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The Difference between Career Barrier Recognition and Career Preparation Behavior by Mandatory military service Planning Level among Male College Students (남자대학생의 군 의무복무계획 수준에 따른 진로장벽인식과 진로준비행동의 차이)

  • Hong, Hye-Young;Kang, Hye-Young
    • 대한공업교육학회지
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    • v.38 no.2
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    • pp.218-239
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    • 2013
  • This study aims to understand the status of mandatory military service planning and career barrier recognition as well as to analyze the difference between how students perceive mandatory military service as a potential barrier to their future careers(career barrier recognition) and career preparation behavior by the mandatory military service planning level among male college students. For the purpose, inquiries for the subject were set up as follows. 1. What are the levels of mandatory military service planning and career barrier recognition? 2. Is there a difference in career barrier recognition depending on the level of mandatory military service planning? 3. Is there a difference in career preparation behaviour depending on the level of mandatory military service planning? This study found out the level of mandatory military service, military barrier recognition and career preparation behavior of 284 male students from 4 universities in Daejeon and Chungnam area. Along with that, descriptive statistic, correlation analysis and t-test were conducted with SPSS 17.0 program The results of this study are as follows: First, 79.2% of male students have higher mandatory military service planning than the average value. Meanwhile, considering 3 sub-factors of mandatory military service planning, the ratio of those with high scores in practicality is lower than importance and concreteness. Based on this, it is assumable that they have a low perception for practical and concrete behaviors such as data collection in mandatory military service planning, which indicates their awareness has not developed into concrete behaviors even though they recognize the importance of planning. Also 73.9% of male students responded higher career barrier recognition than the average value shows that they recognize mandatory military service as a barrier relatively highly. Especially, those who answered "Very much" (7 scores) for every inquiry in career barrier recognition accounted for 16.9%, which forms the biggest group. and considering the response by each inquiry, it is ascertained that they consider the absence by mandatory military service time or military service as the biggest difficulty. Second, the difference in career barrier recognition between the top 30% and bottom 30% of mandatory military service planning is not statistically significant. However, in terms of importance and the sub-factor of mandatory military service planning, a significant inter-group difference in career barrier recognition is shown. In other words, to join the military is recognized as an obstacle in their career barrier recognition regardless of the mandatory military service planning level. Also, a group which considers the importance of the mandatory military service planning highly recognizes the military as the bigger obstacle compared to the other groups which are not considered in this way. Third, the difference in career barrier recognition between the top 30% and the bottom 30% of the mandatory military service planning is statistically significant. The need of mandatory military service planning is marked by the fact that those with a high level of mandatory military service planning show stronger career barrier recognition than those without plans. Through the study, the need of mandatory military service planning is suggested to both male students and career consultants considering the mandatory military service from a perspective of career based on Korean reality. Also, as precedent studies on pre-inducted men can be hardly found currently, this study is significant in accumulating empirical data about mandatory military service, a unique characteristic of the Korean career development process.

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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  • Categorizing Quality Features of Franchisees: In the case of Korean Food Service Industry (프랜차이즈 매장 품질요인의 속성분류: 국내 외식업을 중심으로)

    • Byun, Sook-Eun;Cho, Eun-Seong
      • Journal of Distribution Research
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      • v.16 no.1
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      • pp.95-115
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      • 2011
    • Food service is the major part of franchise business in Korea, accounting for 69.9% of the brands in the market. As the food service industry becomes mature, many franchisees have struggled to survive in the market. In general, consumers have higher levels of expectation toward service quality of franchised outlets compared that of (non-franchised) independent ones. They also tend to believe that franchisees deliver standardized service at the uniform food price, regardless of their locations. Such beliefs seem to be important reasons that consumers prefer franchised outlets to independent ones. Nevertheless, few studies examined the impact of qualify features of franchisees on customer satisfaction so far. To this end, this study examined the characteristics of various quality features of franchisees in the food service industry, regarding their relationship with customer satisfaction and dissatisfaction. The quality perception of heavy-users was also compared with that of light-users in order to find insights for developing differentiated marketing strategy for the two segments. Customer satisfaction has been understood as a one-dimensional construct while there are recent studies that insist two-dimensional nature of the construct. In this regard, Kano et al. (1984) suggested to categorize quality features of a product or service into five types, based on their relation to customer satisfaction and dissatisfaction: Must-be quality, Attractive quality, One-dimensional quality, Indifferent quality, and Reverse quality. According to the Kano model, customers are more dissatisfied when Must-be quality(M) are not fulfilled, but their satisfaction does not arise above neutral no matter how fully the quality fulfilled. In comparison, customers are more satisfied with a full provision of Attactive quality(A) but manage to accept its dysfunction. One-dimensional quality(O) results in satisfaction when fulfilled and dissatisfaction when not fulfilled. For Indifferent quality(I), its presence or absence influences neither customer satisfaction nor dissatisfaction. Lastly, Reverse quality(R) refers to the features whose high degree of achievement results in customer dissatisfaction rather than satisfaction. Meanwhile, the basic guidelines of the Kano model have a limitation in that the quality type of each feature is simply determined by calculating the mode statistics. In order to overcome such limitation, the relative importance of each feature on customer satisfaction (Better value; b) and dissatisfaction (Worse value; w) were calculated following the formulas below (Timko, 1993). The Better value indicates how much customer satisfaction is increased by providing the quality feature in question. In contrast, the Worse value indicates how much customer dissatisfaction is decreased by providing the quality feature. Better = (A + O)/(A+O+M+I) Worse = (O+M)/(A+O+M+I)(-1) An on-line survey was performed in order to understand the nature of quality features of franchisees in the food service industry by applying the Kano Model. A total of twenty quality features (refer to the Table 2) were identified as the result of literature review in franchise business and a pre-test with fifty college students in Seoul. The potential respondents of our main survey was limited to the customers who have visited more than two restaurants/stores of the same franchise brand. Survey invitation e-mails were sent out to the panels of a market research company and a total of 257 responses were used for analysis. Following the guidelines of Kano model, each of the twenty quality features was classified into one of the five types based on customers' responses to a set of questions: "(1) how do you feel if the following quality feature is fulfilled in the franchise restaurant that you visit," and "(2) how do you feel if the following quality feature is not fulfilled in the franchise restaurant that you visit." The analyses revealed that customers' dissatisfaction with franchisees is commonly associated with the poor level of cleanliness of the store (w=-0.872), kindness of the staffs(w=-0.890), conveniences such as parking lot and restroom(w=-0.669), and expertise of the staffs(w=-0.492). Such quality features were categorized as Must-be quality in this study. While standardization or uniformity across franchisees has been emphasized in franchise business, this study found that consumers are interested only in uniformity of price across franchisees(w=-0.608), but not interested in standardizations of menu items, interior designs, customer service procedures, and food tastes. Customers appeared to be more satisfied when the franchise brand has promotional events such as giveaways(b=0.767), good accessibility(b=0.699), customer loyalty programs(b=0.659), award winning history(b=0.641), and outlets in the overseas market(b=0.506). The results are summarized in a matrix form in Table 1. Better(b) and Worse(w) index indicate relative importance of each quality feature on customer satisfaction and dissatisfaction, respectively. Meanwhile, there were differences in perceiving the quality features between light users and heavy users of any specific franchise brand in the food service industry. Expertise of the staffs was labeled as Must-be quality for heavy users but Indifferent quality for light users. Light users seemed indifferent to overseas expansion of the brand and offering new menu items on a regular basis, while heavy users appeared to perceive them as Attractive quality. Such difference may come from their different levels of involvement when they eat out. The results are shown in Table 2. The findings of this study help practitioners understand the quality features they need to focus on to strengthen the competitive power in the food service market. Above all, removing the factors that cause customer dissatisfaction seems to be the most critical for franchisees. To retain loyal customers of the franchise brand, it is also recommended for franchisor to invest resources in the development of new menu items as well as training programs for the staffs. Lastly, if resources allow, promotional events, loyalty programs, overseas expansion, award-winning history can be considered as tools for attracting more customers to the business.

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    Comparative analysis of status of safety accidents and importance-performance analysis (IPA) about precautions of safety accidents by employment type of industry foodservices in Jeonbuk area (전북지역 산업체급식소 조리종사자의 고용형태에 따른 안전사고 실태 및 안전사고 예방관리에 대한 중요도와 수행도 분석)

    • So, Hee;Rho, Jeong Ok
      • Journal of Nutrition and Health
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      • v.50 no.4
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      • pp.402-414
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      • 2017
    • Purpose: The purpose of the study was to evaluate the status of safety accidents and importance-performance analysis (IPA) between regular and non-regular employees in industry foodservices. Methods: The participants were regular employees (n = 119) and non-regular employees (n = 163) in industry foodservices in the Jeonbuk area. Demographic characteristics, status of safety accidents, safety education, and importance and performance status were assessed using a self-administered questionnaire. Results: Approximately 66.4% of regular employees and 53.4% of non-regular employees experienced safety accidents (p < 0.05). Types of safety accidents of regular and non-regular employees were mostly burns, and causes were mostly from their own negligence. Approximately 98.3% of regular employees and 95.1% of non-regular employees experienced safety education. Approximately 88.9% of regular employees and 96.8% of non-regular employees received safety education from dietitians. Approximately 41.9% of regular employees and 50.0% of non-regular employees had difficulty applying the contents of safety education due to lack of time during work. As a result of IPA, regular and non-regular employees were aware of the importance of the following and performed them well: 'Clean the floor of the work place', 'Arrange in the work area', 'Wear safety shoes', 'Check for heater cord', and 'Safety cooking when using oil'. On the other hand, they were not aware of the importance of the following and performed them insufficiently: 'Check for the MSDS', 'Aware of chemical signs', 'Wear protection gloves etc.', 'Do stretching exercise', and 'Using ancillary tools'. Conclusion: Therefore, it is necessary to improve the consciousness of dietitians for effective application of safety education contents, development of contents, especially MSDS, and related things.

    Deep Neck Abscesses in Korean Children (소아 심부 경부 농양에 대한 임상적 고찰)

    • Lee, Dae Hyoung;Kim, Sun Mi;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kang, Jin Han
      • Pediatric Infection and Vaccine
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      • v.11 no.1
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      • pp.81-89
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      • 2004
    • Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

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    Recognition and attitude to functional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city (대구시 개원의사와 개국약사의 의약분업에 대한 인식과 태도)

    • Lee, Moo-Sik;Yoon, Nung-Ki;Suh, Suk-Kwon;Park, Jae-Yong
      • Journal of Preventive Medicine and Public Health
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      • v.26 no.1 s.41
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      • pp.1-19
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      • 1993
    • Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.

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    The Actual State and the Utilization for Dental Radiography in Korea (국내 치과방사선의 현황 및 이용 실태)

    • Shin, Gwi-Soon;Kim, You-Hyun;Lee, Bo-Ram;Kim, Se-Young;Lee, Gui-Won;Park, Chang-Seo;Park, Hyok;Chang, Kye-Yong
      • Journal of radiological science and technology
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      • v.33 no.2
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      • pp.109-120
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      • 2010
    • The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.

    Radiation Therapy Alone for Early Stage Non-small Cell Carcinoma of the Lung (초기 비소세포폐암의 방사선 단독치료)

    • Chun, Ha-Chung;Lee, Myung-Za
      • Radiation Oncology Journal
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      • v.20 no.4
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      • pp.323-327
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      • 2002
    • Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.

    Analysis of the Causes of Subfrontal Recurrence in Medulloblastoma and Its Salvage Treatment (수모세포종의 방사선치료 후 전두엽하방 재발된 환자에서 원인 분석 및 구제 치료)

    • Cho Jae Ho;Koom Woong Sub;Lee Chang Geol;Kim Kyoung Ju;Shim Su Jung;Bak Jino;Jeong Kyoungkeun;Kim Tae_Gon;Kim Dong Seok;Choi oong-Uhn;Suh Chang Ok
      • Radiation Oncology Journal
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      • v.22 no.3
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      • pp.165-176
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      • 2004
    • Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.

    Bladder Preserving Treatment in Patients with Muscle Invasive Bladder Cancer (근침윤성 방광암 환자의 방광 보존적 치료 결과)

    • Yu, Jeong-Il;Oh, Dong-Ryol;Huh, Seung-Jae;Choi, Han-Yong;Lee, Hyon-Moo;Jeon, Seong-Soo;Yim, Ho-Young;Kim, Won-Suk;Lim, Do-Hoon;Ahn, Yong-Chan;Park, Won
      • Radiation Oncology Journal
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      • v.25 no.2
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      • pp.70-78
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      • 2007
    • [ $\underline{Purpose}$ ]: This study analyzed the tumor response, overall survival, progression free survival and related prognostic factors in patients with muscle invasive bladder cancer subjected to bladder preserving treatment. $\underline{Materials\;and\;Methods}$: Between August 1995 and June 2004, 37 patients with muscle invasive (transitional cell carcinoma, clinically stage T2-4) bladder cancer were enrolled for the treatment protocol of bladder preservation. There were 33 males and 4 females, and the median age was 67 years (range $38{\sim}86\;years$). Transurethral resection of the bladder (TURB) was performed in 17 patients who underwent complete resection. The median radiation dose administered was 64.8 Gy (range $55.8{\sim}67\;Gy$). The survival rate was calculated by the Kaplan-Meier method. $\underline{Results}$: An evaluation of the response rate was determined by abdomen-pelvic CT and cystoscopy at three months after radiotherapy. A complete response was seen in 17 patients (46%). The survival rate at three years was 54.7%, with 54 months of median survival (range $3{\sim}91$ months). During the study, 17 patients died and 13 patients had died from bladder cancer. The progression free survival rate at three years was 37.2%. There were 24 patients (64.9%) who had disease recurrence: 16 patients (43.2%) had local recurrence, 6 patients (16.2%) had a distant recurrence, and 2 patients (5.4%) had both a local and distant recurrence. The survival rate (p=0.0009) and progression free survival rates (p=0.001) were statistically significant when compared to the response rate after radiotherapy. $\underline{Conclusion}$: The availability of complete TURB and appropriate chemoradiotherapy were important predictors for bladder preservation and survival.


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