• Radiation Oncology Journal
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• v.23 no.3
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• pp.143-156
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• 2005

Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

• Journal of Global Scholars of Marketing Science
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• v.18 no.4
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• pp.157-194
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• 2008

The popularity of communities on the internet has captured the attention of marketing scholars and practitioners. By adapting to the culture of the internet, however, and providing consumer with the ability to interact with one another in addition to the company, businesses can build new and deeper relationships with customers. The economic potential of online communities has been discussed with much hope in the many popular papers. In contrast to this enthusiastic prognostications, empirical and practical evidence regarding the economic potential of the online community has shown a little different conclusion. To date, even communities with high levels of membership and vibrant social arenas have failed to build financial viability. In this perspective, this study investigates the role of various kinds of influencing factors to online community loyalty and basically suggests the framework that explains the process of building purchase loyalty. Even though the importance of building loyalty in an online environment has been emphasized from the marketing theorists and practitioners, there is no sufficient research conclusion about what is the process of building purchase loyalty and the most powerful factors that influence to it. In this study, the process of building purchase loyalty is divided into three levels; characteristics of community site such as content superiority, site vividness, navigation easiness, and customerization, the mediating variables such as self congruency, consumer experience, and consumer to consumer interactivity, and finally various factors about online community loyalty such as visit loyalty, affect, trust, and purchase loyalty are those things. And the findings of this research are as follows. First, consumer-to-consumer interactivity is an important factor to online community purchase loyalty and other loyalty factors. This means, in order to interact with other people more actively, many participants in online community have the willingness to buy some kinds of products such as music, content, avatar, and etc. From this perspective, marketers of online community have to create some online environments in order that consumers can easily interact with other consumers and make some site environments in order that consumer can feel experience in this site is interesting and self congruency is higher than at other community sites. It has been argued that giving consumers a good experience is vital in cyber space, and websites create an active (rather than passive) customer by their nature. Some researchers have tried to pin down the positive experience, with limited success and less empirical support. Web sites can provide a cognitively stimulating experience for the user. We define the online community experience as playfulness based on the past studies. Playfulness is created by the excitement generated through a website's content and measured using three descriptors Marketers can promote using and visiting online communities, which deliver a superior web experience, to influence their customers' attitudes and actions, encouraging high involvement with those communities. Specially, we suggest that transcendent customer experiences(TCEs) which have aspects of flow and/or peak experience, can generate lasting shifts in beliefs and attitudes including subjective self-transformation and facilitate strong consumer's ties to a online community. And we find that website success is closely related to positive website experiences: consumers will spend more time on the site, interacting with other users. As we can see figure 2, visit loyalty and consumer affect toward the online community site didn't directly influence to purchase loyalty. This implies that there may be a little different situations here in online community site compared to online shopping mall studies that shows close relations between revisit intention and purchase intention. There are so many alternative sites on web, consumers do not want to spend money to buy content and etc. In this sense, marketers of community websites must know consumers' affect toward online community site is not a last goal and important factor to influnece consumers' purchase. Third, building good content environment can be a really important marketing tool to create a competitive advantage in cyberspace. For example, Cyworld, Korea's number one community site shows distinctive superiority in the consumer evaluations of content characteristics such as content superiority, site vividness, and customerization. Particularly, comsumer evaluation about customerization was remarkably higher than the other sites. In this point, we can conclude that providing comsumers with good, unique and highly customized content will be urgent and important task directly and indirectly impacting to self congruency, consumer experience, c-to-c interactivity, and various loyalty factors of online community. By creating enjoyable, useful, and unique online community environments, online community portals such as Daum, Naver, and Cyworld are able to build customer loyalty to a degree that many of today's online marketer can only dream of these loyalty, in turn, generates strong economic returns. Another way to build good online community site is to provide consumers with an interactive, fun, experience-oriented or experiential Web site. Elements that can make a dot.com's Web site experiential include graphics, 3-D images, animation, video and audio capabilities. In addition, chat rooms and real-time customer service applications (which link site visitors directly to other visitors, or with company support personnel, respectively) are also being used to make web sites more interactive. Researchers note that online communities are increasingly incorporating such applications in their Web sites, in order to make consumers' online shopping experience more similar to that of an offline store. That is, if consumers are able to experience sensory stimulation (e.g. via 3-D images and audio sound), interact with other consumers (e.g., via chat rooms), and interact with sales or support people (e.g. via a real-time chat interface or e-mail), then they are likely to have a more positive dot.com experience, and develop a more positive image toward the online company itself). Analysts caution, however, that, while high quality graphics, animation and the like may create a fun experience for consumers, when heavily used, they can slow site navigation, resulting in frustrated consumers, who may never return to a site. Consequently, some analysts suggest that, at least with current technology, the rule-of-thumb is that less is more. That is, while graphics etc. can draw consumers to a site, they should be kept to a minimum, so as not to impact negatively on consumers' overall site experience.

• Applied Biological Chemistry
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• v.11
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• pp.1-27
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• 1969

More than thirty kinds of sea food pickles have been eaten in Korea. Out of these salted yellow tail pickle, salted clam pickle, salted oyster pickle, and salted cuttlefish pickle were employed for the analysis of their components, identification of main fermenting microbes, and determination of enzyme characteristics concerned. Also studied was the effect of enzymic action of microbes, which are concerned with the fermenting of pickles, on the production of flavorous 5'-mononucleotides and amino acids. The results are summarized as follows: 1. Microflora observed in the pickles are: (a) Total count of viable cells after 1-2 months of pickling was found to be $10^7$ and that after 6 months decreased to $10^4$. (b) Microbial occurence in the early stage of pickling was observed to be 10-20% Micrococcus spp., 10-20% Brevibacterium spp., 0-30% Sarcina spp., 20-30% Leuconostoc spp., ca 30% Bacillus spp., 0-10% Pseudomonas spp., 0-10% Flavobacterium spp., and 0-20% yeast. (c) Following the early stage of pickling, mainly halophilic bacteria such as Bacillus subtilis, Leuconostoc mesenteroides, Pediococcus halophilus and Sarcina litoralis, were found to exhibit an effect on the fermentation of pickle and their enzyme activities were in direct concern in fermentation of pickles. (d) Among the bacteria participating in the fermentation, Sarcina litoralis 8-14 and 8-16 strains were in need of high nutritional requirement and the former was grown only in the presence of purine, pyrimidine and cystine and the latter purine, pyrimidine and glutamic acid. 2. Enzyme characteristics studied in relation to the raw materials and the concerned microbes isolated are as follows: (a) A small amount of protease was found in the raw materials and 30-60% decrease in protease activity was demonstrated at 7% salt concentration. (b) Protease activity of halophilic bacteria, Bacillus subtilis 7-6, 11-1, 3-6 and 9-4 strains, in the complete media decreased by 10-30% at the 7% salt concentration and that of Sarcina litoralis 8-14 and 8-16 strains decreased by 10-20%. (c) Proteins in the raw materials were found to be hydrolyzed to yield free amino acids by protease in the fermenting microbes. (d) No accumulation of flavorous 5'-mononucleotides was demonstrated because RNA-depolymerase in the raw materials and the pickles tended to decompose RNA into nucleoside and phosphoric acid. (e) The enzyme produced in Bacillus subtilis 3-6 strain isolated from the salted clam pickles, was ascertained to be 5'-phosphodiesterase because of its ability to decompose RNA and thus accumulating 5'-mononucleotide. (f) It was demonstrated that the activity of phosphodiesterase in Bacillus subtilis 3-6 strain was enhanced by some components in the corn steep liquor and salted clam pickle. The enzyme activity was found to decrease by 10-30% and 40-60% at the salt concentration of 10% and 20%, respectively. 3. Quantitative data for free amino acids in the pickles are as follows: (a) Amounts of acidic amino acids such as glutamic and aspartic acids in salted clam pickle, were observed to be 2-10 times other pickles and it is considered that the abundance in these amino acids may contribute significantly to the specific flavor of this food. (b) Large amounts of basic amino acids such as arginine and histidine were found to occur in salted yellow tail pickle. (c) It is much interesting that in the salted cuttlefish pickle the contents of sulfur-containing amino acids were exceedingly high compared with those of others: cystine was found to be 17-130 times and methionine, 7-19 times. (d) In the salted oyster pickle a high content of some essential amino acids such as lysine, threonine, isoleucine and leucine, was demonstrated and a specific flavor of the pickle was ascribed to the sweet amino acids. Contents of alanine and glycine in the salted oyster pickle were 4 and 3-14 times as much as those of the others respectively. 4. Analytical data for 5'-mononucleotides in the pickles are as follows: (a) 5'-Adenylic acid and 3'-adenylic acid were found in large amounts in the salted yellow tail pickle and 5'-inosinic acid in lesser amount. (b) 5'-Adenylic acid, especially 3'-adenylic acid predominated in amount in the salted oyster pickle over that in the other pickles. (c) The salted cuttlefish pickle was found to contain only 5'-adenylic acid and 3'-adenylic acid. It has become evident from the above fact that clam and the invertebrate lack of adenylic deaminase and contain high content of adenylic acid. Thus, they were demonstrated to be the AMP-type. (d) 5'-Inosinic acid was contained in the salted yellow tail pickle in a significant concentration, and it might be considered to be IMP-type. 5. Comparative data for flavor with regard to the flavorous amino acids and the contents of 5'-mononucleotides are: (a) A specific flavor of salted yellow tail pickle was ascribed to the abundance in glutamic acid and aspartic acid, and to the existence of a small amount of flavorous 5'-inosinic acid. The combined effect of these components was belived to exhibit a synergistic action in producing a specific fiavor to the pickle. (b) A specific flavor of salted clam pickle has been demonstrated to be attributable to the richness in glutamic acid and aspartic acid rather than to that of 5'-mononucleotides.