Pulmonary Resection in the Treatment of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵환자의 폐절제술에 관한 연구)
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- Tuberculosis and Respiratory Diseases
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- v.45 no.6
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- pp.1143-1153
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- 1998
Background : Recent outbreaks of pulmonary disease due to drug-resistant strains of Mycobacterium Tuberculosis have resulted in significant morbidity and mortality in patients worldwide. We reviewed our experience to evaluate the effects of pulmonary resection on the management of multidrug-resistant tuberculosis. Method : A retrospective review was performed of 41 patients undergoing pulmonary resection for multidrug-resistant tuberculosis between January 1993 and December 1997. We divided these into 3 groups according to the radiologic findings : (1) patients who have reasonably localized lesion (Localized Lesion Group ; LLG) (2) patients who have cavitary lesions after pulmonary resection on chest roentgenogram (Remained Cavity Group : RCG) (3) patients who have Remained infiltrative lesions postoperatively (Remained infiltrative group : RIG). We evaluated the negative conversion rate after resection and overall response rate of the groups. Then they were compared with the results of the chemotherapy on the multi drug-resistant tuberculosis which has been outcome by Goble et al. Goble et al reported that negative conversion rate was 65% and overall response rate, 56% over a mean period of 5.1 months. Results : Seventy five point six percent were men and 24.4% women with a median age of 31 years (range, 16 to 60 years). Although the patients were treated preoperatively with multidrug regimens in an effort to reduce the mycobacterial burden, 22 of 41 were still sputum culture positive at the time of surgery. 20 of 22 patients(90.9%, p<0.01) responded which is defined as negative sputum cultures within 2 months postoperative. Of 26 patients with the sufficient follow up data, 19 have Remained sputum culture negative for a mean duration of 25.7 months (73.1%, p<0.05). The bulk of the disease was manifest in one lung, but lesser amounts of contralateral disease were demonstrated in 15, consisted of 8 in RIG and 7 in RCG, of 41. 12 of 12 patients (100%, p<0.01) who were sputum positive at the time of surgery in LLG converted successfully. 14 of 15 patients (93.3%, p<0.05) with the follow up have completed treatment and not relapsed for a mean period of 25. 7 months. The mean length of postoperative drug therapy of LLG was 12.2 months. In RIG, postoperative negative conversion rate was 83.3% which was not significant statistically. There was a statistical significance in overall response rate (100%, p<0.05) of RIG for a mean period of 24.4 months with a mean length of postoperative chemotherapy, 11.8 months. In RCG a statistically lower overall response rate (14.3%, p<0.01) has been revealed for a mean duration of follow up, 24.2 months. A negative conversion rate of RCG was 75% which was not significant statistically. Conclusion : Surgery plays an important role in the management of patients with multidrug-resistant Mycobacterium tuberculosis infection. Aggressive pulmonary resection should be performed for resistant Mycobacterium tuberculosis infection to avoid treatment failure or relapse. Especially all cavitary lesions on preoperative chest roentgenogram should be resected completely. If all of them could not be resected perfectly, you should not open the thorax.
Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by
Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.
The purpose of present study is to analyze the genetic variation of natural stand of Pinus densiflora. In 1975 following after the selection of 1974, twenty trees from each of three natural populations of the species were selected and their open-pollinated seeds were collected, and the locations and conditions of the populations ate presented in table 1, 2 and figure 1. Some morphological traits of the populations were already detailed in our second report of this series, in which Myong-Ju and Ul-Jin populations were regarded to be superior phenotypically to suweon population. The morphological traits of cone, seed and seed-wing, and also the growth performances and needle characters of the seedling were observed in the present study according to the previous methods. The results obtained are summarized as follows; 1. The meteorological data obtained by averaging the records of 30 year period (1931~1960) measured from the nearest meteorological stations to each population are shown in fig.2, 3, 4. The distributional patterns of investigated climate factors are generally considered to be similar among the locations. However, the precipitation density during growing season and the air temperature during dormant season on Suweon area, population 6, were quite different from those of the other areas. 2. The measurements of fresh cone weight, length, diameter and cone index, i.e., length to diameter ratio are presented in table 7. As shown in table 7, all these traits except for cone diameter seem to be highly significant in population differences and family differences within population. 3. The morphological traits of seed and seed-wing are detailed in table 8, 9, and highly significant differences are recognized among the populations and the families within population in seed-wing length, seed-wing index, seed weight, seed-length and seed index but not among the populations in the other observed traits. The values of correlation coefficient between the characters of cone and seed are given in table 10 and the positive significant correlations can be observed in the most parts of the compared traits. 4. Significant statistical differences among populations and families within population are observed in the growth performances of 1-0 and 1-1 seedling height of these progenies. But the differences in root collar diameter are shown only among families within population. As shown in table 13, the most parts of correlations are not significant statistically between the growth performances of seedling and the seed characters. 5. The number of stomata row on both sides of needle and the serration density were measured in the seedlings from each of the families of the three populations. As shown in table 15, statistical differences are considered to be significant among the populations and among the families within population in serration density but not among the populations in stomata row on both sides of the needle. The results differ from those of the third report of this series. Even if one of the reason seems to be the diversity of selected populations, it could not be confirmed definitely. The correlations between progenies and parents are not generally observed in the investigated traits of needle as shown in table 16.
This paper describes a collaborative project between academia and industry which focused on improving the marketing and product development strategies for two private label apparel brands of a large regional department store chain in the southeastern United States. The goal of the project was to revitalize product lines of the two brands by incorporating student ideas for new solutions, thereby giving the students practical experience with a real-life industry situation. There were a number of key players involved in the project. A privately-owned department store chain based in the southeastern United States which was seeking an academic partner had recognized a need to update two existing private label brands. They targeted middle-aged consumers looking for casual, moderately priced merchandise. The company was seeking to change direction with both packaging and presentation, and possibly product design. The branding and product development divisions of the company contacted professors in an academic department of a large southeastern state university. Two of the professors agreed that the task would be a good fit for their classes - one was a junior-level Intermediate Brand Management class; the other was a senior-level Fashion Product Development class. The professors felt that by working collaboratively on the project, students would be exposed to a real world scenario, within the security of an academic learning environment. Collaboration within an interdisciplinary team has the advantage of providing experiences and resources beyond the capabilities of a single student and adds "brainpower" to problem-solving processes (Lowman 2000). This goal of improving the capabilities of students directed the instructors in each class to form interdisciplinary teams between the Branding and Product Development classes. In addition, many universities are employing industry partnerships in research and teaching, where collaboration within temporal (semester) and physical (classroom/lab) constraints help to increase students' knowledge and experience of a real-world situation. At the University of Tennessee, the Center of Industrial Services and UT-Knoxville's College of Engineering worked with a company to develop design improvements in its U.S. operations. In this study, Because should be lower case b with a private label retail brand, Wickett, Gaskill and Damhorst's (1999) revised Retail Apparel Product Development Model was used by the product development and brand management teams. This framework was chosen because it addresses apparel product development from the concept to the retail stage. Two classes were involved in this project: a junior level Brand Management class and a senior level Fashion Product Development class. Seven teams were formed which included four students from Brand Management and two students from Product Development. The classes were taught the same semester, but not at the same time. At the beginning of the semester, each class was introduced to the industry partner and given the problem. Half the teams were assigned to the men's brand and half to the women's brand. The teams were responsible for devising approaches to the problem, formulating a timeline for their work, staying in touch with industry representatives and making sure that each member of the team contributed in a positive way. The objective for the teams was to plan, develop, and present a product line using merchandising processes (following the Wickett, Gaskill and Damhorst model) and develop new branding strategies for the proposed lines. The teams performed trend, color, fabrication and target market research; developed sketches for a line; edited the sketches and presented their line plans; wrote specifications; fitted prototypes on fit models, and developed final production samples for presentation to industry. The branding students developed a SWOT analysis, a Brand Measurement report, a mind-map for the brands and a fully integrated Marketing Report which was presented alongside the ideas for the new lines. In future if the opportunity arises to work in this collaborative way with an existing company who wishes to look both at branding and product development strategies, classes will be scheduled at the same time so that students have more time to meet and discuss timelines and assigned tasks. As it was, student groups had to meet outside of each class time and this proved to be a challenging though not uncommon part of teamwork (Pfaff and Huddleston, 2003). Although the logistics of this exercise were time-consuming to set up and administer, professors felt that the benefits to students were multiple. The most important benefit, according to student feedback from both classes, was the opportunity to work with industry professionals, follow their process, and see the results of their work evaluated by the people who made the decisions at the company level. Faculty members were grateful to have a "real-world" case to work with in the classroom to provide focus. Creative ideas and strategies were traded as plans were made, extending and strengthening the departmental links be tween the branding and product development areas. By working not only with students coming from a different knowledge base, but also having to keep in contact with the industry partner and follow the framework and timeline of industry practice, student teams were challenged to produce excellent and innovative work under new circumstances. Working on the product development and branding for "real-life" brands that are struggling gave students an opportunity to see how closely their coursework ties in with the real-world and how creativity, collaboration and flexibility are necessary components of both the design and business aspects of company operations. Industry personnel were impressed by (a) the level and depth of knowledge and execution in the student projects, and (b) the creativity of new ideas for the brands.
The anthropomorphism of brands, defined as seeing human beings in brands (Puzakova, Kwak, and Rosereto, 2008) is the focus of this study. Specifically, the research objective is to understand the ways in which brands are rendered humanlike. By analyzing consumer readings of stories found on food product packages we intend to show how marketers and consumers humanize a spectrum of brands and create meanings. Our research question considers the possibility that a single brand may host multiple or single meanings, associations, and personalities for different consumers. We start by highlighting the theoretical and practical significance of our research, explain why we turn our attention to packages as vehicles of brand meaning transfer, then describe our qualitative methodology, discuss findings, and conclude with a discussion of managerial implications and directions for future studies. The study was designed to directly expose consumers to potential vehicles of brand meaning transfer and then engage these consumers in free verbal reflections on their perceived meanings. Specifically, we asked participants to read non-nutritional stories on selected branded food packages, in order to elicit data about received meanings. Packaging has yet to receive due attention in consumer research (Hine, 1995). Until now, attention has focused solely on its utilitarian function and has generated a body of research that has explored the impact of nutritional information and claims on consumer perceptions of products (e.g., Loureiro, McCluskey and Mittelhammer, 2002; Mazis and Raymond, 1997; Nayga, Lipinski and Savur, 1998; Wansik, 2003). An exception is a recent study that turns its attention to non-nutritional packaging narratives and treats them as cultural productions and vehicles for mythologizing the brand (Kniazeva and Belk, 2007). The next step in this stream of research is to explore how such mythologizing activity affects brand personality perception and how these perceptions relate to consumers. These are the questions that our study aimed to address. We used in-depth interviews to help overcome the limitations of quantitative studies. Our convenience sample was formed with the objective of providing demographic and psychographic diversity in order to elicit variations in consumer reflections to food packaging stories. Our informants represent middle-class residents of the US and do not exhibit extreme alternative lifestyles described by Thompson as "cultural creatives" (2004). Nine people were individually interviewed on their food consumption preferences and behavior. Participants were asked to have a look at the twelve displayed food product packages and read all the textual information on the package, after which we continued with questions that focused on the consumer interpretations of the reading material (Scott and Batra, 2003). On average, each participant reflected on 4-5 packages. Our in-depth interviews lasted one to one and a half hours each. The interviews were tape recorded and transcribed, providing 140 pages of text. The products came from local grocery stores on the West Coast of the US and represented a basic range of food product categories, including snacks, canned foods, cereals, baby foods, and tea. The data were analyzed using procedures for developing grounded theory delineated by Strauss and Corbin (1998). As a result, our study does not support the notion of one brand/one personality as assumed by prior work. Thus, we reveal multiple brand personalities peacefully cohabiting in the same brand as seen by different consumers, despite marketer attempts to create more singular brand personalities. We extend Fournier's (1998) proposition, that one's life projects shape the intensity and nature of brand relationships. We find that these life projects also affect perceived brand personifications and meanings. While Fournier provides a conceptual framework that links together consumers’ life themes (Mick and Buhl, 1992) and relational roles assigned to anthropomorphized brands, we find that consumer life projects mold both the ways in which brands are rendered humanlike and the ways in which brands connect to consumers' existential concerns. We find two modes through which brands are anthropomorphized by our participants. First, brand personalities are created by seeing them through perceived demographic, psychographic, and social characteristics that are to some degree shared by consumers. Second, brands in our study further relate to consumers' existential concerns by either being blended with consumer personalities in order to connect to them (the brand as a friend, a family member, a next door neighbor) or by distancing themselves from the brand personalities and estranging them (the brand as a used car salesman, a "bunch of executives.") By focusing on food product packages, we illuminate a very specific, widely-used, but little-researched vehicle of marketing communication: brand storytelling. Recent work that has approached packages as mythmakers, finds it increasingly challenging for marketers to produce textual stories that link the personalities of products to the personalities of those consuming them, and suggests that "a multiplicity of building material for creating desired consumer myths is what a postmodern consumer arguably needs" (Kniazeva and Belk, 2007). Used as vehicles for storytelling, food packages can exploit both rational and emotional approaches, offering consumers either a "lecture" or "drama" (Randazzo, 2006), myths (Kniazeva and Belk, 2007; Holt, 2004; Thompson, 2004), or meanings (McCracken, 2005) as necessary building blocks for anthropomorphizing their brands. The craft of giving birth to brand personalities is in the hands of writers/marketers and in the minds of readers/consumers who individually and sometimes idiosyncratically put a meaningful human face on a brand.
Previous research has presupposed that the evaluation of consumer who received any recovery after experiencing product failure should be better than the evaluation of consumer who did not receive any recovery. The major purposes of this article are to examine impacts of product defect failures rather than service failures, and to explore effects of recovery on postrecovery product attitudes. First, this article deals with the occurrence of severe and unsevere failure and corresponding service recovery toward tangible products rather than intangible services. Contrary to intangible services, purchase and usage are separable for tangible products. This difference makes it clear that executing an recovery strategy toward tangible products is not plausible right after consumers find out product failures. The consumers may think about backgrounds and causes for the unpleasant events during the time gap between product failure and recovery. The deliberation may dilutes positive effects of recovery efforts. The recovery strategies which are provided to consumers experiencing product failures can be classified into three types. A recovery strategy can be implemented to provide consumers with a new product replacing the old defective product, a complimentary product for free, a discount at the time of the failure incident, or a coupon that can be used on the next visit. This strategy is defined as "a rewarding effort." Meanwhile a product failure may arise in exchange for its benefit. Then the product provider can suggest a detail explanation that the defect is hard to escape since it relates highly to the specific advantage to the product. The strategy may be called as "a strengthening effort." Another possible strategy is to recover negative attitude toward own brand by giving prominence to the disadvantages of a competing brand rather than the advantages of its own brand. The strategy is reflected as "a weakening effort." This paper emphasizes that, in order to confirm its effectiveness, a recovery strategy should be compared to being nothing done in response to the product failure. So the three types of recovery efforts is discussed in comparison to the situation involving no recovery effort. The strengthening strategy is to claim high relatedness of the product failure with another advantage, and expects the two-sidedness to ease consumers' complaints. The weakening strategy is to emphasize non-aversiveness of product failure, even if consumers choose another competitive brand. The two strategies can be effective in restoring to the original state, by providing plausible motives to accept the condition of product failure or by informing consumers of non-responsibility in the failure case. However the two may be less effective strategies than the rewarding strategy, since it tries to take care of the rehabilitation needs of consumers. Especially, the relative effect between the strengthening effort and the weakening effort may differ in terms of the severity of the product failure. A consumer who realizes a highly severe failure is likely to attach importance to the property which caused the failure. This implies that the strengthening effort would be less effective under the condition of high product severity. Meanwhile, the failing property is not diagnostic information in the condition of low failure severity. Consumers would not pay attention to non-diagnostic information, and with which they are not likely to change their attitudes. This implies that the strengthening effort would be more effective under the condition of low product severity. A 2 (product failure severity: high or low) X 4 (recovery strategies: rewarding, strengthening, weakening, or doing nothing) between-subjects design was employed. The particular levels of product failure severity and the types of recovery strategies were determined after a series of expert interviews. The dependent variable was product attitude after the recovery effort was provided. Subjects were 284 consumers who had an experience of cosmetics. Subjects were first given a product failure scenario and were asked to rate the comprehensibility of the failure scenario, the probability of raising complaints against the failure, and the subjective severity of the failure. After a recovery scenario was presented, its comprehensibility and overall evaluation were measured. The subjects assigned to the condition of no recovery effort were exposed to a short news article on the cosmetic industry. Next, subjects answered filler questions: 42 items of the need for cognitive closure and 16 items of need-to-evaluate. In the succeeding page a subject's product attitude was measured on an five-item, six-point scale, and a subject's repurchase intention on an three-item, six-point scale. After demographic variables of age and sex were asked, ten items of the subject's objective knowledge was checked. The results showed that the subjects formed more favorable evaluations after receiving rewarding efforts than after receiving either strengthening or weakening efforts. This is consistent with Hoffman, Kelley, and Rotalsky (1995) in that a tangible service recovery could be more effective that intangible efforts. Strengthening and weakening efforts also were effective compared to no recovery effort. So we found that generally any recovery increased products attitudes. The results hint us that a recovery strategy such as strengthening or weakening efforts, although it does not contain a specific reward, may have an effect on consumers experiencing severe unsatisfaction and strong complaint. Meanwhile, strengthening and weakening efforts were not expected to increase product attitudes under the condition of low severity of product failure. We can conclude that only a physical recovery effort may be recognized favorably as a firm's willingness to recover its fault by consumers experiencing low involvements. Results of the present experiment are explained in terms of the attribution theory. This article has a limitation that it utilized fictitious scenarios. Future research deserves to test a realistic effect of recovery for actual consumers. Recovery involves a direct, firsthand experience of ex-users. Recovery does not apply to non-users. The experience of receiving recovery efforts can be relatively more salient and accessible for the ex-users than for non-users. A recovery effort might be more likely to improve product attitude for the ex-users than for non-users. Also the present experiment did not include consumers who did not have an experience of the products and who did not perceive the occurrence of product failure. For the non-users and the ignorant consumers, the recovery efforts might lead to decreased product attitude and purchase intention. This is because the recovery trials may give an opportunity for them to notice the product failure.
This study analyses the difference of contents and tones of arguments among three Korean major newspapers, the Kyunghyang Shinmoon, the HanKyoreh, and the Dong-A Ilbo. It is commonly accepted that newspapers in Korea explicitly deliver their own tone of arguments when they talk about some sensitive issues and topics. It could be controversial if readers of newspapers read the news without being aware of the type of tones of arguments because the contents and the tones of arguments can affect readers easily. Thus it is very desirable to have a new tool that can inform the readers of what tone of argument a newspaper has. This study presents the results of clustering and classification techniques as part of text mining analysis. We focus on six main subjects such as Culture, Politics, International, Editorial-opinion, Eco-business and National issues in newspapers, and attempt to identify differences and similarities among the newspapers. The basic unit of text mining analysis is a paragraph of news articles. This study uses a keyword-network analysis tool and visualizes relationships among keywords to make it easier to see the differences. Newspaper articles were gathered from KINDS, the Korean integrated news database system. KINDS preserves news articles of the Kyunghyang Shinmun, the HanKyoreh and the Dong-A Ilbo and these are open to the public. This study used these three Korean major newspapers from KINDS. About 3,030 articles from 2008 to 2012 were used. International, national issues and politics sections were gathered with some specific issues. The International section was collected with the keyword of 'Nuclear weapon of North Korea.' The National issues section was collected with the keyword of '4-major-river.' The Politics section was collected with the keyword of 'Tonghap-Jinbo Dang.' All of the articles from April 2012 to May 2012 of Eco-business, Culture and Editorial-opinion sections were also collected. All of the collected data were handled and edited into paragraphs. We got rid of stop-words using the Lucene Korean Module. We calculated keyword co-occurrence counts from the paired co-occurrence list of keywords in a paragraph. We made a co-occurrence matrix from the list. Once the co-occurrence matrix was built, we used the Cosine coefficient matrix as input for PFNet(Pathfinder Network). In order to analyze these three newspapers and find out the significant keywords in each paper, we analyzed the list of 10 highest frequency keywords and keyword-networks of 20 highest ranking frequency keywords to closely examine the relationships and show the detailed network map among keywords. We used NodeXL software to visualize the PFNet. After drawing all the networks, we compared the results with the classification results. Classification was firstly handled to identify how the tone of argument of a newspaper is different from others. Then, to analyze tones of arguments, all the paragraphs were divided into two types of tones, Positive tone and Negative tone. To identify and classify all of the tones of paragraphs and articles we had collected, supervised learning technique was used. The Na
Recommender system has become one of the most important technologies in e-commerce in these days. The ultimate reason to shop online, for many consumers, is to reduce the efforts for information search and purchase. Recommender system is a key technology to serve these needs. Many of the past studies about recommender systems have been devoted to developing and improving recommendation algorithms and collaborative filtering (CF) is known to be the most successful one. Despite its success, however, CF has several shortcomings such as cold-start, sparsity, gray sheep problems. In order to be able to generate recommendations, ordinary CF algorithms require evaluations or preference information directly from users. For new users who do not have any evaluations or preference information, therefore, CF cannot come up with recommendations (Cold-star problem). As the numbers of products and customers increase, the scale of the data increases exponentially and most of the data cells are empty. This sparse dataset makes computation for recommendation extremely hard (Sparsity problem). Since CF is based on the assumption that there are groups of users sharing common preferences or tastes, CF becomes inaccurate if there are many users with rare and unique tastes (Gray sheep problem). This study proposes a new algorithm that utilizes Social Network Analysis (SNA) techniques to resolve the gray sheep problem. We utilize 'degree centrality' in SNA to identify users with unique preferences (gray sheep). Degree centrality in SNA refers to the number of direct links to and from a node. In a network of users who are connected through common preferences or tastes, those with unique tastes have fewer links to other users (nodes) and they are isolated from other users. Therefore, gray sheep can be identified by calculating degree centrality of each node. We divide the dataset into two, gray sheep and others, based on the degree centrality of the users. Then, different similarity measures and recommendation methods are applied to these two datasets. More detail algorithm is as follows: Step 1: Convert the initial data which is a two-mode network (user to item) into an one-mode network (user to user). Step 2: Calculate degree centrality of each node and separate those nodes having degree centrality values lower than the pre-set threshold. The threshold value is determined by simulations such that the accuracy of CF for the remaining dataset is maximized. Step 3: Ordinary CF algorithm is applied to the remaining dataset. Step 4: Since the separated dataset consist of users with unique tastes, an ordinary CF algorithm cannot generate recommendations for them. A 'popular item' method is used to generate recommendations for these users. The F measures of the two datasets are weighted by the numbers of nodes and summed to be used as the final performance metric. In order to test performance improvement by this new algorithm, an empirical study was conducted using a publically available dataset - the MovieLens data by GroupLens research team. We used 100,000 evaluations by 943 users on 1,682 movies. The proposed algorithm was compared with an ordinary CF algorithm utilizing 'Best-N-neighbors' and 'Cosine' similarity method. The empirical results show that F measure was improved about 11% on average when the proposed algorithm was used