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Assessment of the Usefulness of an IMRT Plan Using a Shell-Type Pseudo Target with Patients in Stage III or IV of NSCLC (비소세포폐암 III, IV기 환자에 있어서 Shell-Type Pseudo Target을 이용한 세기 조절 방사선치료계획기법의 유용성 평가)

  • Lee, Sang-Bong;Park, Ki-Ju;Park, Du-Chan;Kim, Man-Wo;Kim, Jun-Gon;Noh, Sung-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.95-106
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    • 2012
  • Purpose: The objective of this study was to investigate the usefulness of an IMRT treatment plan according to whether there was a shell-type pseudo target during radiation therapy for patients in Stage III or IV of non-small cell lung cancer (NSCLC). Materials and Methods: After setting an IMRT (Intensity-Modulated Radiation Therapy, IMRT) plan for when there was a shell-type pseudo target (SPT) and when there was none (WSPT) with 22 patients in Stage III or IV of NSCLC, the investigator analyzed dose-volume histograms (DVHs) and made assessment with dosimetric comparisons such as homogeneity index (HI) inside the tumor target, conformity index (CI) of the tumor target, spinal cord maximum dose, Esophagus $V_{50%}$, mean lung dose (MLD), and $V_{40%}$, $V_{30%}$, $V_{20%}$, $V_{10%}$, $V_{5%}$. Results: The mean CI of WSPT and SPT was $1.22{\pm}0.04$ and $1.16{\pm}0.032$ ($.000^*$), respectively, and the mean HI of WSPT and SPT was $1.06{\pm}0.015$ and $1.07{\pm}0.014$ ($.000^*$), respectively. In SPT, the mean of each CI difference decreased by $-5.16{\pm}2.54%$, while HI increased by average $0.81{\pm}0.47%$. Esophagus $V_{50%}$ recorded $14.54{\pm}12.01%$ (WSPT) and $12.14{\pm}11.09%$ ($.000^*$, SPT) with the mean of SPT differences dropping by $-26.37{\pm}25.05%$. Mean spinal cord maximum dose was $3,898.44{\pm}1,075.0$ cGy (WSPT) and $3,810.8{\pm}1,134.9$ cGy ($.004^*$, SPT) with SPT dropping by average $-3.36{\pm}5.81%$. As for lung $V_{X%}$, the mean of $V_{5%}$ and $V_{10%}$ differences was $-1.62{\pm}2.29%$ ($.006^*$) and $-1.98{\pm}5.02%$ ($.005^*$), respectively with SPT making a decrease. The mean of V20%, V30%, and V40% differences was $-3.51{\pm}3.07%$ ($.000^*$), $-4.84{\pm}6.01%$ ($.000^*$), and $-6.16{\pm}8.46%$ ($.001^*$), respectively, with SPT making a decrease with statistical significance. In MLD assessment, SPT also dropped by average $-2.83{\pm}2.41%$ ($.000^*$). Those results show that SPT allows for mean 169 cGy (Max: 547 cGy, Min: 6.4 cGy) prescription dose. Conclusion: An IMRT treatment plan with SPT during radiation therapy for patients in Stage III or IV of NSCLC will help to reduce the risk of lung toxicity and radiation-induced pneumonia by cutting down radiation doses entering the normal lung, reduce the local control failure rate during radiation therapy due to increasing prescription doses to a certain degree, and increase treatment effects.

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The efficacy of continuous positive airway pressure (CPAP) for patient with left breast cancer (좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가)

  • Jung, Il Hun;Ha, Jin Sook;Chang, Won Suk;Jeon, Mi Jin;Kim, Sei Joon;Jung, Jin Wook;Park, Byul Nim;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.43-49
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    • 2019
  • Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

A Study on medical Qigong mentioned in ${\ll}$Samilshingo${\gg}$ (三一神誥) (${\ll}$삼일신고(三一神誥)${\gg}$에 나타난 의료기공(醫療氣功)에 관(關)한 연구(硏究))

  • Ban, Chang-Yul
    • Journal of Korean Medical Ki-Gong Academy
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    • v.7 no.2
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    • pp.40-94
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    • 2004
  • Recently, meditation, Zen meditation and Qigong became popular in western. For that reason, Value of Korea traditional methods for health promotion have been evaluated but theoretical evidence about that is insufficient. ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經). So, I reviewed history of Korea Qigong according to period, in order to produce theoretical evidence of Korea medical Qigong and investigated ${\ulcorner}$Han${\lrcorner}$ thought (${\ulcorner}$${\lrcorner}$ 思想) as theoretical evidence of Korea Qigong. I have obtained following results by comparing meaning of god, a view of human body and practice method of the ${\ll}$Samilshingo${\gg}$ (三一神誥) with ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經). Sinsundo(神仙道) of native to race became active during the period of the Three Kingdoms but more disappeared due to under the influence of Taoism. So only has been remained in existence since the period of the unity silla. There could accept positively the foreign ideas belonging to Confucianism, Buddhism and Taoism have been brought since the period of the Three Kingdoms because ${\ll}$Samilshingo${\gg}$ (三一神誥), one of three the scriptures as the origin of ${\ulcorner}$Han${\lrcorner}$ thought(${\ulcorner}$${\lrcorner}$ 思想) included the original form of three religion belonging to Confucianism, Buddhism, Taoism. Three common results as theoretical evidence of Qigong were found out by comparing ${\ll}$Samilshingo${\gg}$ (三一神誥) with ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經). First, in meaning of god, there is not only different from the gods of heaven and the gods of human but also keep understanding with each other and there was common feature of logical structure that function of god was divided into three. Second, In a view of human body, there were in common with ${\ll}$Samilshingo${\gg}$ (三一神誥) as theory of only as energy(氣一元論), theory of bisection as truth false(眞妄二分論), theory of trisection as spirit(性) destiny(命) nature(精) and mind(心) energy(氣) body(身)(性 命 精, 心 氣 身의 三分論) and ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經) as theory of only as energy(氣一元論), theory of bisection as shape and god(形神二分論), theory of trisection as nature(精) energy(氣) god(神) or shape(形) energy(氣) god(神)(精 氣 神, 形 氣 神의 三分論) according to formal part. Also, spirit(性) destiny(命) nature(精) as truths of three(三眞) were understand as nature(精) energy(氣) god(神) as treasure of three(三寶) by part of reason and mind(心) energy(氣) body(身) as false of three(三妄) were understand as nature(精) energy(氣) god(神) as treasure of three(三寶) by part of function. Third, In practice method, pause of thinking(止感) modulation of breath(調息). prohibition of sensibility(禁觸) mentioned in ${\ll}$Samilshingo${\gg}$ (三一神誥) as practice method each were understand regulation of an etiological cause as an internal cause, an external cause and not internal and external cause in oriental medicine. Namely, pause of thinking(止感) was understand as regulation method of emotion, mind and nature. modulation of breath(調息) was not only as modulation of energy from the inner parts of the body but also that from the internal and external parts of the body, prohibition of sensibility(禁觸) was understand as regulation method of ear, eye, mouth, and nose and posture, life style. These results suggest that ${\ll}$Samilshingo${\gg}$ (三一神誥) is worth meaning of Korea medical Qigong because meaning of god, a view of human body, practice method of mentioned in ${\ll}$Samilshingo${\gg}$ (三一神誥) is common with that of ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經) as theoretical evidence of Qigong.

Spontaneous Passage of Gastrointestinal Foreign Bodies in Children (소아에서 위장관 이물의 자연 배출에 대한 경험적 고찰)

  • Lee, Ji-Hyuk;Nam, Suk-Hyun;Lee, Jee-Hyun;Lee, Hae-Jeong;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.157-165
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    • 2007
  • Purpose: Ingested foreign bodies are removed by endoscopy, surgery or spontaneous passage, however, the decision of therapeutic modality chosen depends on the type, size, shape and location of the ingested foreign bodies. Therefore, this study was conducted to investigate the rate and characteristics of foreign bodies that were passed spontaneously out of the intestine. Methods: One hundred and sixty patients who visited Samsung Medical Center for treatment of gastrointestinal foreign bodies between January 2001 to July 2007 were enrolled in this study. Related data was colleted by reviewing the medical records of patients with proven foreign bodies retrospectively, as well as by conducting phone interviews with the parents of the patients. All cases were classified based on the nature and location of the ingested foreign body, as well as whether it was treated by spontaneous passage. Results: Of the 160 cases involving the passage of foreign bodies in children were included in this study (95 boys and 65 girls), endoscopic removals, operative removals or spontaneous passages were conducted in 80, 3 and 77 patients, respectively. The spontaneous passage rates for each type of object were as follows; coins (36.5%), bead and baduk stones (83.3%), long and sharp materials (52.6%), magnets (69.2%) and disc batteries (50.0%). In cases involving round-shaped foreign bodies, such as coins, the diverse spontaneous passage rates were more diverse. When foreign bodies were stuck below esophagus, similar sized coins and baduk stones had spontaneous passage rates greater than 80% regardless of age. Conclusion: It is better for clinicians to wait for spontaneous passage to occur in cases involving coins or round-shaped foreign bodies that are located at or below the stomach.

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Nutritional Assessment and the Effectiveness of Dietary Counseling in Infants and Young Children with Iron Deficiency Anemia (철결핍성 빈혈을 가진 영유아에서 영양학적 평가 및 영양상담 효과)

  • Kim, Ja Kyoung;Ko, Eun Young;Lee, Yu Jin;Jun, Yong Hun;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.11-16
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    • 2003
  • Purpose : Iron deficiency is still the most common nutrient deficient disorder despite the improvement in general health and nutrition. This study is designed to evaluate the dietary history of infants and young children with iron deficiency anemia(IDA) and the effects of nutritional counseling. Methods : This study was conducted on 120 children from 6 to 36 months of age with IDA. Their parents completed a questionnaire and took counsel for nutrition. IDA was defined as Hb <11.0 g/dL, ferritin <10 ng.mL or transferrin saturation <15%, or Hb increase >1 g/dL after iron preparation. The questionnaire consisted of their feeding patterns, weaning time and kinds of food. Results : In the 120 infants and young children aged from 6 to 36 months, the parents of 82 cases was counseled about nutrition. Fifty six infants among 82 cases have started weaning and the main foods of weaning were rice and/or rice gruel. Nutritional problems in weaning were that some children over one year of age were using a bottle, and parents restricted weaning food at will because of allergic disease or chronic disease. Most parents were satisfied with the nutritional counseling given from a clinical dietitian and showed good compliance. Conclusion : Many infants and young children with IDA were provided with non iron-fortified foods and made an inadequate wean. Most parents were satisfied with the nutritional counseling and showed good compliance. The need of dietary counseling was required for prevention and treatment of iron deficiency anemia because of inadequate weaning.

Survey on the Awareness of Guardians of Young Infants on the Weaning of Food in Pohang and Gyeongju Area (두 종합 병원을 방문한 영유아 양육자의 이유식에 대한 인지도 조사)

  • We, Hyun Woo;Seo, Yu Kyung;Kim, Ae Suk;Lee, Sun Ju;Cho, Sung Min;Lee, Dong Seok;Kim, Doo Kwun;Choi, Sung Min
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.233-241
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    • 2006
  • Purpose: This study was carried out to investigate the awareness of the weaning of food using questionnaires, and the relationship with the weight gain in young infants. Methods: From September 2005 to December 2005, we performed a survey on 141 guardians of young infants aged from 6 to 18 months, who visited the pediatric out-patient department at Dongguk University Medical Center. We calculated the total score for each responder from ten questions on the weaning of food and assessed the body weight percentile of each of the young infants. Results: The most commonly reported information source for weaning food was 'the friends around' by 62 respondents (44.0%); 54 (38.3%) responded that the definition of weaning food was the preparatory step before starting a solid diet. Most used a spoon (90.8%) to feed when weaning food with a thin gruel of rice (78.7%). The time for weaning of food was before breast or infant formula feeding (55.3%). Addition of cow's milk was around 12 months (77.3%). The mean score was 6.21; however this did not show a statistically significant correlation with weight gain in young infants. Conclusion: The overall awareness of weaning of food has improved; however, information from doctors has decreased. Although the relationship between the awareness of weaning of food and the growth of young infants was not statistically significant, further studies on weaning of food, with larger and controlled sample sizes may provide important information.

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FOI and Government Records Management Reforms under Obama Administration (미국 정보자유제도와 정부기록관리 혁신 오바마 행정부의 정부개방정책을 중심으로)

  • Lee, Sang-min
    • The Korean Journal of Archival Studies
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    • no.35
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    • pp.3-40
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    • 2013
  • Establishment and expansion of a FOI regime is a fundamental basis for modern democracy. Informed decisions and supports by the people are critical to establishment of democratic institutions and policies. The best tool to make informed decisions and to ensure accountability is the FOI. For effective FOI, good records management is necessary requirement. This paper observes and analyses the development of the FOI in the U.S., the Open Government policy, and the government records management reforms under Obama Administration to search viable solutions for Korean FOI and public records management reforms. Major revisions and advancement of the FOIA in the United States are examined, especially the revision of the FOIA as the OPEN Government Act of 2007. The FOIA revision enhanced greatly the freedom of information in the U.S. including the establishment of an independent FOI ombudsman by the Congress. The paper also discusses the Presidential memoranda on the Open Government and the FOI by President Obama, the following directives, Presidential memorandum on government records management and the Government Records Management Directive. Major contents of the directives, plans, and achievement are summarized and analysed. Finally, this paper compares the government records management reforms under former President Roh Mu Hyun with the Obama's reform drive. The comparison found that major difference in the "top-down" government records reforms are the difference in democratic institutions such as weak congressional politics, strong bureaucratic obstacles, and relatively weak social and professional supports for the reforms in Korea, while these reforms were similar in terms that they were driven by insightful political leaders. Independent FOI ombudsman and national records administration are necessary for such democratic reforms.

Comparison of Treatment Planning System(TPS) and actual Measurement on the surface under the electron beam therapy with bolus (전자선 치료 시 Bolus를 적용한 경우 표면선량의 Treatment Planning System(TPS) 계산 값과 실제 측정값의 비교)

  • Kim, Byeong Soo;Park, Ju Young;Park, Byoung Suk;Song, Yong Min;Park, Byung Soo;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.163-170
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    • 2014
  • Purpose : If electron, chosen for superficial oncotherapy, was applied with bolus, it could work as an important factor to a therapy result by showing a drastic change in surface dose. Hence the calculation value and the actual measurement value of surface dose of Treatment Planning System (TPS) according to four variables influencing surface dose when using bolus on an electron therapy were compared and analyzed in this paper. Materials and Methods : Four variables which frequently occur during the actual therapies (A: bolus thickness - 3, 5, 10 mm, B: field size - $6{\time}6$, $10{\time}10$, $15{\time}15cm2$, C: energy - 6, 9, 12 MeV, D: gantry angle - $0^{\circ}$, $15^{\circ}$) were set to compare the actual measurement value with TPS(Pinnacle 9.2, philips, USA). A computed tomography (lightspeed ultra 16, General Electric, USA) was performed using 16 cm-thick solid water phantom without bolus and total 54 beams where A, B, C, and D were combined after creating 3, 5 and 10 mm bolus on TPS were planned for a therapy. At this moment SSD 100 cm, 300 MU was investigated and measured twice repeatedly by placing it on iso-center by using EBT3 film(International Specialty Products, NJ, USA) to compare and analyze the actual measurement value and TPS. Measured film was analyzed with each average value and standard deviation value using digital flat bed scanner (Expression 10000XL, EPSON, USA) and dose density analyzing system (Complete Version 6.1, RIT, USA). Results : For the values according to the thickness of bolus, the actual measured values for 3, 5 and 10 mm were 101.41%, 99.58% and 101.28% higher respectively than the calculation values of TPS and the standard deviations were 0.0219, 0.0115 and 0.0190 respectively. The actual values according to the field size were $6{\time}6$, $10{\time}10$ and $15{\time}15cm2$ which were 99.63%, 101.40% and 101.24% higher respectively than the calculation values and the standard deviations were 0.0138, 0.0176 and 0.0220. The values according to energy were 6, 9, and 12 MeV which were 99.72%, 100.60% and 101.96% higher respectively and the standard deviations were 0.0200, 0.0160 and 0.0164. The actual measurement value according to beam angle were measured 100.45% and 101.07% higher at $0^{\circ}$ and $15^{\circ}$ respectively and standard deviations were 0.0199 and 0.0190 so they were measured 0.62% higher at $15^{\circ}$ than $0^{\circ}$. Conclusion : As a result of analyzing the calculation value of TPS and measurement value according to the used variables in this paper, the values calculated with TPS on 5 mm bolus, $6{\time}6cm2$ field size and low-energy electron at $0^{\circ}$ gantry angle were closer to the measured values, however, it showed a modest difference within the error bound of maximum 2%. If it was beyond the bounds of variables selected in this paper using electron and bolus simultaneously, the actual measurement value could differ from TPS according to each variable, therefore QA for the accurate surface dose would have to be performed.

Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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Emoticon by Emotions: The Development of an Emoticon Recommendation System Based on Consumer Emotions (Emoticon by Emotions: 소비자 감성 기반 이모티콘 추천 시스템 개발)

  • Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.24 no.1
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    • pp.227-252
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    • 2018
  • The evolution of instant communication has mirrored the development of the Internet and messenger applications are among the most representative manifestations of instant communication technologies. In messenger applications, senders use emoticons to supplement the emotions conveyed in the text of their messages. The fact that communication via messenger applications is not face-to-face makes it difficult for senders to communicate their emotions to message recipients. Emoticons have long been used as symbols that indicate the moods of speakers. However, at present, emoticon-use is evolving into a means of conveying the psychological states of consumers who want to express individual characteristics and personality quirks while communicating their emotions to others. The fact that companies like KakaoTalk, Line, Apple, etc. have begun conducting emoticon business and sales of related content are expected to gradually increase testifies to the significance of this phenomenon. Nevertheless, despite the development of emoticons themselves and the growth of the emoticon market, no suitable emoticon recommendation system has yet been developed. Even KakaoTalk, a messenger application that commands more than 90% of domestic market share in South Korea, just grouped in to popularity, most recent, or brief category. This means consumers face the inconvenience of constantly scrolling around to locate the emoticons they want. The creation of an emoticon recommendation system would improve consumer convenience and satisfaction and increase the sales revenue of companies the sell emoticons. To recommend appropriate emoticons, it is necessary to quantify the emotions that the consumer sees and emotions. Such quantification will enable us to analyze the characteristics and emotions felt by consumers who used similar emoticons, which, in turn, will facilitate our emoticon recommendations for consumers. One way to quantify emoticons use is metadata-ization. Metadata-ization is a means of structuring or organizing unstructured and semi-structured data to extract meaning. By structuring unstructured emoticon data through metadata-ization, we can easily classify emoticons based on the emotions consumers want to express. To determine emoticons' precise emotions, we had to consider sub-detail expressions-not only the seven common emotional adjectives but also the metaphorical expressions that appear only in South Korean proved by previous studies related to emotion focusing on the emoticon's characteristics. We therefore collected the sub-detail expressions of emotion based on the "Shape", "Color" and "Adumbration". Moreover, to design a highly accurate recommendation system, we considered both emotion-technical indexes and emoticon-emotional indexes. We then identified 14 features of emoticon-technical indexes and selected 36 emotional adjectives. The 36 emotional adjectives consisted of contrasting adjectives, which we reduced to 18, and we measured the 18 emotional adjectives using 40 emoticon sets randomly selected from the top-ranked emoticons in the KakaoTalk shop. We surveyed 277 consumers in their mid-twenties who had experience purchasing emoticons; we recruited them online and asked them to evaluate five different emoticon sets. After data acquisition, we conducted a factor analysis of emoticon-emotional factors. We extracted four factors that we named "Comic", Softness", "Modernity" and "Transparency". We analyzed both the relationship between indexes and consumer attitude and the relationship between emoticon-technical indexes and emoticon-emotional factors. Through this process, we confirmed that the emoticon-technical indexes did not directly affect consumer attitudes but had a mediating effect on consumer attitudes through emoticon-emotional factors. The results of the analysis revealed the mechanism consumers use to evaluate emoticons; the results also showed that consumers' emoticon-technical indexes affected emoticon-emotional factors and that the emoticon-emotional factors affected consumer satisfaction. We therefore designed the emoticon recommendation system using only four emoticon-emotional factors; we created a recommendation method to calculate the Euclidean distance from each factors' emotion. In an attempt to increase the accuracy of the emoticon recommendation system, we compared the emotional patterns of selected emoticons with the recommended emoticons. The emotional patterns corresponded in principle. We verified the emoticon recommendation system by testing prediction accuracy; the predictions were 81.02% accurate in the first result, 76.64% accurate in the second, and 81.63% accurate in the third. This study developed a methodology that can be used in various fields academically and practically. We expect that the novel emoticon recommendation system we designed will increase emoticon sales for companies who conduct business in this domain and make consumer experiences more convenient. In addition, this study served as an important first step in the development of an intelligent emoticon recommendation system. The emotional factors proposed in this study could be collected in an emotional library that could serve as an emotion index for evaluation when new emoticons are released. Moreover, by combining the accumulated emotional library with company sales data, sales information, and consumer data, companies could develop hybrid recommendation systems that would bolster convenience for consumers and serve as intellectual assets that companies could strategically deploy.