• Journal of Intelligence and Information Systems
• /
• v.23 no.4
• /
• pp.127-146
• /
• 2017

Services using artificial intelligence have begun to emerge in daily life. Artificial intelligence is applied to products in consumer electronics and communications such as artificial intelligence refrigerators and speakers. In the financial sector, using Kensho's artificial intelligence technology, the process of the stock trading system in Goldman Sachs was improved. For example, two stock traders could handle the work of 600 stock traders and the analytical work for 15 people for 4weeks could be processed in 5 minutes. Especially, big data analysis through machine learning among artificial intelligence fields is actively applied throughout the financial industry. The stock market analysis and investment modeling through machine learning theory are also actively studied. The limits of linearity problem existing in financial time series studies are overcome by using machine learning theory such as artificial intelligence prediction model. The study of quantitative financial data based on the past stock market-related numerical data is widely performed using artificial intelligence to forecast future movements of stock price or indices. Various other studies have been conducted to predict the future direction of the market or the stock price of companies by learning based on a large amount of text data such as various news and comments related to the stock market. Investing on commodity asset, one of alternative assets, is usually used for enhancing the stability and safety of traditional stock and bond asset portfolio. There are relatively few researches on the investment model about commodity asset than mainstream assets like equity and bond. Recently machine learning techniques are widely applied on financial world, especially on stock and bond investment model and it makes better trading model on this field and makes the change on the whole financial area. In this study we made investment model using Support Vector Machine among the machine learning models. There are some researches on commodity asset focusing on the price prediction of the specific commodity but it is hard to find the researches about investment model of commodity as asset allocation using machine learning model. We propose a method of forecasting four major commodity indices, portfolio made of commodity futures, and individual commodity futures, using SVM model. The four major commodity indices are Goldman Sachs Commodity Index(GSCI), Dow Jones UBS Commodity Index(DJUI), Thomson Reuters/Core Commodity CRB Index(TRCI), and Rogers International Commodity Index(RI). We selected each two individual futures among three sectors as energy, agriculture, and metals that are actively traded on CME market and have enough liquidity. They are Crude Oil, Natural Gas, Corn, Wheat, Gold and Silver Futures. We made the equally weighted portfolio with six commodity futures for comparing with other commodity indices. We set the 19 macroeconomic indicators including stock market indices, exports & imports trade data, labor market data, and composite leading indicators as the input data of the model because commodity asset is very closely related with the macroeconomic activities. They are 14 US economic indicators, two Chinese economic indicators and two Korean economic indicators. Data period is from January 1990 to May 2017. We set the former 195 monthly data as training data and the latter 125 monthly data as test data. In this study, we verified that the performance of the equally weighted commodity futures portfolio rebalanced by the SVM model is better than that of other commodity indices. The prediction accuracy of the model for the commodity indices does not exceed 50% regardless of the SVM kernel function. On the other hand, the prediction accuracy of equally weighted commodity futures portfolio is 53%. The prediction accuracy of the individual commodity futures model is better than that of commodity indices model especially in agriculture and metal sectors. The individual commodity futures portfolio excluding the energy sector has outperformed the three sectors covered by individual commodity futures portfolio. In order to verify the validity of the model, it is judged that the analysis results should be similar despite variations in data period. So we also examined the odd numbered year data as training data and the even numbered year data as test data and we confirmed that the analysis results are similar. As a result, when we allocate commodity assets to traditional portfolio composed of stock, bond, and cash, we can get more effective investment performance not by investing commodity indices but by investing commodity futures. Especially we can get better performance by rebalanced commodity futures portfolio designed by SVM model.

• Journal of Yeungnam Medical Science
• /
• v.8 no.2
• /
• pp.185-201
• /
• 1991

A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

• Journal of Distribution Research
• /
• v.17 no.1
• /
• pp.87-115
• /
• 2012

Introduction: In these days, a loyalty program is one of the most common marketing mechanisms (Lacey & Sneath, 2006; Nues & Dreze, 2006; Uncles et al., 20003). In recent years, Coalition Loyalty Program is more noticeable as one of progressed forms. In the past, loyalty program was operating independently by single product brand or single retail channel brand. Now, companies using Coalition Loyalty Program share their programs as one single service and companies to participate to this program continue to have benefits from their existing program as well as positive spillover effect from the other participating network companies. Instead of consumers to earn or spend points from single retail channel or brand, consumers will have more opportunities to utilize their points and be able to purchase other participating companies products. Issues that are related to form of loyalty programs are essentially connected with consumers' perceived view on convenience of using its program. This can be a problem for distribution companies' strategic marketing plan. Although Coalition Loyalty Program is popular corporate marketing strategy to most companies, only few researches have been published. However, compared to independent loyalty program, coalition loyalty program operated by third parties of partnership has following conditions: Companies cannot autonomously modify structures of program for individual companies' benefits, and there is no guarantee to operate and to participate its program continuously by signing a contract. Thus, it is important to conduct the study on how coalition loyalty program affects companies' success and its process as much as conducting the study on effects of independent program. This study will complement the lack of coalition loyalty program study. The purpose of this study is to find out how consumer loyalty affects affiliated brands, its cause and mechanism. The past study about loyalty program only provided the variation of performance analysis, but this study will specifically focus on causes of results. In order to do these, this study is designed and to verify three primary objects as following; First, based on opinions of Switching Barriers (Fornell, 1992; Ping, 1993; Jones, et at., 2000) about causes of loyalty of coalition brand, 'brand attractiveness' and 'brand switching cost' are antecedents and causes of change in 'brand loyalty' will be investigated. Second, influence of consumers' perception and attitude prior to joining coalition loyalty program, influence of program in retail brands, brand attractiveness and spillover effect of switching cost after joining coalition program will be verified. Finally, the study will apply 'prior brand preference' as a variable and will provide a relationship between effects of coalition loyalty program and prior preference level. Hypothesis Hypothesis 1. After joining coalition loyalty program, more preferred brand (compared to less preferred brand) will increase influence on brand attractiveness to brand loyalty. Hypothesis 2. After joining coalition loyalty program, less preferred brand (compared to more preferred brand) will increase influence on brand switching cost to brand loyalty. Hypothesis 3. (1)Brand attractiveness and (2)brand switching cost of more preferred brand (before joining the coalition loyalty program) will influence more positive effects from (1)program attractiveness and (2)program switching cost of coalition loyalty program (after joining) than less preferred brand. Hypothesis 4. After joining coalition loyalty program, (1)brand attractiveness and (2)brand switching cost of more preferred brand will receive more positive impacts from (1)program attractiveness and (2)program switching cost of coalition loyalty program than less preferred brand. Hypothesis 5. After joining coalition loyalty program, (1)brand attractiveness and (2)brand switching cost of more preferred brand will receive less impacts from (1)brand attractiveness and (2)brand switching cost of different brands (having different preference level), which joined simultaneously, than less preferred brand. Method : In order to validate hypotheses, this study will apply experimental method throughout virtual scenario of coalition loyalty program if consumers have used or available for the actual brands. The experiment is conducted twice to participants. In a first experiment, the study will provide six coalition brands which are already selected based on prior research. The survey asked each brand attractiveness, switching cost, and loyalty after they choose high preference brand and low preference brand. One hour break was provided prior to the second experiment. In a second experiment, virtual coalition loyalty program "SaveBag" was introduced to participants. Participants were informed that "SaveBag" will be new alliance with six coalition brands from the first experiment. Brand attractiveness and switching cost about coalition program were measured and brand attractiveness and switching cost of high preference brand and low preference brand were measured as same method of first experiment. Limitation and future research This study shows limitations of effects of coalition loyalty program by using virtual scenario instead of actual research. Thus, future study should compare and analyze CLP panel data to provide more in-depth information. In addition, this study only proved the effectiveness of coalition loyalty program. However, there are two types of loyalty program, which are Single and Coalition, and success of coalition loyalty program will be dependent on market brand power and prior customer attitude. Therefore, it will be interesting to compare effects of two programs in the future.

• Journal of Distribution Research
• /
• v.17 no.1
• /
• pp.65-86
• /
• 2012

The $20^{th}$ century was the era of manufacturer brands which built higher brand equity for consumers. Consumers moved from generic products of inconsistent quality produced by local factories in the $19^{th}$ century to branded products from global manufacturers and manufacturer brands reached consumers through distributors and retailers. Retailers were relatively small compared to their largest suppliers. However, sometime in the 1970s, things began to slowly change as retailers started to develop their own national chains and began international expansion, and consolidation of the retail industry from mom-and-pop stores to global players was well under way (Kumar and Steenkamp 2007, p.2) In South Korea, since the middle of the 1990s, the bulking up of retailers that started then has changed the balance of power between manufacturers and retailers. Retailer private labels, generally referred to as own labels, store brands, distributors own private-label, home brand or own label brand have also been performing strongly in every single local market (Bushman 1993; De Wulf et al. 2005). Private labels now account for one out of every five items sold every day in U.S. supermarkets, drug chains, and mass merchandisers (Kumar and Steenkamp 2007), and the market share in Western Europe is even larger (Euromonitor 2007). In the UK, grocery market share of private labels grew from 39% of sales in 2008 to 41% in 2010 (Marian 2010). Planet Retail (2007, p.1) recently concluded that "[PLs] are set for accelerated growth, with the majority of the world's leading grocers increasing their own label penetration." Private labels have gained wide attention both in the academic literature and popular business press and there is a glowing academic research to the perspective of manufacturers and retailers. Empirical research on private labels has mainly studies the factors explaining private labels market shares across product categories and/or retail chains (Dahr and Hoch 1997; Hoch and Banerji, 1993), factors influencing the private labels proneness of consumers (Baltas and Doyle 1998; Burton et al. 1998; Richardson et al. 1996) and factors how to react brand manufacturers towards PLs (Dunne and Narasimhan 1999; Hoch 1996; Quelch and Harding 1996; Verhoef et al. 2000). Nevertheless, empirical research on factors influencing the production in terms of a manufacturer-retailer is rather anecdotal than theory-based. The objective of this paper is to bridge the gap in these two types of research and explore the factors which influence on manufacturer's private label production based on two competing theories: S-C-P (Structure - Conduct - Performance) paradigm and resource-based theory. In order to do so, the authors used in-depth interview with marketing managers, reviewed retail press and research and presents the conceptual framework that integrates the major determinants of private labels production. From a manufacturer's perspective, supplying private labels often starts on a strategic basis. When a manufacturer engages in private labels, the manufacturer does not have to spend on advertising, retailer promotions or maintain a dedicated sales force. Moreover, if a manufacturer has weak marketing capabilities, the manufacturer can make use of retailer's marketing capability to produce private labels and lessen its marketing cost and increases its profit margin. Figure 1. is the theoretical framework based on a strategic market management perspective, integrated concept of both S-C-P paradigm and resource-based theory. The model includes one mediate variable, marketing capabilities, and the other moderate variable, competitive intensity. Manufacturer's national brand reputation, firm's marketing investment, and product portfolio, which are hypothesized to positively affected manufacturer's marketing capabilities. Then, marketing capabilities has negatively effected on private label production. Moderating effects of competitive intensity are hypothesized on the relationship between marketing capabilities and private label production. To verify the proposed research model and hypotheses, data were collected from 192 manufacturers (212 responses) who are producing private labels in South Korea. Cronbach's alpha test, explanatory / comfirmatory factor analysis, and correlation analysis were employed to validate hypotheses. The following results were drawing using structural equation modeling and all hypotheses are supported. Findings indicate that manufacturer's private label production is strongly related to its marketing capabilities. Consumer marketing capabilities, in turn, is directly connected with the 3 strategic factors (e.g., marketing investment, manufacturer's national brand reputation, and product portfolio). It is moderated by competitive intensity between marketing capabilities and private label production. In conclusion, this research may be the first study to investigate the reasons manufacturers engage in private labels based on two competing theoretic views, S-C-P paradigm and resource-based theory. The private label phenomenon has received growing attention by marketing scholars. In many industries, private labels represent formidable competition to manufacturer brands and manufacturers have a dilemma with selling to as well as competing with their retailers. The current study suggests key factors when manufacturers consider engaging in private label production.

• Journal of Global Scholars of Marketing Science
• /
• v.18 no.4
• /
• pp.245-276
• /
• 2008

Brand equity is one of the most important concepts in business practice as well as in academic research. Successful brands can allow marketers to gain competitive advantage (Lassar et al.,1995), including the opportunity for successful extensions, resilience against competitors' promotional pressures, and the ability to create barriers to competitive entry (Farquhar, 1989). Branding plays a special role in service firms because strong brands increase trust in intangible products (Berry, 2000), enabling customers to better visualize and understand them. They reduce customers' perceived monetary, social, and safety risks in buying services, which are obstacles to evaluating a service correctly before purchase. Also, a high level of brand equity increases consumer satisfaction, repurchasing intent, and degree of loyalty. Brand equity can be considered as a mixture that includes both financial assets and relationships. Actually, brand equity can be viewed as the value added to the product (Keller, 1993), or the perceived value of the product in consumers' minds. Mahajan et al. (1990) claim that customer-based brand equity can be measured by the level of consumers' perceptions. Several researchers discuss brand equity based on two dimensions: consumer perception and consumer behavior. Aaker (1991) suggests measuring brand equity through price premium, loyalty, perceived quality, and brand associations. Viewing brand equity as the consumer's behavior toward a brand, Keller (1993) proposes similar dimensions: brand awareness and brand knowledge. Thus, past studies tend to identify brand equity as a multidimensional construct consisted of brand loyalty, brand awareness, brand knowledge, customer satisfaction, perceived equity, brand associations, and other proprietary assets (Aaker, 1991, 1996; Blackston, 1995; Cobb-Walgren et al., 1995; Na, 1995). Other studies tend to regard brand equity and other brand assets, such as brand knowledge, brand awareness, brand image, brand loyalty, perceived quality, and so on, as independent but related constructs (Keller, 1993; Kirmani and Zeithaml, 1993). Walters(1978) defined information search as, "A psychological or physical action a consumer takes in order to acquire information about a product or store." But, each consumer has different methods for informationsearch. There are two methods of information search, internal and external search. Internal search is, "Search of information already saved in the memory of the individual consumer"(Engel, Blackwell, 1982) which is, "memory of a previous purchase experience or information from a previous search."(Beales, Mazis, Salop, and Staelin, 1981). External search is "A completely voluntary decision made in order to obtain new information"(Engel & Blackwell, 1982) which is, "Actions of a consumer to acquire necessary information by such methods as intentionally exposing oneself to advertisements, taking to friends or family or visiting a store."(Beales, Mazis, Salop, and Staelin, 1981). There are many sources for consumers' information search including advertisement sources such as the internet, radio, television, newspapers and magazines, information supplied by businesses such as sales people, packaging and in-store information, consumer sources such as family, friends and colleagues, and mass media sources such as consumer protection agencies, government agencies and mass media sources. Understanding consumers' purchasing behavior is a key factor of a firm to attract and retain customers and improving the firm's prospects for survival and growth, and enhancing shareholder's value. Therefore, marketers should understand consumer as individual and market segment. One theory of consumer behavior supports the belief that individuals are rational. Individuals think and move through stages when making a purchase decision. This means that rational thinkers have led to the identification of a consumer buying decision process. This decision process with its different levels of involvement and influencing factors has been widely accepted and is fundamental to the understanding purchase intention represent to what consumers think they will buy. Brand equity is not only companies but also very important asset more than product itself. This paper studies brand equity model and influencing factors including information process such as information searching and information resources in the fashion market in Asia and Europe. Information searching and information resources are influencing brand knowledge that influences consumers purchase decision. Nine research hypotheses are drawn to test the relationships among antecedents of brand equity and purchase intention and relationships among brand knowledge, brand value, brand attitude, and brand loyalty. H1. Information searching influences brand knowledge positively. H2. Information sources influence brand knowledge positively. H3. Brand knowledge influences brand attitude. H4. Brand knowledge influences brand value. H5. Brand attitude influences brand loyalty. H6. Brand attitude influences brand value. H7. Brand loyalty influences purchase intention. H8. Brand value influence purchase intention. H9. There will be the same research model in Asia and Europe. We performed structural equation model analysis in order to test hypotheses suggested in this study. The model fitting index of the research model in Asia was $X^2$=195.19(p=0.0), NFI=0.90, NNFI=0.87, CFI=0.90, GFI=0.90, RMR=0.083, AGFI=0.85, which means the model fitting of the model is good enough. In Europe, it was $X^2$=133.25(p=0.0), NFI=0.81, NNFI=0.85, CFI=0.89, GFI=0.90, RMR=0.073, AGFI=0.85, which means the model fitting of the model is good enough. From the test results, hypotheses were accepted. All of these hypotheses except one are supported. In Europe, information search is not an antecedent of brand knowledge. This means that sales of global fashion brands like jeans in Europe are not expanding as rapidly as in Asian markets such as China, Japan, and South Korea. Young consumers in European countries are not more brand and fashion conscious than their counter partners in Asia. The results have theoretical, practical meaning and contributions. In the fashion jeans industry, relatively few studies examining the viability of cross-national brand equity has been studied. This study provides insight on building global brand equity and suggests information process elements like information search and information resources are working differently in Asia and Europe for fashion jean market.

• Journal of Distribution Research
• /
• v.17 no.3
• /
• pp.1-24
• /
• 2012

Franchises have recently emerged as the most rapidly expanding industry positioned to create a large impact in the domestic economic. The Chinese franchise industry developed rapidly in the period prior and subsequent to WTO accession with more than 50% of new franchises brands emerging since 2000. M&A transactions in the Chinese franchise industry have progressed actively. In the period from 2005-2007, due to the wholesale and retail market opening in accordance with the guidelines laid forth within the MOU by the WTO the Chinese franchise market is now the largest market in the world all despite a short history of only 20 years. The amount of franchise market research on China is disproportional to its current size and development potential. Beginning in the 1990s, market research conducted by the International Franchise Association focused on emerging markets in Eastern Europe and China. While the research dealt with the Chinese investment environment, it insufficiently explained the market region and cultural environment. The purpose of this research is (i) to investigate the determinants of the performance of franchise systems in China and (ii) new contract renewals based on performance factors. This study will complement existing research in terms of the franchisee perspective. This study may also prove of the benefit to the franchise companies entering the Chinese franchise market enabling them to develop an effective strategy. This study shows that support, incentives, and system standardization by franchisor yielded a positive effect on management performance. This is consistent with previous studies by Shin (2000) and Kim (2008) targeting Korean franchises. Therefore, in the Chinese market, the franchisor must focus on support, incentives, and system standardization rather than concentrate only on the recruitment of franchisees in order to improve revenue. Hypotheses regarding franchisor control have been dismissed in existing research, in the opinion of this study, due to their complexity and inability to control the merchant as a one-kind-assessment-standard. Our findings show that the franchisees' financial condition, management ability and entrepreneurial spirit, among franchisee's characteristics, have a positive effect on franchisor's business performance and satisfaction for the franchisee. This is consistent with previous studies on headquarters' management performance of Lussier (1996), Heo and Jang (2008), and franchisees' financial condition, management ability and entrepreneurial spirit effect on franchisor's satisfaction of Weaven and Franzer (2007), Kim (2009), Han (2009), and Yoon etc. (2008). Therefore, when permitting a franchisee, financial condition, management ability, entrepreneurship of the franchisee should be carefully considered. Among relational factors between franchisor and franchisee, trust has the positive influence on the management performance of the franchisor while conflict has a negative effect. However, trust, commitment and conflict factors have been shown not to have any impact on the satisfaction of the franchise headquarters. This result is consistent with the previous studies of Pavlou and Ba (2000), Morrison (1999), Weaven and Frazer (2007), Kim and Park (1994), Sohn (2007) which show that trust between franchisor and the franchisees have a positive effect and that conflict has a negative impact on franchisor's management performance. Other factors causing a negative effective on the franchisor's management performance are a rapid environmental changes and uncertainty in the business. This is consistent with Campbell et al (2007), Kim and Kim (2009), Han and Baek (2008). Finally, the high management performance and satisfaction of the franchise headquarters has a positive effect on the intention of franchise renewal. In the case of large markets such as China, the franchisor's strategy and the role is very important. In this study, we also investigated the characteristics of franchisor and franchisee, relationship, and environmental uncertainty affecting on the management performance and satisfaction of franchisor. Recently, Korean franchises are attempting to enter foreign markets through the rise in popularity of Korean culture and entertainment commonly referred to as the Korean wave. This study provides recommendations for Korean franchises intending on entering the Chinese market. First, in order to achieve stable profits, the franchise corporation needs to support the operation of the individual franchisee through incentives and standardization of services. Second, because trust between the franchisor and franchisee has a positive effect on management performance, on-going discussion and cooperation is necessary to reduce the level of conflict.

• Korean Journal of Weed Science
• /
• v.10 no.4
• /
• pp.294-304
• /
• 1990

For the survey of weed distribution in the cultivated upland of Korea, weed species were investigated at 2 field by crop of 2 myon per kun in 81 kun selected among the 139 kun of the whole country. 232 species in 46 families were observed, totally. From among the result, 165 species in 39 families the in winter crop field, 189 species in 41 families in the summer crop field were classified. 122 species in 34 families were emerged the from the upland crop field of the whole season. Further more, in the 10 dominant weed species which emerged from upland crop field, Alopecurus aequalis, Chenopodium album, slellaria media, Galium spurieum, Capsella bursa-pastoris and Rorippa islandica were dominated in the winter upland and paddy field, and that Erigeron canadensis, Cyperus amuricus, Equisetum arvense and Arenaria serpyllifolia were dominated in the winter upland field, additionally. Stellaria alsine, Bothriospermum tenellum, Trigonotis peduncularis and Polygonum arviculare were dominated in the winter cropping on drained paddy field, additionally. In the summer crop field, Digitaria sanguinalis, Portulaca oleracea, Acalypha australis, Echinochloa crus-galli, Setaria viridis, Persicaria hydropiper, Amaranthus lividus, commelina communis, Chenopodium album and Cyperecs amuricus were dominated.

• Radiation Oncology Journal
• /
• v.17 no.3
• /
• pp.209-216
• /
• 1999

Purpose : To evaluate the effectiveness of external radiation therapy and the prognostic factors, we retrospectively analyzed therapeutic results of malignant extrahepatic biliary obstruction (EHBO). Methods and Materials : We analyzed the results of the external radiation therapy in 59 patients of inoperable malignant EHBO who had been treated with more than 10 Gy of external radiation therapy from April 1984 to December 1990. There were 21 stomach cancer ($35.6\%$), 12 pancreas cancer ($20.3\%$), 15 extrahepatic biliary cancer ($18.0\%$) and 11 another cancer ($18.0\%$). Their pathologies were confirmed in 31 patients ($52.5\%$). They divided into 27 adenocarcinoma and 4 nonadenocarcinoma. Their chief complaints were jaundice in 47 patients ($79.7\%$) and abdominal pain in 15 patients ($49.2\%$). Twelve patients had slightly increased bilirubin level in liver function test without jaundice. We treated twenty four patients ($40.6\%$) with percutaneous transhepatic biliary drainage (PTBD) and 32 patients ($54\%$) with systemic chemotherapy (CT). We performed external radiation therapy (ERT) upto $10.8\~55.8$ Gy (median 37.8 Gy) with palliative aim. Results : Overall median survival duration was $7.80\pm1.15$ months. The response rates of jaundice were $81.8\%$ in PTBO group and $66.7\%$ in non-PTBD group without statistical significance. The improving rate of jaundice was not significantly different in decreased ratio of total bilirubin level. But abdominal pain was more decreased in CT group than non-CT group (p<0.05). The significant prognostic factors were high performance status (Karnofski Performance Status >70), total radiation dose more than 35 Gy and good response of pain after therapy. There were increased in bacterial cholagitis in PTBD group and gastrointestinal complications in CT group. Conclusion : External radiotheapy could improve jaundice and abdominal pain in malignant EHBO patients, Overall survival duration was prolonged in patients with higher performance status and patients who had been treated with more than 35 Gy of total radiation dose. In the future, we expect not only better palliative role but also the prolongation of survival of using the ERT combined with other treatment method. But to achieve certain conclusion, we need luther study consisted with many kinds of treatment methods including new technologies in RT.

• Radiation Oncology Journal
• /
• v.17 no.3
• /
• pp.217-222
• /
• 1999

Purpose : To evaluate prognostic factors and survival rates of the patients who received radiation therapy for locally recurrent uterine cervical cancer after curative surgery. Materials and Methods : Between October 1983 and July 1990, fifty three patients who received radiation therapy for locally recurrent cervical cancer after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea were analysed retrospectively. Age at diagnosis ranged from 33 to 69 years (median 53 years). Pathological analysis showed that forty five ($84.9\%$) patients had squamous cell carcinoma, seven ($13.2\%$) patients had adenocarcinoma, and one (1.9%) patient had adenosquamous cell carcinoma. The interval between hysterectomy and tumor recurrence ranged from 2 months to 25 years (mean 34.4 months). The recurrent sites were vaginal stump in 41 patients ($77.4\%$) and pelvic side wall in 12 patients ($22.6\%$). Recurrent tumor size was devided into two groups : less than 3 cm in 43 patients ($81.1\%$) and more than 3 cm in 10 patients ($18.9\%$). External beam irradiation of whole pelvis was done first up to 46.8 Gy to 50.4 Gy in 5 weeks to 6 weeks, followed by either external beam boost to the recurrent site in 18 patients ($34\%$) or intracavitary irradiation in 24 patients ($45.3\%$). Total dose of radiation ranged from 46.8 Gy to 111 Gy (median 70.2 Gy). Follow up period ranged from 2 to 153 months with a median of 35 months. Results : Overall response rate was $66\%$ (35/53). Among them, six patients ($17.1\%$) relapsed between 7 months and 116 months after radiation therapy (mean 47.7 months), Therefore overall recurrence rate was $45.3\%$. Overall five-year actuarial survival rate was $78.9\%$ and distant failure rate was $10\%$ (5/50). The significant prognostic factors affecting survival rate were interval between primary surgery and tumor recurrence (p=0.0055), recurrent tumor size (p=0.0039), and initial response to radiation therapy (p=0.0428). Complications were observed in 10 ($20/%$) patients, which included mild to moderate lower gastrointestinal, genitourinary, or skin manifestations. One patient died of pulmonary embolism just after intracavitary irradiation. Conclustion : Radiation therapy is the effective treatment for the patients with locally recurrent cervical cancer after curative surgery. These results suggest that interval between primary surgery and tumor recurrence, recurrent tumor size, and initial response to radiation therapy were significant prognostic factors for recurrent cervical cancer.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.3
• /
• pp.357-363
• /
• 1994

We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.