Pre-operative Concurrent Chemoradiotherapy for Stage IlIA (N2) Non-Small Cell Lung Cancer (N2 병기 비소세포 폐암의 수술 전 동시화학방사선요법)
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- Radiation Oncology Journal
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- v.17 no.2
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- pp.100-107
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- 1999
Purpose: This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Materials and Methods Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45~67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in T2, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal Iymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intravenous cis-Platin (100 mg/m
These studies were made at Suwon in 1972 and at Suwon, Iri, and Kwangju in 1973 to investigate grain filling process and variation of grain quality of NB 68513 and Caprock as hard red winter wheat, Suke ＃169 as soft red winter wheat variety and Yungkwang as semi-hard winter variety, grown under-three different fertilizer levels and seeding dates. Other experiments were conducted to find the effects of temperature, humidity and light intensity on the grain filling process and grain quality of Yungkwang and NB 68513 wheat varieties. These, experiments were conducted at Suwon in 1973 and 1974. 1. Grain filling process of wheat cultivars: 1) The frequency distribution of a grain weight shows that wider distribution of grain weight was associated with large grain groups rather than small grain group. In the large grain groups, the frequency was mostly concentrated near mean value, while the frequency was dispersed over the values in the small grain group. 2) The grain weight was more affected by the grain thickness and width than by grain length. 3) The grain weight during the ripening period was rapidly increased from 14 days after flowering to 35 days in Yungkwang and from 14 days after flowering to 28 days in NB 68513. The large grain group, Yungkwang was rather slowly increased and took a longer period in increase of endosperm ratio of grain than the small grain group, NB 68513. 4) In general, the 1, 000 grain weight was reduced under high temperature, low humidity, while it was increased under low temperature and high humidity condition, and under high temperature and humidity condition. The effect of shading on grain weight was greater in high temperature than in low temperature condition and no definite tendency was found in high humidity condition. 5) The effects of temperature, humidity and shading on 1, 000 grain weight were greater in large-grain group, Yungkwang than in small grain group, NB 68513. Highly significant positive correlation was found between 1, 000 grain weight and days to ripening. 6) The 1, 000 grain weight and test weight were increased more or less as the fertilizer levels applied were increased. However, the rate of increasing 1, 000 grain weight was low when fertilizer levels were increased from standard to double. The 1, 000 grain weight was high when planted early. Such tendency was greater in Suwon than in Kwangju or Iri area. 2. Milling quality: 7) The milling rate in a same group of varieties was higher under the condition of low temperature, high humidity and early maturing culture which were responsible for increasing 1, 000 grain weight. No definite relations were found along with locations. 8) In the varieties tested, the higher milling rate was found in large grain variety, Yungkwang, and the lowest milling rate was obtained from Suke ＃ 169, the small grain variety. But the small grained hard wheat variety such as Caprock and NB 68513 showed higher milling rate compared with the soft wheat variety, Suke ＃ 169. 9) There were no great differences of ash content due to location, fertilizer level and seeding date while remarkable differences due to variety were found. The ash content was high in the hard wheat varieties such as NB 68513, Caprock and low in soft wheat varieties such as Yungkwang and Suke ＃ 169. 3. Protein content: 10) The protein content was increased under the condition of high temperature, low humidity and shading, which were responsible for reduction of 1, 000 grain weight. The varietal differences of protein content due to high temperature, low humidity and shading conditions were greater in Yungkwang than in NB 68513. 11) The high content of protein in grain within one to two weeks after flowering might be due to the high ratio of pericarp and embryo to endosperm. As grains ripen, the effects of embryo and pericarp on protein content were decreased, reducing protein content. However, the protein content was getting increased from three or four weeks after flowering, and maximized at seven weeks after flowering. The protein content of grain at three to four weeks after flowering increased as the increase of 1, 000 grain weight. But the protein content of matured grain appeared to be affected by daily temperature on calender rather than by duration of ripening period. 12) Highly significant positive correlation value was found between the grain protein content and flour protein content. 13) The protein content was increased under the high level of fertilizers and late seeding. The local differences of protein content were greater in Suwon than in Kwangju and Iri. 14) Protein content in the varieties tested were high in Yungkwang, NB 68513 and Caprock, and low in Suke ＃ 169. However, variation in protein content due to the cultural methods was low in Suke ＃ 169. 15) Protein yield per unit area was increased in accordance with increase of fertilizer levels and early maturing culture. However, nitrogen fertilizer was utilized rather effectively in early maturing culture and Yungkwang was the highest in protein yield per unit area. 4. Physio-chemical properties of wheat flour: 16) Sedimentation value was higher under the conditions of high temperature, low humidity and high levels of fertilizers than under the conditions of low temperature, high moisture and low levels of fertilizers. Such differences of sedimentation values were more apparent in NB 68513 and Caprock than Yungkwang and Suke ＃ 169. The local difference of sedimentation value was greater in Suwon than in Kwangju and Iri. Even though the sedimentation value was highly correlated with protein content of grain, the high humidity was considered one of the factors affecting sedimentation value. 17) Changes of Pelshenke values due to the differences of cultural practices and locations were generally coincident with sedimentation values. 18) The mixing time required for mixogram was four to six minutes in NB 68513, five to seven minutes in Cap rock. The great variation of mixing time for Yungkwang and Suke ＃ 169 due to location and planting conditions was found. The mixing height and area were high in hard wheat than in soft wheat. Variation of protein content due to cultural methods were inconsistent. However, the pattern of mixogram were very much same regardless the treatments applied. With this regard, it could be concluded that the mixogram is a kind of method expressing the specific character of the variety. 19) Even though the milling property of NB 68513 and Caprock was deteriorated under either high temperature and low humidity of high fertilizer levels and late seeding conditions, baking quality was better due to improved physio-chemical properties of flour. In contrast, early maturing culture deteriorated physio-chemical properties, milling property of grain and grain protein yield per unit area was increased. However, it might be concluded that the hard wheat production of NB 68513 and Caprock for baking purpose could be done better in Suwon than in Iri or Kwangju area. 5. Interrelationships between the physio-chemical characters of wheat flour: 20) Physio-chemical properties of flour didn't have direct relationship with milling rate and ash content. Low grain weight produced high protein content and better physio-chemical flour properties. 21) In hard wheat varieties like NB 68513 and Caprock, protein content was significantly correlated with sedimentation value, Pelshenke value and mixing height. However, gluten strength and baking quality were improved by the increased protein content. In Yungkwang and Suk ＃ 169, protein content was correlated with sedimentation value, but no correlations were found with Pelshenke value and mixing height. Consequently, increase of protein content didn't improve the gluten strength in soft wheat. 22) The highly significant relationships between protein content and gluten strength and sedimentation . value, and between Pelshenke value, mixogram and gluten strength indicated that the determination of mixogram and Pelshenke value are useful for de terming soft and hard type of varieties. Determination of sedimentation value is considered useful method for quality evaluation of wheat grain under different cultural practices.
Trust has been studied extensively in psychology, economics, and sociology, and its importance has been emphasized not only in marketing, but also in business disciplines in general. Unlike past relationships between suppliers and buyers, which take considerable advantage of private networks and may involve unethical business practices, partnerships between suppliers and buyers are at the core of success for industrial marketing amid intense global competition in the 21st century. A high level of mutual cooperation occurs through an exchange relationship based on trust, which brings long-term benefits, competitive enhancements, and transaction cost reductions, among other benefits, for both buyers and suppliers. In spite of the important role of trust, existing studies in buy-supply situations overlook the role of trust and do not systematically analyze the effect of trust on relational performance. Consequently, an in-depth study that determines the relation of trust to the relational performance between buyers and suppliers of business services is absolutely needed. Business services in this study, which include those supporting the manufacturing industry, are drawing attention as the economic growth engine for the next generation. The Korean government has selected business services as a strategic area for the development of manufacturing sectors. Since the demands for opening business services markets are becoming fiercer, the competitiveness of the business service industry must be promoted now more than ever. The purpose of this study is to investigate the effect of the mutual trust between buyers and suppliers on relational performance. Specifically, this study proposed a theoretical model of trust-relational performance in the transactions of business services and empirically tested the hypotheses delineated from the framework. The study suggests strategic implications based on research findings. Empirical data were collected via multiple methods, including via telephone, mail, and in-person interviews. Sample companies were knowledge-based companies supplying and purchasing business services in Korea. The present study collected data on a dyadic basis. Each pair of sample companies includes a buying company and its corresponding supplying company. Mutual trust was traced for each pair of companies. This study proposes a model of trust-relational performance of buying-supplying for business services. The model consists of trust and its antecedents and consequences. The trust of buyers is classified into trust toward the supplying company and trust toward salespersons. Viewing trust both at the individual level and the organizational level is based on the research of Doney and Cannon (1997). Normally, buyers are the subject of trust, but this study supposes that suppliers are the subjects. Hence, it uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers, like buyers, are the subject of trust since transactions are normally bilateral. From this point of view, suppliers' trust in buyers is as important as buyers' trust in suppliers. The suppliers' trust is influenced by the extent to which it trusts the buying companies and the buyers. This classification of trust using an individual level and an organization level is based on the suggestion of Doney and Cannon (1997). Trust affects the process of supplier selection, which works in a bilateral manner. Suppliers are actively involved in the supplier selection process, working very closely with buyers. In addition, the process is affected by the extent to which each party trusts its partners. The selection process consists of certain steps: recognition, information search, supplier selection, and performance evaluation. As a result of the process, both buyers and suppliers evaluate the performance and take corrective actions on the basis of such outcomes as tangible, intangible, and/or side effects. The measurement of trust used for the present study was developed on the basis of the studies of Mayer, Davis and Schoorman (1995) and Mayer and Davis (1999). Based on their recommendations, the three dimensions of trust used for the study include ability, benevolence, and integrity. The original questions were adjusted to the context of the transactions of business services. For example, a question such as "He/she has professional capabilities" has been changed to "The salesperson showed professional capabilities while we talked about our products." The measurement used for this study differs from those used in previous studies (Rotter 1967; Sullivan and Peterson 1982; Dwyer and Oh 1987). The measurements of the antecedents and consequences of trust used for this study were developed on the basis of Doney and Cannon (1997). The original questions were adjusted to the context of transactions in business services. In particular, questions were developed for both buyers and suppliers to address the following factors: reputation (integrity, customer care, good-will), market standing (company size, market share, positioning in the industry), willingness to customize (product, process, delivery), information sharing (proprietary information, private information), willingness to maintain relationships, perceived professionalism, authority empowerment, buyer-seller similarity, and contact frequency. As a consequential variable of trust, relational performance was measured. Relational performance is classified into tangible effects, intangible effects, and side effects. Tangible effects include financial performance; intangible effects include improvements in relations, network developing, and internal employee satisfaction; side effects include those not included either in the tangible or intangible effects. Three hundred fifty pairs of companies were contacted, and one hundred five pairs of companies responded. After deleting five company pairs because of incomplete responses, one hundred five pairs of companies were used for data analysis. The response ratio of the companies used for data analysis is 30% (105/350), which is above the average response ratio in industrial marketing research. As for the characteristics of the respondent companies, the majority of the companies operate service businesses for both buyers (85.4%) and suppliers (81.8%). The majority of buyers (76%) deal with consumer goods, while the majority of suppliers (70%) deal with industrial goods. This may imply that buyers process the incoming material, parts, and components to produce the finished consumer goods. As indicated by their report of the length of acquaintance with their partners, suppliers appear to have longer business relationships than do buyers. Hypothesis 1 tested the effects of buyer-supplier characteristics on trust. The salesperson's professionalism (t=2.070, p<0.05) and authority empowerment (t=2.328, p<0.05) positively affected buyers' trust toward suppliers. On the other hand, authority empowerment (t=2.192, p<0.05) positively affected supplier trust toward buyers. For both buyers and suppliers, the degree of authority empowerment plays a crucial role in the maintenance of their trust in each other. Hypothesis 2 tested the effects of buyerseller relational characteristics on trust. Buyers tend to trust suppliers, as suppliers make every effort to contact buyers (t=2.212, p<0.05). This tendency has also been shown to be much stronger for suppliers (t=2.591, p<0.01). On the other hand suppliers trust buyers because suppliers perceive buyers as being similar to themselves (t=2.702, p<0.01). This finding confirmed the results of Crosby, Evans, and Cowles (1990), which reported that suppliers and buyers build relationships through regular meetings, either for business or personal matters. Hypothesis 3 tested the effects of trust on perceived risk. It has been found that for both suppliers and buyers the lower is the trust, the higher is the perceived risk (t=-6.621, p<0.01 for buyers; t=-2.437, p<0.05). Interestingly, this tendency has been shown to be much stronger for buyers than for suppliers. One possible explanation for this higher level of perceived risk is that buyers normally perceive higher risks than do suppliers in transactions involving business services. For this reason, it is necessary for suppliers to implement risk reduction strategies for buyers. Hypothesis 4 tested the effects of trust on information searching. It has been found that for both suppliers and buyers, contrary to expectation, trust depends on their partner's reputation (t=2.929, p<0.01 for buyers; t=2.711, p<0.05 for suppliers). This finding shows that suppliers with good reputations tend to be trusted. Prior experience did not show any significant relationship with trust for either buyers or suppliers. Hypothesis 5 tested the effects of trust on supplier/buyer selection. Unlike buyers, suppliers tend to trust buyers when they think that previous transactions with buyers were important (t=2.913 p<0.01). However, this study did not show any significant relationship between source loyalty and the trust of buyers in suppliers. Hypothesis 6 tested the effects of trust on relational performances. For buyers and suppliers, financial performance reportedly improved when they trusted their partners (t=2.301, p<0.05 for buyers; t=3.692, p<0.01 for suppliers). It is interesting that this tendency was much stronger for suppliers than it was for buyers. Similarly, competitiveness was reported to improve when buyers and suppliers trusted their partners (t=3.563, p<0.01 for buyers; t=3.042, p<0.01 for suppliers). For suppliers, efficiency and productivity were reportedly improved when they trusted buyers (t=2.673, p<0.01). Other performance indices showed insignificant relationships with trust. The findings of this study have some strategic implications. First and most importantly, trust-based transactions are beneficial for both suppliers and buyers. As verified in the study, financial performance can be improved through efforts to build and maintain mutual trust. Similarly, competitiveness can be increased through the same kinds of effort. Second, trust-based transactions can facilitate the reduction of perceived risks inherent in the purchasing situation. This finding has implications for both suppliers and buyers. It is generally believed that buyers perceive higher risks in a highly involved purchasing situation. To reduce risks, previous studies have recommended that suppliers devise risk-reducing tactics. Moving beyond these recommendations, the present study uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers are also susceptible to perceived risks, especially when they supply services that require very technical and sophisticated manipulations and maintenance. Consequently, buyers and suppliers must solve problems together in close collaboration. Hence, mutual trust plays a crucial role in the problem-solving process. Third, as found in this study, the more authority a salesperson has, the more he or she can be trusted. This finding is very important with regard to tactics. Building trust is a long-term assignment; however, when mutual trust has not been developed, suppliers can overcome the problems they encounter by empowering a salesperson with the authority to make certain decisions. This finding applies to suppliers as well.