 8(20.5%) articles on pesticide intoxication, 7(17,9%) on farmer's diseases, 7(17.9%) on vinyl-house diseases, and 6(15.4%) on accidents. From a total of 96 articles in disease epidemiology 56(58.3%) articles were on parasites, 16(16.7%) on non-infectious diseases, 12(12.5) on infectious diseases. From 105 articles in health control 25(23.8%) articles were on medical care utilization patterns, 18(17.1%) on the health care delivery system, and 13(12.4%) on maternal and child health. In the analysis of the 10 most prevalent subjects dealt in the above articles, 6(46.2%) articles were on parasites and 4(30.8%) on non-infectious diseases were recorded in the 1970s. In the 1980s, 28(38.4%) were on parasites. 9(12.3%) on the health care system, 7(9.6%) on medical care utilization patterns, 5(6.8%) on maternal and child health, and 4(5.5%) were on pesticide intoxication. In the 1990s, 22(14.3%) articles were on parasites. 18(11.7%) on medical care utilization patterns, 16(10.4%) on senile health, 14(9.1%) on the health care system, 10(6.5%) on infectious diseases, arid 10(6.5%) were on non-infectious diseases. In conclusion, the research activity on rural health has been strengthened in this country because the original articles in The Korean Journal of Rural Medicine have significantly increased in the past 24 years. In the 1970s and 1980s, research on disease epidemiology was most prevalent, but in the 1990s papers on health care were most popular. In addition, the articles on parasites were most frequently published in the 1970s, 1980s, and 1990s, showing that parasitic problem was the main theme in those eras. However, in the 1990s, it was evident that the articles on parasites were decreasing and articles on the subject of medical care utilization patterns and senile health increased. Hereafter it was expected that research on health care would be more common in rural health in Korea.

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Correlation of p53 Protein Overexpression, Gene Mutation with Prognosis in Resected Non-Small Cell Lung Cancer(NSCLC) Patients (비소세포폐암에서 p53유전자의 구조적 이상 및 단백질 발현이 예후에 미치는 영향)

  • Lee, Y.H.;Shin, D.H.;Kim, J.H.;Lim, H.Y.;Chung, K.Y.;Yang, W.I.;Kim, S.K.;Chang, J.;Roh, J.K.;Kim, S.K.;Lee, W.Y.;Kim, B.S.;Kim, B.S.
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.339-353
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    • 1994
  • Background : The p53 gene codes for a DNA-binding nuclear phosphoprotein that appears to inhibit the progression of cells from the G1 to the S phase of the cell cycle. Mutations of the p53 gene are common in a wide variety of human cancers, including lung cancer. In lung cancers, point mutations of the p53 gene have been found in all histological types including approximately 45% of resected NSCLC and even more frequently in SCLC specimens. Mutant forms of the p53 protein have transforming activity and interfere with the cell-cycle regulatory function of the wild-type protein. The majority of p53 gene mutations produce proteins with altered conformation and prolonged half life; these mutant proteins accumulate in the cell nucleus and can be detected by immunohistochemical staining. But protein overexpression has been reported in the absence of mutation. p53 protein overexpression or gene mutation is reported poor prognostic factor in breast cancer, but in lung cancer, its prognostic significance is controversial. Method : We investigated the p53 abnormalities by nucleotide sequencing, polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), and immunohistochemical staining. We correlated these results with each other and survival in 75 patients with NSCLC resected with curative intent. Overexpression of the p53 protein was studied immunohistochemically in archival paraffin- embedded tumor samples using the D07(Novocastra, U.K.) antibody. Overexpression of p53 protein was defined by the nuclear staining of greater than 25% immunopositive cells in tumors. Detection of p53 gene mutation was done by PCR-SSCP and nucleotide sequencing from the exon 5-9 of p53 gene. Result: 1) Of the 75 patients, 36%(27/75) showed p53 overexpression by immunohistochemical stain. There was no survival difference between positive and negative p53 immunostaining(overall median survival of 26 months, disease free median survival of 13 months in both groups). 2) By PCR-SSCP, 27.6%(16/58) of the patients showed mobility shift. There was no significant difference in survival according to mobility shift(overall median survival of 27 in patients without mobility shift vs 20 months in patients with mobility shift, disease free median survival of 8 months vs 10 months respectively). 3) Nucleotide sequence was analysed from 29 patients, and 34.5%(10/29) had mutant p53 sequence. Patients with the presence of gene mutations showed tendency to shortened survival compared with the patients with no mutation(overall median survival of 22 vs 27 months, disease free median survival of 10 vs 20 months), but there was no statistical significance. 4) The sensitivity and specificity of immunostain based on PCR-SSCP was 67.0%, 74.0%, and that of the PCR-SSCP based on the nucleotide sequencing was 91.8%, 96.2% respectively. The concordance rate between the immunostain and PCR-SSCP was 62.5%, and the rate between the PCR-SSCP and nucleotide sequencing was 95.3%. Conclusion : In terms of detection of p53 gene mutation, PCR-SSCP was superior to immunostaining. p53 gene abnormalities either overexpression or mutation were not a significant prognostic factor in NSCLC patients resected with curative intent. However, patients with the mutated p53 gene showed the trends of early relapse.

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Packing effects on the intracavitary radiation Therapy 3-Dimension plan of the uterine cervix cancer (자궁경부암 강내조사 3차원 치료계획 시 Packing의 유용성 분석)

  • Si, Chang-Keun;Jo, Jung-Kun;Lee, Du-Hyun;Kim, Sun-Yeung;Kim, Tae-Yoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.1
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    • pp.1-8
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    • 2005
  • Purpose : An effect of a packing to uterine treatment of a cervical cancer using a dose-volume histogram for a point dose and a volume dose of the bladder and the rectum was analyzed by establishing a three-dimensional treatment plan using a CT image. Materials and methods : Reference points of the bladder and the rectum were marked, respectively at a treatment plan device (plato brachytherapy V14.2.4) by photographing CT(marconi, USA) when the packing was used and removed under the same condition and a treatment plan was performed to Apoint depending on ICRU38. However, in case of the rectum, a maximum point was looked up and compared with the above point because the point presented from the ICRU is not proper as a representative value of a rectum point dose. Further, the volume dose depending on volume of $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder was measured. The measured values were used to analyze the effect of the packing through a Wilcoxon Signed Rank Test (a SAS statistical analysis process program). Result : The reference points at the bladder and rectum doses when the packing was removed were $116.94\;35.42\%$ and $117.59\;21.08\%$, respectively. The points when the packing was used were $107.08\;38.12\%$ and $95.19\;21.32\%$, respectively. After the packing was used, the reference points at the bladder and the rectum were decreased by $9.86\%$ and $22.4\%$, respectively. When the packing was removed, the maximum points at the bladder and the rectum were $164.51\;50.89\%,\;128.81\;33.05\%$, respectively. When the packing was used, the maximum points at the bladder and the rectum were $142.31\;44.79,\;110.08\;37.03\%$, respectively. After the packing was used, the maximum points at the bladder and the rectum were decreased by $22.2\%$ and $18.73\%$, respectively. When the packing was removed, the bladder volume at $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder were $48.62{\pm}18.09\%,\;16.12{\pm}11.15\%,\;and\;7.51{\pm}6.63\%$, respectively and its rectum volume were $23.41{\pm}14.44\%,\;6.27{\pm}4.28\%,\;2.79{\pm}2.27\%$, respectively. When the packing was used, the bladder volume at $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder were $40.33{\pm}16.72,\;11.63{\pm}8.72,\;and\;4.87{\pm}4.75\%$, respectively and its rectum volume were $18.96{\pm}8.37\%,\;4.75{\pm}2.58\%,\;and\;1.58{\pm}1.06\%$, respectively. After the packing was used, the bladder volume at $50\%,\;80\%,\;and\;100\%$ point doses of the rectum and the bladder were decreased by $8.29\%,\;4.49\%,\;and\;2.64\%$, respectively and its bladder volume were decreased by $4.45\%,\;1.52\%,\;and\;1.21\%$, respectively. Conclusion : Values at Reference point doses of the bladder and the rectum recommended from the ICRU 38 were 0.0781 and 0.0781, respectively and values of their maximum point doses were 0.0156 and 0.0156, respectively, as a result of which an effect of the packing using at the uterine intracavitary treatment of an uterine cervical cancer through the three-dimensional treatment plan used CT were measured. That is, the values at reference point doses and the values at maximum point doses show similar difference. However, P value was 0.15 at over $50\%,\;80\%,\;and\;100\%$ volume doses and the value shows no similar difference. In other words, the effect of the packing looks like having a difference at the point dose, but actually shows no difference at the volume dose. The reason is that the volume of the bladder and the rectum are wide but the volume of the packing is only a portion. Therefore, the effect of decreasing the point dose was not great. Further, the farer the distance is, the more weak the intensity of radiation is because the intensity of radiation is proportional to inverse square of a distance. Therefore, the effort to minimize an obstacle of the bladder and the rectum by using the packing should be made.

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Implementation of integrated monitoring system for trace and path prediction of infectious disease (전염병의 경로 추적 및 예측을 위한 통합 정보 시스템 구현)

  • Kim, Eungyeong;Lee, Seok;Byun, Young Tae;Lee, Hyuk-Jae;Lee, Taikjin
    • Journal of Internet Computing and Services
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    • v.14 no.5
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    • pp.69-76
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    • 2013
  • The incidence of globally infectious and pathogenic diseases such as H1N1 (swine flu) and Avian Influenza (AI) has recently increased. An infectious disease is a pathogen-caused disease, which can be passed from the infected person to the susceptible host. Pathogens of infectious diseases, which are bacillus, spirochaeta, rickettsia, virus, fungus, and parasite, etc., cause various symptoms such as respiratory disease, gastrointestinal disease, liver disease, and acute febrile illness. They can be spread through various means such as food, water, insect, breathing and contact with other persons. Recently, most countries around the world use a mathematical model to predict and prepare for the spread of infectious diseases. In a modern society, however, infectious diseases are spread in a fast and complicated manner because of rapid development of transportation (both ground and underground). Therefore, we do not have enough time to predict the fast spreading and complicated infectious diseases. Therefore, new system, which can prevent the spread of infectious diseases by predicting its pathway, needs to be developed. In this study, to solve this kind of problem, an integrated monitoring system, which can track and predict the pathway of infectious diseases for its realtime monitoring and control, is developed. This system is implemented based on the conventional mathematical model called by 'Susceptible-Infectious-Recovered (SIR) Model.' The proposed model has characteristics that both inter- and intra-city modes of transportation to express interpersonal contact (i.e., migration flow) are considered. They include the means of transportation such as bus, train, car and airplane. Also, modified real data according to the geographical characteristics of Korea are employed to reflect realistic circumstances of possible disease spreading in Korea. We can predict where and when vaccination needs to be performed by parameters control in this model. The simulation includes several assumptions and scenarios. Using the data of Statistics Korea, five major cities, which are assumed to have the most population migration have been chosen; Seoul, Incheon (Incheon International Airport), Gangneung, Pyeongchang and Wonju. It was assumed that the cities were connected in one network, and infectious disease was spread through denoted transportation methods only. In terms of traffic volume, daily traffic volume was obtained from Korean Statistical Information Service (KOSIS). In addition, the population of each city was acquired from Statistics Korea. Moreover, data on H1N1 (swine flu) were provided by Korea Centers for Disease Control and Prevention, and air transport statistics were obtained from Aeronautical Information Portal System. As mentioned above, daily traffic volume, population statistics, H1N1 (swine flu) and air transport statistics data have been adjusted in consideration of the current conditions in Korea and several realistic assumptions and scenarios. Three scenarios (occurrence of H1N1 in Incheon International Airport, not-vaccinated in all cities and vaccinated in Seoul and Pyeongchang respectively) were simulated, and the number of days taken for the number of the infected to reach its peak and proportion of Infectious (I) were compared. According to the simulation, the number of days was the fastest in Seoul with 37 days and the slowest in Pyeongchang with 43 days when vaccination was not considered. In terms of the proportion of I, Seoul was the highest while Pyeongchang was the lowest. When they were vaccinated in Seoul, the number of days taken for the number of the infected to reach at its peak was the fastest in Seoul with 37 days and the slowest in Pyeongchang with 43 days. In terms of the proportion of I, Gangneung was the highest while Pyeongchang was the lowest. When they were vaccinated in Pyeongchang, the number of days was the fastest in Seoul with 37 days and the slowest in Pyeongchang with 43 days. In terms of the proportion of I, Gangneung was the highest while Pyeongchang was the lowest. Based on the results above, it has been confirmed that H1N1, upon the first occurrence, is proportionally spread by the traffic volume in each city. Because the infection pathway is different by the traffic volume in each city, therefore, it is possible to come up with a preventive measurement against infectious disease by tracking and predicting its pathway through the analysis of traffic volume.

The study for the roles of intratracheally administered histamine in the neutrophil-mediated acute lung injury in rats: (호중구를 매개하는 백서의 급성 폐손상의 병리가전에 있어 기도내로 투여한 히스타민의 역활에 관하여)

  • Koh, Youn-Suck;Hybertson, Brooks M.;Jepson, Eric K.;Kim, Mi-Jung;Lee, In-Chul;Lim, Chae-Man;Lee, Sang-Do;Kim, Dong-Soon;Kim, Won-Dong;Repine, John E.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.308-322
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    • 1996
  • Background : Neutrophils are considered to play critical roles in the development of acute respiratory distress syndrome. Histamine, which is distributed abundantly in lung tissue, increases the rolling of neutrophills via increase of P-selectin expression on the surface of endothelial cells and is known to have some interrelationships with IL-1, IL-8 and TNF-$\alpha$. We studied to investigate the effect of the histamine on the acute lung injury of the rats induced by intratracheal insufflation of TNF-$\alpha$ which has less potency to cause lung injury compared to IL-1 in rats. Methods : We intratracheally instilled saline or TNF(R&D, 500ng), IL-1(R&D, 50ng)or histamine of varius dose(1.1, 11 and $55\;{\mu}g/kg$) with and without TNF separately in Sprague-Dawley rats weighing 270-370 grams. We also intratracheally treated IL-1(50ng) along with histamine($55\;{\mu}g/kg$). In cases, there were synergistic effects induced by histamine on the parameters of TNF-induced acute lung injury, antihistamines(Sigma, mepyramine as a $H_1$ receptor blockade and ranitidine as a $H_2$ receptor blockade, 10 mg/kg in each)were co-administered intravenously to the rats treated TNF along with histamine($1.1\;{\mu}g/kg$) intratraeheally. Then after 5 h we measured lung lavage neutrophil numbers, lavage cytokine-induced neutrophil chemoattractants(CINC), lung myeloperoxidase activity(MPO) and lung leak. We also intratracheally insufflated TNF with/without histamine($11\;{\mu}g/kg$), then after 24 h measured lung leak in rats. Statistical analyses were done by Kruskal-Wallis nonparametric ANOVA test with Dunn's multiple comparison test or by Mann-Whitney U test. Results : We found that rats given TNF, histamine alone(11 and $55\;{\mu}g/kg$), and TNF with histamine(l.1, 11, and $55\;{\mu}g/kg$) intratracheally had increased (p<0.05) lung MPO activity compared with saline-treated control rats. TNF with histamine $11\;{\mu}g/kg$ had increased MPO activity (P=0.0251) compared with TNF-treated rats. TNF and TNF with histamine(1.1, 11, and $55\;{\mu}g/kg$) intratracheally had all increased (p<0.05) lung leak, lavage neutophil numbers and lavage CINC activities compared with saline. TNF with histamine $1.1\;{\mu}g/kg$ had increased (p=0.0367) lavage neutrophil numbers compared with TNF treated rats. But there were no additive effect of histamine with TNF compared with TNF alone in acute lung leak on 5 h and 24 h in rats. Treatment of rats with the $H_1$ and $H_2$ antagonists resulted in inhibitions of lavage neutrophil accumulations and lavage CINC activity elevations elicited by co-treated histamine in TNF-induced acute lung injury intratracheally in rats. We also found that rats given IL-1 along with histamine intratracheally did not have increase in lung leak compared with IL-1 treated rats. Conclusion : Histamine administered intratracheally did not have synergistic effects on TNF-induced acute lung leak inspite of additive effects on increase in MPO activity and lavage neutrophil numbers in rats. These observations suggest that instilling histamine intratracheally would not play synergistic roles in neutrophil-mediated acute lung injury in rats.

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An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation (사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구)

  • Jung, Mi Wha
    • Korean Journal of Occupational Health Nursing
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    • v.3
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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  • A Study on the Sasang Constitutional Distribution Among the People in the United States of America (북미지역주민(北美地域住民)의 사상체질(四象體質) 분포(分布)에 관(關)한 연구(硏究))

    • Koh, Byung-hee;Kim, Seon-ho;Park, Byung-gwan;Lavelle, Jonathan D;Tecun, Marianne;Anthony Jr., Ross;Hobbs, Ron;Zolli, Frank;Chin, Kyung-hee
      • Journal of Sasang Constitutional Medicine
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      • v.11 no.2
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      • pp.119-150
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      • 1999
    • In spite of recent remarkable recent development in both western and oriental medical sciences, there is still only a shallow understanding of individual differences for various prognoses of incurable diseases and immunopathy diseases. Nevertheless, the care, cure and prevention methods of Sasang Constitutional Medicine are broadly used as an effective treatment of incurable diseases like immunopathy diseases and stress-related diseases and diseases due to aging. In this sense, the establishment of classification norms is urgent and essential for the worldwide application of Sasang Constitutional Medicine(SCM). This study began with the confirmation process of whether Sasang Constitutional types exist in Americans. To accomodate for cultural differences, the distinguishing tool was readjusted so that Sasang Constitutional Types in Americans could be determined. Hence, the selected tool is the new QSCCII+, which is a newly revised English version of the QSCCII. QSCCII was made and standardized by Dept. of SCM in Kyung Hee Medical Center and Dr. Kim7). The evaluation methods of the old version were improved in the new QSCCII+ through necessary statistical manipulation. The original QSCCII was officially authorized by the Korean Society of Sasang Constitutional Medicine as the only computerized version of Sasang diagnostics. This study is the first attempt to design a new diagnostic tool for the classification of Sasang Constitutional types in North Americans with the revision of QSCCII. The subjects of this study were selected from the cooperative people among the students and staffs of the University of Bridgeport and the patients who visited the Clinic in the Health Science Center. This study takes for about 1 year from 1998. 8 to 1999. 8 The conclusions of the study can be summarized as follows: 1. Sasang constitutional types also exist in Americans. It can also naturally be inferred that Sasang Constitutional types exist in all human beings, for there are many different human races in America. 2. There are more So-Yang In's than any other types in American white people. This result confirms the hypothesis that there also exist Sasang Constitutional types in westerners. 3. The result of repetitive tests suggests that the new QSCCII+ is an effective diagnostic tool for westerners when we consider the constant diagnostic results of the QSCCII+. 4. Sasang Constitutional types exit in the sample group regardless of racial difference. 5. The question items that were not often checked by Americans need to be modified into more understandable expressions. 6. The standardization of diagnosis for Americans should be established by use of the QSCCII+ 7. It can be guessed that there are many Tae-yang In's among the 71 persons who could not be clearly classified by the QSCCII+. Due to the scarcity of Tae-yang-In in general, it is important to improve upon the discernability of the QSCC II+. 8. The results of the Sasang Constitutional distribution in North Americans are as follows: The percentage of So-yang In distribution in the sample group is 36.25%(87persons), that of Tae-eum In is 13.75%(33persons), and that of So-eum In is 20.41%(49persons).

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    Spatial Distribution of Aging District in Taejeon Metropolitan City (대전광역시 노령화 지구의 공간적 분포 패턴)

    • Jeong, Hwan-Yeong;Ko, Sang-Im
      • Journal of the Korean association of regional geographers
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      • v.6 no.2
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      • pp.1-19
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      • 2000
    • This study is to investigate and analyze regional patterns of aging in Taejeon Metropolitan city-the overpopulated area of Choong-Cheong Province-by cohort analysis method. According to the population structure transition caused by rapid social and economic changes, Korea has made a rapid progress in population aging since 1970. This trend is so rapid that we should prepare for and cope with aging society. It is not only slow to cope with it in our society, but also there are few studies on population aging of the geographical field in Korea. The data of this study are the reports of Population and Housing Censuses in 1975 and 1985 and General Population and Housing Censuses with 10% sample survey in 1995 taken by National Statistical Office. The research method is to sample as the aging district the area with high aged population rate where the populations over 60 reside among total population during the years of 1975, 1985, 1995 and to sample the special districts of decreasing population where the population decreases very much and the special districts of increasing population in which the population increases greatly, presuming that the reason why aged population rate increases is that non-elderly population high in mobility moves out. It is then verified and ascertained whether it is true or not with cohort analysis method by age. Finally regional patterns in the city are found through the classification and modeling by type based on the aging district, the special districts of decreasing population, and the special districts of increasing population. The characteristics of the regional patterns show that there is social population transition and that non-elderly population moves out. The aging district with the high aged population rate is divided into high-level keeping-up type, relative falling type below the average of Taejeon city in aging progress, and relative rising type above the average of the city. This district can be found at both the central area of the city and the suburbs because Taejeon city has the characteristic of over-bounded city. But it cannot be found at the new built-up area with the in-migration of large population. The special districts of decreasing population where the population continues to decrease can be said to be the population doughnuts found at the CBD and its neighboring inner area. On the other hand, the special districts of increasing population where the population continues to increase are located at the new built-up area of the northern part in Taejeon city. The special districts of decreasing population are overlapping with the aging district and higher in aged population rate by the out-migration of non-elderly population. The special districts of increasing population are not overlapping with the aging district and lower in aged population rate by the in-migration of non-elderly population. To clarify the distribution map of the aging district, the special districts of decreasing and increasing population and the aging district are divided into four groups such as the special districts of decreasing population group-the same one as the aging district, the special districts of decreasing population group, the special districts of increasing population group, and the other district. With the cohort analysis method by age used to investigate the definite increase and decrease of aging population through population transition of each group, it is found that the progress of population aging is closely related to the social population fluctuation, especially that aged population rate is higher with the out-migration of non-elderly population. This is to explain each model of CBD, inner area, and the suburbs after modeling the aging district, the special districts of decreasing population, and the special districts of increasing population in Taejeon city. On the assumption that the city area is a concentric circle, it is possible to divide it into three areas such as CBD(A), the inner area(B), and the suburbs(C). The special districts of increasing and decreasing population in the city are divided into three districts-the special districts of decreasing population(a), the special districts of increasing population(b), and the others(c). The aging district of this city is divided into the aging district($\alpha$) and the others($\beta$). And then modeling these districts, it is probable to find regional patterns in the city. $Aa{\alpha}$ and $Ac{\beta}$ patterns are found in the CBD, in which $Aa{\alpha}$ is the special district of decreasing population and is higher in aged population rate because of aged population low in mobility staying behind and out-migration of non-elderly population. $Ba{\alpha}$, $Ba{\beta}$, $Bb{\beta}$, and $Bc{\beta}$ patterns are found in the inner area, in which neighboring area $Ba{\alpha}$ pattern is located. $Bb{\beta}$ pattern is located at the new developing area of newly built apartment complex. $Cb{\beta}$, $Cc{\alpha}$, and $Cc{\beta}$ patterns are found in the suburbs, among which $Cc{\alpha}$ pattern is highest in population aging. It is likely that the $Cc{\beta}$ under housing land readjustment on a large scale will be the $Cb{\beta}$ pattern. As analyzed above, marriage and out-migration of new family, non-elderly population, with house purchase are main factors in accelerating population aging in the central area of the city. Population aging is responsible for the great increase of aged population with longer life expectancy by the low death rate, the out-migration of non-elderly population, and the age group of new aged population in the suburbs. It is necessary to investigate and analyze the regional patterns of population aging at the time when population problems caused by aging as well as longer life expectancy are now on the increase. I hope that this will help the future study on population aging of the geographical field in Korea. As in the future population aging will be a major problem in our society, local autonomy should make a plan for the problem to the extent that population aging progresses by regional groups and inevitably prepare for it.

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    Study on the Relationships Among Perceived Shopping Values, Brand Equity, and Store Loyalty of Korean and Chinese Consumers: A Case of Large Discount Store (한국과 중국 소비자의 쇼핑 경험가치 지각과 브랜드자산 및 점포충성도의 관계에 관한 비교 연구: 대형 할인점을 중심으로)

    • Hwang, Soonho;Oh, Jongchul;Yoon, Sungjoon
      • Asia Marketing Journal
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      • v.14 no.2
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      • pp.209-237
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      • 2012
    • 1. Research Purpose Consumers rely on various clues to evaluate their decision to patronize a retail store, and store brand is one of them (Dodds 1991; Grewal et al. 1998). As consumers find ever increasing variety of contact points connecting them to specific store, the value of experiential shopping as a means of increasing store's brand equity warrants greater attention from scholars of retail management. Retail shopping values are credited for creating not only cognitive experiences like brand knowledge but also emotional experiences such as shopping pleasure and pride (Schmitt 1999). This may be because today's consumers place emphasis on emotional values associated with shopping pleasure, lifestyle brought to life, brand relationship, and store atmosphere more than utilitarian values such as product quality and price. Many previous literature found this to be true (Ahn and Lee 2011; Mathwick et al. 2001). This brings forth important research issues and questions regarding the roles of shopping experiential values and brand equity with regard to consumer's retail patronage choice. However, despite this importance, research on this area remains quite inadequate (Hwang 2010). For this reason, this study aims to verify the relationships among experiential shopping values, retail store brand equity and tries to link that with customer loyalty by surveying large-scale discount store shoppers in Korea and China. 2. Research Contents In order to carry out the research objective, this study conducted comprehensive literature survey on previous literature by discussing major findings and implications with regard to shopping values and retail brand equity and store loyalty. For data collection, researcher employed survey-based research method where data were collected in two major cities of Korea (Seoul) and China (Bejing) and sampling frame was based on patrons of large discount stores in both countries. Specific research questions raised in this study are as follows; RQ1: How do Korean and Chinese consumers differently perceive of shopping values regarding shopping at large-sclae discount stores? RQ2: Are there differences in consumers' emotional consumption propensities? RQ3: Do Korean and Chinese consumers display different perceptions of brand equity towards large-scale discount stores? RQ4: Are there differences in relationships between shopping values and brand equity for Korean and Chinese consumers? For statistical analysis, SPSS17.0, AMOS17.0 and SmartPLS were employed. 3. Research Results The data collected through face-to-face survey conducted in Seoul and Bejing revealed appropriate data validity and reliability as a result of exploratory/confirmatory factor analysis and reliability tests, andh SEM model yielding satisfactory model fitness. The result of the study may be summarized by three main points. First, as a result of testing differences in consumption dispositions, Chinese consumers showed higher scores in aesthetic and symbolic dispositions, whereas Korean consumers scored higher in hedonic disposition. Second, testing on perceptions toward brand equity of large discount stores showed that Korean consumers exhibited more positive perceptions of brand awareness and brand image than Chinese counterparts. Third, the result of exploratory factor analysis on the experiential shopping values revealed different factors for each country. On Korean side, consumer interest value, aesthetic value, and hedonic value were prominent, whereas on Chinese side, hedonic value, aesthetic value, consumer interest value, and service excellence value were found salient. 4. Research Implications While many previous studies on inter-country differences in retailing area mainly focused on cultural dispositions or orientations to explain the differences, this study sets itself apart by specifically targeting individual consumer's shopping values from an experiential viewpoint. The study result provides important theoretical as well as practical implications for large-scale discount store, especially the impotance of fully exploring the linkage between shopping values and brand equity, which has significant influence on loyalty. Therefore, the specific implications deriving from the result shed some important insights upon the consumption values based on shopping experiences and brand equity. The differences found in store shoppers between the two countries may also provide useful insights for Korean and Chinese retailers who plan to expand their operations globally. Related strategic implications derived from this study is the importance of localizing retail strategy which is based on the differences found in experiential shopping values between the two country groups. Especially the finding that Chinese consumers value consumer interest and service excellence, whereas Koreans place importance on hedonic or aesthetic values indicates the need to differentiate the consumer's psychographical profiles when it comes to expanding retail operations globally. Particularly important will be to pursue price-orienated strategy in China in consideration of the high emphasis on consumer interests and service excellence, but to emphasize the symbolic aspects of brand equity in Korea by maximizing the brand equity associated with aesthetic values and hedonic orientations. 5. Recommendations This study focused on generic retail branded discount stores in both countries, thus making it difficult to tease out store-specific strategies based on specific retail brands. Future studies may benefit fro employing actual brand names in survey questionnaire to verify relationship between shopping values and brand-based store strategy. As with other studies of this nature, this study needs to strengthen the result's generalizability by selecting respondents from a wider spectrum of respondents.

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