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Dose Verification Study of Brachytherapy Plans Using Monte Carlo Methods and CT Images (CT 영상 및 몬테칼로 계산에 기반한 근접 방사선치료계획의 선량분포 평가 방법 연구)

  • Cheong, Kwang-Ho;Lee, Me-Yeon;Kang, Sei-Kwon;Bae, Hoon-Sik;Park, So-Ah;Kim, Kyoung-Joo;Hwang, Tae-Jin;Oh, Do-Hoon
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.253-260
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    • 2010
  • Most brachytherapy treatment planning systems employ a dosimetry formalism based on the AAPM TG-43 report which does not appropriately consider tissue heterogeneity. In this study we aimed to set up a simple Monte Carlo-based intracavitary high-dose-rate brachytherapy (IC-HDRB) plan verification platform, focusing particularly on the robustness of the direct Monte Carlo dose calculation using material and density information derived from CT images. CT images of slab phantoms and a uterine cervical cancer patient were used for brachytherapy plans based on the Plato (Nucletron, Netherlands) brachytherapy planning system. Monte Carlo simulations were implemented using the parameters from the Plato system and compared with the EBT film dosimetry and conventional dose computations. EGSnrc based DOSXYZnrc code was used for Monte Carlo simulations. Each $^{192}Ir$ source of the afterloader was approximately modeled as a parallel-piped shape inside the converted CT data set whose voxel size was $2{\times}2{\times}2\;mm^3$. Bracytherapy dose calculations based on the TG-43 showed good agreement with the Monte Carlo results in a homogeneous media whose density was close to water, but there were significant errors in high-density materials. For a patient case, A and B point dose differences were less than 3%, while the mean dose discrepancy was as much as 5%. Conventional dose computation methods might underdose the targets by not accounting for the effects of high-density materials. The proposed platform was shown to be feasible and to have good dose calculation accuracy. One should be careful when confirming the plan using a conventional brachytherapy dose computation method, and moreover, an independent dose verification system as developed in this study might be helpful.

A Model based Vocational Evaluation for People with Psychiatric Disabilities (정신장애인 직업재활모델과 직업평가 - 직업기능척도 개발을 위한 예비연구 -)

  • Lee, Seong-Gyu;Kim, Sang-Hee
    • Korean Journal of Social Welfare
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    • v.54
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    • pp.123-147
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    • 2003
  • It is well known that one of essential features of psychiatric disability is vocational impairment. Since the year of 2000 when psychiatric disability was declared as one of disability categories in Korea, vocational rehabilitation programs have been actively administered. At this point, it is compelling that vocational evaluation serves as a means of screening out the most promising candidates, identifying their vocational deficits and strengths, designing the individualized vocational interventions, and evaluating vocational outcomes. Still, vocational evaluation for people with psychiatric disabilities has been more problematic than for any other group with disabilities. The authors argued that vocational evaluation for people with psychiatric disabilities should be based on a certain vocational rehabilitation model to address those problems. It is because there exists an indispensible relationship between the vocational rehabilitation model and vocational evaluation. In other words, the main purposes, measurement time points, and focus of vocational evaluation may depend on which of vocational rehabilitation models to make a choice of. In addition, the vocational rehab model(i.e., vocational readiness model or graduation model) underlying traditional vocational evaluation does not seem to work for people with psychiatric disabilities. Authors argued that accelerating model fits for psychiathric characteristics which are often unpredictable and turbulent. As a preliminary step of developing vocational functioning instrument incorporating the demand characteristics of the accelerating model, post-hoc analyses were done on data from a vocational functioning measure and the results were critically examined from viewpoints of accelerating model. For these purposes, discussions were made about a) general functioning of vocational evaluation, (b) relation between vocational rehabilitation model and vocational evaluation, (c) the reasons why the accelerating model is more appropriate to the characterstics of psychiatric clients than the graduation model, (d) post-hoc analytic results reviewed from viewpoints of accelerating model-based vocational evaluation This study is significant in that it attempted model-based, model-specific vocational evaluation as a preliminary step for developing vocational functioning assessment instruments ill future.

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Development of a Real-Time Mobile GIS using the HBR-Tree (HBR-Tree를 이용한 실시간 모바일 GIS의 개발)

  • Lee, Ki-Yamg;Yun, Jae-Kwan;Han, Ki-Joon
    • Journal of Korea Spatial Information System Society
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    • v.6 no.1 s.11
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    • pp.73-85
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    • 2004
  • Recently, as the growth of the wireless Internet, PDA and HPC, the focus of research and development related with GIS(Geographic Information System) has been changed to the Real-Time Mobile GIS to service LBS. To offer LBS efficiently, there must be the Real-Time GIS platform that can deal with dynamic status of moving objects and a location index which can deal with the characteristics of location data. Location data can use the same data type(e.g., point) of GIS, but the management of location data is very different. Therefore, in this paper, we studied the Real-Time Mobile GIS using the HBR-tree to manage mass of location data efficiently. The Real-Time Mobile GIS which is developed in this paper consists of the HBR-tree and the Real-Time GIS Platform HBR-tree. we proposed in this paper, is a combined index type of the R-tree and the spatial hash Although location data are updated frequently, update operations are done within the same hash table in the HBR-tree, so it costs less than other tree-based indexes Since the HBR-tree uses the same search mechanism of the R-tree, it is possible to search location data quickly. The Real-Time GIS platform consists of a Real-Time GIS engine that is extended from a main memory database system. a middleware which can transfer spatial, aspatial data to clients and receive location data from clients, and a mobile client which operates on the mobile devices. Especially, this paper described the performance evaluation conducted with practical tests if the HBR-tree and the Real-Time GIS engine respectively.

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A Study on the Nursing Performance of the Home Care Nurses in Seoul (서울지역 가정간호사의 업무수행능력 실태조사)

  • Suh, Moon-Ja;Park, Ho-Ran;Kang, Hyun-Sook;Kim, So-Sun;Shin, Kyung-Lim;Kim, Keun-Soon;Kim, Hae-Sook
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.46-58
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    • 1999
  • The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

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The Role of Lymphocyte Compartment and Cytokine in Coal Workers Pneumoconiosis (진폐증환자에서의 임파구 분획 및 싸이토카인의 역할)

  • Lee, Jung-Yeon;Yoo, Kwang-Ha;Ahn, Hae-Ryon;Kim, Sung-Ryul;Lee, Hae-Woon;Ahn, Cheol-Min;Kim, Hyung-Joong
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.241-250
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    • 2002
  • Background : Coal-worker's pneumoconiosis(CWP) is characterized by a chronic inflammatory lung reaction associated with macrophage accumulation in the alveolar spaces. CWP is usually divided into two stage : simple pneumoconiosis(SP) where there are a limited number of fibrotic lesions remain limited, with radiological opacities smaller than 1cm and progressive massive fibrosis(PMF), which is characterized by the development of a perifocal extensive fibrotic response of the lung and severe alterations in pulmonary function. In this study, the lymphocyte compartment and cytokine were evaluated by measuring the serum levels in the control, SP and PMF groups. Materials and Methods : The coal workers selected for this study were employees(patients?) of the Tae-Baek and Dong-Hae hospital. All were men, 45-76 years old and the mean duration of their exposure to coal dust was 23.2 years in the lymphocyte compartment and 24.3 years in the cytokine checked group. According to X-ray examination results, the patients were classified into either one of the SP, PMF categories. The normal controls examined were 26-70 years old men. The serum cytokine levels were estimated by using an end point enzyme immunoassay technique. Results : T lymphocyte, helper and suppressor T cells were highly related to pneumoconiosis in this study. A statistically significant decrease in the number of suppressor T lymphocytes was observed in the simple pneumoconiosis patients and at the same time, there was an increase in the lymphocyte index. Howevere, there was no statistically difference in the serum cytokines levels among the SP, PMF and control groups. Conclusion : T lymphocyte, helper T, and suppressor T cells may be highly related to the development of CWP compared to the control group particularly in the early stage of pneumoconiosis. The changes observed in the immunological system in patients with pneumoconiosis may lie at the bottom of the pathogenesis of fibrosis. Further study is needed to evaluate the lymphocyte compartment as a marker for pneumoconiosis development in the early stage.

Changes in Quality of Citron Juice by Storage and Extraction Conditions (유자과즙의 저장 및 착즙조건에 따른 품질변화)

  • Park, Kee-Jai;Jung, Sung-Won;Kim, Jong-Hoon;Jeong, Jin-Woong
    • Applied Biological Chemistry
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    • v.38 no.2
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    • pp.141-146
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    • 1995
  • Changes of physicochemical properties of citron juice prepared by two different extraction methods, rotary-crushing and belt-pressing method, were investigated during the storage at $5^{\circ}C$ and $-20^{\circ}C$. Temperature drop of citron juice extracted by belt-pressing method was faster than that of citron juice prepared by rotary-crushing method and its freezing point was $0.8{\sim}0.9^{\circ}C$. During the storage, pH of stored citron juice with rotary-crushing method was increased up to 3.5 after 6 months storage while that of citron juice extracted by belt-pressing method was not changed significantly during the same storage time. Acidity of rotary-crushed citron juice was reduced a little more than that of belt-pressed citron juice during the storage. However, changes of soluble solid content were influenced largely by the storage temperature than by the extraction method. Contents of formol nitrogen and vitamin C were reduced remarkably in all of stored citron juice and $92{\sim}82%$ of farmol nitrogen and $72{\sim}43%$ of vitamin C were remained after 6 months of storage. Among the changes of color value, L values were reduced in the whole stored citron juice and a and b value had a different change pattern respectively according to the extraction and storage temperature. Changes in the content of both amino acid and fatty acid compositions was also observed after same storage period. Especially, in the case of change of fatty acid composition, content of linoleic acid and linolenic acid were reduced after 6 months storage, while those of palmitic acid, stearic acid and oleic acid were increased.

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The Study on U.S. GARA and Aircraft Products Liability (일반항공에서의 제조물책임에 관한 연구 - 미국 일반항공진흥법(GARA)을 중심으로 -)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.2
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    • pp.55-86
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    • 2014
  • The U.S. General Aviation Revitalization Act of 1994 (the "GARA") created a statute of repose that bars any claims arising from an aviation product or component more than 18 years after its date of delivery. The statute was enacted to protect general aviation aircraft manufacturers from the excessive product liability costs. The GARA included four exceptions: (a) medical emergency patients, (b) those not on the aircraft, (c) those based on written warranties, and (d) those causally related to a "knowing misrepresentation" made by the manufacturer to the FAA. The GARA also incorporates a provision for revised starting point of reckoning to which any repairs or replacements of an aviation product. This note aimed to discuss General Aviation and GARA in depth including the meaning of statue of repose, its exceptions. The various precedents about GARA were also reviewed in here as well. From the GARA, as a comparative legal issue in aviation product liability, there can be some suggestions for revision of Korean Products Liability Act. First, it seems to be reasonable to regulate the specific statute of repose provisions for various category of products. In GARA, the period of 18 years is reasonable concerning to the average aircraft life. Second, in order to avoid exhausting debate and for the judicial economy, it needs to clarify when the statute begins to run. GARA's 18 year limitation period begins to run on the different date whether it was delivered to its first purchaser or a person engaged in the business of selling the aircraft. Last but not least, proper exceptions should be added into the law for equity matter of the statute of repose does not apply. For example, a manufacturer is not protected by GARA if it knowingly misrepresents certain safety information to the FAA.

Quality and Functional Components of Commercial Chungkukjang Powders (시판 청국장 분말제품의 품질 및 기능성분)

  • Lee, Hyo-Jin;Cho, Sang-A;Shin, Jin-Gi;Kim, Jeong-Sang;Jeong, Yong-Jin;Moon, Kwong-Duck;Kwon, Joong-Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.1
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    • pp.65-71
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    • 2007
  • Five different commercial chungkukjang powders (A$\sim$E) were compared based on their physicochemical, organoleptic and functional properties. The proximate composition of the five samples ranged from 6.07 to 8.54% in moisture, 15.31 to 27.07% in crude protein, 20.19 to 24.75% in crude lipid, 34.84 to 52.41% in carbohydrate, and 3.69 to 5.26% in ash. The pH of the samples ranged from 5.58 to 6.11, and Hunter's colors showed 70.01$\sim$77.22 for L value, 0.91$\sim$4.64 for a value and 23.72$\sim$31.00 for b value depending on the product. The microbial counts were 8.16$\sim$g.60 log CFU/g for aerobic bacteria, $\sim$4.16 log CFU/g for yeasts & molds, and 1.07$\sim$3.88 log CFU/g for coliforms. The contents of reducing sugars and amino-N were 1.89$\sim$2.41% and 2.83$\sim$7.31%, respectively. Free amino acids were mainly composed of glutamic acid, valine, leucine, phenylalanine, and lysine. The amounts of total phenolics and total flavonoids were 108$\sim$302 mg% and 2.73$\sim$9.41, respectively, with some variations in the products. However, the isoflavone contents, which were composed of genistein (63.26$\sim$217.16${\mu}g/g$), daidzein (58.24$\sim$166.65${\mu}g/g$), genistin (2.66$\sim$55.68${\mu}g/g$), and glycitein (12.26$\sim$17.82${\mu}g/g$), were apparently different per product. The sensory scores for color, smell, taste and overall preference for the five chungkukjang products, which were evaluated by panels in their 20's and 30's using 7-point scoring test, ranged from 3.20 to 4.05.

SURFACE ROUGHNESS OF EXPERIMENTAL COMPOSITE RESINS USING CONFOCAL LASER SCANNING MICROSCOPE (공초점 레이저 주사 현미경을 이용한 실험적 레진의 표면 조도에 대한 연구)

  • Bae, J.H.;Lee, M.A.;Cho, B.H.
    • Restorative Dentistry and Endodontics
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    • v.33 no.1
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    • pp.1-8
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    • 2008
  • The purpose of this study was to evaluate the effect of a new resin monomer, filler size and polishing technique on the surface roughness of composite resin restorations using confocal laser scanning microscopy. By adding new methoxylated Bis-GMA (Bis-M-GMA, 2,2-bis[4-(2-methoxy-3-methacryloyloxy propoxy) phenyl] propane) having low viscosity, the content of TEGDMA might be decreased. Three experimental composite resins were made: EX1 (Bis-M-GMA/TEGDMA = 95/5 wt%, 40 nm nanofillers); EX2 (Bis-M-GMA/TEGDMA = 95/5 wt%, 20 nm nanofillers); EX3 (Bis-GMA/TEGDMA = 70/30 wt%, 40 nm nanofillers). Filtek Z250 was used as a reference. Nine specimens (6 mm in diameter and 2 mm in thickness) for each experimental composite resin and Filtek Z250 were fabricated in a teflon mold and assigned to three groups. In Mylar strip group, specimens were left undisturbed. In Sof-lex group, specimens were ground with #1000 SiC paper and polished with Sof-lex discs. In DiaPolisher group, specimens were ground with #1000 SiC paper and polished with DiaPolisher polishing points. The Ra (Average roughness), Rq (Root mean square roughness), Rv (Valley roughness), Rp (Peak roughness), Rc (2D roughness) and Sc (3D roughness) values were determined using confocal laser scanning microscopy. The data were statistically analyzed by Two-way ANOVA and Tukey multiple comparisons test (p = 0.05). The type of composite resin and polishing technique significantly affected the surface roughness of the composite resin restorations (p < 0.001). EX3 showed the smoothest surface compared to the other composite resins (p < 0.05). Mylar strip resulted in smoother surface than other polishing techniques (p < 0.05). Bis-M-GMA. a new resin monomer having low viscosity, might reduce the amount of diluent, but showed adverse effect on the surface roughness of composite resin restorations.

The Impacts of Social Support and Psychological Factors on Guild Members' Flow and Loyalty in MMORPG (MMORPG에서 길드 구성원들의 사회적 지지와 심리적 요인들이 플로우 및 충성도에 미치는 영향)

  • Kang, Ju-Seon;Ko, Yoon-Jung;Ko, Il-Sang
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.69-98
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    • 2009
  • We investigated what factors motivate gamers to participate in a guild and why they continue to be engaged as members of the guild. We find that, based on the result of focus group interviews with MMORPG gamers, social support and self-esteem factors play important roles. Considering both prior research and the focus group interviews we have conducted, we define social support and character control as independent variables. Character identity, guild identity, and self-esteem are proposed as mediating variables while guild flow and game loyalty as dependent variables. Accordingly, we develop the research model and hypotheses, and verify them empirically. Based on our experiences of playing the WoW game, we proposed a research model and conducted focus-group interviews (FGIs). FGIs involve formulating a hypothesis and then collecting some relevant data. FGIs were conducted face-to-face with students of C University in Korea. We formulated structured interview schedules, and the questions were based on our research variables and personal experiences. The questions for the interviews encompassed the following areas: (a) the demographic characteristics of the focus group; (b) the number of years for which respondents had played online games; (c) the motive for starting a game; (d) the number of game-characters assumed by each gamer; (e) the type of game played; and (f) other issues such as the reasons for involvement in the play, the willingness to reuse the game in case new versions were released, etc. On average, it took two hours to interview each of three groups. A primary set of FGIs was conducted with three groups on the premise that there would be some differences caused by character race (Horde vs. Alliance) or by playable server (Normal vs. Combat). With respect to the manner of playing, we found that guild members shared information, felt a sense of belonging, and played computer games for quite a long time through the guild; however, they did not undergo these experiences when playing alone. Gamers who belonged to a specific guild helped other players without expecting compensation for that, freely shared information about the game, gave away items for free, and more generous with other members who made mistakes. The guild members were aware of the existence other members and experienced a sense of belonging through interactions with, and evaluations from, other players. It was clear that social support was shown within the guild and that it played an important role as a major research variable. Based on the results of the first FGIs, a second set of in-depth FGIs was carried out with a focus on the psychology of the individual within the guild and the social community of the guild. The second set of FGIs also focused on the guild's offline meetings. Gamers, over all, recognize the necessity of joining a community, not only off-line but also online world of the guild. They admit that the guild is important for them to easily and conveniently enjoy playing online computer games. The active behavior and positive attitudes of existing guild members can motivate new members of the guild to adapt themselves to the guild environment. They then adopt the same behaviors and attitudes of established guild members. In this manner, the new members of the guild strengthen the bonds with other gamers while feeling a sense of belonging, and developing social identity, thereby. It was discovered that the interaction among guild members and the social support encouraged new gamers to quickly develop a sense of social identity and increase their self-esteem. The guild seemed to play the role of socializing gamers. Sometimes, even in the real world, the guild members helped one another; therefore, the features of the guild also spilled over to the offline environment. We intend to use self-esteem, which was found through the second set of FGIs, as an important research variable. To collect data, an online survey was designed with a questionnaire to be completed by WoW gamers, who belong to a guild. The survey was registered on the best three domestic game-sites: 'WoW playforum,' 'WoW gamemeca,' and 'Wow invent.' The selected items to be measured in the questionnaire were decided based on prior research and data from FGIs. To verify the content of the questionnaire, we carried out a pilot test with the same participants to point out ambiguous questions as a way to ensure maximum accuracy of the survey result. A total of 244 responses were analyzed from the 250 completed questionnaires. The SEM analysis was used to test goodness-of-fit of the model. As a result, we found important results as follows: First, according to the statistics, social support had statistically significant impacts on character control, character identity, guild identity and self-esteem. Second, character control had significant effects on character identity, guild identity and self-esteem. Third, character identity shows its clear impact on self-esteem and game loyalty. Fourth, guild identity affected self-esteem, guild flow and game loyalty. Fifth, self-esteem had a positive influence on the guild flow. These days, the number of virtual community is rising along with its significance largely because of the nature of the online games. Accordingly, this study is designed to clarify the psychological relationship between gamers within the guild that has been generally established by gamers to play online games together. This study focuses on the relationships in which social support influences guild flow or game loyalty through character control, character identity, guild identity, and self-esteem, which are present within a guild in the MMORPG game environment. The study results are as follows. First, the effects of social support on character control, character identity, guild identity and self-esteem are proven to be statistically significant. It was found that character control improves character identity, guild identity and self-esteem. Among the seven variables, social support, which is derived from FGIs, plays an important role in this study. With the active support of other guild members, gamers can improve their ability to develop good characters and to control them. Second, character identity has a positive effect on self-esteem and game loyalty, while guild identity has a significant effect on self-esteem, guild flow and game loyalty. Self-esteem affects guild flow. It was found that the higher the character and guild identities become, the greater the self-esteem is established. Contrary to the findings of prior research, our study results indicate that the relationship between character identity and guild flow is not significant. Rather, it was found that character identity directly affects game players' loyalty. Even though the character identity had no direct effect on increasing guild flow, it has indirectly affected guild flow through self-esteem. The significant relationship between self-esteem and guild flow indicates that gamers achieve flow, i.e., a feeling of pleasure and excitement through social support. Several important implications of this study should be noted. First, both qualitative and quantitative methods were used to conduct this study. Through FGIs, it was observed that both social support and self-esteem are important variables. Second, because guilds had been rarely studied, this research is expected to play an important role in the online community. Third, according to the result, six hypotheses (H1, H5, H6, H7, H8, and H11) setup based on FGIs, were statistically significant; thus, we can suggest the corresponding relationships among the variables as a guideline for follow-up research. Our research is significant as it has following implications: first, the social support of the guild members is important when establishing character control, character identity, guildidentity and self-esteem. It is also a major variable that affects guild flow and game loyalty. Second, character control when improved by social support shows notable influence on the development of character identity, guild identity and self-esteem. Third, character identity and guild identity are major factors to help establish gamers' own self-esteem. Fourth, character identity affects guild flow through self-esteem and game loyalty. The gamers usually express themselves through characters; the higher character identity is, the more loyalty a gamer has. Fifth, guild identity, established within the guild, has clear effects on self-esteem, guild flow and game loyalty. Sixth, qualitative and quantitative methods are employed to conduct this study. Based on the results of focus group interviews and SEM analysis, we find that the social support by guild members and psychological factors are significant in strengthening the flow of guild and loyalty to the game. As such, game developers should provide some extra functions for guild community, through which gamers can play online games in collaboration with one another. Also, we suggest that positive self-esteem which is built up through social support can help gamers achieve higher level of flow and satisfaction, which will consequently contribute to minimizing the possibility for the players to develop negative attitude toward the guild they belong to.