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The Relationship between Trust, Trustworthiness, and Repeat Purchase Intentions: A Multidimensional Approach (신뢰대상의 다차원적 접근법에 의한 신뢰와 재구매 의도와의 관계)

  • Lee, Soo-Hyung;Park, Mi-Ryong
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.1-31
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    • 2008
  • Trust is central to human relationships, at all times and places. The importance of trust is fundamental in all areas of human life, not only in the area of business administration. 2,500 years ago in China, Confucius taught that the foundation of politics was the trust of the people, more important even than military strength or the supply of food. Shakespeare's play, "Much Ado about Nothing' is about trust and deception. These days, trust and transparency in a commercial organization's business culture form the basis of the 'social capital' by which that organization increases its productivity. A successful company raises productivity by the accumulation of social capital, derived from a trust relationship between business partners, and between the company and consumers. Trust is the crucial factor. At the national level, building trust determines a nation's competitiveness. For a company, long term trust relationships with customers are essential for its survival in a business environment of rapid change. Such relationships, based on trust, are important assets to ensure a company's competitive advantage, and need to be organic to that company's business culture. Because of this importance, trust relationships have been studied in diverse areas within business administration, and especially within marketing, where they form the basis of a successful relationship between producer and consumer. However, what has been lacking is a unified definition of trust. Research has been conducted on the basis of various definitions and models. The majority of researchers have not considered the multidimensional character of the concept of trust until now. Approaches based on a one dimensional model have undermined the value of research results. Furthermore, researchers have only considered trust and trustworthiness as a single component. The majority of research has explored the consequences of perceived trust for outcomes such as loyalty or cooperation, but has neglected the effects of trustworthiness upon the mechanisms of consumer trust. This study focuses on the dimension of trust from such a perspective. It seeks to verify the effect of trust on customer intentions by breaking it down into three separate components: 1) the salesperson, 2) the product/service, and 3) the company. The purposes of this paper are as follows: Firstly, we review the multidimensional nature of trust objects: the salesperson, the product/service, and the company. Secondly, we analyze the relationship between multidimensional trust and trustworthiness. Thirdly, we analyze the connection between trust and repeat purchase intentions for the maintenance of long term relationships. For these purposes the author has developed several hypotheses as follows: H1-1: The competence of a salesperson is positively associated with the trust given by the consumer to the salesperson. H1-2: The benevolence of a salesperson is positively associated with the trust given by the consumer to the salesperson. H2-1: The competence of product/service is positively associated with the trust given by the consumer to the product/service. H2-2: The benevolence of product/service is positively associated with the trust given by the consumer to the product/service. H3-1: The reputation of a company is positively associated with the trust given by the consumer to the company. H3-2: The physical environment of a company is positively associated with the trust given by the consumer to the company. H4-1: Trust in a salesperson is positively associated with repeat purchase intentions. H4-2: Trust in a product/service is positively associated with repeat purchase intentions. H4-3: Trust in a company is positively associated with repeat purchase intentions. The data was compiled from 366 questionnaires. 500 questionnaires were collected, but some of the data was considered unsuitable and inappropriate. The subjects of the survey were male and female customers purchasing products at department stores in Seoul, Daegu and Gyeongbuk. It was carried out between Oct. 25 and 29, 2007. The data was analyzed by frequency analysis using SPSS 12.0 and structural equation modeling using LISREL 8.7. The result of the overall model analysis is as follows: Chi-Square=445.497, d.f.=185, p-value=0.0, GFI=.901, RMSEA=.0617, NNFI=.986, NFI=.981, CFI=.989, AGFI=.864, RMR=.0872. The results of the overall model analysis were coherent. It was found that trust is a multi-dimensional construct, that each of the dimensions of trust are meaningful influences on customer's repurchase intention. Trust in a company may be the most relevant, while trust in a product/service and a salesperson may be less relevant to repurchase intentions. The effective factors in determining trust in a salesperson and a company's product/service were found to be competence and benevolence. Factors in determining trust in a company were its reputation and physical environment, and the relationship of each effective trust factor has been verified in this research. As a result, it was found that competence and benevolence have a meaningful influence on trust in a salesperson and in product/service. It was also found that a company's reputation influences the overall trust in the company significantly but a company's physical environment does not have much effect.

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A Comparative Study of Food Habits and Body Satisfaction of Middle School Students According to Clinical Symptoms (일부 남녀 중학생의 건강 관련 임상증상에 따른 식습관과 체헝관심도에 관한 연구)

  • Sung, Chung-Ja
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.2
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    • pp.202-208
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    • 2005
  • This study was conducted to examine the food habits, knowledge of nutrition and actual conditions of food ingestion of adolescent middle school students according to questionnaire answers. Questionnaires were completed by 524 students, divided into a healthy group (n=289) and an unhealthy group (n=235) according to clinical signs. Further questions were asked of the two groups in the areas of food habits, knowledge of nutrition and nutritional attitude. The results were as follows: Mean age of all subjects was 14, heights for male and female students were 162.0 em, and 157.2 cm, weights were 53.4 kg, and 49.4, respectively. Heights and weights of male students were greater than those of female students. The body mass index (BMI) for male and female students was 20.3 kg/$m^2$ and 20.0 kg/$m^2$, respectively, and all data were within normal ranges. There were no significant differences in mean age, height, weight, and BMI between the healthy and unhealthy groups. There was no significant difference in body image recognition between the two groups, although the ratio of dissatisfaction with their own body shape was significantly higher in the female unhealthy group (46.1%), than in the female healthy group (33.0%) (p<0.05). In the area of the struggle to control body weight during the previous year, the female unhealthy group (59.4%) was higher than the female healthy group (38.4%) (p<0.01). There was no significant difference in the scores between the two groups in the areas of knowledge of nutrition and the nutritional attitude. Meal frequency and meal patterns were showed that having breakfast less than 4x/week was significantly higher in the female unhealthy group (44.0%), than in the female healthy group (30.7%) (p<0.01). Meal frequency for suppers<4x/week showed that the female unhealthy group (18.8%) was also higher than the female healthy group (10.7%). Therefore, the unhealthy group exhibited a higher pattern of missing both breakfast and supper. The male unhealthy group (16.7%) dined out more frequently than the male healthy group (12.3%) (p<0.01), and female unhealthy group also indulged in snacking significantly more frequently than the female healthy group. The unhealthy group also ate only 1 item for meals more frequently than the healthy group and no significant difference. The conclusion of this study is that adolescent Korean middle school students, who showed a higher incidence of clinical symptoms, representing an unhealthy status, missed breakfast and supper, and dined out and indulged in snacking more frequently. Their quality of breakfast and satisfaction of body image were also lower than the healthy group. These results indicated that there is a high correlation between a Korean adolescent's health status, food habits and body image satisfaction. It is recommended that a more intense program of nutritional education and monitoring be introduce into the current Korean middle-school system in order to optimally support and maximize the health potential of the current population of Korean student.

A Study on improvement of curriculum in Nursing (간호학 교과과정 개선을 위한 조사 연구)

  • 김애실
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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Effectiveness of Smoking Prevention Program based on Social Influence Model in the Middle School Students (흡연예방교육에 의한 청소년들의 흡연에 대한 지식 및 태도변화와 흡연량의 감소 효과)

  • Roh, Won-Hwan;Kang, Pock-Soo;Kim, Sok-Beom;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.37-56
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    • 2001
  • This study was conducted to analyze the degree of changes in knowledge and attitude toward smoking and to examine the factors affecting knowledge and attitude for smoking after providing a smoking prevention program based on social influence model for a year to middle school students. Study population consists of 665 subjects of middle school students(aged 14 years) in Gumi city in Kyeongsangbukdo Province. Among them three-hundred sixty-seven students(intervention group) were educated to a smoking prevention program for 1 year from April 1999 to April 2000. School-based four-class program to prevent smoking was developed. The program provides instruction about short and long-term negative physiologic and social consequences of smoking and also discussed the health hazards of smoking, social pressure to smoke, peer norms regarding tobacco use, and refusal skill. A 45-item self-administered structured questionnaire was designed to evaluate the change of knowledge, attitude, smoking rate and the amount of smoking. The instrument was comprised of 11 knowledge items, thirteen attitude item and demographic items. Each scales were created by summing responses to each items within each scales and high scores on the knowledge, attitude, and smoking behavioral intention scales indicated positive responses. Based on the changes before and after the implementation of smoking prevention program between intervention and control group, the change of scores on knowledge were significantly different between the control group and the intervention group(p<0.05) and the change of scores on the attitude toward smoking was significantly different between intervention and control group. The change of smoking rate were not showing a significant difference between two groups but the amount of smoking were significantly reduced in intervention group than control group. In multiple regression analysis on changes of knowledge about smoking, the variables of smoking prevention program education, previous knowledge on smoking and students' school performance were selected the significant variables. In multiple regression to analysis of the factors influencing changes in attitude toward smoking, the variables of smoking prevention program education, previous knowledge on smoking were shown to be significant. The smoking prevention program was effective on change of knowledge and attitude of middle school students. In considering that the policy should be needed to extent of implementation of school-based health education curricula based on social influence model and it would contribute to reduce smoking of students.

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Activities of Daily Living and Instrumental Activities of Daily Living of Elderlies in Chollabuk-Do Area (일부 전북지역 노인들의 일상생활동작능력과 수단적 일상생활동작능력)

  • Lee, Ki-Nam;Jeung, Jae-Yeal;Jahng, Doo-Sub;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.65-83
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    • 2000
  • To know the relationship of general characteristics with activities of daily living(ADL) and instrumental activities of daily living(IADL), we carried out the study on the elderies living in Chollabuk-Do area during 6 months, from June to December in 1999. Study subjects were 281, women and men were 195(69.6%) and 85(30.4%) respectively. Mean ages of women and men were 71.9 and 70.8 respectively. 81.1% elderies has disease and 18.9% were disease free. Disease prevalences of movement joint disease, others, circulatory disease, digestive disease, dental disease, respiratory disease were 50.1%, 25.0%, 10.5%, 9.4%, 8.5%, and 6.3% respectively. The percentages to the use of medical institution in recent were 40.0% for hospital, 16.8% for oriental hospital, 14.5% for public health center, 10.9% for drug store, 10.0% for others, and 7.8% for dental service. The percentages to the improvement of symptom after the use of medical institution were 62.3% for normal, 19.4% for improvement, and 18.2% for non-improvement. The percentages to the health situation were 37.1% for bad, 35.7% for good, and 27.1% for normal. Activities of daily living were 67.1% for 6 scores, 27.9% for 5 scores, 2.1% for 4 scores and ADL of women was lower than the men's. Instrumental activities of daily living were 50.4% for 5 scores, 19.3% for 3 scores, 12.1% for 4 scores and IADL of women was lower than the men's. Frequencies of disability in ADL were 28.9% for incontinence, 6.1% for bathing, 2.9% for meal, 2.5% for walking around house, 1.8% for toilet use, 1.4% for dressing and disability frequencies of women in 6 items of ADL were higher than the men's. The percentages of high, intermediate, low ADL in activities of daily living were 67.1%, 32.5%, 0.4% respectively and decrease of high ADL, increase of intermediate ADL were found with the increasing of age. Frequencies of disability in IADL were 42.9% for payment in and out, 31.8% for payment of written claim, 21.1% for shopping, 16.4% for preparation of meal, and 11.8% for use of bus. All items of women in IADL was higher than the men's but preparation of meal. The percentages of high, intermediate, low IADL in instrumental activities of daily living were 50.4%, 42.5%, 7.1% and decrease of high IADL, increase of intermediate IADL were found with the increasing of age. Mean of ADL with the general characteristics was 5.56 and 2 variables of level of education, health situation were statistically significant. Mean of IADL with the general characteristics was 3.76 and 8 variables of age, sex, level of education, occupation, presence of spouse, duty of living cost, health situation, category of ADL were statistically significant. With the result of stepwise regression, ADL was statistically related with religion, health situation and ADL was statistically related with level of education, living together with family, duty of living cost, health situation.

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Study on Health Behavior of Hypertensive Patients and Compliance for Treatment of Antihypertensive Medication (고혈압 환자들의 순응도와 건강행태의 관계)

  • Kim, Joo-Yeon;Lee, Dong-Bae;Cho, Young-Chae;Lee, Sok-Goo;Chang, Seong-Sil;Kwon, Yun-Hyung;Lee, Tae-Yong
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.29-49
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    • 2000
  • Objectives: To estimate the prevalence rate of hypertension, the changes of health behavior, and compliance for the drug treatment after diagnosed as hypertension. Methods: 7,030 persons who live in Cheonan City of Chungnam Province were selected by the cluster sampling method, and 5,372 persons were surveyed by questionnaire and health examination. This data is analyzed by Chi-square test on each variable. Results: 49.8%- of men and 38.8%- of women had been diagnosed as hypertension, and the prevalence rate of hypertension was significantly increased with aging in both gender. The prevalence rate tended to decrease in highly educated women group. Unemployed persons or obese persons showed relatively higher prevalence rate. The prevalence rate of hypertension increased in groups with higher total cholesterol levels over 240 mg/dl, and groups with glucose level over 200 mg/dl. 53.1%- of male patients and 66.6%- of female patients showed compliance for antihypertensive treatment. Compliance for treatment was higher in aged group or lower educated group in both gender. Among men, proportion of compliant subjects was higher in unemployed group(49.3%-), and lower in labor or primary industry than the others but among women, there was not any significant difference. And men with compliance for treatment had higher monthly income than the others, but women did not show any. Conclusion : This population had a high prevalence rate of hypertension which may lead to cardiovascular disease. Therefore health education programs and distribution of information must be emphasized in order to increase compliance to treatment and encourage the change of health behavior to promote health.

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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Comparison of Imposed Work of Breathing Between Pressure-Triggered and Flow-Triggered Ventilation During Mechanical Ventilation (기계환기시 압력유발법과 유량유발법 차이에 의한 부가적 호흡일의 비교)

  • Choi, Jeong-Eun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.592-600
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    • 1997
  • Background : The level of imposed work of breathing (WOB) is important for patient-ventilator synchrony and during weaning from mechanical ventilation. Triggering methods and the sensitivity of demand system are important determining factors of the imposed WOB. Flow triggering method is available on several modern ventilator and is believed to impose less work to a patient-triggered breath than pressure triggering method. We intended to compare the level of imposed WOB on two different methods of triggering and also at different levels of sensitivities on each triggering method (0.7 L/min vs 2.0 L/min on flow triggering ; $-1\;cmH_2O$ vs $-2cm\;H_2O$ on pressure triggering). Methods : The subjects were 12 patients ($64.8{\pm}4.2\;yrs$) on mechanical ventilation and were stable in respiratory pattern on CPAP $3\;cmH_2O$. Four different triggering sensitivities were applied at random order. For determination of imposed WOB, tracheal end pressure was measured through the monitoring lumen of Hi-Lo Jet tracheal tube (Mallincrodt, New York, USA) using pneumotachograph/pressure transducer (CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Other data of respiratory mechanics were also obtained by CP-100 pulmonary monitor. Results : The imposed WOB was decreased by 37.5% during 0.7 L/min on flow triggering compared to $-2\;cmH_2O$ on pressure triggering and also decreased by 14% during $-1\;cmH_2O$ compared to $-2\;cmH_2O$ on pressure triggering (p < 0.05 in each). The PTP(Pressure Time Product) was also decreased significantly during 0.7 L/min on flow triggering and $-1\;cmH_2O$ on pressure triggering compared to $-2\;cmH_2O$ on pressure triggering (p < 0.05 in each). The proportions of imposed WOB in total WOB were ranged from 37% to 85% and no significant changes among different methods and sensitivities. The physiologic WOB showed no significant changes among different triggering methods and sensitivities. Conclusion : To reduce the imposed WOB, flow triggering with sensitivity of 0.7 L/min would be better method than pressure triggering with sensitivity of $-2\;cm\;H_2O$.

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Plasma Activity of Lysosomal Enzymes in Active Pulmonary Tuberculosis (활동성 폐결핵 환자에서 혈중 리소솜 효소의 활성도)

  • Koh, Youn-Suck;Choi, Jeong-Eun;Kim, Mi-Kyung;Lim, Chae-Man;Kim, Woo-Sung;Chi, Hyun-Sook;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.646-653
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    • 1995
  • Background: The confirmative diagnosis of pulmonary tuberculosis(Tb) can be made by the isolation of Mycobacterium Tuberculosis(MTb) in the culture of the sputum, respiratory secretions or tissues of the patients, but positive result could not always be obtained in pulmonary Tb cases. Although there are many indirect ways of the diagnosis of Tb, clinicians still experience the difficulty in the diagnosis of Tb because each method has its own limitation. Therefore development of a new diagnostic tool is clinically urgent. It was reported that silica cause some lysosomal enzymes to be released from macrophages in vitro and one of these enzymes is elevated in workers exposed to silica dust and in silicotic subjects. In pulmonary Tb, alveolar macrophages are known to be activated after ingestion of MTb. Activated macrophages can kill MTb through oxygen free radical species and digestive enzymes of lysosome. But if macrophages allow the bacilli to grow intracellularly, the macrophages will die finally and local lesion will enlarge. Then it is assumed that the lysosomal enzymes would be released from the dead macrophages. The goal of this investigation was to determine if there are differences in the plasma activities of lysosomal enzymes, ($\beta$-glucuronidase(GLU) and $\beta$-N-acetyl glucosaminidase(NAG), among the groups of active and inactive pulmonary Tb and healthy control, and to see if there is any possibility that the plasma activity of GLU and NAG can be used as diagnostic indicies of active pulmonary Tb. Methods: The plasma were obtained from 20 patients with bacteriologically proven active pulmonary Tb, 15 persons with inactive Tb and 20 normal controls. In 10 patients with active pulmonary Tb, serial samples after 2 months of anti-Tb medications were obtained. Plasma GLU and NAG activities were measured by the fluorometric methods using 4-methylumbelliferyl substrates. All data are expressed as the mean $\pm$ the standard error of the mean. Results: The activites of GLU and NAG in plasma of the patients with active Tb were $21.52{\pm}3.01$ and $325.4{\pm}23.37$(nmol product/h/ml of plasma), respectively. Those of inactive pulmonary Tb were $24.87{\pm}3.78$, $362.36{\pm}33.92$ and those of healthy control were $25.45{\pm}4.05$, $324.44{\pm}28.66$(nmol product/h/ml of plasma), respectively. There were no significant differences in the plasma activities of both enzymes among 3 groups. The plasma activities of GLU at 2 months after anti-Tb medications were increased($42.18{\pm}5.94$ nmol product/h/ml of plasma) in the patients with active pulmonary Tb compared with that at the diagnosis of Tb(P-value <0.05). Conclusion: The results of the present investigation suggest that the measurement of the plasma activities of GLU and NAG in the patients with active pulmonary Tb could not be a useful method for the diagnosis of active Tb. Further investigation is necessary to define the reasons why the plasma activities of the GLU was increased in the patients with active pulmonary Tb after Tb therapy.

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Tuberculin Skin Test and Plasma Prostaglandin $E_2$ In Patients of New and Intractable Pulmonary Tuberculosis (초치료 및 난치 폐결핵 환자의 투베르쿨린 피부검사와 혈장 Prostaglandin $E_2$)

  • Kim, Ji-Hong;Choi, In-Hwan;Kim, Mee-Ae;Shin, Chul-Shik;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.669-676
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    • 1995
  • Background: The cell-mediated immunity is needed for eradicating the tubercle bacilli. Prostaglandin(PG), especially PG $E_2$, is involved in cellular immunosuppression. It is known that the PG $E_2$ is suppressed by indomethacin. For using indomethacin as a immunomodulator of intractable pulmonary tuberculosis(Tbc) patients, we measured the tuberculin skin test(TST) and the plasma PG $E_2$ levels. Method: The forty-eight inpatients with sputum positive acid-fast stain bacilli were classified into 6 groups according to antiTbc chemotherapy history(new and intractable cases), plain chest roetgenogram(minimal and far advanced cases), and TST reaction(nagative and positive cases). Except for one group(n=2; new, minimal, and negative cases of TST reaction) of the 6 groups, all subjects(n=46) were measured for the plasma PG $E_2$, levels with radioimmunoassay. Results: 1) There was no significant difference in the plasma PG $E_2$ levels among A group(far advanced and positive TST reaction cases, n=10, $11.22{\pm}2.86\;pg/ml$), B group(minimal and negative TST reaction cases, n=9, $11.35{\pm}2.20$) and C group(far advanced and positive TST reaction cases, n=7, $11.11{\pm}2.30$) in the new cases(p>0.05). 2) There was no significant difference in the plasma PG $E_2$ levels between positive(n=10, $9.25{\pm}2.21$) and negative(n=10, $8.25{\pm}1.13$) groups by TST in the intractable cases(p>0.05). 3) Comparing the plasma PG $E_2$ levels between new(n=26, $11.35{\pm}2.41$) and intractable(n=20, $8.75{\pm}1.78$) groups, the intractable group had significi- andy lower plasma PG $E_2$ levels(p<0.05). 4) There was no significant difference in the plasma PG $E_2$ levels between negative(n=19, $9.88{\pm}2.43$) and positive(n=27, $10.46{\pm}2.56$) groups by TST(p>0.05). 5) There was no significant difference in the plasma PG $E_2$ levels between male(n=32, $10.07{\pm}2.44$) and female(n=14, $10.56{\pm}2.70$)(p>0.05). 6) There was no significant difference in the plasma PG $E_2$ levels among 2nd(n=5, $10.21{\pm}2.86$), 3rd(n=9, $9.97{\pm}2.47$), 4th(n=13, $11.35{\pm}2.33$) and 5th(n=19, $9.57{\pm}2.48$) decades(p>0.05). 7) There was no significant correlation between the induration sizes of the TST and the plasma PG $E_2$ levels(r=0.054, p>0.05). Conclusion: From the above results, the plasma PG $E_2$ levels of intractable group are not higher as the authors had expected. There was no significant difference in the plasma PG $E_2$ levels by the lesion sizes of plain chest roentgenogram and the induration sizes of TST, so more study will be needed to use the indomethacin as a immunomodulator for intractable pulmonary tuberculosis patients.

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