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Clinical Implication of Cyclooxygenase-2 Expression for Rectal Cancer Patients with Lymph Node Involvement (림프절 전이를 동반한 직장암 환자들에서 Cyclooxygenase-2 발현의 임상적 의미)

  • Lee, Hyung-Sik;Choi, Young-Min;Hur, Won-Joo;Kim, Su-Jin;Kim, Dae-Cheol;Roh, Mee-Sook;Hong, Young-Seoub;Park, Ki-Jae
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.210-217
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    • 2009
  • Purpose: To assess the influence of cyclooxygenase-2 (COX-2) expression on the survival of patients with a combination of rectal cancer and lymph node metastasis. Materials and Methods: The study included rectal cancer patients treated by radical surgery and postoperative radiotherapy at the Dong-A university hospital from 1998 to 2004. A retrospective analysis was performed on a subset of patients that also had lymph node metastasis. After excluding eight of 86 patients, due to missing tissue samples in three, malignant melanoma in one, treatment of gastric cancer around one year before diagnosis in one, detection of lung cancer after one year of diagnosis in one, liver metastasis in one, and refusal of radiotherapy after 720 cGy in one, 78 patients were analyzed. The immunohistochemistry for COX-2 was conducted with an autostainer (BenchMark; Ventana, Tucson, AZ, USA). An image analyzer (TissueMine; Bioimagene, Cupertino, CA, USA) was used for analysis after scanning (ScanScope; Aperio, Vista, CA, USA). A survival analysis was performed using the Kaplan Meier method and significance was evaluated using the log rank test. Results: COX-2 was stained positively in 62 patients (79.5%) and negatively in 16 (20.5%). A total of 6 (7.7%), 15 (19.2%), and 41 (52.6%) patients were of grades 1, 2, and 3, respectively for COX-2 expression. No correlation was found between being positive of COX-2 patient characteristics, which include age (<60-year old vs. $\geq$60), sex, operation methods (abdominoperineal resection vs. lower anterior resection), degrees of differentiation, tumor size (<5 cm vs. $\geq$5 cm), T stages, N stages, and stages (IIIa, IIIb, IIIc). The 5-year overall and 5-year disease free survival rates for the entire patient population were 57.0% and 51.6%, respectively. The 5-year overall survival rates for the COX-2 positive and negative patients were 53.0% and 72.9%, respectively (p=0.146). Further, the 5-year disease free survival rates for the COX-2 positive and negative patients were 46.3% and 72.7%, respectively (p=0.118). The 5-year overall survival rates were significantly different (p<0.05) for the degree of differentiation, N stage, and stage, whereas the 5-year disease free survival rates were significant for N stage and stage. Conclusion: Being positive for and the degree of COX-2 expression did not have a significant influence on the survival of rectal cancer patients with lymph node metastasis. However, N stage and stage did significantly influence the rateof survival. Further analysis of a greater sample size is necessary for the verification of the effect of COX-2 expression on the survival of rectal cancer patients with lymph node involvement.

A Study of Current Perception Threshold of Trigeminal Nerve after Tooth Implantation (치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구)

  • Lim, Hyun-Dae;Lee, Jung-Hyun;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.187-200
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    • 2007
  • This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.

The Origin of Changseung and Ongjung Stone (장승의 기원과 옹중석)

  • Chung, Seung Mo
    • Korean Journal of Heritage: History & Science
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    • v.46 no.1
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    • pp.160-175
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    • 2013
  • There is the need to make a sharp distinction as regards JANGSEUNGs (Korean traditional totem poles) that are different in origin, history and function. This study is to identify the functions of the figures, as well as to trace stone JANGSEUNGs to their origins. In this regard, researched were conducted into the origins of JANGSEUNGs and their changes in history. There was a tradition in the GORYEO Dynasty (an ancient dynasty in the Korean Peninsula) that it erected JANGSAENGs (the archaic name of JANGSEUNGs) or allied stone figures within temples; especially, 'TONGDOSA GUKJANGSAENG SEOKPYO (a stone JANGSAENG that was erected by the royal command and is at the entrance of TONGDO Temple located in YANGSAN, South GYEONGSANG Province, South Korea)' functions as a stone monument rather than as a stone sign. In the engraved inscription, it is written that it should be erected in the form of PANA as before. 'PANA' refers to 'ZHONGKUI', a god in Chinese Taoism believed to exorcise devils that spread diseases. The inscription is to define the territory of TONGDO Temple. The article on HAN JUN GYEOM in a book 'WORAKGI (a travelogue on WORAK Mountain in North CHUNGCHEONG Province, South Korea)' written by HEO MOK makes it possible to guess the scale of GUKJANGSAENGs erected in DOGAP Temple. The stones, on which 'GUKJANGSAENG' or 'HWANGJANGSAENG' were engraved, are not JANGSAENGs but are demarcation posts. In the JOSEON Dynasty (the last dynasty in the Korean Peninsula) JANGSAENGs functioned as signposts. Unlike JANGSAENGs in temples, they were made of wood. At first, the word 'JANGSAENG' was written '長生' in Chinese characters, but in the JOSEON Dynasty another character '木 (wood)' was added to them, and thus the orthography was likely to change into 'JANGSEUNG.' In the JOSEON Dynasty, in addition, optative or geomantic figures were not called 'JANGSEUNG.' Historically, for instance, there has been no case where 'DOL HARBANGs (stone figures found only in JEJU ISLAND, South Korea)' are called 'JANGSEUNG.' In a book 'TAMRA GINYEON (a historical record on JEJU Island, South Korea)' it is written that KIM MONG GYU, JEJU governor, erected ONGJUNG Stones outside the fortress gate. ONGJUNG Stones usually refer to stone statues erected in front of ancient kings or dignitaries' mausoleums. Moreover, they were geomantic figures erected to suppress miasma. A magazine 'GWANGJUEUPJI (a journal on old GWANGJU, South Korea, 1899)' shows that two two ONGJUNG Stones were so erected that they might look at each other to suppress miasma from a pathway through which lucks lose. On the two stone figures located in BUAN-EUP, North JEOLLA Province, South Korea, inscriptions 'SANGWON JUJANGGUN' and 'HAWON DANGJANGGUN' were engraved. The words are to identify the figures' sexes. They are a kind of optative geomantic figures, and therefore there is no reason to call them 'JANGSAENG' or 'JANGSEUNG' or 'DANGSAN.' The words 'SANGWON' and 'HAWON' are closely associated with Taoism. Since then, the words have been widely used as inscriptions on stone figures in temples, and subsequently are used for JANGSEUNGs. A hatted ONGJUNG Stone, found in BUKANSAN Fortress, disappeared and other ones may be being buried somewhere. Meanwhile, ONGJUNG Stones in JEJU Island and stone figures in BUAN-EUP have hardly been displaced and thus have properly functioned. Stone figures, made in those days, seem to be most similar in function to JANGSAENGs made during the GORYEO Dynasty. Specifically, like earlier JANGSAENGs, stone figures made during the early to mid-18th century were likely to function not only as optative figures but as boundary stones. Most of stone figures in temples were made whenever the land use survey was conducted throughout the nation, but given that at the same period of time, the commonalty filed many lawsuits against grave sites, temples might erect many stone figures to mark their territories. Currently, wooden or stone figures are commonly called 'JANGSEUNG', but they were erected in different epochs and for different reasons. Their origins are to be sought in stone figures that functioned not only as optative figures in temples but as boundary stones during the GORYEO Dynasty.

The Marketing Effect of Loyalty Program on Relational Market Behavior : Focusing in Franchise Membership Fitness Club (로열티 프로그램이 고객 참여와 소비자-브랜드 관계에 기초한 관계형 시장 행동에 미치는 영향 : 프랜차이즈 회원제 휘트니스클럽을 대상으로)

  • Yoon, Kyung-Goo;Shin, Geon-Cheol
    • Journal of Distribution Research
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    • v.17 no.2
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    • pp.1-28
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    • 2012
  • I. Introduction : The purpose of this study is to test empirically hypothetical causality among constructs used in previous studies to build the model of relational market behavior on customers' participation and consumer-brand relationship after introducing theories of relationship marketing, loyalty program, consumer-brand relationship, customers' participation in service marketing as previous studies with regard to relational market behavior, which Bagozzi(1995) and Peterson(1995) commented on constructs and definition suggested by Sheth and Parvatiyar (1995). For this purpose, loyalty program by the service provider, customers' participation and consumer-brand relationship as preceding variables explain relational market behavior defined by Sheth and Parvatiyar(1995). This study proposes that loyalty program as a tool of relationship marketing will be effective in that consumers' participation in marketing relationship results in a narrow range of choice(Sheth and Parvatiyar, 1995) because consumers think that their participation motive result in benefits(Peterson, 1995). Also, it is proposed that the quality of consumer-brand relationship explain the performance of relationship as well as the intermediary effect because the loyalty program could be evaluated based on relationship with customers. We reviewed the variables with regard to performance of relationship based on relation maintain in marketing literature, and then tested our hypotheses related to several performance variables including loyalty and intention of relation maintain based on the previous studies and constructs(Bendapudi and Berry, 1997 ; Bettencourt, 1997 ; Palmatier, Dant, Grewal and Evans, 2006 ; You Jae Yi and Soo Jin Lee, 2006). II. Study Model : Analyses about hypothetical causality were proceeded. The marketing effect of loyalty program on relational market behavior was empirically tested in study regarding a service provider. The research model in according to the path hypotheses (loyalty program ${\rightarrow}$ customers' participation ${\rightarrow}$ consumer-brand relationship ${\rightarrow}$ relational market behavior and loyalty program ${\rightarrow}$ consumer-brand relationship, and loyalty program ${\rightarrow}$ relational market behavior and customers' participation ${\rightarrow}$ consumer-brand relationship, and customers' participation ${\rightarrow}$ relational market behavior) proceeded as an activity for customer relation management was suggested. The main purpose of study is to see if relational market behavior could be brought as a result of developing relationship between consumers and a corporate into being stronger and more valuable when a corporate or a service provider try aggressively to build the relationship with customers (Bettencourt, 1997; Palmatier, Dant, Grewal and Evans, 2006; Sheth and Parvatiyar, 1995). III. Conclusion : The results of research into the membership fitness club, one of service areas with high level of customer participation (Bitner, Faranda, Hubbert and Zeithaml, 1997; Chase, 1978; Kelley, Donnelly, Jr. and Skinner, 1990) are as follows: First, causalities in according to path hypotheses were tested, after the preceding variables affecting relational market behavior and conceptual frame were suggested. In study, all hypotheses were supported as expected. This result confirms the proposition suggested by Sheth and Parvatiyar(1995), who claimed that intention of consumer and corporate to participate in marketing relationship brings high level of marketing productivity. Also, as a corporate or a service provider try aggressively to build relationship with customers, the relationship between consumers and a corporate can be developed into stronger and more valuable one (Bettencourt, 1997; Palmatier, Dant, Grewal and Evans, 2006). This finding supports the logic of relationship marketing. Second, because the question regarding the path hypothesis of consumer-brand relationship ${\rightarrow}$ relational market behavior are still at issue, the further analyses were conducted. In particular, there existed the mediating effects of consumer-brand relationship toward relational market behavior. Also, multiple regressions were conducted to see if which one strongly influences relational market behavior among specific question items with regard to consumer-brand relationship. As a result, the influence between items composing consumer-brand relationship and ones composing relational market behavior was different. Among items composing consumer-brand relationship, intimacy was an influence of sustaining relationship, word of mouth, and recommendation, intimacy and interdependence were influences of loyalty, intimacy and self-connection were influences of tolerance and advice. Notably, commitment among items measuring consumer-brand relationship had the negative influence with relational market behavior. This means that bringing relational market behavior is not consumer-brand relationship without personal commitment, but effort to build customer relationship like intimacy, interdependence, and self-connection. This finding confirms the results of Breivik and Thorbjornsen(2008). They reported that six variables composing the quality of consumer-brand relationship have higher explanation in regression model directly affecting performance of consumer-brand relationship. As a result of empirical analysis, among the constructs with regard to consumer-brand relationship, intimacy(B=0.512), interdependence(B=0.196), and quality of partner(B=0.153) had the effects on relation maintain. On the contrary, self-connection, love and passion, and commitment had little effect and did not show the statistical significance(p<0.05). On the other hand, intimacy(B=0.668) and interdependence(B=0.181) had the high regression estimates on word of mouth and recommendation. Regarding the effect on loyalty, explanation level of the model was high(R2=0.515), intimacy(0.538), interdependence(0.223), and quality of partner(0.177) showed the statistical significance(p<0.05). Furthermore, intimacy(0.441) had the strong effect as well as self-connection(0.201) and interdependence (0.163) had the effect on tolerance and forgive. And these three variables showed effects even on advice and suggestion, intimacy(0.373), self-connection(0.270), interdependence (0.155) respectively. Third, in study with regard to the positive effect(loyalty program ${\rightarrow}$ customers' participation, loyalty program ${\rightarrow}$ consumer-brand relationship, loyalty program ${\rightarrow}$ relational market behavior, customers' participation ${\rightarrow}$ consumer-brand relationship, customers' participation ${\rightarrow}$ relational market behavior, consumer-brand relationship ${\rightarrow}$ relational market behavior), the path hypothesis of customers' participation ${\rightarrow}$ consumer-brand relationship, was supported. The fact that path hypothesis of customers' participation ${\rightarrow}$ consumer-brand relationship was supported confirms assertion by Bitner(1995), Fournier(1994), Sheth and Parvatiyar(1995) about consumer relationship to participate in marketing relationship.

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