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The Effect of Herding Behavior and Perceived Usefulness on Intention to Purchase e-Learning Content: Comparison Analysis by Purchase Experience (무리행동과 지각된 유용성이 이러닝 컨텐츠 구매의도에 미치는 영향: 구매경험에 의한 비교분석)

  • Yoo, Chul-Woo;Kim, Yang-Jin;Moon, Jung-Hoon;Choe, Young-Chan
    • Asia pacific journal of information systems
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    • v.18 no.4
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    • pp.105-130
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    • 2008
  • Consumers of e-learning market differ from those of other markets in that they are replaced in a specific time scale. For example, e-learning contents aimed at highschool senior students cannot be consumed by a specific consumer over the designated period of time. Hence e-learning service providers need to attract new groups of students every year. Due to lack of information on products designed for continuously emerging consumers, the consumers face difficulties in making rational decisions in a short time period. Increased uncertainty of product purchase leads customers to herding behaviors to obtain information of the product from others and imitate them. Taking into consideration of these features of e-learning market, this study will focus on the online herding behavior in purchasing e-learning contents. There is no definite concept for e-learning. However, it is being discussed in a wide range of perspectives from educational engineering to management to e-business etc. Based upon the existing studies, we identify two main view-points regarding e-learning. The first defines e-learning as a concept that includes existing terminologies, such as CBT (Computer Based Training), WBT (Web Based Training), and IBT (Internet Based Training). In this view, e-learning utilizes IT in order to support professors and a part of or entire education systems. In the second perspective, e-learning is defined as the usage of Internet technology to deliver diverse intelligence and achievement enhancing solutions. In other words, only the educations that are done through the Internet and network can be classified as e-learning. We take the second definition of e-learning for our working definition. The main goal of this study is to investigate what factors affect consumer intention to purchase e-learning contents and to identify the differential impact of the factors between consumers with purchase experience and those without the experience. To accomplish the goal of this study, it focuses on herding behavior and perceived usefulness as antecedents to behavioral intention. The proposed research model in the study extends the Technology Acceptance Model by adding herding behavior and usability to take into account the unique characteristics of e-learning content market and e-learning systems use, respectively. The current study also includes consumer experience with e-learning content purchase because the previous experience is believed to affect purchasing intention when consumers buy experience goods or services. Previous studies on e-learning did not consider the characteristics of e-learning contents market and the differential impact of consumer experience on the relationship between the antecedents and behavioral intention, which is the target of this study. This study employs a survey method to empirically test the proposed research model. A survey questionnaire was developed and distributed to 629 informants. 528 responses were collected, which consist of potential customer group (n = 133) and experienced customer group (n = 395). The data were analyzed using PLS method, a structural equation modeling method. Overall, both herding behavior and perceived usefulness influence consumer intention to purchase e-learning contents. In detail, in the case of potential customer group, herding behavior has stronger effect on purchase intention than does perceived usefulness. However, in the case of shopping-experienced customer group, perceived usefulness has stronger effect than does herding behavior. In sum, the results of the analysis show that with regard to purchasing experience, perceived usefulness and herding behavior had differential effects upon the purchase of e-learning contents. As a follow-up analysis, the interaction effects of the number of purchase transaction and herding behavior/perceived usefulness on purchase intention were investigated. The results show that there are no interaction effects. This study contributes to the literature in a couple of ways. From a theoretical perspective, this study examined and showed evidence that the characteristics of e-learning market such as continuous renewal of consumers and thus high uncertainty and individual experiences are important factors to be considered when the purchase intention of e-learning content is studied. This study can be used as a basis for future studies on e-learning success. From a practical perspective, this study provides several important implications on what types of marketing strategies e-learning companies need to build. The bottom lines of these strategies include target group attraction, word-of-mouth management, enhancement of web site usability quality, etc. The limitations of this study are also discussed for future studies.

The Effects of Diluted Fibrin Glue about Continuous Air Leakage after Lung Surgery (폐수술 후 지속적 공기누출에 희석한 Fibrin Glue의 효과)

  • Choi Chang-Woo;Lee Seong-Jin;Lee Chol-Sae;Lee Kihl-Rho;Lee Seock-Yeol
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.770-774
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    • 2006
  • Background: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leak-age and observed the effects and efficiency of treatment. Material and Method: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. Results: Continuous air leakages disappeared in all f6 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complications were transient and disappeared without specific treatment. Conclusion: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.

$H_2$ Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study (노인 인구에서 $H_2$ Receptor Antagonist와 위암과의 관련성: 코호트 내 환자-대조군 연구)

  • Kim, Yoon-I;Heo, Dae-Seog;Lee, Seung-Mi;Youn, Kyoung-Eun;Koo, Hye-Won;Bae, Jong-Myon;Park, Byoung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.245-254
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    • 2002
  • Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.

Radiation-induced Pulmonary Toxicity following Adjuvant Radiotherapy for Breast Cancer (유방암 환자에서 보조적 방사선치료 후의 폐 손상)

  • Moon, Sung-Ho;Kim, Tae-Jung;Eom, Keun-Young;Kim, Jee-Hyun;Kim, Sung-Won;Kim, Jae-Sung;Kim, In-Ah
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.109-117
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    • 2007
  • [ $\underline{Purpose}$ ]: To evaluate the incidences and potential predictive factors for symptomatic radiation pneumonitis (SRP) and radiographic pulmonary toxicity (RPT) following adjuvant radiotherapy (RT) for patients with breast cancer. A particular focus was made to correlate RPT with the dose volume histogram (DVH) parameters based on three-dimensional RT planning (3D-RTP) data. $\underline{Materials\;and\;Methods}$: From September 2003 through February 2006, 171 patients with breast cancer were treated with adjuvant RT following breast surgery. A radiation dose of 50.4 Gy was delivered with tangential photon fields on the whole breast or chest wall. A single anterior oblique photon field for supraclavicular (SCL) nodes was added if indicated. Serial follow-up chest radiographs were reviewed by a chest radiologist. Radiation Therapy Oncology Group (RTOG) toxicity criteria were used for grading SRP and a modified World Health Organization (WHO) grading system was used to evaluate RPT. The overall percentage of the ipsilateral lung volume that received ${\geq}15\;Gy\;(V_{15}),\;20\;Gy\;(V_{20})$, and $30\;Gy\;(V_{30})$ and the mean lung dose (MLD) were calculated. We divided the ipsilateral lung into two territories, and defined separate DVH parameters, i.e., $V_{15\;TNGT},\;V_{20\;TNGT},\;V_{30\;TNGT},\;MLD_{TNGT}$, and $V_{15\;SCL},\;V_{20\;SCL},\;V_{30SCL},\;MLD_{SCL}$ to assess the relationship between these parameters and RPT. $\underline{Results}$: Four patients (2.1%) developed SRP (three with grade 3 and one with grade 2, respectively). There was no significant association of SRP with clinical parameters such as, age, pre-existing lung disease, smoking, chemotherapy, hormonal therapy and regional RT. When 137 patients treated with 3D-RTP were evaluated, 13.9% developed RPT in the tangent (TNGT) territory and 49.2% of 59 patients with regional RT developed RPT in the SCL territory. Regional RT (p<0.001) and age (p=0.039) was significantly correlated with RPT. All DVH parameters except for $V_{15\;TNGT}$ showed a significant correlation with RPT (p<0.05). $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory than $V_{15\;SCL}$ for the SCL territory. $\underline{Conclusion}$: The incidence of SRP was acceptable with the RT technique that was used. Age and regional RT were significant factors to predict RPT. The DVH parameter was good predictor for RPT for the SCL territory while $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory.

Mitral Valve Repair for Active and Healed Endocarditis (급성 혹은 치유된 심내막염 환자에서의 승모판막성형술)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Sae;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Wook-Sung;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.820-827
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    • 2003
  • Background: Mitral valve repair rather than replacement for mitral regurgitation (MR) offers a number of well-accepted benefits. However, the surgical results of repair for mitral valve endocarditis remain largely unknown. Material and Method: Fourteen patients who underwent mitral valve repair for MR caused by mitral valve endocarditis from April 1995 through October 2001 were reviewed retrospectively. There were 9 male patients and mean age was 32$\pm$10 years. Four patients had previous embolism and 2 had active infections. The grade of MR were III in 6 patients and IV in 8. Operatively, mitral annuloplasty was performed in 12 patients and various valvuloplasty techniques were applied in all patients. One patient had immediate valve replacement due to residual MR after weaning of cardiopulmonary bypass. Result: There was no early operative death. Early postoperative transthoracic echocardiography revealed no or grade I of MR and no or mild mitral stenosis in 13 patients. After the mean follow-up of 36 months, there was no late death, and no or grade I of MR in 11 patients (84.6%) and no or mild mitral stenosis in 12 patients (92.3%). Reoperation required in one patient (7.1%). The cumulative freedom from recurrent MR and valve-related reoperation at 5 years were 91$\pm$9% and 75$\pm$22%, respectively. Conclusion: This study suggests that mitral valve repair for mitral regurgitation caused by endocarditis offers good early and intermediate survival and functional improvement without reinfection, and it is an attractive alternative to valve replacement in selective patients with bacterial endocariditis.

A study on eating habits of the Buddhist Priesthood in Seoul and Kyongnam -I. Dietary pattern and special food- (서울, 경남지역 승가(僧家)의 식생활(食生活)에 관한 조사연구 -I. 식이패턴과 특별식 중심으로-)

  • Cho, Eun-Ja;Park, Sun-Hee
    • Journal of the Korean Society of Food Culture
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    • v.9 no.2
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    • pp.111-118
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    • 1994
  • The purpose of this study was to understand dietaty culture of the Buddhist priesthood in Seoul and Kyungnam. This survey was carried out through questionnaries and the subjects were 26 temples and hermitages. The results of this study can be summarized as follow: 1. Most of the Buddhist priesthood takes meal three times for a day regularly. The substitution food was used mainly rice gruel, fruits, powder of roasted grain, kinds of cookie and confectionary, kinds of steamed dish and milk. 2. The seasoning substances were used necessarily soy sauce, soybean paste, salt and sesame, sesame oil, vegetable oil, and used rarely Jepi powder, red powder, chinese pepper and M.S.G. 3. Eating table was used chiefly for Buddhist priethood and a vistor, and tea and cookie, D'ock, noodle were used often. Event and party foods of temple were used Bibimbab, Ogokbab, Yagbab, D'ockguk, soybean of noodle. 4. Offering food to Buddha was used to Five-offered to Buddha(香, 燈, 茶, 果, 米) primarily and religious food was used scarcely. 5. Special food was used D'ock, hand made cookie and confectionaries, kinds of chinish medicine tea and pine needle tea. Injulmi and Julpyun were prepared most frequently, and used to mixed rice flour with mugwort now and then. Coating and filling powders for D'ock were used to red bean, mung bean and soy bean. Kinds of hand made cookie were Yagkwa, Kangjeong, Dasik, Jungkwa and Yangeng. Beverages were thick hot beverage, kinds of leaf tea, chilled beverage, Yaksu mixed with soy sauce and bamboo salt, kinds of chinese medicine tea, milk and milk products and pine needles tea. 6. Preserved foods were used edible mountain herbs and seaweeds in drying and frying.

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Geochemical Studies of the Trace Element of the Basalt in the Kilauea, Hawaii (킬라우에아 현무암의 미량원소에 대한 지구화학적 연구)

  • Park, Byeong-Jun;Jang, Yun-Deuk;Kwon, Suk-Bom;Kim, Jeong-Jin
    • Economic and Environmental Geology
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    • v.40 no.5
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    • pp.675-689
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    • 2007
  • Kilauea volcano's summit area was formed by continuous ind/or sporadic eruption activities for several hundreds years. In this study, we mainly focused on the trace elements characteristics through systematic sample rocks erupted from 1790 to September of 1982. Under the microscope it can be observed some main minerals such as olivine, clinopyroxene. and plagioclase with minor opaque minerals including Cr-spinel and ilmenite. Zr, V, Y, Ti elements show incompatible activities with MgO while Ni, Cr, Co elements show highly compatible properties. Elements like as Ba, Rb, Th, Sr, Nd are highly incompatible to show positive trends with $K_2O$. In the REE diagram LREE is more enriched than HREE suggesting typical Oceanic Island Basalt(OIB) type. It can be suggested that Sr have an effect on the fractionation of plagioclase from the kink in the $K_2O$ variation diagram. Y/Ho ratio diagram shows there was no fluids effect in the historical Kilauea volcano but Zr/Hf ratio diagram shows a significant difference between Kilauea lavas and PuuOo lavas. There are distinctive changes of trace element contents showing in particular abrupt changes of temporal variations between 1924 and 1954. Moreover, PuuOo lavas which had been erupted since 1983 follow these decreasing trends of trace element variation. Therefore, it is strongly suggested that these abrupt changes of trace elements trends result from the huge collapse geological event which formed Halemaumau crater in 1924 causing contamination effects of crustal contents into magma chamber and from the changes of parental magma composition injected into Kilauea volcano's summit magma reservoir.

A Survey on Clients' Home Care Satisfaction in Taejon City in Korea (일개 시지역의 가정간호 수혜자들의 만족도 조사)

  • Kim, Sun-Sook;So, Hee-Young;Lee, Tae-Yong
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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A Study on the Differences of Cognitive Functions, Neurobehavioral Symptoms and Daily Living Functions According to the Lateralization of Lesion in Patients with Non-Traumatic Subcortical Cerebrovascular Disease (비외상성 피질하 뇌혈관질환 환자에서 병소의 편측성에 따른 인지기능, 정신행동증상 및 일상생활기능의 차이에 대한 연구)

  • Park, Young-Soo;Lee, Young-Ho;Choi, Young-Hee;Ko, Dae-Kwan;Chung, Young-Cho;Park, Byoung-Kwan;Kim, Soo-Ji;Chung, Suk-Haui;Ko, Byoung-Hee;Song, Il-Byoung;Park, Kun-Woo;Lee, Dae-Hie
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.56-67
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    • 1996
  • Objectives : This study was designed to find clinical factors that could be differentiated by the lateralization of lesion and also find clinical factors to predict the lateralization of lesion. Methods : The subjects were 65 cooperative inpatients and outpatients with non-traumatic subcortical cerebrovascular disease without neurologic and psychiatric history from January 1995 to September 1995 ; 48 patients in Kyung Hee University, Oriental Medicine Hospital, 35 patients in Anam Hospital, Korea University were examined as subjects, but authors excluded 20 patients whose data were incomplete or who had uncertain lesions on brain CT or MRI. The 65 patients were divided into three groups-group with left hemispheric lesion, group with right hemispheric lesion, group with both hemispheric lesion-according to the finding of brain imaging study. Their cognitive functions were evaluated by the Benton Neuropsychological Assessment(BNA), their subjective neurobehavioral symptoms by Symptom Check List-90-R(SCL-90-R), their objective neurobehavioral symptoms by Neurobehavioral Rating Scale, and their daily living functions by Geriatric Evaluation by Relative's Rating Instrument(GERRl) and Instrumental Activities of Daily Living Scale(IADLs). Results : The results were as follows : 1) The results of cognitive function test indicated that the group with right hemispheric lesion showed low functions in Tactile Form Perception(left), the group with left hemispheric lesion showed low functions in Finger localization(right), the group with right hemispheric lesion showed low functions in Finger Localization(left). 2) Though, there were little significant differences in subjective neurobehavioral symptoms, the group with right hemispheric lesion showed higher scores in all symptoms except hostility. 3) Though, there were little significant differences in objective neurobehavioral symptoms, the group with both hemispheric lesion showed higher scores in cognition, guilty/disinhibition, the group with left hemispheric lesion showed higher scores in lability of mood, the group with right hemispheric lesion showed highest scores in psychotism, neurotism, agitation-hostility and decreased motivation/emotional withdrawal. 4) There were little significant differences among three groups in Daily Living Functions, but the group with right hemispheric lesion showed the lowest functions in Instrumental Activities of Daily Living. 5) As a result of discriminant analysis on each factor's contribution to the prediction of lesion, Finger Localization(left), Phoneme Discrimination and Tactile Form Perception(right) showed that they had the potentiality to predict lesion. Conclusion : The results suggest that there are little significant differences among the groups of three non-traumatic subcortical cerebrovascular disease in cognitive functions, but the group with right hemispheric lesion showed more serious and various changes in subjective and objective neurobehavioral symptoms, and showed low functions in Instrumental Activities of Daily Living. This results suggest the possibility that the decline of the daily living function in the group with right hemispheric lesion were due to various symptoms, not due to cognitive dysfunction. The confirmation of the possibility should be worked out through the follow-up study of some groups containing cortical lesion. Apart from these findings, Finger Localization, Tactile Form Perception(right) and Phoneme Discrimination suggest that they can be used as clinically valuable cognitive parameters that predict the lateralization of lesion in non-traumatic cerebrovascular disease.

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Effects of Intracavitary Urokinase Instillation in Complicated Pleural Effusion (합병성 흉막 삼출에 대한 국소적 Urokinase 주입치료 효과에 관한 연구)

  • Sohn, Dong-Hyun;Yoon, Su-Mi;Kim, Chung-Mi;Park, Ik-Soo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.357-364
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    • 2000
  • Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

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