• Title/Summary/Keyword: Validity issue

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An Effects of Authentic Leadership and Transformational Leadership on Change Supportive Behavior in Small and Medium-size Business: Focused on Mediating Effect of Positive Psychological Capital (중소기업에서 상사의 변혁적 리더십과 진성 리더십이 변화지지행동에 미치는 영향: 긍정심리자본의 매개효과에 관한 연구)

  • Kim, Kyu Han;Huh, Chul Moo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.2
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    • pp.135-149
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    • 2019
  • Today, a growing number of companies are in trouble because leaders are lack of authentic leadership. Small and midium sized companies have the same issue. To correct the issue, there must be a real change in the relationship between managers and employees of the company as well as outside the company. In 21st century, authentic leadership is required. However, the research about determinants of change supportive behavior is not sufficient. Therefore, the purpose of this study is how manager's transformational leadership and authentic leadership affects change supportive behavior of employees in small and midium sized companies. The study also has to prove the role of positive psychological capital as a parameter. Data were collected from 424 employees working for small and midium sized companies in metropolitan area around Seoul and Gyeonggi. The data were analyzed using statistical package SPSS ver.21.0 and AMOS ver.18.0. Based on the research, First, the transformational leadership does not affect the change supportive behavior. However, authentic leadership affects the change supportive behavior. Also, positive psychological capital playes a role as parameter when transformational and authentic leadership, that are independent variable, affect change supportive behavior. On the other hand, the research shows that authentic leadership has more influence than transformational leadership on positive psychological capital. Transformational leadership without genuine attitude cannot affect change support behavior of employees in small and medium sized companies. Therefore, to affect change supportive behavior of employee, authentic leadership with genuine mind is required. After discussing the conclusions and implications of this study. the direction of the study for the follow - up study was suggested.

A Study on the Moderating Effect of Perceived Voluntariness in the Organizational Information System Usage and Performance (정보시스템 사용과 성과에 있어서 자발성의 조절효과에 관한 연구)

  • Lee, Seung-Chang;Lee, Ho-Geun;Jung, Chang-Wook;Chung, Nam-Ho;Suh, Eung-Kyo
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.195-221
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    • 2009
  • According to an industry report, a large number of organizations have invested in Organizational Information System(OIS) in the past few years. Several research results indicate that successful investments in OIS lead to productivity enhancement, while failed ones result in undesirable consequences such as financial losses and dissatisfaction among employees. In spite of huge investments, however, many organizations have failed in achieving the hoped-for returns from OIS. Thus, understanding user acceptance, adoption, and usage of new IS(Information Systems) is an important issue for IS practitioners. Indeed, study of the user acceptance of new information system has been one of the most important research topics in the contemporary IS literature. Several theoretical models are tested to examine 'user acceptance' and 'usage behavior' in IS context. While many research models incorporate 'ease of use' or 'usefulness' as important factors in explaining user acceptance, Technology Acceptance Model(TAM) has been one of the most widely applied models in user acceptance and usage behavior. Even in recent IS studies that employ theories of innovation diffusion in the area of IS implementation, a major focus has been on the user's perception of information technologies. In this research, we study 'voluntariness' as an important factor in IS acceptance by users. Voluntariness is defined as "the degree to which the use of the innovation is perceived as being voluntary, or of free will" When examining the diffusion of accepting OIS, a thoughtful consideration should be given to 'perceived voluntariness.' Current article has following research questions: 1) What models are appropriate to explain the success of OIS? and 2) How does the 'voluntariness' affect the success of OIS? In order to answer these questions, a research model is proposed to describe the detailed nature of association among three independent variables (IT usage level, task interdependency, and organizational support), a mediating variable (IS usage), a dependent variable (perceived performance), and a moderating variable(perceived voluntariness). The central claim of this article is that organizations hardly realize expected returns from OIS investments unless perceived voluntariness is effectively managed after operating OIS. As an example of OIS in this study we have selected the Intranet of Republic of Korea Air Force (ROKAF). ROKAF has implemented the Intranet in an attempt to improve communication and coordination within the organization. To test our research model and hypotheses, survey questionnaires were first sent out to 400 Intranet users. With the assistance of ROKAF, Intranet users were initially identified among its members, and subjects were randomly drawn from the pool. 377 survey responses were finally returned. The unit of measurement and analysis in this research is a personal level. Path analysis based on structural equation modeling was used to test research hypotheses. Construct validity represents accordance between the theoretical base concept of constructs and its measurement items. Tests for the reliability and discriminant validity are accepted, thus verifying our survey instrument. In this research, we have proposed a conceptual framework to highlight the importance of perceived voluntariness after organization deploys OIS. The results of our analysis present several key finding. First, all three independent variables (IT usage level, task interdependency, and organizational support) have significant effects on IS usage, which will eventually improve performance. Thus, IS usage plays a mediating role between antecedent variables (IT usage level. task interdependency, and organizational support) and performance improvement. Second, the effect of the task dependency was the highest for IS usage among the three antecedent variables. This is highly plausible since one of the Intranet's major capabilities is to facilitate communication among members within an organization. Accordingly, we conclude that the higher the task dependency, the higher Intranet usage. The effect of user's IT usage level was the second, while the effect of the organizational support was the third. Finally, the perceived voluntariness plays a pivotal role in enhancing perceived performance in personal level after launching the Intranet. Relationships among investigated variables were significantly different between groups with a high level and a low level of voluntariness. The impact of the Intranet usage on the performance was greater in the higher level voluntariness group than in the lower one. For the lower level voluntariness group, the user's IT usage had the highest effect on the Intranet usage among the three antecedent variables. In short, our study suggests that the higher the perceived voluntariness is the more IS usage will be. Perceived voluntariness was found to have a moderating effect on the relationships among user IT usage level, task interdependency, IS usage, and perceived performance, supporting all the hypotheses on the moderating effect. Most of all, user IT usage level has the strongest influence on IS usage, indicating that users with superior IT usage are more likely to enjoy a high level of perceived performance.

Thought Experiments: on the Working Imagination and its Limitation (사고실험 - 상상의 작용과 한도에 대해)

  • Hwang, Hee-sook
    • Journal of Korean Philosophical Society
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    • v.146
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    • pp.307-328
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    • 2018
  • The use of thought experiments has a long history in many disciplines including science. In the field of philosophy, thought experiments have frequently appeared in the pre-existing literature on the contemporary Analytic Philosophy. A thought experiment refers to a synthetic environment where the designer of the experiment-with his or her intuition and imagination-tests common-sense knowledge. It can be understood as a conceptual tool for testing the validity of the common understanding of an issue or a phenomenon. However, we are not certain about the usefulness or efficacy of a thought experiment in knowledge production. The design of a thought experiment is meant to lure readers into believing as intended by the experiment itself. Thus, regardless of the purpose of a thought experiment, many readers who encounter the experiment could feel deceived. In this paper, to analyze the logic of thought experiments and to seek the source of uneasiness the readers and critics may feel about thought experiments, I draw lessons from three renowned thought-experiments: Thomson's 'ailing violinist', Putnam's 'brain in a vat', and Searle's 'Chinese room'. Imaginative thought experiments are usually constructed around a gap between the reality and the knowledge/information at hand. From the three experiments, several lessons can be learned. First, the evidence of the existence of a gap provided via thought experiments can serve as arguments for counterfactual situations. At the same time, the credibility and efficacy of the thought experiments can be damaged as soon as the thought-experiments are carried out with inappropriate and/or murky directions regarding the procedures of the experiment or the background of the study. According to D. R. Hofstadter and D. C. Dennett(1981), the 'knob setting' in a thought experiment can be altered in the middle of a simulation of the experimental condition, and then the implications of the thought experiment change altogether, indicating that an entirely different conclusion can be deduced from thought experiment. Lastly, some pre-suppositions and bias of the experiment designers play a considerable role in the validity and the chances of success of a thought experiment; thus, it is recommended that the experiment-designers refrain from exercising too much of their imagination in order to avoid contaminating the design of the experiment and/or wrongly accepting preconceived/misguided conclusions.

Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method (한방병원의 침도 시술 동의서의 현황 조사와 델파이 기법을 활용한 표준 시술 동의서 개발)

  • Jihun Kim;Bonhyuk Goo;Hyongjun Kim;Kyoungsuk Seo;Myungjin Oh;Myungseok Ryu;Sang-Hoon Yoon;Kwang Ho Lee;Hyun-Jong Lee;Jungtae Leem;Hyungsun Jun;Jeong Ihn Sook;Sung Woon Choi;Tae Wook Lee;Yeonhak Kim;Yoona Oh;Kunhyung Kim;Gi Young Yang;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.182-201
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    • 2024
  • Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

A Study on the Effect of the Introduction Characteristics of Cloud Computing Services on the Performance Expectancy and the Intention to Use: From the Perspective of the Innovation Diffusion Theory (클라우드 컴퓨팅 서비스의 도입특성이 조직의 성과기대 및 사용의도에 미치는 영향에 관한 연구: 혁신확산 이론 관점)

  • Lim, Jae Su;Oh, Jay In
    • Asia pacific journal of information systems
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    • v.22 no.3
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    • pp.99-124
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    • 2012
  • Our society has long been talking about necessity for innovation. Since companies in particular need to carry out business innovation in their overall processes, they have attempted to apply many innovation factors on sites and become to pay more attention to their innovation. In order to achieve this goal, companies has applied various information technologies (IT) on sites as a means of innovation, and consequently IT have been greatly developed. It is natural for the field of IT to have faced another revolution which is called cloud computing, which is expected to result in innovative changes in software application via the Internet, data storing, the use of devices, and their operations. As a vehicle of innovation, cloud computing is expected to lead the changes and advancement of our society and the business world. Although many scholars have researched on a variety of topics regarding the innovation via IT, few studies have dealt with the issue of could computing as IT. Thus, the purpose of this paper is to set the variables of innovation attributes based on the previous articles as the characteristic variables and clarify how these variables affect "Performance Expectancy" of companies and the intention of using cloud computing. The result from the analysis of data collected in this study is as follows. The study utilized a research model developed on the innovation diffusion theory to identify influences on the adaptation and spreading IT for cloud computing services. Second, this study summarized the characteristics of cloud computing services as a new concept that introduces innovation at its early stage of adaptation for companies. Third, a theoretical model is provided that relates to the future innovation by suggesting variables for innovation characteristics to adopt cloud computing services. Finally, this study identified the factors affecting expectation and the intention to use the cloud computing service for the companies that consider adopting the cloud computing service. As the parameter and dependent variable respectively, the study deploys the independent variables that are aligned with the characteristics of the cloud computing services based on the innovation diffusion model, and utilizes the expectation for performance and Intention to Use based on the UTAUT theory. Independent variables for the research model include Relative Advantage, Complexity, Compatibility, Cost Saving, Trialability, and Observability. In addition, 'Acceptance for Adaptation' is applied as an adjustment variable to verify the influences on the expected performances from the cloud computing service. The validity of the research model was secured by performing factor analysis and reliability analysis. After confirmatory factor analysis is conducted using AMOS 7.0, the 20 hypotheses are verified through the analysis of the structural equation model, accepting 12 hypotheses among 20. For example, Relative Advantage turned out to have the positive effect both on Individual Performance and on Strategic Performance from the verification of hypothesis, while it showed meaningful correlation to affect Intention to Use directly. This indicates that many articles on the diffusion related Relative Advantage as the most important factor to predict the rate to accept innovation. From the viewpoint of the influence on Performance Expectancy among Compatibility and Cost Saving, Compatibility has the positive effect on both Individual Performance and on Strategic Performance, while it showed meaningful correlation with Intention to Use. However, the topic of the cloud computing service has become a strategic issue for adoption in companies, Cost Saving turns out to affect Individual Performance without a significant influence on Intention to Use. This indicates that companies expect practical performances such as time and cost saving and financial improvements through the adoption of the cloud computing service in the environment of the budget squeezing from the global economic crisis from 2008. Likewise, this positively affects the strategic performance in companies. In terms of effects, Trialability is proved to give no effects on Performance Expectancy. This indicates that the participants of the survey are willing to afford the risk from the high uncertainty caused by innovation, because they positively pursue information about new ideas as innovators and early adopter. In addition, they believe it is unnecessary to test the cloud computing service before the adoption, because there are various types of the cloud computing service. However, Observability positively affected both Individual Performance and Strategic Performance. It also showed meaningful correlation with Intention to Use. From the analysis of the direct effects on Intention to Use by innovative characteristics for the cloud computing service except the parameters, the innovative characteristics for the cloud computing service showed the positive influence on Relative Advantage, Compatibility and Observability while Complexity, Cost saving and the likelihood for the attempt did not affect Intention to Use. While the practical verification that was believed to be the most important factor on Performance Expectancy by characteristics for cloud computing service, Relative Advantage, Compatibility and Observability showed significant correlation with the various causes and effect analysis. Cost Saving showed a significant relation with Strategic Performance in companies, which indicates that the cost to build and operate IT is the burden of the management. Thus, the cloud computing service reflected the expectation as an alternative to reduce the investment and operational cost for IT infrastructure due to the recent economic crisis. The cloud computing service is not pervasive in the business world, but it is rapidly spreading all over the world, because of its inherited merits and benefits. Moreover, results of this research regarding the diffusion innovation are more or less different from those of the existing articles. This seems to be caused by the fact that the cloud computing service has a strong innovative factor that results in a new paradigm shift while most IT that are based on the theory of innovation diffusion are limited to companies and organizations. In addition, the participants in this study are believed to play an important role as innovators and early adapters to introduce the cloud computing service and to have competency to afford higher uncertainty for innovation. In conclusion, the introduction of the cloud computing service is a critical issue in the business world.

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A Study on Air Operator Certification and Safety Oversight Audit Program in light of the Convention on International Civil Aviation (시카고협약체계에서의 항공안전평가제도에 관한 연구)

  • Lee, Koo-Hee;Park, Won-Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.1
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    • pp.115-157
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    • 2013
  • Some contracting States of the Convention on International Civil Aviation (commonly known as the Chicago Convention) issue FAOC(Foreign AOC and/or Operations Specifications) and conduct various safety audits for the foreign operators. These FAOC and safety audits on the foreign operators are being expanded to other parts of the world. While this trend is the strengthening measure of aviation safety resulting in the reduction of aircraft accident, it is the source of concern from the legal as well as economic perspectives. FAOC of the USA doubly burdens the other contracting States to the Chicago Convention because it is the requirement other than that prescribed by the Chicago Convention of which provisions are faithfully observed by almost all the contracting States. The Chicago Convention in its Article 33 stipulates that each contracting State recognize the validity of the certificates of airworthiness and licenses issued by other contracting States as long as they meet the minimum standards of the ICAO. Consequently, it is submitted that the unilateral action of the USA, China, Mongolia, Australia, and the Philippines issuing the FOAC to the aircraft of other States is against the Convention. It is worry some that this breach of international law is likely to be followed by the European Union which is believed to be in preparation for its own unilateral application. The ICAO established by the Chicago Convention to be in charge of safe and orderly development of the international civil aviation has been in hard work to both upgrade and emphasize the safe operation of aircraft. As the result of these endeavors, it prepared a new Annex 19 to the Chicago Convention with the title of "Safety Management" and with the applicable date 14 November 2013. It is this Annex and other ICAO documents relevant to the safety that the contracting States to the Chicago Convention have to observe. Otherwise, it is the economical burden due to probable delay in issuing the FOAC and bureaucracies combined with many different paperworks and regulations depending on where the aircraft is flown. It is exactly to avoid this type of confusion and waste that the Chicago Convention aimed at when it was adopted in 1944. The State of the operator shall establish a system for both the certification and the continued surveillance of the operator in accordance with ICAO SARPs to ensure that the required standards of operations are maintained. Certainly the operator shall meet and maintain the requirements established by the States in which it operate. The authority of a State stops where the authority of another State intervenes or where the former has yielded its power by an international agreement for the sake of international cooperation. Hence, it is not within the realm of the State to issue FAOC towards foreign operators for the reason that these foreign operators are flying in and out of the State. Furthermore, there are other safety audits such as ICAO USOAP, IATA IOSA, FAA IASA, and EU SAFA that assure the safe operation of the aircraft, but within the limit of their power and in compliance with the ICAO SARPs. If the safety level of any operator is not satisfactory, the operator could be banned to operate in the contracting States with watchful eyes until the ICAO SARPs are met. This time-honoured practice has been applied without any serious problems. Besides, we have the new Annex 19 to strengthen and upgrade with easy reference for contracting States. We don't have no reason to introduce additional burden to the States by unilateral actions of some States. These actions have to be corrected. On the other hand, when it comes to the carriage of the Personal or Pilot Log Book, the Korean regulation requiring it is in contrast with other relevant provisions of USA, USOAP, IOSA, and SAFA. The Chicago Convention requires in its Articles 29 and 34 only the carriage of the Journey Log Book and some other certificates, but do not mention the Personal Log Book at all. Paragraph 5.1.1.1 of Annex 1 to the Chicago Convention even makes it clear that the carriage in the aircraft of the Personal Log Book is not required on international flights. The unique Korean regulation in this regards giving the unnecessary burden to the national flag air carriers has to be lifted at once.

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How Enduring Product Involvement and Perceived Risk Affect Consumers' Online Merchant Selection Process: The 'Required Trust Level' Perspective (지속적 관여도 및 인지된 위험이 소비자의 온라인 상인선택 프로세스에 미치는 영향에 관한 연구: 요구신뢰 수준 개념을 중심으로)

  • Hong, Il-Yoo B.;Lee, Jung-Min;Cho, Hwi-Hyung
    • Asia pacific journal of information systems
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    • v.22 no.1
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    • pp.29-52
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    • 2012
  • Consumers differ in the way they make a purchase. An audio mania would willingly make a bold, yet serious, decision to buy a top-of-the-line home theater system, while he is not interested in replacing his two-decade-old shabby car. On the contrary, an automobile enthusiast wouldn't mind spending forty thousand dollars to buy a new Jaguar convertible, yet cares little about his junky component system. It is product involvement that helps us explain such differences among individuals in the purchase style. Product involvement refers to the extent to which a product is perceived to be important to a consumer (Zaichkowsky, 2001). Product involvement is an important factor that strongly influences consumer's purchase decision-making process, and thus has been of prime interest to consumer behavior researchers. Furthermore, researchers found that involvement is closely related to perceived risk (Dholakia, 2001). While abundant research exists addressing how product involvement relates to overall perceived risk, little attention has been paid to the relationship between involvement and different types of perceived risk in an electronic commerce setting. Given that perceived risk can be a substantial barrier to the online purchase (Jarvenpaa, 2000), research addressing such an issue will offer useful implications on what specific types of perceived risk an online firm should focus on mitigating if it is to increase sales to a fullest potential. Meanwhile, past research has focused on such consumer responses as information search and dissemination as a consequence of involvement, neglecting other behavioral responses like online merchant selection. For one example, will a consumer seriously considering the purchase of a pricey Guzzi bag perceive a great degree of risk associated with online buying and therefore choose to buy it from a digital storefront rather than from an online marketplace to mitigate risk? Will a consumer require greater trust on the part of the online merchant when the perceived risk of online buying is rather high? We intend to find answers to these research questions through an empirical study. This paper explores the impact of enduring product involvement and perceived risks on required trust level, and further on online merchant choice. For the purpose of the research, five types or components of perceived risk are taken into consideration, including financial, performance, delivery, psychological, and social risks. A research model has been built around the constructs under consideration, and 12 hypotheses have been developed based on the research model to examine the relationships between enduring involvement and five components of perceived risk, between five components of perceived risk and required trust level, between enduring involvement and required trust level, and finally between required trust level and preference toward an e-tailer. To attain our research objectives, we conducted an empirical analysis consisting of two phases of data collection: a pilot test and main survey. The pilot test was conducted using 25 college students to ensure that the questionnaire items are clear and straightforward. Then the main survey was conducted using 295 college students at a major university for nine days between December 13, 2010 and December 21, 2010. The measures employed to test the model included eight constructs: (1) enduring involvement, (2) financial risk, (3) performance risk, (4) delivery risk, (5) psychological risk, (6) social risk, (7) required trust level, (8) preference toward an e-tailer. The statistical package, SPSS 17.0, was used to test the internal consistency among the items within the individual measures. Based on the Cronbach's ${\alpha}$ coefficients of the individual measure, the reliability of all the variables is supported. Meanwhile, the Amos 18.0 package was employed to perform a confirmatory factor analysis designed to assess the unidimensionality of the measures. The goodness of fit for the measurement model was satisfied. Unidimensionality was tested using convergent, discriminant, and nomological validity. The statistical evidences proved that the three types of validity were all satisfied. Now the structured equation modeling technique was used to analyze the individual paths along the relationships among the research constructs. The results indicated that enduring involvement has significant positive relationships with all the five components of perceived risk, while only performance risk is significantly related to trust level required by consumers for purchase. It can be inferred from the findings that product performance problems are mostly likely to occur when a merchant behaves in an opportunistic manner. Positive relationships were also found between involvement and required trust level and between required trust level and online merchant choice. Enduring involvement is concerned with the pleasure a consumer derives from a product class and/or with the desire for knowledge for the product class, and thus is likely to motivate the consumer to look for ways of mitigating perceived risk by requiring a higher level of trust on the part of the online merchant. Likewise, a consumer requiring a high level of trust on the merchant will choose a digital storefront rather than an e-marketplace, since a digital storefront is believed to be trustworthier than an e-marketplace, as it fulfills orders by itself rather than acting as an intermediary. The findings of the present research provide both academic and practical implications. The first academic implication is that enduring product involvement is a strong motivator of consumer responses, especially the selection of a merchant, in the context of electronic shopping. Secondly, academicians are advised to pay attention to the finding that an individual component or type of perceived risk can be used as an important research construct, since it would allow one to pinpoint the specific types of risk that are influenced by antecedents or that influence consequents. Meanwhile, our research provides implications useful for online merchants (both online storefronts and e-marketplaces). Merchants may develop strategies to attract consumers by managing perceived performance risk involved in purchase decisions, since it was found to have significant positive relationship with the level of trust required by a consumer on the part of the merchant. One way to manage performance risk would be to thoroughly examine the product before shipping to ensure that it has no deficiencies or flaws. Secondly, digital storefronts are advised to focus on symbolic goods (e.g., cars, cell phones, fashion outfits, and handbags) in which consumers are relatively more involved than others, whereas e- marketplaces should put their emphasis on non-symbolic goods (e.g., drinks, books, MP3 players, and bike accessories).

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Suitability of Measuring a Kidney Depth with Assessment of Glomerular Filtration Rateusing 99mTc-DTPA in the Ectopic Kidney and Pediatric Patients (99mTc-DTPA를 이용한 사구체여과율 검사에서 이소성 신장과 소아 환자의 신장 깊이 측정방법의 적절성)

  • Choi, Jae Min;Lee, Young Hee;Shim, Dong Oh
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.62-67
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    • 2014
  • A glomerular filtration rate (GFR) study is a test that uses radioactive materials or tracers (radiopharmaceuticals) and a computer to see how well the kidneys are working. Asan Medical Center analyzed and compared data between kidney depth, acquired from kidney donors' CT image and acquired from Gates method's GFR value that are calculated by Tonnesen equation. This study was able to confirm that kidney depth measured from CT image was higher than the Gates Method's GFR value, which was calculated by Tonnessen equation; the direct relationship among pathologic results is confirmed. Particularly, kidney donor whose kidney was at the pelvic area had direct relationship with other clinical results. During the GFR test, it is necessary to confirm the location of kidney has no change with reference of CT image. If kidney depth is manually corrected using CT image when we measures GFR of deformed or horse-shoe kidney, it would be possible to acquire the compatible value which is equivalent to clinical result. There would be a possible issue of appropriateness that whether the applied GFR using CT image's kidney depth has clinical validity. In case of a pediatric patient, the GFR derived from Tonnesen was quiet underestimated while manual method and Gordon stay in normal range. Which results may be correct among them? There have been many reports about kidney depth, to be an accurate index of GFR in children. As one of the study performers, we should contemplate what the best option for pediatric patients would be.

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A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War (파월국군장병의 고엽제 위해에 관한 예비적 역학조사)

  • Kim, Joung-Soon;Lee, Hyun-Sul;Lee, Hong-Bok;Lee, Won-Young;Park, Young-Joo;Kim, Sung-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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Health-related Quality of Life Measurement with St. George's Respiratory Questionnaire in Post-tuberculous Destroyed Lung (결핵후 폐손상에서 한국어판 St. George's Respiratory Questionnaire를 이용한 건강 관련 삶의 질 평가)

  • Lee, Byoung Hoon;Kim, Young Sam;Lee, Ki Deok;Lee, Jae Hyung;Kim, Sang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.183-190
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    • 2008
  • Background: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. Methods: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George's Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. Results: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean $VO_2max%$ predicted ($39.0%{\pm}10.9%$) and $O_2$ pulse% predicted ($61.3%{\pm}13.6%$) were markedly decreased. In the SGRQ, the impact score (mean $27.8{\pm}18.5$) was significantly lower than the symptom score (mean $53.9{\pm}20.9$) or activity score (mean $50.8{\pm}27.3$) (p<0.05, p<0.01). Cronbach's alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with $FEV_1%$ predicted (r=-0.46, p<0.05) and $SaO_2$ (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). Conclusion: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.