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

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

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The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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Studies on the Effects of Rice Plant on the Changes of Materials in Submerged Paddy Soils (수도재배(水稻栽培)가 답상태토양(畓狀態土壤)의 물질변화(物質變化)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Kim, Kwang Sik
    • Korean Journal of Soil Science and Fertilizer
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    • v.7 no.2
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    • pp.71-97
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    • 1974
  • Many studies on the changes of the materials in the water-logged paddy soil have been reported, but there will be several problems to apply them on the field soil. The main differences between the method of soil packed in beaker or column tube to that of natural field furrow slice are with or without of the rice root and the effect of water percolation. On the other hand, the mechanism of the water percolation on the changes of material in the natural field furrow slice are gradually understood. The purpose of this experiment is to know the effect of the rice cultivation on the chemical and physical changes of material in the water-logged paddy soil. Obtained results are as follows. 1. The physical and chemical changes on the water-logged paddy soil in the non-planted control-plot were nearly the same as the beaker or column tube experiment, while in the planted plot, slightly altered patterns were observed. 2. The relation between the number of tillers and total cation, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, Fe and Mn in the leachate showed very high significance. T hisresult showed that the leaching of those cation was promoted by growing of the rice r- of the rice root. 3. On the other hand, the concentration of the potassium, silica and phosphorus in leachates was gradually decreased and that of $NH_4$-N could not detect after the stage of active tillering. These facts revealed that such components were absorbed by rice plant. 4. The highly significant correlation between the number of tillers and the concentration of the total cation, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, $Fe^{{+}{+}}$, Fe and Mn in the percolated water was observed except that of $Mg^{{+}{+}}$. It was also showed that the rice root promoted the leaching of those cation. 5. The very high significance in the correlation between $HCO_3{^-}$ and the number of tillers indicated that the higher activity of the rice root was, the more $HCO_3{^-}$ concentration in the leachate was increased. 6. The relationship between the $HCO_3{^-}$ and the total cation, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, $Fe^{{+}{+}}$, Fe and Mn was appeared very highly significant. $HCO_3{^-}$, the metabolite of the rice root, promoted the leaching of $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, $Fe^{{+}{+}}$ and Mn. This fact might be a result that these cations were leached as the form of bicarbonate. 7. The iron in the leachate was the form of $Fe^{{+}{+}}$ and the correlation between $Fe^{{+}{+}}$ and $HCO_3{^-}$ was very highly significant. This result indicated that it seemed to be ferrous bicarbonate when it is leached out. 8. In the rhizosphere, ferrous iron was decreased gradually and the concentration of glucose was as high as 2 to 3 times in comparison with the other parts of the soil. These facts were the same as the previous reports in which rhizosphere was oxidized by the oxigen excreted from the root, and was enriched by the organic matter which was also excreted from the root and accumulated residues of the root. 9. ${\beta}$-Glucosidase and phosphatase activity in the rhizosphere was higher than that of the other parts of the soil. This facts might be attributed to the vigorous activity of microorganism in the rhizosphere where glucose concentration was high. 10. The pH in the leachate of the planted plot was lower than that of control, and the Eh on the planted soil was elevated in the last stage.

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Comparison of CT based-CTV plan and CT based-ICRU38 plan in Brachytherapy Planning of Uterine Cervix Cancer (자궁경부암 강내조사 시 CT를 이용한 CTV에 근거한 치료계획과 ICRU 38에 근거한 치료계획의 비교)

  • Cho, Jung-Ken;Han, Tae-Jong
    • Journal of Radiation Protection and Research
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    • v.32 no.3
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    • pp.105-110
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    • 2007
  • Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as Point A, is still used widely. A 3-dimensional ICR plan based on CT image provides dose-volume histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planing system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume$(average{\pm}SD)$ of CTV, rectum and bladder in all of 11 patients is $21.8{\pm}6.6cm^3,\;60.9{\pm}25.0cm^3,\;111.6{\pm}40.1cm^3$ respectively. The volume covered by 100% isodose curve is $126.7{\pm}18.9cm^3$ in ICRU plan and $98.2{\pm}74.5cm^3$ in CTV plan(p=0.0001), respectively. In (On) ICRU planning, $22.0cm^3$ of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of $62.2{\pm}4.8cm^3$ other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was $90.1{\pm}21.3%$ and $68.7{\pm}26.6%$ in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was $86.4{\pm}18.3%$ and $76.9{\pm}15.6%$ in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was $137.2{\pm}50.1%,\;101.1{\pm}41.8%$ in ICRU plan and $107.6{\pm}47.9%,\;86.9{\pm}30.8%$ in CTV plan, respectively. Therefore, the radiation dose to normal organ was lower in CTV plan than in ICRU plan. But the normal tissue dose was remarkably higher than a recommended dose in CTV plan in one patient whose residual tumor size was greater than 4cm. The volume of rectum receiving more than 80% isodose (V80rec) was $1.8{\pm}2.4cm^3$ in ICRU plan and $0.7{\pm}1.0cm^3$ in CTV plan(p=0.02). The volume of bladder receiving more than 80% isodose(V80bla) was $12.2{\pm}8.9cm^3$ in ICRU plan and $3.5{\pm}4.1cm^3$ in CTV plan(p=0.005). According to these parameters, CTV plan could also save more normal tissue compared to ICRU38 plan. Conclusion : An unnecessary excessive radiation dose is irradiated to normal tissues within 100% isodose area in the traditional ICRU plan in case of a small size of cervix cancer, but if we use CTV plan based on CT image, the normal tissue dose could be reduced remarkably without a compromise of tumor dose. However, in a large tumor case, we need more research on an effective 3D-planing to reduce the normal tissue dose.

The Purpose and background of this study (노인질환에 대한 한양방동시종합검진 결과에 대한 보고)

  • Gwon, Gyeong-Suk;Lee, Tae-Hwan;Song, Jeong-Mo;Kim, In-Seop;Yun, Ho-Yeong;Im, Jun-Gyu
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.9-27
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    • 1994
  • This study is to analyze of senile disease status and the social problem according to increased old ages, and then to find distributions of old man's diseases and health status efficiency of oriental-occidental contemporary health examination. And it is the first oriental-occidental contemporary health examination of old man performed by JeonJu Woosuk University Oriental Medicine Hospital and Woosuk-Clinic in nation. Methods The objects in this research are 641's old man of KimJe Gun's over 60's years performed medical examination at JeonJu Woosuk University Oriental- Mmedicine-Hospital and Woosuk-Clinic by oriental-occidental medical contemporary exam., from 1994, 24th June till 1994. 13th July. The 1st occident medical examination methods were consisted of chest x-ray check. blood and urine exam., measurement of blood pressure, visual power and audiometry. The Oriental medical examination methods were consisted of four diagnostics (望,聞,問,切), present illness. chief complaint, past history, families history, social history by question and SA Sang constitution test index. The results and conclusions The results and conclusions are the next: 1. In order of distribution. the athletic disease (75.8%),the digestive disease(43.4%), the circulatory disease(41.5%), the respiratory disease(22.3%), EENT disease(8.1%), the endocrinopathy(5.6%), and the genito-urinary disease(5.3%) are the results of the object about 641's old man, by the oriental-occidental medicine's contemporay exam. 2. Distribution of disease distiction are lumbago. gastritis and peptic ulcer. knee joint pain. heart disease. hypertension. chronic bronchitis. asthma. anemia. DM. Tbc. visual disturbance. CVA. etc in order. 3. Disease distribution according to age is almost high incident in 60-75years. Disease incidence is decreased except E.E.N.T disease in over 76years. 4. The relationships of disease and family history are: the 25.0% of CVA pts. has family history and the 11.6% of hypertension pts has family history. so they showed high relative family history. In addition the 5.6% of TBC pts. and the 2.6% of DM pts. have family history. 5. The relationships of disease and drinking are: Drinking proportion is the 36.4% in respiratory disease pts. the 34.7% in hypertension pts. the 33.3% in heart disease pts.. the 28.4% in digestive disease pts.. but because of no surveying drinking amount we can't know the absolut relationships of disease and drinking. 6. The relationships of Disease and smoking are: Smoking proportion is the 44.1% in respiratory disease pts.. the 38.0% in Heart disease pts.. the 29.8% in Hypertension pts.. but because of no surveying of smoking amount. we can't know the absolut relationships of disease and smoking. 7. Distribution of Sasang constitution is : Tae-eum-in 44.8%. So-yang-in 30.7%. So-eum-in 24.6%. Tae-yang-in 0.0%. And disease distribution of Sasang constitution distinction is ; Tae-eum-in has high incidence of circulation disease(50.0%) and respiratory disease(23.1%).So-yang-in has high incidence of athletics disease(77.7%) and EENT disease(12.2%), So-eum-in has high incidence of digestive disease(65.8%). 8. Distribution of abnormal result in occidental medical examination and oriental-occidental contemporal exam result is considerably different. This is the reason of needing oriental medicine exam, for characteristics of Senile. I think that the oriental-occidental contemporary examination in old man is much more effecient than only occident medical examination. This oriental-occidental contemporary examination has many defects because it is the first practice. To participate in the public health program efficiently. I think that we must improve lots of problems and present the model of the oriental-occidental contemporary examination and the project of oriental medicine's for public health.

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The Impact of Market Environments on Optimal Channel Strategy Involving an Internet Channel: A Game Theoretic Approach (시장 환경이 인터넷 경로를 포함한 다중 경로 관리에 미치는 영향에 관한 연구: 게임 이론적 접근방법)

  • Yoo, Weon-Sang
    • Journal of Distribution Research
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    • v.16 no.2
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    • pp.119-138
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    • 2011
  • Internet commerce has been growing at a rapid pace for the last decade. Many firms try to reach wider consumer markets by adding the Internet channel to the existing traditional channels. Despite the various benefits of the Internet channel, a significant number of firms failed in managing the new type of channel. Previous studies could not cleary explain these conflicting results associated with the Internet channel. One of the major reasons is most of the previous studies conducted analyses under a specific market condition and claimed that as the impact of Internet channel introduction. Therefore, their results are strongly influenced by the specific market settings. However, firms face various market conditions in the real worlddensity and disutility of using the Internet. The purpose of this study is to investigate the impact of various market environments on a firm's optimal channel strategy by employing a flexible game theory model. We capture various market conditions with consumer density and disutility of using the Internet.

    shows the channel structures analyzed in this study. Before the Internet channel is introduced, a monopoly manufacturer sells its products through an independent physical store. From this structure, the manufacturer could introduce its own Internet channel (MI). The independent physical store could also introduce its own Internet channel and coordinate it with the existing physical store (RI). An independent Internet retailer such as Amazon could enter this market (II). In this case, two types of independent retailers compete with each other. In this model, consumers are uniformly distributed on the two dimensional space. Consumer heterogeneity is captured by a consumer's geographical location (ci) and his disutility of using the Internet channel (${\delta}_{N_i}$).
    shows various market conditions captured by the two consumer heterogeneities.
    (a) illustrates a market with symmetric consumer distributions. The model captures explicitly the asymmetric distributions of consumer disutility in a market as well. In a market like that is represented in
    (c), the average consumer disutility of using an Internet store is relatively smaller than that of using a physical store. For example, this case represents the market in which 1) the product is suitable for Internet transactions (e.g., books) or 2) the level of E-Commerce readiness is high such as in Denmark or Finland. On the other hand, the average consumer disutility when using an Internet store is relatively greater than that of using a physical store in a market like (b). Countries like Ukraine and Bulgaria, or the market for "experience goods" such as shoes, could be examples of this market condition. summarizes the various scenarios of consumer distributions analyzed in this study. The range for disutility of using the Internet (${\delta}_{N_i}$) is held constant, while the range of consumer distribution (${\chi}_i$) varies from -25 to 25, from -50 to 50, from -100 to 100, from -150 to 150, and from -200 to 200.
    summarizes the analysis results. As the average travel cost in a market decreases while the average disutility of Internet use remains the same, average retail price, total quantity sold, physical store profit, monopoly manufacturer profit, and thus, total channel profit increase. On the other hand, the quantity sold through the Internet and the profit of the Internet store decrease with a decreasing average travel cost relative to the average disutility of Internet use. We find that a channel that has an advantage over the other kind of channel serves a larger portion of the market. In a market with a high average travel cost, in which the Internet store has a relative advantage over the physical store, for example, the Internet store becomes a mass-retailer serving a larger portion of the market. This result implies that the Internet becomes a more significant distribution channel in those markets characterized by greater geographical dispersion of buyers, or as consumers become more proficient in Internet usage. The results indicate that the degree of price discrimination also varies depending on the distribution of consumer disutility in a market. The manufacturer in a market in which the average travel cost is higher than the average disutility of using the Internet has a stronger incentive for price discrimination than the manufacturer in a market where the average travel cost is relatively lower. We also find that the manufacturer has a stronger incentive to maintain a high price level when the average travel cost in a market is relatively low. Additionally, the retail competition effect due to Internet channel introduction strengthens as average travel cost in a market decreases. This result indicates that a manufacturer's channel power relative to that of the independent physical retailer becomes stronger with a decreasing average travel cost. This implication is counter-intuitive, because it is widely believed that the negative impact of Internet channel introduction on a competing physical retailer is more significant in a market like Russia, where consumers are more geographically dispersed, than in a market like Hong Kong, that has a condensed geographic distribution of consumers.
    illustrates how this happens. When mangers consider the overall impact of the Internet channel, however, they should consider not only channel power, but also sales volume. When both are considered, the introduction of the Internet channel is revealed as more harmful to a physical retailer in Russia than one in Hong Kong, because the sales volume decrease for a physical store due to Internet channel competition is much greater in Russia than in Hong Kong. The results show that manufacturer is always better off with any type of Internet store introduction. The independent physical store benefits from opening its own Internet store when the average travel cost is higher relative to the disutility of using the Internet. Under an opposite market condition, however, the independent physical retailer could be worse off when it opens its own Internet outlet and coordinates both outlets (RI). This is because the low average travel cost significantly reduces the channel power of the independent physical retailer, further aggravating the already weak channel power caused by myopic inter-channel price coordination. The results implies that channel members and policy makers should explicitly consider the factors determining the relative distributions of both kinds of consumer disutility, when they make a channel decision involving an Internet channel. These factors include the suitability of a product for Internet shopping, the level of E-Commerce readiness of a market, and the degree of geographic dispersion of consumers in a market. Despite the academic contributions and managerial implications, this study is limited in the following ways. First, a series of numerical analyses were conducted to derive equilibrium solutions due to the complex forms of demand functions. In the process, we set up V=100, ${\lambda}$=1, and ${\beta}$=0.01. Future research may change this parameter value set to check the generalizability of this study. Second, the five different scenarios for market conditions were analyzed. Future research could try different sets of parameter ranges. Finally, the model setting allows only one monopoly manufacturer in the market. Accommodating competing multiple manufacturers (brands) would generate more realistic results.

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  • Dual Path Model in Store Loyalty of Discount Store (대형마트 충성도의 이중경로모형)

    • Ji, Seong-Goo;Lee, Ihn-Goo
      • Journal of Distribution Research
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      • v.15 no.1
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      • pp.1-24
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      • 2010
    • I. Introduction The industry of domestic discount store was reorganized with 2 bigs and 1 middle, and then Home Plus took over Home Ever in 2008. In present, Oct, 2008, E-Mart has 118 outlets, Home Plus 112 outlets, and Lotte Mart 60 stores. With total number of 403 outlets, they are getting closer to a saturation point. We know that the industry of discount store has been getting through the mature stage in retail life cycle. There are many efforts to maintain existing customers rather than to get new customers. These competitions in this industry lead firms to acknowledge 'store loyalty' to be the first strategic tool for their sustainable competitiveness. In other words, the strategic goal of discount store is to boost up the repurchase rate of customers throughout increasing store loyalty. If owners of retail shops can figure out main factors for store loyalty, they can easily make more efficient and effective retail strategies which bring about more sales and profits. In this practical sense, there are many papers which are focusing on the antecedents of store loyalty. Many researchers have been inspecting causal relationships between antecedents and store loyalty; store characteristics, store image, atmosphere in store, sales promotion in store, service quality, customer characteristics, crowding, switching cost, trust, satisfaction, commitment, etc., In recent times, many academic researchers and practitioners have been interested in 'dual path model for service loyalty'. There are two paths in store loyalty. First path has an emphasis on symbolic and emotional dimension of service brand, and second path focuses on quality of product and service. We will call the former an extrinsic path and call the latter an intrinsic path. This means that consumers' cognitive path for store loyalty is not single but dual. Existing studies for dual path model are as follows; First, in extrinsic path, some papers in domestic settings show that there is 'store personality-identification-loyalty' path. Second, service quality has an effect on loyalty, which is a behavioral variable, in the mediation of customer satisfaction. But, it's very difficult to find out an empirical paper applied to domestic discount store based on this mediating model. The domestic research for store loyalty concentrates on not only intrinsic path but also extrinsic path. Relatively, an attention for intrinsic path is scarce. And then, we acknowledge that there should be a need for integrating extrinsic and intrinsic path. Also, in terms of retail industry, this study is meaningful because retailers want to achieve their competitiveness by using store loyalty. And so, the purpose of this paper is to integrate and complement two existing paths into one specific model, dual path model. This model includes both intrinsic and extrinsic path for store loyalty. With this research, we would expect to understand the full process of forming customers' store loyalty which had not been clearly explained. In other words, we propose the dual path model for discount store loyalty which has been originated from store personality and service quality. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. II. Research Model Dual path model integrates intrinsic path and extrinsic path into one specific model. Intrinsic path put an emphasis on quality characteristics and extrinsic path focuses on brand characteristics. Intrinsic path is based on information processing perspective, and extrinsic path emphasizes symbolic and emotional dimension of brand. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. Hypotheses are as follows; Hypothesis 1: Service quality perceived by customers in discount store has an positive effect on customer satisfaction Hypothesis 2: Store personality perceived by customers in discount store has an positive effect on store identification Hypothesis 3: Customer satisfaction in discount store has an positive effect on store loyalty. Hypothesis 4: Store identification has an positive effect on store loyalty. III. Results and Implications We examined consumers who patronize discount stores for samples of this study. With the structural equation model(SEM) analysis, we empirically tested the validity and fitness of the dual path model for store loyalty in discount stores. As results, the fitness indices of this model were well fitted to data obtained. In an intrinsic path, service quality(SQ) is positively related to customer satisfaction(CS), customer satisfaction(CS) has very significantly positive effect on store loyalty(SL). Also, in an extrinsic path, the store personality(SP) is positively related to store identification(SI), it shows significant effect on store loyalty. Table 1 shows the results as follows; There are some theoretical and practical implications. First, Many studies on discount store loyalty have been executed from various perspectives. But there has been no integrative view on this issue. And so, this research was theoretically designed to integrate various and controversial arguments into one systematic model. We empirically tested dual path model forming store loyalty, and brought up a systematic and integrative framework for future studies. We want to expect creative and aggressive research activities. Second, a few established papers are focused on the relationship between antecedents and store loyalty; store characteristics, atmosphere, sales promotion in store, service quality, trust, commitment, etc., There has been some limits in understanding thoroughly the formation process of store loyalty with a singular path, intrinsic or extrinsic. Beyond these limits in single path, we could propose the new path for store loyalty. This is meaningful. Third, discount store firms make and execute marketing strategies for increasing store loyalty. This research provides real practitioners with reference framework needed for actual strategy formation. Because this paper shows integrated and systematic path for store loyalty. A special feature of this study is to represent 6 sub dimensions of service quality in intrinsic path and 4 sub dimensions of store personality in extrinsic path. Marketers can make more analytic marketing planning with concrete sub dimensions of service quality and store personality. When marketers of discount stores make strategic planning like MPR, Ads, campaign, sales promotion, they can use many items which are more competitive than competitors.

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    Comparisons of Unicortical and Bicortical Lateral Mass Screws in the Cervical Spine : Safety vs Strength (경추부의 후관절 나사못 고정술에서 단피질삽입법과 양피질 삽입법 간의 특성에 관한 비교)

    • Park, Choon-Keun;Hwang, Jang-Hoe;Ji, Chul;Lee, Jae Un;Sung, Jae Hoon;Choi, Seung-Jin;Lee, Sang-Won;Seybold, Eric;Park, Sung-Chan;Cho, Kyung-Suok;Park, Chun-Kun;Kang, Joon-Ki
      • Journal of Korean Neurosurgical Society
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      • v.30 no.10
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      • pp.1210-1219
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      • 2001
    • Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

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    Studies on the Appraisal of Stumpage Value in the Forest Land - With Respect to Kyung-Ju Area - (산원지(山元地) 임목평가(林木平価)에 관(関)한 연구(研究) - 경주지방(慶州地方)을 중심(中心)으로 -)

    • Rha, Sang Soo;Park, Tai Sik
      • Journal of Korean Society of Forest Science
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      • v.52 no.1
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      • pp.37-49
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      • 1981
    • The purpose of the study is to find out the objective method of valuation on the forest stands through the analysis of logging costs that is positively related to timber production. The two forest (Amgog, Whangryoung), located nereby, but forest type, logging and skidding conditions being slightly different, were slected to carry out the study. The objective timber stumpage value were determined by investigating the appropriate timber production costs and profits of logging operations. The main result obtained in this study are as follows: 1. The rate of logging cost in consisting of timber market price is 13.15% in the area of Amgog logging place and 19.48% in Whangryoung. 2. The rate of the other production cost excluding logging cost is 15.36% in the area of Amgog logging place and 28.85% in Whangryoung. 3. The total rate of timber production cost in consisting of the market price is more than 28.51% in the area of Amgog logging place and 48.33% in Whangryoung, 4. Though the productivity of forest land is affected by the selection of tree species, tending, treatments and effective management of forest land, the more important problem is improvement of logging condition. 5. The rate of production cost in timber price is so high that we should endeavore to improve the productivity of labour and its quality, and minimize the difference of piece work per day in accordance to the various site condition. 6. Although the profit of forest industry is related to the period of recapturing investment, it is more closely related to the working condition, risk of investment and continuous change of social investment interest. 7. If the right variables which are related to the timber market, are objectively obtained, the stumpage value of mature forests can be objectively caculated by applying straight line discounting method or compound discounting method in caculating the stump to market price.

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    Research Framework for International Franchising (국제프랜차이징 연구요소 및 연구방향)

    • Kim, Ju-Young;Lim, Young-Kyun;Shim, Jae-Duck
      • Journal of Global Scholars of Marketing Science
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      • v.18 no.4
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      • pp.61-118
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      • 2008
    • The purpose of this research is to construct research framework for international franchising based on existing literature and to identify research components in the framework. Franchise can be defined as management styles that allow franchisee use various management assets of franchisor in order to make or sell product or service. It can be divided into product distribution franchise that is designed to sell products and business format franchise that is designed for running it as business whatever its form is. International franchising can be defined as a way of internationalization of franchisor to foreign country by providing its business format or package to franchisee of host country. International franchising is growing fast for last four decades but academic research on this is quite limited. Especially in Korea, research about international franchising is carried out on by case study format with single case or empirical study format with survey based on domestic franchise theory. Therefore, this paper tries to review existing literature on international franchising research, providing research framework, and then stimulating new research on this field. International franchising research components include motives and environmental factors for decision of expanding to international franchising, entrance modes and development plan for international franchising, contracts and management strategy of international franchising, and various performance measures from different perspectives. First, motives of international franchising are fee collection from franchisee. Also it provides easier way to expanding to foreign country. The other motives including increase total sales volume, occupying better strategic position, getting quality resources, and improving efficiency. Environmental factors that facilitating international franchising encompasses economic condition, trend, and legal or political factors in host and/or home countries. In addition, control power and risk management capability of franchisor plays critical role in successful franchising contract. Final decision to enter foreign country via franchising is determined by numerous factors like history, size, growth, competitiveness, management system, bonding capability, industry characteristics of franchisor. After deciding to enter into foreign country, franchisor needs to set entrance modes of international franchising. Within contractual mode, there are master franchising and area developing franchising, licensing, direct franchising, and joint venture. Theories about entrance mode selection contain concepts of efficiency, knowledge-based approach, competence-based approach, agent theory, and governance cost. The next step after entrance decision is operation strategy. Operation strategy starts with selecting a target city and a target country for franchising. In order to finding, screening targets, franchisor needs to collect information about candidates. Critical information includes brand patent, commercial laws, regulations, market conditions, country risk, and industry analysis. After selecting a target city in target country, franchisor needs to select franchisee, in other word, partner. The first important criteria for selecting partners are financial credibility and capability, possession of real estate. And cultural similarity and knowledge about franchisor and/or home country are also recognized as critical criteria. The most important element in operating strategy is legal document between franchisor and franchisee with home and host countries. Terms and conditions in legal documents give objective information about characteristics of franchising agreement for academic research. Legal documents have definitions of terminology, territory and exclusivity, agreement of term, initial fee, continuing fees, clearing currency, and rights about sub-franchising. Also, legal documents could have terms about softer elements like training program and operation manual. And harder elements like law competent court and terms of expiration. Next element in operating strategy is about product and service. Especially for business format franchising, product/service deliverable, benefit communicators, system identifiers (architectural features), and format facilitators are listed for product/service strategic elements. Another important decision on product/service is standardization vs. customization. The rationale behind standardization is cost reduction, efficiency, consistency, image congruence, brand awareness, and competitiveness on price. Also standardization enables large scale R&D and innovative change in management style. Another element in operating strategy is control management. The simple way to control franchise contract is relying on legal terms, contractual control system. There are other control systems, administrative control system and ethical control system. Contractual control system is a coercive source of power, but franchisor usually doesn't want to use legal power since it doesn't help to build up positive relationship. Instead, self-regulation is widely used. Administrative control system uses control mechanism from ordinary work relationship. Its main component is supporting activities to franchisee and communication method. For example, franchisor provides advertising, training, manual, and delivery, then franchisee follows franchisor's direction. Another component is building franchisor's brand power. The last research element is performance factor of international franchising. Performance elements can be divided into franchisor's performance and franchisee's performance. The conceptual performance measures of franchisor are simple but not easy to obtain objectively. They are profit, sale, cost, experience, and brand power. The performance measures of franchisee are mostly about benefits of host country. They contain small business development, promotion of employment, introduction of new business model, and level up technology status. There are indirect benefits, like increase of tax, refinement of corporate citizenship, regional economic clustering, and improvement of international balance. In addition to those, host country gets socio-cultural change other than economic effects. It includes demographic change, social trend, customer value change, social communication, and social globalization. Sometimes it is called as westernization or McDonaldization of society. In addition, the paper reviews on theories that have been frequently applied to international franchising research, such as agent theory, resource-based view, transaction cost theory, organizational learning theory, and international expansion theories. Resource based theory is used in strategic decision based on resources, like decision about entrance and cooperation depending on resources of franchisee and franchisor. Transaction cost theory can be applied in determination of mutual trust or satisfaction of franchising players. Agent theory tries to explain strategic decision for reducing problem caused by utilizing agent, for example research on control system in franchising agreements. Organizational Learning theory is relatively new in franchising research. It assumes organization tries to maximize performance and learning of organization. In addition, Internalization theory advocates strategic decision of direct investment for removing inefficiency of market transaction and is applied in research on terms of contract. And oligopolistic competition theory is used to explain various entry modes for international expansion. Competency theory support strategic decision of utilizing key competitive advantage. Furthermore, research methodologies including qualitative and quantitative methodologies are suggested for more rigorous international franchising research. Quantitative research needs more real data other than survey data which is usually respondent's judgment. In order to verify theory more rigorously, research based on real data is essential. However, real quantitative data is quite hard to get. The qualitative research other than single case study is also highly recommended. Since international franchising has limited number of applications, scientific research based on grounded theory and ethnography study can be used. Scientific case study is differentiated with single case study on its data collection method and analysis method. The key concept is triangulation in measurement, logical coding and comparison. Finally, it provides overall research direction for international franchising after summarizing research trend in Korea. International franchising research in Korea has two different types, one is for studying Korean franchisor going overseas and the other is for Korean franchisee of foreign franchisor. Among research on Korean franchisor, two common patterns are observed. First of all, they usually deal with success story of one franchisor. The other common pattern is that they focus on same industry and country. Therefore, international franchise research needs to extend their focus to broader subjects with scientific research methodology as well as development of new theory.

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