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Evaluation of Usefulness of Portal Image Using Electronic Portal Imaging Device (EPID) in the Patients Who Received Pelvic Radiation Therapy (골반강 내 방사선 치료 환자에서 Electronic Portal Imaging Device(EPID)를 이용한 Portal Image의 유용성에 관한 연구)

  • Kim Woo Chul;Park Won;Kim Heon Jong;Park Seong Young;Cho Young Kap;Loh John J;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.497-504
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    • 1998
  • Purpose : To evaluate the usefulness of electronic portal imaging device through objective compare of the images acquired using an EPID and a conventional port film Materials and Methods : From Apr. to Oct. 1997, a total of 150 sets of images from 20 patients who received radiation therapy in the pelvis area were evaluated in the Inha University Hospital and Severance Hospital. A dual image recording technique was devised to obtain both electronic portal images and port film images simultaneously with one treatment course. We did not perform double exposure five to ten images were acquired from each patient. All images were acquired from posteroanterior (PA) view except images from two patients. A dose rate of 100-300 Mu/min and a 10-MV X-ray beam were used and 2-10 MUs were required to produce a verification image during treatment. Kodak diagnostic film with metal/film imaging cassette which was located on the top of the EPID detector was used for the port film. The source to detector distance was 140 cm. Eight anatomical landmarks (pelvic brim, sacrum, acetabulum. iliopectineal line, symphysis, ischium, obturator foramen, sacroiliac joint) were assessed. Four radiation oncologist joined to evaluate each image. The individual landmarks in the port film or in the EPID were rated - very clear (1), clear (2), visible (3), not clear (4), not visible (5). Results : Using an video camera based EPID system. there was no difference of image quality between no enhanced EPID images and port film images. However, when we provided some change with window level for the portal image, the visibility of the sacrum and obturator foramen was improved in the portal images than in the port film images. All anatomical landmarks were more visible in the portal images than in the port film when we applied the CLAHE mode enhancement. The images acquired using an matrix ion chamber type EPID were also improved image qualify after window level adjustment. Conclusion : The quality of image acquired using an electronic portal imaging device was comparable to that of the port film. When we used the enhance mode or window level adjustment. the image quality of the EPID was superior to that of the port film. EPID may replace the port film.

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A Comparative Study of the Oriental and the Occidental Medical Literature on the Etiologies & Treatments for Palmoplantar Hyperhidrosis (수족한(手足汗)의 원인(原因)과 치료법(治療法)에 대한 동(東).서의학적(西醫學的) 고찰(考察))

  • Ko, Young-Chul;Shin, Jo-Young
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.268-295
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    • 1997
  • Sweating is natural phenomenon necessary for the regulation of an individual's body-temperature. The secretion of sweat is mediated by a portion of our vegetative nervous system(the sympathetic nervous system). In some people, this system is working at a very high activity level, far higher than needed to keep a constant temperature. This condition is referred to as hyperhidrosis. Especially excessive sweating of the hands and the feet is palmoplantar hyperhidrosis or volar hyperhidrosis. This is by far the most distressing condition. It was founded that the first important cause of this was emotional factor. The hands are much more exposed in social and prefessional activities than any other part of our body. Many individuals with palmoplantar hyperhidrosis are limited in their choice of proffession, because unable to manipulate materials sensitive to humidity or reluctant to shake hands; some patients arrive to the point to avoid social contact. The occidental medical treatments for palmoplantar hyperhidrosis include application of topical agents(chemical antiperspirants such as aluminum chloride), iontophoresis(treatment with electrical current), or surgery(thoracic sympathectomy). It was reported that the most effective treatment was thoracic sympathectomy. So this study was started to find the easy and effective oriental medical treatments against the occidental medical treatments through the oriental medical literature. The occidental medical idea for palmoplantar hyperhidrosis is only limited in neurologic system, so surgery is the best treatment. But the oriental medical idea for palmoplantar hyperhidrosis is much wider, so the oriental medical causes and treatments for this are able to be veriety. And the oriental medical teatment is freely in treating the patients of palmoplantar hyperhidrosis, because entire idea including pulse, facial color, mental condition, constitution and other symptom exists in the oriental medicine. The results of a bibliographic study of causes and treatments for palmoplantar are as follows; 1. The main causes of pa1moplantar hyperhidrosis are heat in the stomach, damp-heat in the spleen and the stomach, insufficiency of the spleen-qi and the stomach-qi, deficiency of the spleen-yin and the stomach-yin, and the others are the stomach-cold syndrome, stasis of blood and dyspepsia in the stomach, disorder of the liver-qi, deficiency of the heart-yin and the kidney-yin, deficiency of the heart-yang and the kidney-yang, stagnated heat in the liver and the spleen, the lung channel-heat etc. 2. The main methods of medical treatments for palmoplantar hyperhidrosis are clearing out the stomach-heat, eliminating dampness and heat in the spleen and the stomach, invigorating the spleen-qi and the stomach-qi, reinforcing the spleen-yin and the stomach-yin, warming the stomach, relaxing the liver and alleviating of mental depression and tonifying the heart and the kidney etc. 3. The main prescriptions of palmoplantar hyperhidrosis are Taesihotang, Palmultang-kakam, Samyeongbaechusan, Chongbisan, Sasammaekmundongtang, the others are Leejungtang, Hwangkikonjungtang, Seungkitang, Boyumtang, Baekhotang, Chongsimyonjayum, Moyrosan, etc. 4. Local medicine for external use are liquid after boiling alum in water for about 1 or 2 hours, liquid after boiling alum and pueraria root in water and liquid after boiling stragalus root, pueraria root, ledebouriella root and schizonepeta in water, etc. 5. The methods of acupuncture therapy include invigorating Bokyru, Yumkuk and purgating Hapkouk, or invigorating Bokyru, Kihae and purgating Hapkouk, or steadying Hapkouk, Nokung.

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The Implementation and limits of Involuntary Detention of the Tuberculosis Prevention Act (결핵예방법의 격리명령의 실행과 한계에 관하여)

  • Kim, Jang Han
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.55-84
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    • 2015
  • The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

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Study of Philosophical Background of '虛' Described in "Huang Di Nei Jing" ("황제내경(黃帝內經)"의 '허(虛)'와 그 철학적 배경에 대한 연구)

  • Lee, Jin-Woo;Hong, Moo-Chang;Bae, Hyun-Su;Shin, Min-Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.4
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    • pp.766-783
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    • 2006
  • This study describes philosophical background regarding '虛' in oriental medicine in an effort to understand the relationships among some of the Eastern philosophy in accordance with differentiated meanings in several resources by analyzing examples of '虛' in Huang Di Nei Jing. The various usages of '虛' used in Huang Di Nei Jing are as follows: naming; condition of pulse; emptiness; '太虛' which was referred universal space by Chinese ; insufficiency, lack or scarcity, deficiency ; and the description of vitality, mental faculties. 外丹修煉(training by external substances) had the attitude do that withdraw the death by taking external materials. The meaning of '虛'in 外丹修煉 is similar to that in oriental medicine in terms of deficiency. That is, both 外丹修煉 and the oriental medicine consider that the death and disease are caused by the deficiency of something. However, there also exists difference between 外丹修煉 and the oriental medicine. 外丹修煉 supplements through withdrawal prohibition due to the characteristic of unchangeability and stern or immortal while oriental medicine provides concrete object of deficiency. 精(essence of life), 氣(ki, functional activity), and fe(vitality) not only have been considered as basic component of human body, but they also have been an important subject of health preservation for longevity with health in Taoism and oriental medicine. In oriental medicine, 精 and 氣 have been perceived as physical basis of human body and 神 as controller. 內丹修煉(Training of internal active substances) 掠nds to return to '虛', the early state of life through individual training, and attempts to withdraw death through continuous recurrence. The oriental medicine and 內丹修煉 held great value of 神 among health preservation of 精, 氣, and 神. They seek theoretical basis from philosophical Taoism. However, '虛' in Taoism is different from that in training by internal substances and oriental medicine: '虛' in philosophical Taoism has metaphysical concept which refers overcome of life and death, but '虛' in 內丹修煉 and oriental medicine have empirical concept. '太虛' is considered as formless space where it is emp Dut filled with 氣. It is conceptualized with the premise of the relevant adaptation of human body to natural environment theory referring that the interaction between the heaven and the earth makes changes; all creation is originated , and human is affected by the interaction of the heaven and the earth. Furthermore, in $\ulcorner$運氣七篇$\lrcorner$ (Seven chapters described about the five circuit phases and the six atmospheric influences), the expression that the earth is in the center of '太虛' and huge amount of 氣 supports it proves that $\ulcorner$運氣七篇$\lrcorner$ adapts '渾天設'(Chaotic universe thee). In Taoism, '虛' is the grounds where all creation is generated in the optimal condition of Tao. As regards the aspect of mentality, it is the condition in which one can free from the dualistic concepts such as right and wrong, beauty and ugliness, life and death, and so on. Although the ultimate goal of oriental medicine, the achievement of longevity without sickness, might contrast with the Taoist belief that perceives life and death as the natural phenomena or the flowing of the 氣, and eliminates all international, the idea of Taoism that one should live substantial life with naivety, and make Harmony with the nature might be influential to the oriental medicine.

Development of highly uniform variety for processing using SSR markers in radish (Raphanus sativus L) (분자표지를 활용한 고품질 가공용 고순도 무 품종 육성)

  • Jung, Un-Hwa;Oh, Jong-Hyuck;Kim, Young-Gyu;Ahn, Chun-Hee;Lee, Kwang-Sik;Choi, Su-Ryun;Lim, Yong-Pyo;Park, Su-Hyoung;Choi, Ki-Young;Lee, Yong-Beom
    • Journal of Plant Biotechnology
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    • v.41 no.1
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    • pp.56-63
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    • 2014
  • Using commercial radish varieties for processing, about 30% of radish was discarded due to the root shape and low purity. To raise the processing ability, we tried to develop a new variety producing H-shaped root. As another characteristic required in variety for processing is high purity, we tried to raise purity using simple sequence repeats (SSR) markers for testing seed purity in every segregating generation. To develop Male-sterile (MS) seeding parent, we crossed commercial variety of 'Gwan dong spring' and 'Gyeo ryong spring'. One elite inbred was selected as recurrent parent for the MS plant. The major horticultural traits of selected inbred line were disease resistance, late bolting, heat resistance and bright green root top color. To develop pollen parent, we crossed commercial variety of 'Tae sang king' and 'Seoul spring'. We used individual selection method to develop H-shaped hard root and disease resistant inbred. In each segregating generation, we selected one plant based on phenotype and the uniformity of selected plant was tested by SSR markers using self-pollinated seeds. In the first segregating generation, 64.6% of sib plants shared the same band in PCR amplification using ACMP-490 primer and 66.7% using cnu-316 primer. The uniformity of segregating generations using ACMP-490 and cnu-316 raised in second generation to 68.8%, 70.8%, respectively; in third generation to 93.8%, 100%; in fourth generation to 93.8%, 100%; in fifth generation to 95.8%, 100%; in sixth generation to 100%, 100%. A novel cross was made using selected MS parent and pollen parent. When we checker the horticultural traits using autumn cultivation, the novel cross variety produced H-shaped root comparing other commercial varieties and produced highly uniform radish. Thus we registered this novel cross variety as 'YR ORE' at 2013 (Registration No. 4550).

Lung cancer, chronic obstructive pulmonary disease and air pollution (대기오염에 의한 폐암 및 만성폐색성호흡기질환 -개인 흡연력을 보정한 만성건강영향평가-)

  • Sung, Joo-Hon;Cho, Soo-Hun;Kang, Dae-Hee;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.585-598
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    • 1997
  • Background : Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of ai. pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. Method : This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i. e., mainly potential environmental diseases. We reconstructed a nested case-control study wit5h Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed? questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects' Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are putative chronic environmental diseases, while controls are mainly acute environmental diseases. for exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, $O_3,\;SO_2$, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results : Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-at-tainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of $O_3$ and CO exceedance counts (to corrected error level -0.017) and less strongly and consistently with $SO_2$ and TSP. $SO_2$ and TSP showed weaker and less consistent relationship. $O_3$ and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). Conclusions : Although not decisive due to potential misclassication of exposure, these results wert drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. $O_3$ might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.

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In Vivo Preperation of Standard Reference Materials of Lead in Blood (생체내 혈중 납 표준물질의 제조)

  • Chung, Kyou-Chull;Choi, Ho-Chun
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.863-873
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    • 1995
  • This report describes a preperation and characterization of canine blood lead(Pb) standard reference material(SRM). Three adult beagle dogs(A, B, and C)were orally dosed with gelatin capsules containing $Pb(NO_3)_2$, equivalent to $10\sim80mg$ Pb/kg body weight. Blood was drawn 24 hours after the dose from the cephalic vein into lead free 500ml Pyrex beaker in which EDTA.K was contained as an anticoagulant. The amount of lead given to individual dog was varied arbitrarily. Three month later, 3 canine animals were orally dosed with lead secondarily to make mixed SRM(D1) which was mixed different concentrations of lead in bloods with A1, B1, and C1 in vitro. The SRMs for A, B, C, A1, B1, C1, and D1 were distributed 2ml each into more than 300 lead free bottles, and were stored in refregerator at $4^{\circ}C$. The amount of lead in canine whole blood samples were determined using a Varian 30A atomic absorption spectrophotometer(AAS) with a model GTA-96 graphite tube atomizer with D2 background correction and a Hitachi Z-8100 AAS with Zeeman background correction. The sensitivity and detection limits for lead determination of Varian 30A were $0.46{\mu}g/L,\;0.34{\mu}g/L,\;and\;0.56{\mu}g/L,\;0.14{\mu}g/L$ of Hitachi Z-8100, respectively. Day to day variations in determination of blood lead concentration in a certain sample were $31.11{\pm}1.36{\mu}g/100ml$ by Varian 30A, and $33.08{\pm}0.82{\mu}g/100ml$ by Hitachi Z-8100, showing the difference of 3% between the two results. At the blood lead concentrations of $56.31{\pm}1.98{\mu}g/100ml(A),\;40.89{\pm}0.80{\mu}g/100ml(B),\;59.01{\pm}1.38{\mu}g/100ml(C)$, the precisions of replicated measurements by AAS were 3.52%, 1.96%, and 2.34%, respectively. Coefficient variation(CV) of SRMs(A, B, and C) within a standard sample were ranged from 0.92% to 7.50%, and those between 5 standard samples were 1.21%, 2.64%, and 1.11%, respectively, showing inter-vial variation of $1{\mu}g/100ml$. Lead levels in SRMs during one month storage were unchanged. The overall recoveries were $89.6\sim100.4%,\;91.6\sim101.9%,\;90.3\sim100.0%$ for A, B, and C SRMs, means were $56.46{\pm}2.69{\mu}g/100ml,\;39.35{\pm}1.89{\mu}g/100ml,\;57.40{\pm}2.31{\mu}g/100ml$, and measurement ranges were$52.88{\pm}59.26{\mu}g/100ml,\;37.47{\pm}41.68{\mu}g/100ml,\;54.80{\pm}60.69{\mu}g/100ml$, respectively. Those results were laid within confidence limits values. The lead concentrations in the mixed sample(D1) stored over one month period were ranged from $32.76{\mu}g/100ml\;to\;33.54{\mu}g/100ml$, with CV ranging from 1.2% to 2.7%. The results were similiar to each of single samples(A1, B1, and C1) in respect of homogeneity and stability. Results of the mixed blood sample analysed after 1 month storage at $4^{\circ}C$ by four other laboratories(L1, L2, L3, L4) were similar with those of our laboratory($L5;31.18{\pm}0.24{\mu}g/100ml$, acceptable range by $CDC;25.18\sim37.18{\mu}g/100ml$), showing the concentrations of $25.91{\pm}1.19{\mu}g/100ml(L1),\;34.16{\pm}0.22{\mu}g/100ml(L2),\;35.68{\pm}0.85{\mu}g/100ml(L3),\;30.95{\pm}0.46{\mu}g/100ml(L4)$ in a each samples.

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Genetic Relationship and Characteristics Using Microsatellite DNA Loci in Horse Breeds. (Microsatellite DNA를 이용한 말 집단의 유전적 특성 및 유연 관계)

  • Cho, Gil-Jae
    • Journal of Life Science
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    • v.17 no.5 s.85
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    • pp.699-705
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    • 2007
  • The present study was conducted to investigate the genetic characteristic and to establish the parentage verification system of the Korean native horse(KNH). A total number of 192 horses from six horse breeds including the KNH were genotyped using 17 microsatellite loci. This method consisted of multiplexing PCR procedure. The number of alleles per locus varied from 5 to 10 with a mean value of 7.35 in KNH. The expected heterozygosity and observed heterozygosity were ranged from 0.387 to 0.841(mean 0.702) and from 0.429 to 0.905(mean 0.703), respectively. The total exclusion probability of 17 microsatellite loci was 0.9999. Of the 17 markers, AHT4, AHT5, CA425, HMS2, HMS3, HTG10, LEX3 and VHL20 marker have relatively high PIC value(>0.7). This study found that there were specific alleles, P allele at AHT5, Q allele and R allele at ASB23, H allele at CA425, S allele at HMS3, J allele at HTG10 and J allele at LEX3 marker in KNH when compared with other horse populations. Also, the results showed two distinct clusters: the Korean native horse cluster(Korean native horse, Mongolian horse), and the European cluster(Jeju racing horse, Thoroughbred horse). These results present basic information for detecting the genetic markers of the KNH, and has high potential for parentage verification and individual identification of the KNH.

Reduced Number of Endothelial Progenitor Colony-Forming Units in Patients with Preeclampsia

  • Kim, Shin-Young;Park, So-Yeon;Kim, Jin-Woo;Lee, Mi-Bum;Han, You-Jung;Ahn, Hyun-Kyong;Choi, Jun-Seek;Han, Jung-Yeol;Kim, Moon-Young;Choi, Kyu-Hong;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.138-144
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    • 2010
  • Purpose: Endothelial progenitor cells (EPCs), which mediates neovascularization of uterine endometrium may be involved in the neovascularization in the utero-placental circulation. Low numbers of endothelial progenitor colony-forming unit (CFU) in culture are predictive biomarker of vascular disease. The aim of the present study was to evaluate whether the number of CFU in preeclampsia differed from that in normal pregnancy. Materials and Methods: Women with singleton normal (n=26) or preeclamptic (n=20) pregnancies were studied during the third trimester. The number of EPCs was quantified by CFU methodology. Plasma levels of angiogenic factors, vascular endothelial growth factor (VEGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and placental growth factor (PlGF) were determined by enzyme-linked immunoassay. Results: CFU numbers were significantly decreased in the preeclamptic patients compared with the controls (median, 3; range 1-12 vs. 31; 3-81 CFU/well, P<0.001). A majority of the cells comprising individual colonies were positive for endothelial characteristics (Ulex europaeus lectin staining and acetylated low-density lipoprotein uptake). Plasma levels of the sFlt-1 were highly elevated (P<0.001) in patient with preeclampsia compared to controls, whereas PlGF were highly reduced (P=0.004), but these factors did not associate with CFU numbers. Conclusion: Our results suggest that reduced numbers of CFU obtained from maternal peripheral blood may contribute to the development of preeclampsia.

The Effects of Virtual Reality Advertisement on Consumer's Intention to Purchase: Focused on Rational and Emotional Responses (가상현실(Virtual Reality) 광고가 소비자 구매의도에 미치는 영향: 이성적인 반응과 감성적인 반응의 통합)

  • Cha, Jae-Yol;Im, Kun-Shin
    • Asia pacific journal of information systems
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    • v.19 no.4
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    • pp.101-124
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    • 2009
  • According to Wikipedia, virtual reality (VR) is defined as a technology that allows a user to interact with a computer-simulated environment. Due to a rapid growth in information technology (IT), the cost of virtual reality has been decreasing while the utility of virtual reality advertisements has dramatically increased. Nevertheless, only a few studies have investigated the effects of virtual reality advertisement on consumer behaviors. Therefore, the objective of this study is to empirically examine the effects of virtual reality advertisement. Compared to traditional online advertisements, virtual reality advertisement enables consumers to experience products realistically over the Internet by providing high media richness, interactivity, and telepresence (Suh and Lee, 2005). Advertisements with high media richness facilitate consumers' understanding of advertised products by providing them with a large amount and a high variety of information on the products. Interactivity also provides consumers with a high level of control over the computer-simulated environment in terms of their abilities to adjust the information according to their individual interests and concerns and to be active rather than passive in their engagement with the information (Pimentel and Teixera, 1994). Through high media richness and interactivity, virtual reality advertisements can generate compelling feelings of "telepresence" (Suh and Lee, 2005). Telepresence is a sense of being there in an environment by means of a communication medium (Steuer, 1992). Virtual reality advertisements enable consumers to create a perceptual illusion of being present and highly engaged in a simulated environment, while they are in reality physically present in another place (Biocca, 1997). Based on the characteristics of virtual reality advertisements, a research model has been proposed to explain consumer responses to the virtual reality advertisements. The proposed model includes two dimensions of consumer responses. One dimension is consumers' rational response, which is based on the Information Processing Theory. Based on the Information Processing Theory, product knowledge and perceived risk are selected as antecedents of intention to purchase. The other dimension is emotional response of consumers, which is based on the Attitude-Structure Theory. Based on the Attitude-Structure Theory, arousal, flow, and positive affect are selected as antecedents of intention to purchase. Because it has been criticized to have investigated only one of the two dimensions of consumer response in prior studies, our research model has been built so as to incorporate both dimensions. Based on the Attitude-Structure Theory, we hypothesized the path of consumers' emotional responses to a virtual reality advertisement: (H1) Arousal by the virtual reality advertisement increases flow; (H2) Flow increases positive affect; and (H3) Positive affect increases intension to purchase. In addition, we hypothesized the path of consumers' rational responses to the virtual reality advertisement based on the Information Processing Theory: (H4) Increased product knowledge through the virtual reality advertisement decreases perceived risk; and (H5) Perceived risk decreases intension to purchase. Based on literature of flow, we additionally hypothesized the relationship between flow and product knowledge: (H6) Flow increases product knowledge. To test the hypotheses, we conducted a free simulation experiment [Fromkin and Streufert, 1976] with 300 people. Subjects were asked to use the virtual reality advertisement of a cellular phone on the Internet and then answer questions about the variables. To check whether subjects fully experienced the virtual reality advertisement, they were asked to answer a quiz about the virtual reality advertisement itself. Responses of 26 subjects were dropped because of their incomplete answers. Responses of 274 subjects were used to test the hypotheses. It was found that all of six hypotheses are accepted. In addition, we found that consumers' emotional response has stronger impact on their intention to purchase than their rational response does. This study sheds much light into practical implications for both IS researchers and managers. First of all, while most of previous research has analyzed only one of the customers' rational and emotional responses, we theoretically incorporated and empirically examined both of the two sides. Second, we empirically showed that mediators such as arousal, flow, positive affect, product knowledge, and perceived risk play an important role between virtual reality advertisement and customer's intention to purchase. In addition, the findings of this study can provide a basis of practical strategies for managers. It was found that consumers' emotional response is stronger than their rational response. This result indicates that advertisements using virtual reality should focus on the emotional side, and that virtual reality can be served as an appropriate advertisement tool for fancy products that require their online advertisements to give an impetus to customers' emotion. Finally, even if this study examined the effects of virtual reality advertisement of cellular phone, its findings could be applied to other products that are suited for virtual experience. However, this research has some limitations. We were unable to control different kinds of consumers and different attributes of products on consumers' intention to purchase. It is, therefore, deemed important for future research to control the consumer and product types for more reliable results. In addition to the consumer and product attributes, other variables could affect consumers' intention to purchase. Thus, the future research needs to find ways t control other variables.