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Long-term Effect of Desferrioxamine to rHuEPO Resistant Anemia in Hemodialysis Patients (혈액 투석 환자에서 나타나는 rHuEPO 저항성 빈혈에 대한 Desferrioxamine의 장기 효과)

  • Lim, Sang-Woo;Jung, Hang-Jae;Bae, Sung-Wha;Do, Jun-Young;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.399-414
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    • 1997
  • There are several factors concerning to anemia in chronic renal failure patients. But when rHuEPO is used, most of these factors can be overcome, and the levels of hemoglobin are increased. However, about 10% of the renal failure patients represent rHuEPO-resistant anemia eventhough high dosage of rHuEPO. For these cases, desferrioxamine can be applied to correct rHuEPO resistnacy, and many mechanism of DFO are arguing. So we are going to know whether DFO can be applied to correct anemia of the such patients, how long its effect can be continued. The seven pateients as experimental group(DFO+EPO) who represent refractoriness to rHuEPO and the other seven patients as control group(EPO) were included. Experimental group had lower than 9 g/dL of hemoglobin levels despite high rHuEPO dosage (more than 4000U/Wk) and showed normocytic normochromic anemia. There were no definitve causes of anemia such as hemorrhage or iron deficiency. Control group patients had similar characteristics in age, mean dialysis duration but showed adequate response to rHuEPO. DFO was administered to experimental group for 8 weeks along with rHuEPO(the rHuEPO individual mean dosage had been determined by mean dosage of the previous 6 months. Total mean dosage; 123.5 U/Kg/Wk). After 8 weeks of DFO administration, the hemoglobin and rHuEPO dosage levels were checked for 15 consecutive months. It should be noted that the patients determined their own rHuEPO dosage levels according to hemoglobin levels and economic status. In conrol group, rHuEPO was administered by the same method used in experimental group without DFO through the same period. Fifteen months of observation period after DFO trial were divided as Time I(7 months after DFO trial) and Time II(8 months after Time I). The results are as follows: Before DFO trial, mean hemoglobin level of experimental group was 7.8 g/dL, which is similar level(p>0.05) to control group(mean Hb; 8.2 g/dL). But in experimental group, significantly(p<0.05) higher dosages of rHuEPO(mean; 123.5 U/Kg/Wk) than control group (mean; 41.6 U/Kg/Wk) had been used. It means resistancy to rHuEPO of experimental group. But after DFO trial, the hemoglobin levels of the experimental group were increased significantly(p<0.05), and these effect were continued to Time II.(Time I; mean 8.6g/dL, Time II; mean 8.6g/dL) The effects of DFO to hemoglobin were continued for 15 months after DFO trial with similar degree through Time I, Time II. Also, rHuEPO dosages used in the experimental group were decreased to similar levels of the control group after DFO trial and these effect were also continued for 15 months(Time I; mean 48.1 U/Kg/Wk. Time II; mean 51.8 U/Kg/Wk). In the same period, hemoglobin levels and rHuEPO dosages used in the control group were not changed significantly. Notibly, hemoglobin increment and rHuEPO usage decrement in experimental group were showed maxilly in the 1st month after DFO trial. That is, after the use of DFO, erythopoiesis was enhanced with a reduced rHuEPO dosage. So we think rHuEPO reisistancy can be overcome by DFO therapy. In conclusion, the DFO can improve the anemia caused by chronic renal failure at least over 1 year, and hence, can reduce the dosage of rHuEPO for anemia correction. Additional studies in order to determine the mechanism of DFO on erythropoiesis and careful attention to potential side effects of DFO will be needed.

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Study on the effect of small and medium-sized businesses being selected as suitable business types, on the franchise industry (중소기업적합업종선정이 프랜차이즈산업에 미치는 영향에 관한 연구)

  • Kang, Chang-Dong;Shin, Geon-Chel;Jang, Jae Nam
    • Journal of Distribution Research
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    • v.17 no.5
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    • pp.1-23
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    • 2012
  • The conflict between major corporations and small and medium-sized businesses is being aggravated, the trickle down effect is not working properly, and, as the controversy surrounding the effectiveness of the business limiting system continues to swirl, the plan proposed to protect the business domain of small and medium-sized businesses, resolve polarization between these businesses and large corporations, and protect small family run stores is the suitable business type designation system for small and medium-sized businesses. The current status of carrying out this system of selecting suitable business types among small and medium-sized businesses involves receiving applications for 234 items among the suitable business types and items from small and medium-sized businesses in manufacturing, and then selecting the items of the consultative group by analyzing and investigating the actual conditions. Suitable business type designation in the service industry will involve designation with priority on business types that are experiencing social conflict. Three major classifications of the service industry, related to the livelihood of small and medium-sized businesses, will be first designated, and subsequently this will be expanded sequentially. However, there is the concern that when designated as a suitable business type or item, this will hinder the growth motive for small to medium-sized businesses, and designation all cause decrease in consumer welfare. Also it is highly likely that it will operate as a prior regulation, cause side-effects by limiting competition systematically, and also be in violation against the main regulations of the FTA system. Moreover, it is pointed out that the system does not sufficiently reflect reverse discrimination factor against large corporations. Because conflict between small to medium sized businesses and large corporations results from the expansion of corporations to the service industry, which is unrelated to their key industry, it is necessary to introduce an advanced contract method like a master franchise or local franchise system and to develop local small to medium sized businesses through a franchise system to protect these businesses and dealers. However, this method may have an effect that contributes to stronger competitiveness of small to medium sized franchise businesses by advancing their competitiveness and operational methods a step further, but also has many negative aspects. First, as revealed by the Ministry of Knowledge Economy, the franchise industry is contributing to the strengthening of competitiveness through the economy of scale by organizing existing individual proprietors and increasing the success rate of new businesses. It is also revealed to be a response measure by the government to stabilize the economy of ordinary people and is emphasized as a 'useful way' to revitalize the service industry and improve the competitiveness of individual proprietors, and has been involved in contributions to creating jobs and expanding the domestic market by providing various services to consumers. From this viewpoint, franchises fit the purpose of the suitable business type system and is not something that is against it. Second, designation as a suitable business type may decrease investment for overseas expansion, R&D, and food safety, as well negatively affect the expansion of overseas corporations that have entered the domestic market, due to the contraction and low morale of large domestic franchise corporations that have competitiveness internationally. Also because domestic franchise businesses are hard pressed to secure competitiveness with multinational overseas franchise corporations that are operating in Korea, the system may cause difficulty for domestic franchise businesses in securing international competitiveness and also may result in reverse discrimination against these overseas franchise corporations. Third, the designation of suitable business type and item can limit the opportunity of selection for consumers who have up to now used those products and can cause a negative effect that reduces consumer welfare. Also, because there is the possibility that the range of consumer selection may be reduced when a few small to medium size businesses monopolize the market, by causing reverse discrimination between these businesses, the role of determining the utility of products must be left ot the consumer not the government. Lastly, it is desirable that this is carried out with the supplementation of deficient parts in the future, because fair trade is already secured with the enforcement of the franchise trade law and the best trade standard of the Fair Trade Commission. Overlapping regulations by the suitable business type designation is an excessive restriction in the franchise industry. Now, it is necessary to establish in the domestic franchise industry an environment where a global franchise corporation, which spreads Korean culture around the world, is capable of growing, and the active support by the government is needed. Therefore, systems that do not consider the process or background of the growth of franchise businesses and harm these businesses for the sole reason of them being large corporations must be removed. The inhibition of growth to franchise enterprises may decrease the sales of franchise stores, in some cases even bankrupt them, as well as cause other problems. Therefore the suitable business type system should not hinder large corporations, and as both small dealers and small to medium size businesses both aim at improving competitiveness and combined growth, large corporations, small dealers and small to medium sized businesses, based on their mutual cooperation, should not include franchise corporations that continue business relations with them in this system.

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A Study on the Effects of the Dine-out Franchise Headquarter's Management and Support Policies and Franchise Business Operator's Managerial Characteristics on the Bilateral Relationship and Franchise Store's Satisfaction (외식 프랜차이즈 가맹본부의 관리 및 지원정책과 가맹점 사업자의 경영자적 특성이 양자간 관계와 가맹점의 만족에 미치는 영향에 관한 연구)

  • Seo, SangYun;Jang, JaeNam
    • Journal of Distribution Research
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    • v.17 no.4
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    • pp.81-101
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    • 2012
  • A franchise system develops competitive products for a franchise store through the system established by the franchise head office. Therefore, it has advantages of expanding the marketing effect since the risk of failure is reduced for a founder and the franchise head office supports the overall sales, advertisement and promotional activities. Also, a franchise store has advantages of fulfilling necessary facilities and tools on advantageous terms, reducing expenses by purchasing in bulk, and getting a supply of products with stable qualities. However, aside from such advantages, franchise head offices are forcing franchise stores to make unnecessary investments in equipments and remodel the interior. Also, franchise business operators are being made to share the cost of marketing and multiple franchise stores are being approved within the same business district, and franchise business operators are suffering damages. Therefore, cases of shutting down a franchise store or not renewing the contract are frequent. From the position of a franchise head office, profits that are generated from franchise fees, interior remodeling fees and supplying facilities and materials will increase as the number of new franchise stores increases. However, franchise stores are faced with difficulties due to excessive competitions between similar types of businesses and the overlapping of business districts that come from increases in the number of stores, and they eventually end up shutting down. Therefore, in order for a franchise business operator and franchise head office to grow and develop continuously, opening new stores is important, but successfully renewing the contract by maintaining a relationship with an existing franchise business operator is desirable. In this aspect, a study that examines the elements that can affect the relationship between a franchise business operator and franchise head office is believed to be important for the development of the franchise industry and creating safe jobs for the public. With an emphasis on the relationship between a franchise head office and franchise store, this study attempted to examine the effect of characteristics of a franchise head office and franchise business operator on the bilateral relationship such as the faith and immersion, and wished to review the effects of such faith and immersion on the satisfaction of a franchise store, including an intention of renewing the contract. In particular, in the current situation of great uncertainties in the market, this study also wished to examine how uncertain market elements will affect the relationship between the characteristics of a franchise head office and franchise business operator, and the faith and immersion. The study revealed that among the characteristics of a franchise head office, the standardization management of a franchise head office hinders a franchise store's faith and immersion in a franchise head office. Also, a franchise head office's support was shown to increase a franchise store's faith and immersion. However, it was revealed that a franchise head office's regulation and incentive policies for a franchise store do not affect a franchise store's faith and immersion. Among characteristics of a franchise business operator, a franchise store's healthy financial status and entrepreneur spirits were shown to enhance the faith and immersion in a franchise head office. However, it was shown that excellent business abilities of a franchise business operator actually reduce the immersion for a franchise head office. Also, the faith and immersion in a franchise head office were shown to enhance the intention of renewing the contract by increasing the satisfaction for a franchise head office. In addition, it was originally believed that the effects of a franchise business operator's characteristics on the faith and immersion in a franchise head office will vary depending on the market uncertainty, but the effect of a franchise business operator's characteristics depending on the recognition of uncertainties was shown to be insignificant. Such findings show that instead of making a franchise store pay for equipment investments and marketing and obtaining profits by force, a franchise head office should actively support a franchise store so that a franchise store's business activities can be conducted well, which will bring profits to a franchise store and ultimately to a franchise head office. This is a more desirable direction for the development of both parties. Implications of such findings are summarized as follows. First, it was shown that a franchise head office's standardization management actually reduces a franchise store's faith and immersion. Therefore, it is believed that instead of conducting standardization managements for regulating and managing franchise stores, measures should be developed so that franchise stores can actually participate voluntarily. For this, a head office should put in efforts to develop and provide standardized manuals, and make sure that a self-review system takes root. Second, a franchise head office's incentives did not have significant effects on the faith and immersion, but the support was shown to be effective. Therefore, it can be seen that instead of taking post-measures for a franchise store, taking pre-measures of actively supporting is more effective in maintaining a franchise store. Third, among characteristics of a franchise head office, it was shown that a franchise store's healthy financial status increased the faith and immersion in a franchise head office. Therefore, when selecting a franchise business operator, instead of thoughtlessly opening up franchise stores for the profit of a head office, it is believed that reviewing a franchise business operator's financial firepower and credit status is necessary. As for academic implications, previous studies examined the relationship by focusing on the characteristics of a franchise head office and franchise store, but this study focused on the characteristics of a franchise business operator. Therefore, this study dealt with the importance of a franchise business operator's competence, and is significant because it revealed the fact that a franchise business operator's excellent commercialization ability can become an element that hinders the immersion in a franchise head office. It was originally believed that a franchise store's characteristics will have different effects on the faith and immersion depending on the market uncertainty, but it was shown that the effect of a franchise store's characteristics depending on the recognition of uncertainties was insignificant, and that is the limitation of this study.

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The Marketing Effect of Loyalty Program on Relational Market Behavior : Focusing in Franchise Membership Fitness Club (로열티 프로그램이 고객 참여와 소비자-브랜드 관계에 기초한 관계형 시장 행동에 미치는 영향 : 프랜차이즈 회원제 휘트니스클럽을 대상으로)

  • Yoon, Kyung-Goo;Shin, Geon-Cheol
    • Journal of Distribution Research
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    • v.17 no.2
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    • pp.1-28
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    • 2012
  • I. Introduction : The purpose of this study is to test empirically hypothetical causality among constructs used in previous studies to build the model of relational market behavior on customers' participation and consumer-brand relationship after introducing theories of relationship marketing, loyalty program, consumer-brand relationship, customers' participation in service marketing as previous studies with regard to relational market behavior, which Bagozzi(1995) and Peterson(1995) commented on constructs and definition suggested by Sheth and Parvatiyar (1995). For this purpose, loyalty program by the service provider, customers' participation and consumer-brand relationship as preceding variables explain relational market behavior defined by Sheth and Parvatiyar(1995). This study proposes that loyalty program as a tool of relationship marketing will be effective in that consumers' participation in marketing relationship results in a narrow range of choice(Sheth and Parvatiyar, 1995) because consumers think that their participation motive result in benefits(Peterson, 1995). Also, it is proposed that the quality of consumer-brand relationship explain the performance of relationship as well as the intermediary effect because the loyalty program could be evaluated based on relationship with customers. We reviewed the variables with regard to performance of relationship based on relation maintain in marketing literature, and then tested our hypotheses related to several performance variables including loyalty and intention of relation maintain based on the previous studies and constructs(Bendapudi and Berry, 1997 ; Bettencourt, 1997 ; Palmatier, Dant, Grewal and Evans, 2006 ; You Jae Yi and Soo Jin Lee, 2006). II. Study Model : Analyses about hypothetical causality were proceeded. The marketing effect of loyalty program on relational market behavior was empirically tested in study regarding a service provider. The research model in according to the path hypotheses (loyalty program ${\rightarrow}$ customers' participation ${\rightarrow}$ consumer-brand relationship ${\rightarrow}$ relational market behavior and loyalty program ${\rightarrow}$ consumer-brand relationship, and loyalty program ${\rightarrow}$ relational market behavior and customers' participation ${\rightarrow}$ consumer-brand relationship, and customers' participation ${\rightarrow}$ relational market behavior) proceeded as an activity for customer relation management was suggested. The main purpose of study is to see if relational market behavior could be brought as a result of developing relationship between consumers and a corporate into being stronger and more valuable when a corporate or a service provider try aggressively to build the relationship with customers (Bettencourt, 1997; Palmatier, Dant, Grewal and Evans, 2006; Sheth and Parvatiyar, 1995). III. Conclusion : The results of research into the membership fitness club, one of service areas with high level of customer participation (Bitner, Faranda, Hubbert and Zeithaml, 1997; Chase, 1978; Kelley, Donnelly, Jr. and Skinner, 1990) are as follows: First, causalities in according to path hypotheses were tested, after the preceding variables affecting relational market behavior and conceptual frame were suggested. In study, all hypotheses were supported as expected. This result confirms the proposition suggested by Sheth and Parvatiyar(1995), who claimed that intention of consumer and corporate to participate in marketing relationship brings high level of marketing productivity. Also, as a corporate or a service provider try aggressively to build relationship with customers, the relationship between consumers and a corporate can be developed into stronger and more valuable one (Bettencourt, 1997; Palmatier, Dant, Grewal and Evans, 2006). This finding supports the logic of relationship marketing. Second, because the question regarding the path hypothesis of consumer-brand relationship ${\rightarrow}$ relational market behavior are still at issue, the further analyses were conducted. In particular, there existed the mediating effects of consumer-brand relationship toward relational market behavior. Also, multiple regressions were conducted to see if which one strongly influences relational market behavior among specific question items with regard to consumer-brand relationship. As a result, the influence between items composing consumer-brand relationship and ones composing relational market behavior was different. Among items composing consumer-brand relationship, intimacy was an influence of sustaining relationship, word of mouth, and recommendation, intimacy and interdependence were influences of loyalty, intimacy and self-connection were influences of tolerance and advice. Notably, commitment among items measuring consumer-brand relationship had the negative influence with relational market behavior. This means that bringing relational market behavior is not consumer-brand relationship without personal commitment, but effort to build customer relationship like intimacy, interdependence, and self-connection. This finding confirms the results of Breivik and Thorbjornsen(2008). They reported that six variables composing the quality of consumer-brand relationship have higher explanation in regression model directly affecting performance of consumer-brand relationship. As a result of empirical analysis, among the constructs with regard to consumer-brand relationship, intimacy(B=0.512), interdependence(B=0.196), and quality of partner(B=0.153) had the effects on relation maintain. On the contrary, self-connection, love and passion, and commitment had little effect and did not show the statistical significance(p<0.05). On the other hand, intimacy(B=0.668) and interdependence(B=0.181) had the high regression estimates on word of mouth and recommendation. Regarding the effect on loyalty, explanation level of the model was high(R2=0.515), intimacy(0.538), interdependence(0.223), and quality of partner(0.177) showed the statistical significance(p<0.05). Furthermore, intimacy(0.441) had the strong effect as well as self-connection(0.201) and interdependence (0.163) had the effect on tolerance and forgive. And these three variables showed effects even on advice and suggestion, intimacy(0.373), self-connection(0.270), interdependence (0.155) respectively. Third, in study with regard to the positive effect(loyalty program ${\rightarrow}$ customers' participation, loyalty program ${\rightarrow}$ consumer-brand relationship, loyalty program ${\rightarrow}$ relational market behavior, customers' participation ${\rightarrow}$ consumer-brand relationship, customers' participation ${\rightarrow}$ relational market behavior, consumer-brand relationship ${\rightarrow}$ relational market behavior), the path hypothesis of customers' participation ${\rightarrow}$ consumer-brand relationship, was supported. The fact that path hypothesis of customers' participation ${\rightarrow}$ consumer-brand relationship was supported confirms assertion by Bitner(1995), Fournier(1994), Sheth and Parvatiyar(1995) about consumer relationship to participate in marketing relationship.

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The Effect of Price Discount Rate According to Brand Loyalty on Consumer's Acquisition Value and Transaction Value (브랜드애호도에 따른 가격할인율의 차이가 소비자의 획득가치와 거래가치에 미치는 영향)

  • Kim, Young-Ei;Kim, Jae-Yeong;Shin, Chang-Nag
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.247-269
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    • 2007
  • In recent years, one of the major reasons for the fierce competition amongst firms is that they strive to increase their own market shares and customer acquisition rate in the same market with similar and apparently undifferentiated products in terms of quality and perceived benefit. Because of this change in recent marketing environment, the differentiated after-sales service and diversified promotion strategies have become more important to gain competitive advantage. Price promotion is the favorite strategy that most retailers use to achieve short-term sales increase, induce consumer's brand switch, in troduce new product into market, and so forth. However, if marketers apply or copy an identical price promotion strategy without considering the characteristic differences in product and consumer preference, it will cause serious problems because discounted price itself could make people skeptical about product quality, and the changes of perceived value might appear differently depending on other factors such as consumer involvement or brand attitude. Previous studies showed that price promotion would certainly increase sales, and the discounted price compared to regular price would enhance the consumer's perceived values. On the other hand, discounted price itself could make people depreciate or skeptical about product quality, and reduce the consumers' positivity bias because consumers might be unsure whether the current price promotion is the retailer's best price offer. Moreover, we cannot say that discounted price absolutely enhances the consumer's perceived values regardless of product category and purchase situations. That is, the factors that affect consumers' value perceptions and buying behavior are so diverse in reality that the results of studies on the same dependent variable come out differently depending on what variable was used or how experiment conditions were designed. Majority of previous researches on the effect of price-comparison advertising have used consumers' buying behavior as dependent variable. In order to figure out consumers' buying behavior theoretically, analysis of value perceptions which influence buying intentions is needed. In addition, they did not combined the independent variables such as brand loyalty and price discount rate together. For this reason, this paper tried to examine the moderating effect of brand loyalty on relationship between the different levels of discounting rate and buyers' value perception. And we provided with theoretical and managerial implications that marketers need to consider such variables as product attributes, brand loyalty, and consumer involvement at the same time, and then establish a differentiated pricing strategy case by case in order to enhance consumer's perceived values properl. Three research concepts were used in our study and each concept based on past researches was defined. The perceived acquisition value in this study was defined as the perceived net gains associated with the products or services acquired. That is, the perceived acquisition value of the product will be positively influenced by the benefits buyers believe they are getting by acquiring and using the product, and negatively influenced by the money given up to acquire the product. And the perceived transaction value was defined as the perception of psychological satisfaction or pleasure obtained from taking advantage of the financial terms of the price deal. Lastly, the brand loyalty was defined as favorable attitude towards a purchased product. Thus, a consumer loyal to a brand has an emotional attachment to the brand or firm. Repeat purchasers continue to buy the same brand even though they do not have an emotional attachment to it. We assumed that if the degree of brand loyalty is high, the perceived acquisition value and the perceived transaction value will increase when higher discount rate is provided. But we found that there are no significant differences in values between two different discount rates as a result of empirical analysis. It means that price reduction did not affect consumer's brand choice significantly because the perceived sacrifice decreased only a little, and customers are satisfied with product's benefits when brand loyalty is high. From the result, we confirmed that consumers with high degree of brand loyalty to a specific product are less sensitive to price change. Thus, using price promotion strategy to merely expect sale increase is not recommendable. Instead of discounting price, marketers need to strengthen consumers' brand loyalty and maintain the skimming strategy. On the contrary, when the degree of brand loyalty is low, the perceived acquisition value and the perceived transaction value decreased significantly when higher discount rate is provided. Generally brands that are considered inferior might be able to draw attention away from the quality of the product by making consumers focus more on the sacrifice component of price. But considering the fact that consumers with low degree of brand loyalty are known to be unsatisfied with product's benefits and have relatively negative brand attitude, bigger price reduction offered in experiment condition of this paper made consumers depreciate product's quality and benefit more and more, and consumer's psychological perceived sacrifice increased while perceived values decreased accordingly. We infer that, in the case of inferior brand, a drastic price-cut or frequent price promotion may increase consumers' uncertainty about overall components of product. Therefore, it appears that reinforcing the augmented product such as after-sale service, delivery and giving credit which is one of the levels consisting of product would be more effective in reality. This will be better rather than competing with product that holds high brand loyalty by reducing sale price. Although this study tried to examine the moderating effect of brand loyalty on relationship between the different levels of discounting rate and buyers' value perception, there are several limitations. This study was conducted in controlled conditions where the high involvement product and two different levels of discount rate were applied. Given the presence of low involvement product, when both pieces of information are available, it is likely that the results we have reported here may have been different. Thus, this research results explain only the specific situation. Second, the sample selected in this study was university students in their twenties, so we cannot say that the results are firmly effective to all generations. Future research that manipulates the level of discount along with the consumer involvement might lead to a more robust understanding of the effects various discount rate. And, we used a cellular phone as a product stimulus, so it would be very interesting to analyze the result when the product stimulus is an intangible product such as service. It could be also valuable to analyze whether the change of perceived value affects consumers' final buying behavior positively or negatively.

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Development and evaluation of Pre-Parenthood Education Program for high school students based on Home Economics subject (고등학생을 위한 가정교과 기반 예비부모교육 프로그램 개발 및 평가)

  • Noh, Heui-Yeon;Cho, Jae Soon;Chae, Jung Hyun
    • Journal of Korean Home Economics Education Association
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    • v.29 no.4
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    • pp.161-193
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    • 2017
  • The purpose of this study was to develop and evaluate pre-parenthood education program(PPEP) based on Home Economics(HE) subject for high school students. The development and evaluation of PPEP based on HE subject in this study followed ADDIE model except implementation through 4 processes such as analysis, design, development, and evaluation. First, program development directions were set in three aspects such as 'general development', 'contents', and 'teaching and learning methods'. Themes of the program are 11 in total such as '1. Parenting, what is being a parent', '2. Choosing your spouse, happy marital relationship, the best gift to your children', '3. Pregnancy and birth, a moving meeting with a new life', '4. Taking care of a new born infant for 24 hours', '5. Taking care of infants, relationship with my lovely baby, attachment', '6. Taking care of young children, my child from another planet', '7. Parents and children in healthy family', '8. Parent-child relationship, wise parents to make effective interaction with their children', '9. Parents safety manager at home,', '10. Practice to take care of infants', and '11. Practice of community nurturing support service development'. In particular, learning activities of the program have major characteristics such as 1) utilization of cases including practice problems related to parenting, 2) community exchange activities utilizing learned knowledge and techniques, 3) actual life project activities utilizing learning contents related with parenting, 4) activities inducing positive changes in current life of high school students, and 5) practice activities for the necessities of life such as food, clothing and shelter supporting development of children. Second, the program was developed according to the design. Teaching-learning plans and materials for 17 classes were developed according to 11 themes. The developed plans include class flow and teacher's reference. It starts with receiving a class-related message from a virtual child at the introduction stage and ended with replying to the message by summarizing contents of the class and making a promise as a parent-to-be. That is the basic frame of class flow. Learning materials included various plans and reports necessary for learning activities and they are prepared in details so that they can be play the role of textbooks in regular curriculum. Third, evaluation of developed program was executed by a 5 point Likert scale survey on 13 HE experts on two aspects of program development process and program development results. In the evaluation of development process, mean value was 4.61 and index of content validity was 97.4%. For development results, mean value was 4.37 and index of content validity was 86.9%. These values showed that validity in the development process and results in this study was highly secured and confirmed that PPEP based on HE was appropriate and valid to enhance parent qualifications of high school learners.

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

  • Koh, Youn-Suck;Jang, Yun-Hae;Kim, Woo-Sung;Lee, Jae-Dam;Oh, Soon-Hwan;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.452-461
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    • 1994
  • Background: Tumor necrosis factor(TNF)-$\alpha$ and Interleukin(lL)-$1{\beta}$ are thought to play a major role in the pathogenesis of the septic syndrome, which is frequently associated with adult respiratory distress syndrome(ARDS). In spite of many reports for the role of TNF-$\alpha$ in the pathogenesis of ARDS, including human studies, it has been reported that TNF-$\alpha$ is not sensitive and specific marker for impending ARDS. But there is a possibility that the results were affected by the diversity of pathogenetic mechanisms leading to the ARDS because of various underlying disorders of the study group in the previous reports. The purpose of the present study was to evaluate the roles of TNF-$\alpha$ and IL-$1{\beta}$ as a predictable marker for development of ARDS in the patients with septic syndrome, in which the pathogenesis is believed to be mainly cytokine-mediated. Methods: Thirty-six patients of the septic syndrome hospitalized in the intensive care units of the Asan Medical Center were studied. Sixteens suffered from ARDS, whereas the remaining 20 were at the risk of developing ARDS(acute hypoxemic respiratory failure, AHRF). In all patients venous blood samples were collected in heparin-coated tubes at the time of enrollment, at 24 and 72 h thereafter. TNF-$\alpha$ and IL-$1{\beta}$ was measured by an enzyme-linked immunosorbent assay (ELISA). All data are expressed as median with interquartile range. Results: 1) Plama TNF-$\alpha$ levels: Plasma TNF-$\beta$ levels were less than 10pg/mL, which is lowest detection value of the kit used in this study within the range of the $mean{\pm}2SD$, in all of the normal controls, 8 of 16 subjects of ARDS and in 8 in 20 subjects of AHRF. Plasma TNF-$\alpha$ levels from patients with ARDS were 10.26pg/mL(median; <10-16.99pg/mL, interquartile range) and not different from those of patients at AHRF(10.82, <10-20.38pg/mL). There was also no significant difference between pre-ARDS(<10, <10-15.32pg/mL) and ARDS(<10, <10-10.22pg/mL). TNF-$\alpha$ levels were significantly greater in the patients with shock than the patients without shock(12.53pg/mL vs. <10pg/mL) (p<0.01). There was no statistical significance between survivors(<10, <10-12.92pg/mL) and nonsurvivors(11.80, <10-20.8pg/mL) (P=0.28) in the plasma TNF-$\alpha$ levels. 2) Plasma IL-$1{\beta}$ levels: Plasma IL-$1{\beta}$ levels were less than 0.3ng/mL, which is the lowest detection value of the kit used in this study, in one of each patients group. There was no significant difference in IL-$1{\beta}$ levels of the ARDS(2.22, 1.37-8.01ng/mL) and of the AHRF(2.13, 0.83-5.29ng/mL). There was also no significant difference between pre-ARDS(2.53, <0.3-8.34ngfmL) and ARDS(5.35, 0.66-11.51ng/mL), and between patients with septic shock and patients without shock (2.51, 1.28-8.34 vs 1.46, 0.15-2.13ng/mL). Plasma IL-$1{\beta}$ levels were significantly different between survivors(1.37, 0.4-2.36ng/mL) and nonsurvivors(2.84, 1.46-8.34ng/mL). Conclusion: Plasma TNF-$\alpha$ and IL-$1{\beta}$ level are not a predictable marker for development of ARDS. But TNF-$\alpha$ is a marker for shock in septic syndrome. These result could not exclude a possibility of pathophysiologic roles of TNF-$\alpha$ and IL-$1{\beta}$ in acute lung injury because these cytokine could be locally produced and exert its effects within the lungs.

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A Study on Estimation of Edible Meat Weight in Live Broiler Chickens (육용계(肉用鷄)에서 가식육량(可食肉量)의 추정(推定)에 관(關)한 연구(硏究))

  • Han, Sung Wook;Kim, Jae Hong
    • Korean Journal of Agricultural Science
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    • v.10 no.2
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    • pp.221-234
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    • 1983
  • A study was conducted to devise a method to estimate the edible meat weight in live broilers. White Cornish broiler chicks CC, Single Comb White Leghorn egg strain chicks LL, and two reciprocal cross breeds of these two parent stocks (CL and LC) were employed A total of 240 birds, 60 birds from each breed, were reared and sacrificed at 0, 2, 4, 6, 8 and 10 weeks of ages in order to measure various body parameters. Results obtained from this study were summarized as follows. 1) The average body weight of CC and LL were 1,820g and 668g, respectively, at 8 weeks of age. The feed to gain ratios for CC and LL were 2.24 and 3.28, respectively. 2) The weight percentages of edible meat to body weight were 34.7, 36.8 and 37.5% at 6, 8 and 10 weeks of ages, respectively, for CC. The values for LL were 30.7, 30.5 and 32.3%, respectively, The CL and LC were intermediate in this respect. No significant differences were found among four breeds employed. 3) The CC showed significantly smaller weight percentages than did the other breeds in neck, feather, and inedible viscera. In comparison, the LL showed the smaller weight percentages of leg and abdominal fat to body weight than did the others. No significant difference was found among breeds in terms of the weight percentages of blood to body weight. With regard to edible meat, the CC showed significantly heavier breast and drumstick, and the edible viscera was significantly heavier in LL. There was no consistent trend in neck, wing and back weights. 4) The CC showed significantly larger measurements body shape components than did the other breeds at all time. Moreover, significant difference was found in body shape measurements between CL and LC at 10 weeks of age. 5) All of the measurements of body shape components except breast angle were highly correlated with edible meat weight. Therefore, it appeared to be possible to estimate the edible meat wight of live chickens by the use of these values. 6) The optimum regression equations for the estimation of edible meat weight by body shape measurements at 10 weeks of age were as follows. $$Y_{cc}=-1,475.581 +5.054X_{26}+3.080X_{24}+3.772X_{25}+14.321X_{35}+1.922X_{27}(R^2=0.88)$$ $$Y_{LL}=-347.407+4.549X_{33}+3.003X_{31}(R^2=0.89)$$ $$Y_{CL}=-1,616.793+4.430X_{24}+8.566X_{32}(R^2=0.73)$$ $$Y_{LC}=-603.938+2.142X_{24}+3.039X_{27}+3.289X_{33}(R^2=0.96)$$ Where $X_{24}$=chest girth, $X_{25}$=breast width, $X_{26}$=breast length, $X_{27}$=keel length, $X_{31}$=drumstick girth, $X_{32}$=tibotarsus length, $X_{33}$=shank length, and $X_{35}$=shank diameter. 7) The breed and age factors caused considerable variations in assessing the edible meat weight in live chicken. It seems however that the edible meat weight in live chicken can be estimated fairly accurately with optimum regression equations derived from various body shape measurements.

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Usefulness of Stomach Extension after Drinking Orange Juice in PET/CT Whole Body Scan (PET/CT 전신 영상에서 오렌지 주스(Orange Juice)를 이용한 위장 확장 영상의 유용성)

  • Cho, Seok-Won;Chung, Seok;Oh, Shin-Hyun;Park, Hoon-Hee;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.86-92
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    • 2009
  • Purpose: The PET/CT has a clear distinction on the lesion of the functional image by adding anatomical information. It also could reduce the examination time using CT data as the attenuation-correction. When the stomach was contracted from a fast, it could bring a misinterpretation of the cancer of the lesion with a presence of physiological $^{18}F$-FDG uptake in stomach and it occasionally would bring an additional scan to confirm. To complement this shortcoming, the method that the patients had water before the examination to extend the stomach had been attempted. However, a short excretion time of the stomach did not give sufficiently extended image of the stomach. Then the patients had additional water and had the examination again. Therefore, the noticed fact is that the stomach excretion time depends on calories, protein content, and the level of carbohydrate. In this study, we use an orange juice to evaluate the extension of the stomach and usefulness of it. Materials and Methods: PET/CT scan were obtained on total 150 of patient from February 2008 to October2008, There were 3 groups in this study and each group had 50 patients. First group drank nothing, Second group drank water and third group drank orange juice. The patients (man 25, female 25) not drinking are the age of 30~71 years old (average: 54), the patients (man: 25, female: 25) drinking water (400 cc) are the age of 28~71 years old (average: 54) and the patients (man: 25, female: 25) drinking orange juice (400 cc) are the age of 32~74 years old (average: 56). The patients were fasted in 6-8 hours before the test, the patients were not diabetic. $^{18}F$-FDG 370~555 MBq were injected intravenously. The patients were in stable position for 1 hour, than the image was obtained. The patients drank water and other patients drank orange juice before Whole body scan. The image scan started from mid-femur to skull base. The emission scan acquired for three minutes per bed and the images were reconstructed. Stomach extension analysis is measured from vertical and horizontal length. Results: Stomach Extension was described as the vertical length of the Non Drink Group was $1.20{\pm}0.50\;cm$, horizontal length was $1.4{\pm}0.53\;cm$, the vertical length of the Water Drink Group was $1.67{\pm}0.63\;cm$, horizontal length was $1.65{\pm}0.77\;cm$, the vertical length of Orange juice Drink Group was $3.48{\pm}0.77\;cm$, horizontal length was $3.66{\pm}0.77\;cm$ in coronal image. Stomach Extension was described the vertical length of the Non Drink Group was $2.03{\pm}0.62\;cm$, horizontal length was $1.69{\pm}0.68\;cm$, the vertical length of Water Drink Group was $5.34{\pm}1.62\;cm$, horizontal length was $2.45{\pm}0.72\;cm$, the vertical length of Orange juice Drink Group was $7.74{\pm}1.62\;cm$, horizontal length was $3.57{\pm}0.77\;cm$ in transverse image. The Stomach Extension has specific differences (p<0.001). The SUVs shows the Non Drink Group were measured as Liver $2.52{\pm}0.42$, Lung $0.51{\pm}0.14$, the Water Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$, Orange juice Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$. The SUVs did not have specific differences (p>0.759). Conclusions: There was not a large difference of SUV in three groups. When the patients drank Orange juice and water, the range extension of stomach was higher than without drinking nothing and it was possible to acquire fully extended images. Therefore, it will be possible that unnecessary additional stomach scans will be reduced by drinking orange juice before the examination so that the patients' claim from uncomfortable and long period of fast will be minimized.

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Purification of antigenic proteins of Paragonimus westermani and their applicability to experimental cat paragonimiasis (폐(肺)디스토마(Paragonimus westermani) 감염(感染) 고양이 혈청(血淸)에 대(對)한 ELISA 항체가(抗體價)의 의의(意義))

  • Choi, Won-Young;Yoo, Jae-Eul;Nam, Ho-Woo;Choi, Hyung-Rak
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.177-186
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    • 1986
  • This study was designed to evaluate the partially purified antigens which were fractionated from crude extract of Paragonimus westermani and to monitor the enzyme-linked immunosorbent assay (ELISA) in experimental cat paragonimiasis during the course of infection as well as before and after chemotherapy. Crude extract of 6-month-old adult P. westermani was fractionated to 5 antigens by successive applications of ammonium sulfate precipitation, ion exchange chromatography and gel filtration. And the cats, 10 in each group, were infected with 60, 30, 15, and 5 metacercariae, then the half of each group was treated with praziquantel 2 times in one day of 100mg per kilogram of weight on 150 days after the infection. Sera were collected every 10 days. ELISA was performed with the concentration of $2{\mu}g/ml$ antigen, 100 times diluted sera and 1,000 times diluted alkaline phosphatase conjugated anti-cat IgG. The results were as follows: 1. Absorbance by ELISA with proteins precipitated by differential concentration of ammonium sulfate was the highest at $51{\sim}65%$ precipitate (PA2), followed by $0{\sim}50%$ precipitate (PAl), $66{\sim}80%$ precipitate (PA3), and $81{\sim}90%$ precipitate (PA4). Unprecipitated protein over 90% ammonium sulfate (PA5) showed the lowest antigenicity. 2. Fractionation of PA1, PA2, and PA3 through the DEAE-cellulose column did not differentiate the antigenic proteins. 3. By passing through the Sephadex G-200 column, PA1 and PA2 were fractionated to high molecular weight proteins and those of low molecular weight which showed high absorbance by ELISA (PA1-I, II and PA2-I, II). But PA3 was shown to have a fraction of high molecular weight proteins (PA3-I) which showed high antigenicity. 4. SDS-polyacrylamide gel electrophoresis of PA1-I, P A1-II, PA2-I, PA2-II, PA3-I, and crude extract was performed. Fraction PA1-I was composed of proteins which had the molecular weight of 270 kilodaltons(KD) to 196 KD; of them 220KD protein was major band. Fraction PA2-I was composed of $255{\sim}225\;KD$, and PA3-I, $255{\sim}240\;KD$, respectively. Fraction PA1-II and fraction PA2-II consisted of 30 KD proteins. 5. Absorbance by ELISA began to increase within $10{\sim}20$ days after the infection and reached the highest on $140{\sim}180$ days, then made plateau thereafter. 6. Absorbance by ELISA decreased after praziquantel treatment. In 60 metacercariae infection group, the absorbance had been decreasing, but remained within the positive range during observation period, while those of 30, 15, and 5 metacercariae infection groups turned to negative range. 7. Fraction PA1-II showed the highest antigenicity in ELISA, then fraction PA2-I, fraction PA1-I, fraction PA2-II, fraction PA3-I and crude extract followed. In early phase of infection, the absorbance of fraction PA1-II showed more rapid increase than those of the other fractions and it came to positive range at $20{\sim}30$ days after infection.

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