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The Usefulness of Product Display of Online Store by the Product Type of Usage Situation - Focusing on the moderate effect of the product portability - (사용상황별 제품유형에 따른 온라인 점포 제품디스플레이의 유용성 - 제품 휴대성의 조절효과를 중심으로 -)

  • Lee, Dong-Il;Choi, Seung-Hoon
    • Journal of Distribution Research
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    • v.16 no.2
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    • pp.1-24
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    • 2011
  • 1. Introduction: Contrast to the offline purchasing environment, online store cannot offer the sense of touch or direct visual information of its product to the consumers. So the builder of the online shopping mall should provide more concrete and detailed product information(Kim 2008), and Alba (1997) also predicted that the quality of the offered information is determined by the post-purchase consumer satisfaction. In practice, many fashion and apparel online shopping malls offer the picture information with the product on the real person model to enhance the usefulness of product information. On the other virtual product experience has been suggested to the ways of overcoming the online consumers' limited perceptual capability (Jiang & Benbasat 2005). However, the adoption and the facilitation of the virtual reality tools requires high investment and technical specialty compared to the text/picture product information offerings (Shaffer 2006). This could make the entry barrier to the online shopping to the small retailers and sometimes it could be demanding high level of consumers' perceptual efforts. So the expensive technological solution could affects negatively to the consumer decision making processes. Nevertheless, most of the previous research on the online product information provision suggests the VR be the more effective tools. 2. Research Model and Hypothesis: Presented in

    , research model suggests VR effect could be moderated by the product types by the usage situations. Product types could be defined as the portable product and installed product, and the information offering type as still picture of the product, picture of the product with the real-person model and VR. 3. Methods and Results: 3.1. Experimental design and measured variables We designed the 2(product types) X 3(product information types) experimental setting and measured dependent variables such as information usefulness, attitude toward the shopping mall, overall product quality, purchase intention and the revisiting intention. In the case of information usefulness and attitude toward the shopping mall were measured by multi-item scale. As a result of reliability test, Cronbach's Alpha value of each variable shows more than 0.6. Thus, we ensured that the internal consistency of items. 3.2. Manipulation check The main concern of this study is to verify the moderate effect by the product type of usage situation. indicates that our experimental manipulation of the moderate effect of the product type was successful. 3.3. Results As
    indicates, there was a significant main effect on the only one dependent variable(attitude toward the shopping mall) by the information types. As predicted, VR has highest mean value compared to other information types. Thus, H1 was partially supported. However, main effect by the product types was not found. To evaluate H2 and H3, a two-way ANOVA was conducted. As
    indicates, there exist the interaction effects on the three dependent variables(information usefulness, overall product quality and purchase intention) by the information types and the product types. As predicted, picture of the product with the real-person model has highest mean among the information types in the case of portable product. On the other hand, VR has highest mean among the information types in the case of installed product. Thus, H2 and H3 was supported. 4. Implications: The present study found the moderate effect by the product type of usage situation. Based on the findings the following managerial implications are asserted. First, it was found that information types are affect only the attitude toward the shopping mall. The meaning of this finding is that VR effects are not enough to understand the product itself. Therefore, we must consider when and how to use this VR tools. Second, it was found that there exist the interaction effects on the information usefulness, overall product quality and purchase intention. This finding suggests that consideration of usage situation helps consumer's understanding of product and promotes their purchase intention. In conclusion, not only product attributes but also product usage situations must be fully considered by the online retailers when they want to meet the needs of consumers.

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  • An Exploratory Study of Hospice Care to Patients with Advanced Cancer (암환자를 위한 호스피스 케어에 관한 탐색적 연구)

    • Park, Hye-Ja
      • The Korean Nurse
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      • v.28 no.3
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      • pp.52-67
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      • 1989
    • True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

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    The Characteristics of Retention and Evapotranspiration in the Extensive Greening Module of Sloped and Flat Rooftops (저토심 경사지붕과 평지붕 녹화모듈의 저류 및 증발산 특성)

    • Ryu, Nam-Hyong;Lee, Chun-Seok
      • Journal of the Korean Institute of Landscape Architecture
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      • v.41 no.6
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      • pp.107-116
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      • 2013
    • This study was undertaken to investigate the characteristics of retention and evapotranspiration in the extensive greening module of sloped and flat rooftops for stormwater management and urban heat island mitigation. A series of 100mm depth's weighing lysimeters planted with Sedum kamtschaticum. were constructed on a 50% slope facing four orientations(north, east, south and west) and a flat rooftop. Thereafter the retention and evapotranspiration from the greening module and the surface temperature of nongreening and greening rooftop were recorded beginning in September 2012 for a period of 1 year. The characteristics of retention and evapotranspiration in the greening module were as follows. The water storage of the sloped and flat greening modules increased to 8.7~28.4mm and 10.6~31.8mm after rainfall except in the winter season, in which it decreased to 3.3mm and 3.9mm in the longer dry period. The maximum stormwater retention of the sloped and flat greening modules was 22.2mm and 23.1mm except in the winter season. Fitted stormwater retention function was [Stormwater Retention Ratio(%)=-18.42 ln(Precipitation)+107.9, $R^2$=0.80] for sloped greening modules, and that was [Stormwater Retention Ratio(%)=-22.64 ln(X)+130.8, $R^2$=0.81] for flat greening modules. The daily evapotranspiration(mm/day) from the greening modules after rainfall decreased rapidly with a power function type in summer, and with a log function type in spring and autumn. The daily evapotranspiration(mm/day) from the greening modules after rainfall was greater in summer > spring > autumn > winter by season. This may be due to the differences in water storage, solar radiation and air temperature. The daily evapotranspiration from the greening modules decreased rapidly from 2~7mm/day to less than 1mm/day for 3~5 days after rainfall, and that decreased slowly after 3~5 days. This indicates that Sedum kamtschaticum used water rapidly when it was available and conserved water when it was not. The albedo of the concrete rooftop and greening rooftop was 0.151 and 0.137 in summer, and 0.165 and 0.165 in winter respectively. The albedo of the concrete rooftop and greening rooftop was similar. The effect of the daily mean and highest surface temperature decrease by greening during the summer season showed $1.6{\sim}13.8^{\circ}C$(mean $9.7^{\circ}C$) and $6.2{\sim}17.6^{\circ}C$(mean $11.2^{\circ}C$). The difference of the daily mean and highest surface temperature between the greening rooftop and concrete rooftop during the winter season were small, measuring $-2.4{\sim}1.3^{\circ}C$(mean $-0.4^{\circ}C$) and $-4.2{\sim}2.6^{\circ}C$(mean $0.0^{\circ}C$). The difference in the highest daily surface temperature between the greening rooftop and concrete rooftop during the summer season increased with an evapotranspiration rate increase by a linear function type. The fitted function of the highest daily surface temperature decrease was [Temperature Decrease($^{\circ}C$)=$1.4361{\times}$(Evapotranspiration rate(mm/day))+8.83, $R^2$=0.59]. The decrease of the surface temperature by greening in the longer dry period was due to sun protection by the sedum canopy. The results of this study indicate that the extensive rooftop greening will assist in managing stormwater runoff and urban heat island through retention and evapotranspiration. Sedum kamtschaticum would be the ideal plant for a non-irrigated extensive green roof. The shading effects of Sedum kamtschaticum would be important as well as the evapotranspiration effects of that for the long-term mitigation effects of an urban heat island.

    The Planting and Occurrence Status of Exotic Plants of the Folk Village as National Cultural Heritage - Focus in Hahoe.Yangdong.Hangae Villages - (국가지정 문화재 민속마을의 외래식물 식재 및 발생현황 - 하회.양동.한개마을을 대상으로 -)

    • Rho, Jae-Hyun;Oh, Hyun-Kyung;Han, Yun-Hee;Park, Kyung-Uk;Byun, Moo-Sup;Huh, Joon;Choi, Yung-Hyun;Shin, Sang-Sup;Lee, Hyun-Woo;Kim, Hyo-Jung
      • Journal of the Korean Institute of Traditional Landscape Architecture
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      • v.31 no.2
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      • pp.1-19
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      • 2013
    • This study was carried out to analyze distribution situation of alien plants and to propose management plan in the 3 Folk village in Gyeongsangbuk-do which is Cultural property designated by the State; Hahoe, Yangdong and Hangae. This research is for improve of sincerity of historical site and provide basic information which use about administration of preservation. The results are as follows. 1. Overall flora and alien plants appearance The total flora in the 3 folk villages were listed total 752 taxa including 127 families, 430 genera, 614 species, 5 subspecies, 100 varieties and 33 forms. Among them, woody plants take 263 taxa(35.0%) and herbaceous plants take 489 taxa (65.0%). Flora in the Hahoe, Yangdong and Hangae village were total 534, 479 taxa and 408 taxa and exotic plant index was 30.1%, 38.2% and 37.0% respectively. In types of exotic plants, ornamental exotic plants were 135 taxa, deciduous exotic plants were 21 taxa, cultivating exotic plants were 64 taxa, and naturalized exotic plants were 80 taxa and those result lead that the ornamental exotic plants is the highest ratio. According to the villages, Hahoe village had 161 taxa(30.1%), Yangdong Village had 183 taxa(38.2%), and Hangae village had 151 taxa(37.0%) that Yangdong village showed the most number of exotic plants. 2. Planting of landscape exotic plants in the unit cultural assets Meanwhile, Ornamental exotic plants in old house's gardens in Andong Hahoe village which is designated as a unit assets, those are total 30 taxa; followed by the Okyeon house(8 taxa) is highest and the Yangjindang(7), the Hadong house(6) and the Chunghyodang(5). Magnolia denudata appears the most as for 4 times and Campsis grandiflora etc. each took 2 times. Based on the Yangdong village, Gyeongju, that are found total 51 taxa; followed by the Dugok house(16 taxa) the Sujoldang(14), the Mucheondang(13), and the Sangchunheon (12). High appearance rate of ornamental exotic plants were Viburnum opulus for. hydrangeoides, Lycoris squamigera, Caragagna sinica and Magnolia denudata etc. Based on the Hangae village, Seongju, that are designated total 62 taxa; followed by the Jinsa house(35 taxa), the Gyori house(25), the Hanju head family house(20), and the Hahoe house(16). Taxa with high appearance rates were Caragana sinica, Juniperus chinensis var. horizontalis, Magnolia denudata, Viburnum opulus for. hydrangeoides, Chaenomeles speciosa etc. 3. Problems of exotic plant landscapes in the outer spaces of the folk villages Problems of exotic plant landscapes in the outer spaces of the Hahoe village are as follows. In lower of the Mansongjeong forest, Ambrosia artemisifolia, which are ecosystem disturbance plants designated by the Ministry of Environment, live with high dominance value. This should be have a remove with Sicyos angulatus immediately. In the Nakdong river bed around the Mansongjeong forest is covered with a riparian vegetation forest belt of Robinia pseudoacacia L. forest, Populus nigra var. italic community, and Populus x tomentiglandulosa community colony. Based on the Yangdong village, the planted or naturally distributed Ailanthus altissima colony, sporadically distributed Robinia pseudoacacia as well as Amorpha fruticosa are detected all over the village and ecotones. Based on the Hangae village, Ailanthus altissima and Robinia pseudoacacia are sporadically distributed around the village and there is a sign of spreading. similarity of exotic plantsis 47.0% to 48.6% and a reason why this happened is all of research site in Gyeongsanbuk-do and that is why growth norm of plant is similar, exotic plant which is sales for ornamental and it infer to require related countermeasure of each villages and joint related countermeasure.

    Cosmetic Results of Conservative Treatment for Early Breast Cancer (조기유방암에서 유방보존수술 및 방사선치료후의 미용적 결과)

    • Kim Bo Kyoung;Shin Seong Soo;Kim Seong Deok;Ha Sung Whan;Noh Dong-Young
      • Radiation Oncology Journal
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      • v.19 no.1
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      • pp.21-26
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      • 2001
    • Purpose : This study was peformed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. Materials and Methods : From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients $(90\%)$ and lumpectomy or excisional biopsy for 10 patients $(8.3\%)$. Forty six patients $(38\%)$ received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the sternal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Results : Cosmetic score was excellent or good in $76\%$ (91/120), fair in $19\%$ (23/120) and poor in $5\%$ (6/120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (N0 versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0.0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conclusion : Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary node metastasis and treated with less extensive surgery without chemotherapy.

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    Effects of Adjuvant Radiation Therapy and Chemotherapy Following Curative Surgery in Locally Advanced Rectal Cancer (국소 진행된 직장암에서 근치적 절제술 후 방사선치료와 항암화학요법과의 병용치료에 대한 효과)

    • Kang, Ki-Mun;Choi, Ihl-Bohng;Kim, In-Ah;Jang, Jee-Young;Shin, Kyung-Sub;Jang, Suck-Kyun;Lee, Jae-Hak;Kim, Young-Ha;Won, Chong-Man;Choi, Dong-Hwan;Kim, Jin-Seung;Park, Shinn-Hee
      • Radiation Oncology Journal
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      • v.15 no.2
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      • pp.121-128
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      • 1997
    • Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

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    Angiotensin Converting Enzyme Gene Polymorphism in Alport Syndrome (알포트증후군 환자에서 안지오텐신전환효소 유전자 다형성의 의의)

    • Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil
      • Childhood Kidney Diseases
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      • v.8 no.1
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      • pp.18-25
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      • 2004
    • Purpose : Alport syndrome is clinically characterized by hereditary progressive nephritis causing ESRD with irregular thickening of the GBM and sensory neural hearing loss. The mutations of type IV collagen gene(COL4A5) located on the long arm of X chromosome is considered responsible for most of the structural abnormalities in the GBM of Alport patients. Since no definite clinical prognostic predictor has been reported in the disease yet, we designed this study to evaluate the significance of genetic polymorphism of the angiotensin converting enzyme in children with Alport syndrome as a prognostic factor for disease progression. Methods : ACE I/D genotype were examined by PCR amplification of the genomic DNA in 12 patients with Alport syndrome and 12 of their family members. Alport patients were divided into two groups; the conservative group, those who had preserved renal function for more than 10 years of age, the early CRF group, those who had progressed to CRF within 10 years of age. Results : The mean age of onset was $3.45{\pm}2.4$ years in the conservative group, $4.4{\pm}1.2$ years in the early CRF group. Sex ratios were 5:3 and 2:1 in each group. Among 12 cases of patients, 4 cases were in early CRF group and their mean duration of onset to CRF was 4.5 yews(8.9 years of age). Eight patients(67%) were in the conservative group and they had normal renal function for more than 10 years of age(mean duration of renal preservation was 10.6 years). The incidence of II type ACE gene were in 25.0%(3 cases), ID type in 41.7%(5 cases), DD type in 33.3%(4 cases). There was no significant difference between Alport patient and normal control(II type 44.3%, ID type 40.9%, DD type 14.8%). The incidence of DD type of early CRF group were higher than that of the conservative group(75% vs 12.5%)(p<0.05). There was no difference in ACE gene polymorphism between normal Alport family members and control group. Conclusion : Even though there was no significant difference of ACE polymorphism between Alport patients and the normal control group, the incidence of DD type is significantly increased in early CRF group which means DD type of ACE polymorphism has a possibility of being a predictor for early progression to CRF in Alport patients.

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    Results of Hyperfractionated Radiation Therapy in Bulky Stage Ib, IIa, and IIb Uterine Cervical Cancer (종괴가 큰 병기 Ib, IIa, IIb 자궁경부암에서 다분할 방사선치료의 결과)

    • Kim, Jin-Hee;Kim, Ok-Bae
      • Radiation Oncology Journal
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      • v.15 no.4
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      • pp.349-356
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      • 1997
    • Purpose : To evaluate the efficacy of hyperfractionated radiation therapy in carcinoma of the cervix, especially on huge exophytic and endophytic stage Ib, IIa and IIb Materials and Materials : Fourty one patients with carcinoma of the cervix treated with hyperfractionated radiation therapy at the Department of Therapeutic Radiology, Dongsan Hospital, Keimyung University. School of Medicine from Jul, 1991 to Apr, 1994. According to FIGO s1aging system, therewere stage Ib (3 patients) IIa (6 patients) with exophytic ($\geq$5cm in dinmeter) and huge endophytic mass. and IIb (32 patients) with median age of 55 yeavs old. Radiation therapy consisted of hyperfractionated external irradition to the whole pelvis (120cGy/fraction, 2 fraction/day (minimum interval of 6 hours), 3600-5520cGy) and boost parametrial doses (for a total of 4480-6480cGy) with midline shield $(4\times10cm)$, and combined with intracavitary irradiation (up to 7480-8520cGy in Ib, IIa and 8480-9980cGy in IIb to point A). The maximum and mean follow up durations were 70 and 47 months respectively . Results : Five year local control rate was $78\%$ and the actuarial overall five year survival rate was $66.1\%$ for all patients, $44.4\%$ for stage Ib, IIa and $71.4\%$ for stage IIb. In bulky IIb (above 5cm in tumor size, 11 patients) five year local control rate and five rear survival rate was $88.9\%,\;73\%$ respectively Pelvic lymph node status (negative : $74\%,\;positive:25\%$, p=0.0015) was significant Prognostic factor affecting to five rear survival rate. There was marginally significant survival difference by total dose to A point ($>84Gy\;:\;70\%,\;>84Gy\;:\;42.8\%$, p=0.1). We consider that the difference of total dose to A point by stage (mean Ib,IIa : 79Gy. IIb 89Gy P=0.001) is one of the causes in worse local control and survival of Ib,IIa than IIb The overall recurrence rate was $39\%$ (16/41). The rates of local failure alone. distant failure alone. and combined local and distant failure were $9.7\%,\;19.5\%,\;and\;9.7\%$, respectively. Two Patients developed leukopenia ($\geq$ grade 3) and Three patients develoued grade 3 gastrointestinal complication. Above grade 3 complication was not noted. There was no treatment related death noted. Conclusion : We thought that it may be necessary to increase A point dose to more than 85Gy in hyperfractionated radiotherapy of huge exophytic and endophvtic stage Ib,IIa. We considered that hyperfractionated radiation therapy may be tolerable in huge exophytic and endophytic stage IIb cervical carcinoma with acceptable morbidity and possible survival gain but this was results in small patient group and will be confirmed by long term follow up in many patients.

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    Induction Chemotherapy and Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer (NSCLC) (국소 진행된 비소세포성 폐암에서 유도 화학요법 및 방사선치료)

    • Yun, Sang-Mo;Kim, Jae-Cheol;Park, In-Kyu
      • Radiation Oncology Journal
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      • v.17 no.3
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      • pp.195-202
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      • 1999
    • Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

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    The Analysis of Dose in a Rectum by Multipurpose Brachytherapy Phantom (근접방사선치료용 다목적 팬톰을 이용한 직장 내 선량분석)

    • Huh, Hyun-Do;Kim, Seong-Hoon;Cho, Sam-Ju;Lee, Suk;Shin, Dong-Oh;Kwon, Soo-Il;Kim, Hun-Jung;Kim, Woo-Chul;K. Loh John-J.
      • Radiation Oncology Journal
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      • v.23 no.4
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      • pp.223-229
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      • 2005
    • Purpose: In this work we designed and made MPBP(Multi Purpose Brachytherapy Phantom). The MPBP enables one to reproduce the same patient set-up in MPBP as the treatment of the patient and we tried to get an exact analysis of rectal doses in the phantom without need of in-vivo dosimetry. Materials and Methods: Dose measurements were tried at a point of rectum 1, the reference point of rectum, with a diode detector for 4 patients treated with tandem and ovoid for a brachytherapy of a cervix cancer. Total 20 times of rectal dose measurements were made with 5 times a patient. The set-up variation of the diode detector was analyzed. The same patient set-ups were reproduced in self-made MPBP and then rectal doses were measured with TLD. Results: The measurement results of the diode detector showed that the set-up variation of the diode detector was the maximum $11.25{\pm}0.95mm$ in the y-direction for Patient 1 and the maximum $9.90{\pm}4.50mm,\;20.85{\pm}4.50mm,\;and\;19.15{\pm}3.33mm$ in the z-direction for Patient 2, 3, and 4, respectively. Un analyzing the degree of variation in 3 directions the more variation was showed in the z-direction than x- and y-direction except Patient 1. The results of TLD measurements in MPBP showed the relative maximum error of 8.6% and 7.7% at a point of rectum 1 for Patient 1 and 4, respectively and 1.7% and 1.2% for Patient 2 and 3, respectively. The doses measured at R1 and R2 were higher than those calculated except R point of Patient 2. this can be thought to related to the algorithm of dose calculation, whcih corrects for air and water but is guessed not to consider the correction for the scattered rays, but by considering the self-error (${\pm}5%$) TLD has the relative error of values measured and calculated was analyzed to be in a good agreement within 15%. Conclusion: The reproducibility of dose measurements under the same condition as the treatment could be achieved owing to the self-made MPMP and the dose at the point of interest could be analyzed accurately. If a treatment is peformed after achieving dose optimization using the data obtained in the phantom, dose will be able to be minimized to important organs.


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