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Study about Vaccination of Patients Diagnosed by Antimeasles Antibody in Measles Out break between 2000 and 2001 (2000~2001년 홍역 유행시 홍역 항체 유무로 진단된 환아의 홍역백신 접종 여부에 관한 연구)

  • Kang, Kye Wool;Yoon, Hwa Jun;Park, Seok Won;Kim, Hwang Min;Kim, Jong Soo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.67-73
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    • 2002
  • Purpose : Despite of the appropriate measles vaccination programs, epidemics occur every 2~3 years and especially occurred in large group in late of 2000 and early of 2001. To evaluate the effect of the vaccination, needs for revaccination and to determine the optimal age for revaccination, we examined measles specific IgG and IgM in mealses patients and investigated different antibody appearance according to vaccination history. Methods : Anti-measles antibodies were checked in sera of 201 patients(male : 117, female : 84) that are responsible for Criteria for Disease Control among 298 patients that are suspicious of measles including inpatients and outpatients in Wonju Christian Hospital from June in 2000 to June in 2001. They were checked by immunofluorescent assay. Then we classified them according to sex, month, distribution of age due to vaccination and appearance of measles antibody. Results : The ratio of male and female was 1.4 : 1. The maximum incidence was 38 cases(18.9%) in May in 2001. Incidence was increased from November in 2000 to January in 2001 and decreased in February and March in 2001. Thereafter it was increased from April in 2001 again and decreased from June. There were 93 cases(46.3%) in vaccinated group and 108 cases(53.7%) in unvaccinated group. In the distribution according to age in vaccinated group, there were 54 cases(58.1%) in more than 10 years old, 15 cases(16.0%) between 7 and 10 years old, 12 cases(12.9%) between 15 months and 3 years old, 6 cases (6.5%) between 4 and 6 years old and 6 cases(6.5%) between 6 months and 14 months old. In the distribution according to age in unvaccinated group, there were 88 cases(81.5%) between 6 months and 14 months old, 9 cases(8.3%) between 15 months and 3 years old, 7 cases(6.5%) less than 6 months old, 3 cases(2.8%) more than 10 years old and 1 case(0.9%) between 7 and 10 years old. In the distribution of measles specific IgG and IgM, 78 cas (87.6%) were IgG(+), IgM(+) and 11 cases(12.4%) are IgG(+), IgM(-) in vaccinated group. In unvaccinated group, there were 69 cases(63.9%) of IgG(+), IgM(+) and 39 cases (36.1%) of IgG(-), IgM(+). Con c lu s i on s : We thought that measles incidence was peaked between 6 months and 14 months old in unvaccinated group because of maximum decrement of transplacental matenal antibody and was peaked in more than 10 years old in vaccinated group because of maximum decrement of measles specific IgG. We think that measles revaccination as well as vaccination and especially optimal age for revaccination is very important to prevent measles successfully.

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The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly (농촌지역 노인들의 인지기능 장애와 사망과의 관련성)

  • Sun, Byeong-Hwan;Park, Kyeong-Soo;Na, Baeg-Ju;Park, Yo-Seop;Nam, Hae-Sung;Shin, Jun-Ho;Sohn, Seok-Joon;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.630-642
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    • 1997
  • The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

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Effects of High Glucose and Advanced Glycosylation Endproducts(AGE) on the in vitro Permeability Model (당과 후기당화합물의 생체 외 사구체여과율 모델에 대한 역할)

  • Lee Jun-Ho;Ha Tae-Sun
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.8-17
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    • 2006
  • Purpose : We describe the changes of rat glomerular epithelial cells when exposed to high levels of glucose and advanced glycosylation endproducts(AGE) in the in vitro diabetic condition. We expect morphological alteration of glomerular epithelial cells and permeability changes experimentally and we may correlate the results with a mechanism of proteinuria in DM. Methods : We made 0.2 M glucose-6-phsphate solution mixed with PBS(pH 7.4) containing 50 mg/mL BSA and pretense inhibitor for preparation of AGE. As control, we used BSA. We manufactured and symbolized five culture dishes as follows; B5 - normal glucose(5 mM) + BSA, B30 - high glucose(30 mM) + BSA, A5 - normal glucose(5 mM) + AGE, A30 - high glucose(30 mM) + AGE, A/B 25 - normal glucose(5 mM) + 25 mM of mannitol(osmotic control). After the incubation period of both two days and seven days, we measured the amount of heparan sulfate proteoglycan(HSPG) in each dish by ELISA and compared them with the B5 dish at 2nd and 7th incubation days. We observed the morphological changes of epithelial cells in each culture dish using scanning electron microscopy(SEM). We tried the permeability assay of glomerular epithelial cells using cellulose semi-permeable membrane measuring the amount of filtered BSA through the apical chamber for 2 hours by sandwich ELISA. Results : On the 2nd incubation day, there was no significant difference in the amount of HSPG between the 5 culture dishes. But on the 7th incubation day, the amount of HSPG increased by 10% compared with the B5 dish on the 2nd day except the A30 dish(P<0.05). Compared with the B5 dish on the 7th day the amount of HSPG in A30 and B30 dish decreased to 77.8% and 95.3% of baseline, respectively(P>0.05). In the osmotic control group (A/B 25) no significant correlation was observed. On the SEM, we could see the separated intercellular junction and fused microvilli of glomerular epithelial cells in the culture dishes where AGE was added. The permeability of BSA increased by 19% only in the A30 dish on the 7th day compared with B5 dish on the 7th day in the permeability assay(P<0.05). Conclusion: We observed not only the role of a high level of glucose and AGE in decreasing the production of HSPG of glomerular epithelial cells in vitro, but also their additive effect. However, the role of AGE is greater than that of glucose. These results seems to correlate with the defects in charge selective barrier. Morphological changes of the disruption of intercellular junction and fused microvilli of glomerular epithelial cells seem to correlate with the defects in size-selective barrier. Therefore, we can explain the increased permeability of glomerular epithelial units in the in vitro diabetic condition.

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Epidemiology and Clinical Manifestations of $Henoch-Sch\"{o}nlein$ Purpura in Children (소아 $Henoch-Sch\"{o}nlein$ 자반증의 역학 및 임상양상)

  • Kim Se-Hun;Lee Chong-Guk
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.166-173
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    • 2003
  • Purpose : The cause and pathogenesis of $Henoch-Sch\"{o}nlein$ purpura has been studied for many years but the results are disappointing. Recently the hypothesis that abnormalities involving the glycosylation of the hinge region of immunoglobulin Al(IgAl) may have an important role in the pathogenesis of $Henoch-Sch\"{o}nlein$ purpura is being approved. $Henoch-Sch\"{o}nlein$ purpura is the most common vasculitis Ihat affects children and the prognosis is good. But if kidney invovement occurs, the course may be chronic and troublesome. So we evaluated children with $Henoch-Sch\"{o}nlein$ purpura especially from the point of epidemiology and clinical manifestations. Methods : Investigation of 124 children who were diagnosed with $Henoch-Sch\"{o}nlein$ purpura at Inje University Ilsan Paik Hospital from December 1999 to July 2003 was performed retrospectively through chart review. Efforts were made to get informations about the profile, epidemiology, clinical manifestations, progress of the disease and recurrence rate of patients. Results : The patients were 69 boys and 55 girls, with a mean age of $6.1{\pm}2.7$ years at the time of data collection. The male to female ratio was 1.25 : 1. The occurrence rate was much higher in autumn(from September to November, 31.5%) and winter(from December to February, 28.2%) than in spring and summer, with a peak in November. Joint involvement was shown in 66.9% of patients mostly on the foot/ankle(75.9%), knee(39.8%). Seventy(56.5%) out of 124 patients had abdominal pain and 10 patients(8.1%) showed bloody stools. Renal involvement was observed in 24 patients(19.4%) after 21.1 days on the average. IgA was elevated in 10 of 21 patients(47.6%). $C_3$ and $C_4$ levels were normal in 40 of 49 patients (81.7%) and 47 of 48 patients(97.9%), respectively Antistreptolysin-O(ASO) titer was elevated over 250 Todd units in 29 of 62 Patients(46.8%). Mycoplasma antibody titer was elevated in 21 of 49 patients(42.9%) equal or greater than 1:80. Radiologic studies were peformed in 23 patients. Seven patients(30.4%) showed bowel wall thickening and one of them received intestinal resection and anastomosis operation due to terminal ileum necrosis. Eighty four patients took steroid 1.4 mg/kg/day in average. Recurrence rate was 2.5 in 37 patients(29.8%). Conclusion : $Henoch-Sch\"{o}nlein$ purpura in childhood appears most in about 6 years of age. The occurrence rate is much higher in autumn and winter relatively. Diagnosis can be made through the perspective history taking and the inspection of clinical manifestations, but the laboratory findings are not of great help. A small portion of the patients might show abdominal pain or arthritis before purpura develops, therfore various diagnosis can be made. Radiologic evaluation should be performed to avoid surgical complications in cases accompanying abdominal pain, and long term follow up should be needed especially in patients suffering from kidney involvement. In about 30% of the patients $Henoch-Sch\"{o}nlein$ purpura would recur. Steroid can be used safely without side effects.

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Analysis of Isolated Proteinuria on School Urinary Mass Screening Test in Busan and Kyungsangnam-do Province (학교 신체 검사에서 발견된 단독 단백뇨의 분석)

  • Oh Dong-Hwan;Kim Jung-Soo;Park Ji-Kyoung;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.142-149
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    • 2003
  • Purpose : The urinary mass screening program for the detection of urinary abnormalities in school aged population has been performed in Seoul since 1981. Nation-wide urinary mass screening program was also performed since 1998. The aim of this study was to analyze the cause and nature of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province Methods : The medical records of 44 cases of isolated proteinuria detected by chance on the urinary mass screening test in Busan and Kyungsangnam-do Province, and evaluated for urinary abnormalities at the pediatrics outpatients renal clinics of Busan Paik Hospital from April 2002 to August 2003 were reviewed prospectively. Results : The cause and incidence of isolated proteinuria were as follows; transient proteinuria 4 cases(9.1%), orthostatic proteinuria 36 cases(81.8%) and persistent proteinuria 4 cases (9.1%). The total protein amount of the 24 hour urine were $121.0{\pm}136.4\;mg$ in transient proteinuria, $179.1{\pm}130.0\;mg$ in orthostatic proteinuria and $1532.8{\pm}982.5\;mg$ in persistent proteinuria. In the orthostatic proteinuria group, the total protein amount of the 24 hour urine was in the range of 40-616 mg. Spot urine protein/creatinine ratio(PCR) were $0.10{\pm}0.01$ in transient proteinuria, $0.61{\pm}0.61$ in orthostatic proteinuria and $4.35{\pm}4.04$ in persistent proteinuria. In the orthostatic proteinuria group, spot me PCR was in the range of 0.09-2.32. Renal biopsy was peformed in 4 children of the persisitent proteinuria group. They showed minimal change in 1 case, membranoproliferatiye glomerulonephritis in 2 cases and secondary renal amyloidosis in 1 case. Conclusion : The majority of isolated proteinuria which was detected by chance on school urinary mass screening were transient or orthostatic proteinuria. Even though the incidence of persistent proteinuria was much lower, it is necessary to take care of these children regularly and continuously, because persistent proteinuria itself is a useful marker of the progressive renal problems.

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Assessment Study on Educational Programs for the Gifted Students in Mathematics (영재학급에서의 수학영재프로그램 평가에 관한 연구)

  • Kim, Jung-Hyun;Whang, Woo-Hyung
    • Communications of Mathematical Education
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    • v.24 no.1
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    • pp.235-257
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    • 2010
  • Contemporary belief is that the creative talented can create new knowledge and lead national development, so lots of countries in the world have interest in Gifted Education. As we well know, U.S.A., England, Russia, Germany, Australia, Israel, and Singapore enforce related laws in Gifted Education to offer Gifted Classes, and our government has also created an Improvement Act in January, 2000 and Enforcement Ordinance for Gifted Improvement Act was also announced in April, 2002. Through this initiation Gifted Education can be possible. Enforcement Ordinance was revised in October, 2008. The main purpose of this revision was to expand the opportunity of Gifted Education to students with special education needs. One of these programs is, the opportunity of Gifted Education to be offered to lots of the Gifted by establishing Special Classes at each school. Also, it is important that the quality of Gifted Education should be combined with the expansion of opportunity for the Gifted. Social opinion is that it will be reckless only to expand the opportunity for the Gifted Education, therefore, assessment on the Teaching and Learning Program for the Gifted is indispensible. In this study, 3 middle schools were selected for the Teaching and Learning Programs in mathematics. Each 1st Grade was reviewed and analyzed through comparative tables between Regular and Gifted Education Programs. Also reviewed was the content of what should be taught, and programs were evaluated on assessment standards which were revised and modified from the present teaching and learning programs in mathematics. Below, research issues were set up to assess the formation of content areas and appropriateness for Teaching and Learning Programs for the Gifted in mathematics. A. Is the formation of special class content areas complying with the 7th national curriculum? 1. Which content areas of regular curriculum is applied in this program? 2. Among Enrichment and Selection in Curriculum for the Gifted, which one is applied in this programs? 3. Are the content areas organized and performed properly? B. Are the Programs for the Gifted appropriate? 1. Are the Educational goals of the Programs aligned with that of Gifted Education in mathematics? 2. Does the content of each program reflect characteristics of mathematical Gifted students and express their mathematical talents? 3. Are Teaching and Learning models and methods diverse enough to express their talents? 4. Can the assessment on each program reflect the Learning goals and content, and enhance Gifted students' thinking ability? The conclusions are as follows: First, the best contents to be taught to the mathematical Gifted were found to be the Numeration, Arithmetic, Geometry, Measurement, Probability, Statistics, Letter and Expression. Also, Enrichment area and Selection area within the curriculum for the Gifted were offered in many ways so that their Giftedness could be fully enhanced. Second, the educational goals of Teaching and Learning Programs for the mathematical Gifted students were in accordance with the directions of mathematical education and philosophy. Also, it reflected that their research ability was successful in reaching the educational goals of improving creativity, thinking ability, problem-solving ability, all of which are required in the set curriculum. In order to accomplish the goals, visualization, symbolization, phasing and exploring strategies were used effectively. Many different of lecturing types, cooperative learning, discovery learning were applied to accomplish the Teaching and Learning model goals. For Teaching and Learning activities, various strategies and models were used to express the students' talents. These activities included experiments, exploration, application, estimation, guess, discussion (conjecture and refutation) reconsideration and so on. There were no mention to the students about evaluation and paper exams. While the program activities were being performed, educational goals and assessment methods were reflected, that is, products, performance assessment, and portfolio were mainly used rather than just paper assessment.

A Study of Guidelines for Genetic Counseling in Preimplantation Genetic Diagnosis (PGD) (착상전 유전진단을 위한 유전상담 현황과 지침개발을 위한 기초 연구)

  • Kim, Min-Jee;Lee, Hyoung-Song;Kang, Inn-Soo;Jeong, Seon-Yong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.125-132
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    • 2010
  • Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

An Empirical Study on Motivation Factors and Reward Structure for User's Createve Contents Generation: Focusing on the Mediating Effect of Commitment (창의적인 UCC 제작에 영향을 미치는 동기 및 보상 체계에 대한 연구: 몰입에 매개 효과를 중심으로)

  • Kim, Jin-Woo;Yang, Seung-Hwa;Lim, Seong-Taek;Lee, In-Seong
    • Asia pacific journal of information systems
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    • v.20 no.1
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    • pp.141-170
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    • 2010
  • User created content (UCC) is created and shared by common users on line. From the user's perspective, the increase of UCCs has led to an expansion of alternative means of communications, while from the business perspective UCCs have formed an environment in which an abundant amount of new contents can be produced. Despite outward quantitative growth, however, many aspects of UCCs do not meet the expectations of general users in terms of quality, and this can be observed through pirated contents and user-copied contents. The purpose of this research is to investigate effective methods for fostering production of creative user-generated content. This study proposes two core elements, namely, reward and motivation, which are believed to enhance content creativity as well as the mediating factor and users' committement, which will be effective for bridging the increasing motivation and content creativity. Based on this perspective, this research takes an in-depth look at issues related to constructing the dimensions of reward and motivation in UCC services for creative content product, which are identified in three phases. First, three dimensions of rewards have been proposed: task dimension, social dimension, and organizational dimention. The task dimension rewards are related to the inherent characteristics of a task such as writing blog articles and pasting photos. Four concrete ways of providing task-related rewards in UCC environments are suggested in this study, which include skill variety, task significance, task identity, and autonomy. The social dimensioni rewards are related to the connected relationships among users. The organizational dimension consists of monetary payoff and recognition from others. Second, the two types of motivations are suggested to be affected by the diverse rewards schemes: intrinsic motivation and extrinsic motivation. Intrinsic motivation occurs when people create new UCC contents for its' own sake, whereas extrinsic motivation occurs when people create new contents for other purposes such as fame and money. Third, commitments are suggested to work as important mediating variables between motivation and content creativity. We believe commitments are especially important in online environments because they have been found to exert stronger impacts on the Internet users than other relevant factors do. Two types of commitments are suggested in this study: emotional commitment and continuity commitment. Finally, content creativity is proposed as the final dependent variable in this study. We provide a systematic method to measure the creativity of UCC content based on the prior studies in creativity measurement. The method includes expert evaluation of blog pages posted by the Internet users. In order to test the theoretical model of our study, 133 active blog users were recruited to participate in a group discussion as well as a survey. They were asked to fill out a questionnaire on their commitment, motivation and rewards of creating UCC contents. At the same time, their creativity was measured by independent experts using Torrance Tests of Creative Thinking. Finally, two independent users visited the study participants' blog pages and evaluated their content creativity using the Creative Products Semantic Scale. All the data were compiled and analyzed through structural equation modeling. We first conducted a confirmatory factor analysis to validate the measurement model of our research. It was found that measures used in our study satisfied the requirement of reliability, convergent validity as well as discriminant validity. Given the fact that our measurement model is valid and reliable, we proceeded to conduct a structural model analysis. The results indicated that all the variables in our model had higher than necessary explanatory powers in terms of R-square values. The study results identified several important reward shemes. First of all, skill variety, task importance, task identity, and automony were all found to have significant influences on the intrinsic motivation of creating UCC contents. Also, the relationship with other users was found to have strong influences upon both intrinsic and extrinsic motivation. Finally, the opportunity to get recognition for their UCC work was found to have a significant impact on the extrinsic motivation of UCC users. However, different from our expectation, monetary compensation was found not to have a significant impact on the extrinsic motivation. It was also found that commitment was an important mediating factor in UCC environment between motivation and content creativity. A more fully mediating model was found to have the highest explanation power compared to no-mediation or partially mediated models. This paper ends with implications of the study results. First, from the theoretical perspective this study proposes and empirically validates the commitment as an important mediating factor between motivation and content creativity. This result reflects the characteristics of online environment in which the UCC creation activities occur voluntarily. Second, from the practical perspective this study proposes several concrete reward factors that are germane to the UCC environment, and their effectiveness to the content creativity is estimated. In addition to the quantitive results of relative importance of the reward factrs, this study also proposes concrete ways to provide the rewards in the UCC environment based on the FGI data that are collected after our participants finish asnwering survey questions. Finally, from the methodological perspective, this study suggests and implements a way to measure the UCC content creativity independently from the content generators' creativity, which can be used later by future research on UCC creativity. In sum, this study proposes and validates important reward features and their relations to the motivation, commitment, and the content creativity in UCC environment, which is believed to be one of the most important factors for the success of UCC and Web 2.0. As such, this study can provide significant theoretical as well as practical bases for fostering creativity in UCC contents.

An Empirical Study on Perceived Value and Continuous Intention to Use of Smart Phone, and the Moderating Effect of Personal Innovativeness (스마트폰의 지각된 가치와 지속적 사용의도, 그리고 개인 혁신성의 조절효과)

  • Han, Joonhyoung;Kang, Sungbae;Moon, Taesoo
    • Asia pacific journal of information systems
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    • v.23 no.4
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    • pp.53-84
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    • 2013
  • With rapid development of ICT (Information and Communications Technology), new services by the convergence of mobile network and application technology began to appear. Today, smart phone with new ICT convergence network capabilities is exceedingly popular and very useful as a new tool for the development of business opportunities. Previous studies based on Technology Acceptance Model (TAM) suggested critical factors, which should be considered for acquiring new customers and maintaining existing users in smart phone market. However, they had a limitation to focus on technology acceptance, not value based approach. Prior studies on customer's adoption of electronic utilities like smart phone product showed that the antecedents such as the perceived benefit and the perceived sacrifice could explain the causality between what is perceived and what is acquired over diverse contexts. So, this research conceptualizes perceived value as a trade-off between perceived benefit and perceived sacrifice, and we need to research the perceived value to grasp user's continuous intention to use of smart phone. The purpose of this study is to investigate the structured relationship between benefit (quality, usefulness, playfulness) and sacrifice (technicality, cost, security risk) of smart phone users, perceived value, and continuous intention to use. In addition, this study intends to analyze the differences between two subgroups of smart phone users by the degree of personal innovativeness. Personal innovativeness could help us to understand the moderating effect between how perceptions are formed and continuous intention to use smart phone. This study conducted survey through e-mail, direct mail, and interview with smart phone users. Empirical analysis based on 330 respondents was conducted in order to test the hypotheses. First, the result of hypotheses testing showed that perceived usefulness among three factors of perceived benefit has the highest positive impact on perceived value, and then followed by perceived playfulness and perceived quality. Second, the result of hypotheses testing showed that perceived cost among three factors of perceived sacrifice has significantly negative impact on perceived value, however, technicality and security risk have no significant impact on perceived value. Also, the result of hypotheses testing showed that perceived value has significant direct impact on continuous intention to use of smart phone. In this regard, marketing managers of smart phone company should pay more attention to improve task efficiency and performance of smart phone, including rate systems of smart phone. Additionally, to test the moderating effect of personal innovativeness, this research conducted multi-group analysis by the degree of personal innovativeness of smart phone users. In a group with high level of innovativeness, perceived usefulness has the highest positive influence on perceived value than other factors. Instead, the analysis for a group with low level of innovativeness showed that perceived playfulness was the highest positive factor to influence perceived value than others. This result of the group with high level of innovativeness explains that innovators and early adopters are able to cope with higher level of cost and risk, and they expect to develop more positive intentions toward higher performance through the use of an innovation. Also, hedonic behavior in the case of the group with low level of innovativeness aims to provide self-fulfilling value to the users, in contrast to utilitarian perspective, which aims to provide instrumental value to the users. However, with regard to perceived sacrifice, both groups in general showed negative impact on perceived value. Also, the group with high level of innovativeness had less overall negative impact on perceived value compared to the group with low level of innovativeness across all factors. In both group with high level of innovativeness and with low level of innovativeness, perceived cost has the highest negative influence on perceived value than other factors. Instead, the analysis for a group with high level of innovativeness showed that perceived technicality was the positive factor to influence perceived value than others. However, the analysis for a group with low level of innovativeness showed that perceived security risk was the second high negative factor to influence perceived value than others. Unlike previous studies, this study focuses on influencing factors on continuous intention to use of smart phone, rather than considering initial purchase and adoption of smart phone. First, perceived value, which was used to identify user's adoption behavior, has a mediating effect among perceived benefit, perceived sacrifice, and continuous intention to use smart phone. Second, perceived usefulness has the highest positive influence on perceived value, while perceived cost has significant negative influence on perceived value. Third, perceived value, like prior studies, has high level of positive influence on continuous intention to use smart phone. Fourth, in multi-group analysis by the degree of personal innovativeness of smart phone users, perceived usefulness, in a group with high level of innovativeness, has the highest positive influence on perceived value than other factors. Instead, perceived playfulness, in a group with low level of innovativeness, has the highest positive factor to influence perceived value than others. This result shows that early adopters intend to adopt smart phone as a tool to make their job useful, instead market followers intend to adopt smart phone as a tool to make their time enjoyable. In terms of marketing strategy for smart phone company, marketing managers should pay more attention to identify their customers' lifetime value by the phase of smart phone adoption, as well as to understand their behavior intention to accept the risk and uncertainty positively. The academic contribution of this study primarily is to employ the VAM (Value-based Adoption Model) as a conceptual foundation, compared to TAM (Technology Acceptance Model) used widely by previous studies. VAM is useful for understanding continuous intention to use smart phone in comparison with TAM as a new IT utility by individual adoption. Perceived value dominantly influences continuous intention to use smart phone. The results of this study justify our research model adoption on each antecedent of perceived value as a benefit and a sacrifice component. While TAM could be widely used in user acceptance of new technology, it has a limitation to explain the new IT adoption like smart phone, because of customer behavior intention to choose the value of the object. In terms of theoretical approach, this study provides theoretical contribution to the development, design, and marketing of smart phone. The practical contribution of this study is to suggest useful decision alternatives concerned to marketing strategy formulation for acquiring and retaining long-term customers related to smart phone business. Since potential customers are interested in both benefit and sacrifice when evaluating the value of smart phone, marketing managers in smart phone company has to put more effort into creating customer's value of low sacrifice and high benefit so that customers will continuously have higher adoption on smart phone. Especially, this study shows that innovators and early adopters with high level of innovativeness have higher adoption than market followers with low level of innovativeness, in terms of perceived usefulness and perceived cost. To formulate marketing strategy for smart phone diffusion, marketing managers have to pay more attention to identify not only their customers' benefit and sacrifice components but also their customers' lifetime value to adopt smart phone.

Comparative Uptake of Tc-99m Sestamibi and Tc-99m Tetrofosmin in Cancer Cells and Tissue Expressing P-Glycoprotein or Multidrug Resistance Associated Protein (P-Glycoprotein과 Multidrug Resistance Associated Protein을 발현하는 암세포와 종양에서 Tc-99m Sestamibi와 Tc-99m Tetrofosmin의 섭취율 비교)

  • Cho, Jung-Ah;Lee, Jae-Tae;Yoo, Jung-Ah;Seo, Ji-Hyoung;Bae, Jin-Ho;Jeong, Shin-Young;Ahn, Byeong-Cheol;Sohn, Sang-Gyun;Ha, Jeoung-Hee;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.1
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    • pp.34-43
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    • 2005
  • Purpose: $^{99m}Tc$-sestamibi(MIBI) and $^{99m}Tc$-tetrofosmin have been used as substrates for P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP), which are closely associated with multidrug resistance of the tumors. To understand different handling of radiotracers in cancer cell lines expressing Pgp and MRP, we compared cellular uptakes of $^{99m}Tc$-MIBI and $^{99m}Tc$-tetrofosmin. The effects of cyclosporin A (CsA), well-known multidrug resistant reversing agent, on the uptake of both tracers were also compared. Materials and Methods: HCT15/CL02 human colorectal cancer cells for Pgp expressing cells, and human non-small cell lung cancer A549 cells for MRP expressing cells, were used for in vitro and in vivo studies. RT-PCR, western blot analysis and immunohistochemistry were used for detection of Pgp and MRP. MDR-reversal effect with CsA was evaluated at different drug concentrations after incubation with MIBI or tetrofosmin. Radioactivities of supernatant and pellet were measured with gamma well counter. Tumoral uptake of the tracers were measured from tumor bearing nude mice treated with or without CsA. Results: RT-PCR, western blot analysis of the cells and irnrnunochemical staining revealed selective expression of Pgp and MRP for HCY15/CL02 and A549 cells, respectively. There were no significant difference in cellular uptakes of both tracers in HCT15/CL02 cells, but MIBI uptake was slightly higher than that of tetrofosmin in A549 cells. Co-incubation with CsA resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Uptake of MIBI or tetrofosmin in HCT15/CL02 cells was increased by 10- and 2.4-fold, and by 7.5 and 6.3-fold in A549 cells, respectively. Percentage increase of MIBI was higher than that of tetrofosmin with CsA for both cells (p<0.05). In vivo biodistribution study showed that MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively increased by the time, up to 240 min with CsA. But increases in tumoral uptake were not significantly different between MIBI and tetrofosmin for both tumors. Conclusion: MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators in vitro, but these differences were not evident in vivo tumoral uptake. Both MIBI and tetrofosmin seem to be suitable tracers for imaging Pgp- and MRP-mediated drug resistance in tumors.