• Title/Summary/Keyword: group response

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Relationship Between Usage Needs Satisfaction and Commitment to Apparel Brand Communities: Moderator Effect of Apparel Brand Image (의류 브랜드 커뮤니티의 이용욕구 충족과 커뮤니티 몰입의 관계: 의류 브랜드 이미지의 조절효과)

  • Hong, Hee-Sook;Ryu, Sung-Min;Moon, Chul-Woo
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.51-89
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    • 2007
  • INTRODUCTION Due to the high broadband internet penetration rate and its group-oriented culture, various types of online communities operate in Korea. This study use 'Uses and Gratification Approach, and argue that members' usage-needs satisfaction with brand community is an important factor for promoting community commitment. Based on previous studies identifying the effect of brand image on consumers' responses to various marketing stimuli, this study hypothesizes that brand image can be a moderate variable affecting the relationship between usage-needs satisfaction with brand community and members' commitment to brand community. This study analyzes the influence of usage-needs satisfaction on brand community commitment and how apparel brand image affects the relationships between usage-needs satisfactions and community commitments. The hypotheses of this study are proposed as follows. H1-3: The usage-needs satisfaction of apparel brand community (interest, transaction, relationship needs) influences emotional (H1), continuous (H2), and normative (H3) commitments to apparel brand communities. H4-6: Apparel brand image has a moderating effect on the relationship between usage-needs satisfaction and emotional (H4), continuous (H5), and normative (H6) commitments to apparel brand communities. METHODS Brand communities founded by non-company affiliates were excluded and emphasis was placed instead on communities created by apparel brand companies. Among casual apparel brands registered in 6 Korean portal sites in August 2003, a total of 9 casual apparel brand online communities were chosen, depending on the level of community activity and apparel brand image. Data from 317 community members were analyzed by exploratory factor analysis, moderated regression analysis, ANOVA, and scheffe test. Among 317 respondents answered an online html-type questionnaire, 80.5% were between 16 to 25 years old. There were a total of 150 respondents from apparel brand communities(n=3) recording higher-than-average brand image scores (Mean > 3.75) and a total of 162 respondents from apparel brand communities(n=6) recording lower-than-average brand image scores(Mean < 3.75). In this study, brand community commitment was measured by a 5-point Likert scale: emotional, continuous and normative commitment. The degree of usage-needs satisfaction (interest, transaction, relationship needs) was measured on a 5-point Likert scale. The level of brand image was measured by a 5-point Likert scale: strength, favorability, and uniqueness of brand associations. RESULTS In the results of exploratory factor analysis, the three usage-needs satisfactions with brand community were classified as interest, transaction, and relationship needs. Brand community commitment was also divided into the multi-dimensional factors: emotional, continuous, and normative commitments. The regression analysis (using a stepwise method) was used to test the influence of 3 independent variables (interest-needs satisfaction, transaction-needs, and relationship-needs satisfactions) on the 3 dependent variables (emotional, continuous and normative commitments). The three types of usage-needs satisfactions are positively associated with the three types of commitments to apparel brand communities. Therefore, hypothesis 1, 2, and 3 were significantly supported. Moderating effects of apparel brand image on the relationship between usage-needs satisfaction and brand community commitments were tested by moderated regression analysis. The statistics result showed that the influence of transaction-needs on emotional commitment was significantly moderated by apparel brand image. In addition, apparel brand image had moderating effects on the relationship between relationship-needs satisfaction and emotional, continuous and normative commitments to apparel brand communities. However, there were not significant moderate effects of apparel brand image on the relationships between interest-needs satisfaction and 3 types of commitments (emotional, continuous and normative commitments) to apparel brand communities. In addition, the influences of transaction-needs satisfaction on 2 types of commitments (continuous and normative commitments) were not significantly moderated by apparel brand image. Therefore, hypothesis 4, 5 and 6 were partially supported. To explain the moderating effects of apparel brand image, four cross-tabulated groups were made by averages of usage-needs satisfaction (interest-needs satisfaction avg. M=3.09, transaction-needs satisfaction avg. M=3.46, relationship-needs satisfaction M=1.62) and the average apparel brand image (M=3.75). The average scores of commitments in each classified group are presented in Tables and Figures. There were significant differences among four groups. As can be seen from the results of scheffe test on the tables, emotional commitment in community group with high brand image was higher than one in community group with low brand image when transaction-needs satisfaction was high. However, when transaction-needs satisfaction was low, there was not any difference between the community group with high brand image and community group with low brand image regarding emotional commitment to apparel brand communities. It means that emotional commitment didn't increase significantly without high satisfaction of transaction-needs, despite the high apparel brand image. In addition, when apparel brand image was low, increase in transaction-needs did not lead to the increase in emotional commitment. Therefore, the significant relationship between transaction-needs satisfaction and emotional commitment was found in only brand communities with high apparel brand image, and the moderating effect of apparel brand image on this relationship between two variables was found in the communities with high satisfaction of transaction-needs only. Statistics results showed that the level of emotional commitment is related to the satisfaction level of transaction-needs, while overall response is related to the level of apparel brand image. We also found that the role of apparel brand image as a moderating factor was limited by the level of transaction-needs satisfaction. In addition, relationship-needs satisfaction brought significant increase in emotional commitment in both community groups (high and low levels of brand image), and the effect of apparel brand image on emotional commitment was significant in both community groups (high and low levels of relationship-needs satisfaction). Especially, the effect of brand image was greater when the level of relationship-needs satisfaction was high. in contrast, increase in emotional commitment responding to increase in relationship-needs satisfaction was greater when apparel brand image is high. The significant influences of relationship-needs satisfaction on community commitments (continuous and normative commitments) were found regardless of apparel brand image(in both community groups with low and high brand image). However, the effects of apparel brand image on continuous and normative commitments were found in only community group with high satisfaction level of relationship-needs. In the case of communities with low satisfaction levels of relationship needs, apparel brand image marginally increases continuous and normative commitments. Therefore, we could not find the moderating effect of apparel brand image on the relationship between relationship-needs satisfaction and continuous and normative commitments in community groups with low satisfaction levels of relationship needs, CONCLUSIONS AND IMPLICATIONS From the results of this study, we draw several conclusions; First, the increases in usage-needs satisfactions through apparel brand communities result in the increases in commitments to apparel brand communities, wheres the degrees of such relationship depends on the level of apparel brand image. That is, apparel brand image is a moderating factor strengthening the relationship between usage-needs satisfaction and commitment to apparel brand communities. In addition, the effect of apparel brand image differs, depending on the level and types of community usage-needs satisfactions. Therefore, marketers of apparel brand companies must determine the appropriate usage-needs, depending on the type of commitment they wish to increase and the level of their apparel brand image, to promote member's commitments to apparel brand communities. Especially, relationship-needs satisfaction was very important factor for increasing emotional, continuous and normative commitments to communities. However the level of relationship-needs satisfaction was lower than interest-needs and transaction-needs. satisfaction. According to previous study on apparel brand communities, relationship-need satisfaction was strongly related to member's intention of participation in their communities. Therefore, marketers need to develope various strategies in order to increase the relationship- needs as well as interest and transaction needs. In addition, despite continuous commitment was higher than emotional and normative commitments, all types of commitments to apparel brand communities had scores lower than 3.0 that was mid point in 5-point scale. A Korean study reported that the level of members' commitment to apparel brand community influenced customers' identification with a brand and brand purchasing behavior. Therefore, marketers should try to increase members' usage-needs satisfaction and apparel brand image as the necessary conditions for bringing about community commitments. Second, marketers should understand that they should keep in mind that increasing the level of community usage needs (transaction and relationship) is most effective in raising commitment when the level of apparel brand image is high, and that increasing usage needs (transaction needs) satisfaction in communities with low brand image might not be as effective as anticipated. Therefore, apparel companies with desirable brand image such as luxury designer goods firms need to create formal online brand communities (as opposed to informal communities with rudimentary online contents) to satisfy transaction and relationship needs systematically. It will create brand equity through consumers' increased emotional, continuous and normative commitments. Even though apparel brand is very famous, emotional commitment to apparel brand communities cannot be easily increased without transaction-needs satisfaction. Therefore famous fashion brand companies should focus on developing various marketing strategies to increase transaction-needs satisfaction.

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A Study on the Illumination of Household and Research on the Actual Conditions of Wearing Spectacles in Dwellers (주택의 조명과 거주자의 면경착용 실태조사연구)

  • 석호작;남철현
    • Journal of Environmental Health Sciences
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    • v.17 no.2
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    • pp.54-66
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    • 1991
  • As a result of measuring illumination and making up a question at home visit directly by investigator who trained over twenty days period from October 4 to 24, 1990, in order to render help which illumination problem against house, society against eyes or framing of health instruction potgram by seizing natural lighting actual conditions of house and actual conditions of wearing spectacles and by investigating interrelationship, I can summarize as follows. 1) In property of investigation subject, woman 66.9%, In an age, the twenties was largest of 27.4%, the forties was 20.2%, the fifties was 18.6%, the thirties was 17.4%. In academic career, those of upper secondary school grauates was largest of 28.6%, those who possess university career was 25.9%, those who middle school career was 20.9%, decoding of Korean alphabet was 2%. 2) By a residence area, a big city was 43.3%, farming and fishing villages were 20.3%, the rest was a small town and the administrative office of town, township. In positon of house, the middle area was 43.6%, resident of suburb area was 38.0%. In form of house, a Korean-style house was 40.8%, a western-style house was 34.8%, an apartment house was 11.0%. In the a standard of living, the middle classes 77.2%, the lower classes were 15.3%. In residential house unit of area, from 21 to 30 unit of area was largest of 31.5%, from 10 to 20 unit of area was 19.9%, from 31 to 40 was 18.7%. 3) The wearing spectacles rate of study user was 44.1%. By the area, those who wearing spectacles was more than a half of 50.8% in the resident of big city area. As passing from the farm area to the city, that is being resident of big city was high wearing spectacles rate. In position of house, as being residence in central street showed high wearing spectacles rate. (central street was 51.5%, the middle area was 44.5% and the suburb area was 40.1%.) It seemed similarity difference a variable by position of house from wearing spectacles in standard of 1%. By form of house, wearing spectacles rate those who resident in apartment house was 49.5%, that rate those who resident in a western-style house was high of 49.0%, that rate those who resident in a Korean-style house was the lowest 39.0%. By social position of resident in room, in students case who study showed very high, as university students were very high of 62.3% idn wearing spectacles rate, middle and high school students 'were 50.0%, members of society were 47.6%, workers 20.3%. It seemed similarity difference from academic career in standard of 1%. By an age, the thirties was high of 54.1% in wearing spectacles rate, the twenties was 43.2%, the teenage was the lowest of 11.8%. 4) In illumination of study, over 200Lux was high of 40.1%. but below 99Lux which inappropriate illumination to see the books was 32.4%. Average by area, below 99Lux was 22.7% and over 400Lux was 50.0% in case of wooden floor. As examine by area, below 99Lux was high of 27.0% a case of wooden floor in the big city area, it was not good in illumination passing from the farm area(15.0%) to the city(19.0%). Average illlumination by area of the main living room below 99Lux was high of 37.5%, less than 200Lux was 58.5% of whole. In general, illumination of the main livingroom was inappropriate. By area, the big city was 32.5% below 99Lux, the middle and small city area were 33.8%, town and township area were 45.0%, farming and fishing area were 42.8%. By area, in the big city, illumination of study was 52.5% over 200Lux and 28.9% below 99Lux. In case of the middle and small city, study user of below 99Lux was 38.8% and over 200Lux was 46.9%. In case of the seat of town township, below 99Lux was 34.1% and over 200Lux was 39.7%. In case of farming and fishing area, illumination of study was 33.4% below 99Lux and 48.4% over 200Lux. It tends to high rate of inappropriate illumination. 5) By position of house, in case of wooden floor, less than 100Lux was 24.5% in central street. It was bad illumination than others position of house. In case of the main livingroom, less than 100Lux was 40.4% in the suburb area. It was bad iliumnation than others position of house. In case of study, less than 100Lux was 35.4% in the middle area, it was worse in illumination. In case of the main living room, is seemed similarity difference in standard of 1%. 6) By form of house, in case of wooden floor, illumination of less than 100Lux was 23.8% in a western-style house, it was bad illumination than others form of house. In case of the main livingroom, illumination of less than 100Lux was 47.4% in a Korean-style house, it was remarkably bad illumination than others form of house. In case of study, a Korean-style house was 38.8%, it was very bad illumination than others form of house. In case of the main livingroom and study, it seemed similatrity difference each as P < 0.01 and P < 0.05 in standard of 1%. 7) The wearing spectacles rate of those who use room of illumination over 400Lux was 40.7%, and that of those who use room of illumination less than 100Lux was 28.1%. It seemed similarity differecce in standard of 1%. 8) In period of wearing spectacles, 21.3% of total investigator-highest-was from before five years, 8.6% was from before three years. Among those who use of illumintion less than 99Lux, 34.0% began to wear spectacles from before two years 31.7% was from before five years, 30.3% was from before four years. It seemed similarity difference from period of wearing spectacles by illumination in standard of 1 %. 9) Among cause which sight grow worse, the first was that it was each 33.2% and 27.4% in response rate because watch TV nearly to wearing spectacles person and non-wearing person. The second was that a lot of seeing books was 25.3% in wearing spectacles person and response rate for dark illumination was 7.4% in nonwearing spectacles person. It seemed similarity difference in standard of 1%. (P < 0.01). 10) In experience which take medicine good for eyes, it was 50.1% in wearing spectacles person and 8.5% in non-wearing spectacles person. It seemed similarity difference in standard of 1%(P < 0.01). As we have seen above, inappropriate illumination can be a cause of wearing spectacles. Nevertheless, actually, is realities to indifferent against illumination of house. So it must learn knowledge about health obstacle of illumination through society instruction and school eduction against students as well as general residents. In case that natural lighting is inappropriate structural of house, we must be able to maintain appropriate illumination through artificial illumination. And so eyes which is core of human life have to be protected, related the authorities, related group, and all health medical personnel will organically cooperate with and make efforts.

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Analysis of the Radiation Therapy Outcomes and Prognostic Factors of Thymoma (흉선종에 대한 방사선치료 성적 및 예후인자분석)

  • Lee, Seok-Ho;Lee, Kyu-Chan;Choi, Jin-Ho;Lee, Jae-Ik;Sym, Sun-Jin;Cho, Eun-Kyung
    • Radiation Oncology Journal
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    • v.28 no.1
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    • pp.1-8
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    • 2010
  • Purpose: This retrospective study was performed to evaluate the efficacy of radiation therapy (RT) and to investigate the prognostic factors for thymoma when treated with RT. Materials and Methods: We analyzed 21 patients with thymoma and also received RT from March 2002 to January 2008. The median follow-up time was 37 months (range, 3 to 89 months). The median patient age was 57 years (range, 24 to 77 years) and the gender ratio of males to females was 4:3. Of the 21 patients, complete resections (trans-sternal thymectomy) and R2 resections were performed in 14 and 1 patient, respectively. A biopsy was performed in 6 patients (28.7%). The WHO cell types in the 21 patients were as follows: 1 patient (4.8%) had type A, 10 patients (47.6%) had type B1-3, and 10 patients (47.6%) had type C. Based on Masaoka staging, 10 patients (47.6%) were stage II, 7 patients (33.3%) were stage III, and 4 patients (19.1%) were stage IVa. Three-dimensional RT was adminstered to the tumor volume (planned target volume), including the anterior mediastinum and the residual disease. The total RT dose ranged from 52.0 to 70.2 Gy (median dose, 54 Gy). Consistent with the WHO criteria, the response rate was only analyzed for the 6 patients who received a biopsy only. The prognostic factors analyzed for an estimate of survival included age, gender, tumor size, tumor pathology, Masaoka stage, the possibility of treatment by performing surgery, the presence of myasthenia gravis, and RT dose. Results: The 3-year overall survival rate (OS) and the progression free survival rate (PFS) were 80.7% and 78.2%, respectively. Among the 10 patients with WHO cell type C, 3 of 4 patients (75%) who underwent a complete resection and 3 of 6 patients (50%) who underwent a biopsy survived. Distant metastasis developed in 4 patients (19.1%). The overall response rate in the 6 patients who received biopsy only were as follows: partial remission in 4 patients (66.7%), stable disease in 1 patient (16.6%), and progressive disease in 1 patient (16.6%). Acute RTOG radiation pneumonitis occurred in 1 patient (4.8%), grade 2 occurred in 2 patients (9.5%), grade 3 occurred in 1 patient (4.8%), and grade 4 occurred in 1 patient (4.8%). A univariate analysis revealed that the significant prognostic factors for OS were age (${\geq}60$, 58.3%; <60, 100%; p=0.0194), pathology (WHO cell type A-B3, 100%; C, 58.3%; p=0.0194) and, whether the patient underwent surgery (yes, 93.3%; no, 50%; p=0.0096). Conclusion: For the 15 patients who received surgery, there was no local failure within the radiation field. In patients with WHO cell type C, surgical procedures could have resulted in a more favorable outcome than biopsy alone. We report here our clinical experience in 21 patients with thymoma who were treated by radiation therapy.

The Significance of IL-10, IL-12, IFN-$\gamma$ and ADA in Tuberculous Pleural Fluid (결핵성 흉수에서 IL-10, IL-12, IFN-$\gamma$, ADA 측정의 의의)

  • Jeon, Doo-Soo;Yun, Sang-Myung;Park, Sam-Seok;Lee, Hyo-Jin;Kim, Yun-Seong;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.301-310
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    • 1998
  • Background: Cell mediated immune response mediated by interaction between CD4+ T lymphocytes and macrophagies is thought to play an important role in tuberculous pleurisy. This interaction is dependent on the interplay of various cytokines. The immunologic response of tuberculous pleurisy is thought to depend on the balance between helper T cell(Th1) cytokine Interleukin-12, Interferon gamma and Th2 cytokine IL-4, IL-10. To understand immunologic mechanism in tuberculous pleurisy and evaluate diagnostic value of these cytokines, the concentrations of Th1 cytokine IL-12, IFN -$\gamma$ and Th2 cytokine IL-10 were measured in tuberculous pleurisy and malignant pleural effusion group. Material and Methods: The concentrations of IL-10, IL-12 and IFN-$\gamma$ were measured by ELISA method in pleural fluids and serums of 20 patients with tuberculous pleurisy and 20 patients with malignant pleural effusion ADA activities were measured by spetrophotomery in pleural fluids of both groups. Results: In tuberculous pleurisy, the mean concentrations of IL-10, IL-12 and IFN-$\gamma$ of pleural fluids showed $121.3{\pm}83.7$ pg/mL, $571.4{\pm}472.7$ pg/mL and $420.4{\pm}285.9$ pg/mL. These were significantly higher than that of serum, $21.2{\pm}60.9$ pg/mL, 194.5 pg/mL, $30.1{\pm}18.3$ pg/mL respectively(p< 0.01). In malignant pleural effusion, the mean concentrations of IL-10, IL-12 and IFN-$\gamma$ of pleural fluids showed $88.4{\pm}40.4$ pg/mL, $306.5{\pm}271.1$ pg/mL and $30.5{\pm}54.8$ pg/mL respectively. Compared with that of serum ($43.4{\pm}67.2$ pg/mL, $206.8{\pm}160.6$ pg/mL, $14.6{\pm}3.3$ pg/mL), only IL-10 was significantly higher (p<0.001), but IL-12, IFN-$\gamma$ were not significant. In tuberculous pleural effusion compared with malignant pleural effusion, the concentration of IL-12, IFN-$\gamma$, ADA were significantly higher (p=value 0.046, <0.001, <0.001), but IL-10 was not significant. For differential diagnosis of tuberculous pleurisy from malignant pleural effusion, using cut-off value of IL-12, IFN-$\gamma$, ADA as 300 pg/mL. 100 pg/mL, 45 U/L, the sensitivity/specificity were 60%/70%, 90%/87.5%, 85%/90% respectively. Conclusion: In tuberculous pleurisy, IL-10, IL-12 and IFN-$\gamma$ were selectively concentrated highly in pleural space than serum. Compared with malignant pleural effusion, IL-12 and IFN-$\gamma$ were significantly higher, but IL-10 were not in tuberculous pleural effusion. The results suggest that Th1 pathway contributes to immune resistant mechanism in tuberculous pleurisy. IFN-$\gamma$ and ADA revealed useful methods of differential diagnosis in tuberculous pleurisy from malignant pleural effusion.

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Evaluation of Varietal Difference and Environmental Variation for Some Characters Related to Source and Sink in the Rice Plants (벼의 Source 및 Sink형질의 품종간차이와 환경변이의 평가)

  • Choi, Hae-Chun;Kwon, Yong-Woong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.30 no.4
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    • pp.460-470
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    • 1985
  • Experiments were carried out to evaluate the standard gravity in determining potential kernel size and to determine the effective sampling way by analyzing intra - and inter - plant variations for some source and sink characters using eleven semi-dwarf indica and three japonica cultivars including four semi-dwarf indica nearisogenic lines. Also, additional experiments were conducted to understand yearly variation and variety x year interaction effects for ten characters related to source and sink and to characterize the varietal difference of pre- and post-heading self-competition employing three parental varieties and their F$\sub$5/ progenies in 1982 and 1983. It is desirable to determine the potential kernel size by average kernel wight of rice grains showing above 1.15 specific gravity. There was significant difference in leaf area per tiller, spikelets and sink capacity per panicle among vigorous, intermediate and inferior tillers classified by differentiated order and vigorousness. Although it was difficult to find out any significant difference in grain-fill ratio, ratio of perfectly ripened grain, potential kernel size and sink/source ratio between vigorous and intermediate tillers, there was big difference between them and inferior one. The coefficients of variation within each tiller-group for some characters related to source and sink were larger with the order of vigorous tillers < intermediate one '||'&'||'lt; inferior one, and the average heritability of all characters, evaluated by the ratio of varietal variance (equation omitted) to total variance (equation omitted), were higher with the order of inferior tillers '||'&'||'lt; intemediate one '||'&'||'lt; superior one. Therefore, it is desirable to sample the vigorous tillers to represent the varietal difference of these traits. '82-'83 year variations of three parental cultivars were significant for all traits except for leaf area/tiller, panicles/hill, leaf area index and rough rice yield. The characters showing highly significant variance of variety x year interaction were growth duration from transplanting to heading, leaf area/tiller, sink/source ratio, sink capacity/panicle and grain yield. Generalized yearly response of three parental varieties (Suweon 264, Raegyeong, IR1317-70-l) and their F$\sub$5/ progenies on the 1st and 2nd principal components extracted from ten source and sink characters generally exhibited reduction in both source and sink. However, there were diverse variety x year interactions such as progenies showing similar reaction with their parents and intermediate or recombinational yearly response with little or considerable yearly movement on the four-dimensional planes of the two upper principal components between 1982 and 1983. Sink characters revealing highly significant border effect were grain-fill ratio, spikelets and sink capacity per panicle. Among them the latter two especially showed significant variety x border effect interaction. Self-competition characterized by relative weakness of inside plant's sink characters compared to the border one was more severe during the reproductive stage before heading than maturing stage. Though the larger sink capacity per panicle generally disclosed the severer self-competition, some lines (like Suweon 264) revealed severe self-competition with small sink capacity while a few others showed tender self-competition in spite of big sink capacity per panicle.

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The Results of Definitive Radiation Therapy and The Analysis of Prognostic Factors for Non-Small Cell Lung Cancer (비소세포성 폐암에서 근치적 방사선치료 성적과 예후인자 분석)

  • Chang, Seung-Hee;Lee, Kyung-Ja;Lee, Soon-Nam
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.409-423
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    • 1998
  • Purpose : This retrospective study was tried to evaluate the clinical characteristics of patients, patterns of failure, survival rates, prognostic factors affecting survival, and treatment related toxicities when non-small cell lung cancer patients was treated by definitive radiotherapy alone or combined with chemotherapy. Materials and Methods : We evaluated the treatment results of 70 patients who were treated by definitive radiation therapy for non-small cell lung cancer at the Department of Radiation Oncology, Ewha Womans University Hospital, between March 1982 and April 1996. The number of patients of each stage was 2 in stage I, 6 in stage II, 30 in stage III-A, 29 in stage III-B, 3 in stage IV. Radiation therapy was administered by 6 MV linear accelerator and daily dose was 1.8-2.0 Gy and total radiation dose was ranged from 50.4 Gy to 72.0 Gy with median dose 59.4 Gy. Thirty four patients was treated with combined therapy with neoadjuvant or concurrent chemotherapy and radiotherapy, and most of them were administered with the multi-drug combined chemotherapy including etoposide and cisplatin. The survival rate was calculated with the Kaplan-Meier methods. Results : The overall 1-year, 2-year, and 3-year survival rates were 63$\%$, 29$\%$, and 26$\%$, respectively. The median survival time of all patients was 17 months. The disease-free survival rate for 1-year and 2-year were 23$\%$ and 16$\%$, respectively. The overall 1-year survival rates according to the stage was 100$\%$ for stage I, 80$\%$ for stage II, 61$\%$ for stage III, and 50$\%$ for stage IV. The overall 1-year 2-year, and 3-year survival rates for stage III patients only were 61$\%$, 23$\%$, and 20$\%$, respectively. The median survival time of stage III patients only was 15 months. The complete response rates by radiation therapy was 10$\%$ and partial response rate was 50$\%$. Thirty patients (43$\%$) among 70 patients assessed local control at initial 3 months follow-up duration. Twenty four (80$\%$) of these 30 Patients was possible to evaluate the pattern of failure after achievement of local control. And then, treatment failure occured in 14 patients (58$\%$): local relapse in 6 patients (43$\%$), distant metastasis in 6 patients (43$\%$) and local relapse with distant metastasis in 2 patients (14$\%$). Therefore, 10 patients (23$\%$) were controlled of disease of primary site with or without distant metastases. Twenty three patients (46$\%$) among 50 patients who were possible to follow-up had distant metastasis. The overall 1-year survival rate according to the treatment modalities was 59$\%$ in radiotherapy alone and 66$\%$ in chemoirradiation group. The overall 1-year survival rates for stage III patients only was 51$\%$ in radiotherapy alone and 68$\%$ in chemoirradiation group which was significant different. The significant prognostic factors affecting survival rate were the stage and the achievement of local control for all patients at univariate- analysis. Use of neoadjuvant or concurrent chemotherapy, use of chemotherapy and the achievement of local control for stage III patients only were also prognostic factors. The stage, pretreatment performance status, use of neoadjuvant or concurrent chemotherapy, total radiation dose and the achievement of local control were significant at multivariate analysis. The treatment-related toxicities were esophagitis, radiation pneunonitis, hematologic toxicity and dermatitis, which were spontaneously improved, but 2 patients were died with radiation pneumonitis. Conclusion : The conventional radiation therapy was not sufficient therapy for achievement of long-term survival in locally advanced non-small cell lung cancer. Therefore, aggressive treatment including the addition of appropriate chemotherapeutic drug to decrease distant metastasis and preoperative radiotherapy combined with surgery, hyperfractionation radiotherapy or 3-D conformal radiation therapy for increase local control are needed.

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The Effect of Lidocaine Dose and Pretreated Diazepam on Cardiovascular System and Plasma Concentration of Lidocaine in Dogs Ansthetized with Halothane-Nitrous Oxide (Diazepam 전투여와 Lidocaine 투여용량이 혈중농도 및 심혈역학적 변화에 미치는 영향)

  • Lee, Kyeong-Sook;Kim, Sae-Yeon;Park, Dae-Pal;Kim, Jin-Mo;Chung, Chung-Gil
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.451-474
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    • 1993
  • Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels ($3.97{\pm}0.22-4.48{\pm}0.36$ mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels ($7.50{\pm}0.66-11.83{\pm}0.59$ mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and increased pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was associated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVRI). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered, reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level ($7.64{\pm}0.79-13.79{\pm}0.82$ mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After $CaCl_2$ administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, CVP was rather increased than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.

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A Study on Appropriate Military Strength of Unified Korea (Focused on relative balance strategy and conflict scenario) (통일 한국의 적정 군사력에 관한 연구 - 분쟁 시나리오와 상대적 균형전략을 중심으로 -)

  • Hong, Bong-Gi
    • Journal of National Security and Military Science
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    • s.13
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    • pp.687-738
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    • 2016
  • To prepare for the complicated international relationship regarding Korean Peninsula after reunification, this thesis started off with the awareness that Unified Korea should build its international posture and national security at an early stage by determining its appropriate military strength for independent defense and military strategies that Unified Korea should aim. The main theme of this thesis is 'The research on appropriate military strength of the Unified Korean military'. To derive appropriate military strength of Unified Korea, this research focuses on conflict scenario and relative balance strategy based on potential threats posed by neighboring countries, and this is the part that differentiates this research from other researches. First of all, the main objective of the research is to decide appropriate military strength for Unified Korea to secure defense sufficiency. For this, this research will decide efficient military strategy that Unified Korea should aim. Than by presuming the most possible military conflict scenario, this research will judge the most appropriate military strength for Unified Korea to overcome the dispute. Second, after deciding appropriate military strength, this research will suggest how to operate presumed military strength in each armed force. The result of this thesis is as in the following. First, Unified Korea should aim 'relative balance strategy'. 'Relative balance strategy' is a military strategy which Unified Korea can independently secure defense sufficiency by maintaining relative balance when conflicts occur between neighboring countries. This strategy deters conflicts in advance by relative balance of power in certain time and place. Even if conflict occurs inevitably, this strategy secures initiative. Second, when analyzing neighboring countries interest and strategic environment after unification, the possibility of all-out war will be low in the Korean Peninsula because no other nation wants the Korean Peninsula to be subordinated to one single country. Therefore appropriate military strength of the Unified Korean military would be enough when Unified Korea can achieve relative balance in regional war or limited war. Third, Northeast Asia is a region where economic power and military strength is concentrated. Despite increasing mutual cooperation in the region, conflicts and competition to expand each countries influence is inherent. Japan is constantly enhancing their military strength as they aim for normal statehood. China is modernizing their military strength as they aspire to become global central nation. Russia is also enhancing their military strength in order to hold on to their past glory of Soviet Union as a world power. As a result, both in quality and quantity, the gap between military strength of Unified Korea and each neighboring countries is enlarged at an alarming rate. Especially in the field of air-sea power, arms race is occurring between each nation. Therefore Unified Korea should be equipped with appropriate military strength in order to achieve relative balance with each threats posed by neighboring countries. Fourth, the most possible conflicts between Unified Korea and neighboring countries could be summarized into four, which are Dokdo territorial dispute with Japan, Leodo jurisdictional dispute with China, territorial dispute concerning northern part of the Korea Peninsula with China and disputes regarding marine resources and sea routes with Russia. Based on those conflict scenarios, appropriate military strength for Unified Korea is as in the following. When conflict occurs with Japan regarding Dokdo, Japan is expected to put JMSDF Escort Flotilla 3, one out of four of its Japan Maritime Self-Defense Force Escort Fleet, which is based in Maizuru and JMSDF Maizuru District. To counterbalance this military strength, Unified Korea needs one task fleet, comprised with three task flotilla. In case of jurisdictional conflict with China concerning Leodo, China is expected to dispatch its North Sea fleet, one out of three of its naval fleet, which is in charge of the Yellow Sea. To response to this military action, Unified Korea needs one task fleet, comprised with three task flotilla. In case of territorial dispute concerning northern part of the Korean Peninsula with China, it is estimated that out of seven Military Region troops, China will dispatch two Military Region troops, including three Army Groups from Shenyang Military Region, where it faces boarder with the Korean Peninsula. To handle with this military strength, Unified Korea needs six corps size ground force strength, including three corps of ground forces, two operational reserve corps(maneuver corps), and one strategic reserve corps(maneuver corps). When conflict occurs with Russia regarding marine resources and sea routes, Russia is expected to send a warfare group of a size that includes two destroyers, which is part of the Pacific Fleet. In order to balance this strength, Unified Korea naval power requires one warfare group including two destroyers. Fifth, management direction for the Unified Korean military is as in the following. Regarding the ground force management, it would be most efficient to deploy troops in the border area with china for regional and counter-amphibious defense. For the defense except the border line with china, the most efficient form of force management would be maintaining strategic reserve corps. The naval force should achieve relative balance with neighboring countries when there is maritime dispute and build 'task fleet' which can independently handle long-range maritime mission. Of the three 'task fleet', one task fleet should be deployed at Jeju base to prepare for Dokdo territorial dispute and Leodo jurisdictional dispute. Also in case of regional conflict with china, one task fleet should be positioned at Yellow Sea and for regional conflict with Japan and Russia, one task fleet should be deployed at East Sea. Realistically, Unified Korea cannot possess an air force equal to neither Japan nor China in quantity. Therefore, although Unified Korea's air force might be inferior in quantity, they should possess the systematic level which Japan or China has. For this Unified Korea should build air base in island areas like Jeju Island or Ullenong Island to increase combat radius. Also to block off infiltration of enemy attack plane, air force needs to build and manage air bases near coastal areas. For landing operation forces, Marine Corps should be managed in the size of two divisions. For island defense force, which is in charge of Jeju Island, Ulleung Island, Dokdo Island and five northwestern boarder island defenses, it should be in the size of one brigade. Also for standing international peace keeping operation, it requires one brigade. Therefore Marine Corps should be organized into three divisions. The result of the research yields a few policy implications when building appropriate military strength for Unified Korea. First, Unified Korea requires lower number of ground troops compared to that of current ROK(Republic of Korea) force. Second, air-sea forces should be drastically reinforced. Third, appropriate military strength of the Unified Korean military should be based on current ROK military system. Forth, building appropriate military strength for Unified Korea should start from today, not after reunification. Because of this, South Korea should build a military power that can simultaneously prepare for current North Korea's provocations and future threats from neighboring countries after reunification. The core of this research is to decide appropriate military strength for Unified Korea to realize relative balance that will ensure defense sufficiency from neighboring countries threats. In other words, this research should precisely be aware of threats posed by neighboring countries and decide minimum level of military strength that could realize relative balance in conflict situation. Moreover this research will show the path for building appropriate military strength in each armed force.

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The Effect of Ginkgo Biloba Extract on the Fractionsted Radiation Therapy in C3H Mouse Fibrosarcoma (Ginkgo Biloba Extract가 C3H 마우스 섬유육종의 분할 방사선치료에 미치는 영향)

  • Kim, Jong-Hoon;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.155-164
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    • 2002
  • Purpose : A ginkgo biloba extract (GBE) has been known as a hypoxic cell radiosensitizer. Its mechanisms of action are increase of the red blood cell deformability, decrease the blood viscosity, and decrease the hypoxic cell fraction in the tumor. The aims of this study were to estimate the effect of GBE on fractionated radiotherapy and to clarify the mechanism of action of the GBE by estimating the blood flow in tumor and normal muscle. Materials and Methods : Fibrosarcoma (FSall) growing in a C3H mouse leg muscle was used as the tumor model. When the tumor size reached 7 mm in diameter, the GBE was given intraperitoneally at 1 and 25 hours prior to irradiation. The tumor growth delay was measured according to the various doses of radiation (3, 6, 9, 12 Gy and 15 Gy) and to the fractionation (single and fractionated irradiation) with and without the GBE injection. The radiation dose to the tumor the response relationships and the enhancement ratio of the GBE were measured. In addition, the blood flow of a normal muscle and a tumor was compared by laser Doppler flowmetry according to the GBE treatment. Results : When the GBE was used with single fraction irradiation with doses ranging from 3 to 12 Gy, GBE increased the tumor growth delay significantly (p<0.05) and the enhancement ratio of the GBE was 1.16. In fractionated irradiation with 3 Gy per day, the relationships between the radiation dose (D) and the tumor growth delay (TGD) were TGD $(days)=0.26{\times}D$ (Gy)+0.13 in the radiation alone group, and the TGD $(days)=0.30{\times}D$ (Gy)+0.13 in the radiation with GBE group. As a result, the enhancement ratio was 1.19 ($95\%$ confidence interval; $1.13\~1.27$). Laser Doppler flowmetry was used to measure the blood flow. The mean blood flow was higher in the muscle (7.78 mL/100 g/min in tumor and the 10.15 mL/100 g/min in muscle, p=0.005) and the low blood flow fraction (less than 2 mL/100 g/min) was higher in the tumor $(0.5\%\;vs.\;5.2\%,\;p=0.005)$. The blood flow was not changed with the GBE in normal muscle, but was increased by $23.5\%$ ( p=0.0004) in the tumor. Conclusion : Based on these results, it can be concluded that the GBE enhanced the radiation effect significantly when used with fractionated radiotherapy as well as with single fraction irradiation. Furthermore, the GBE increased the blood flow of the tumor selectively.

The Prognostic Value of the First Day and Daily Updated Scores of the APACHE III System in Sepsis (패혈증환자에서 APACHE III Scoring System의 예후적 가치)

  • Lim, Chae-Man;Lee, Jae-Kyun;Lee, Sung-Soon;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Pyung-Hwan;Choi, Jong-Moo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.871-877
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    • 1995
  • Background: The index which could predict the prognosis of critically ill patients is needed to find out high risk patients and to individualize their treatment. The APACHE III scoring system was established in 1991, but there has been only a few studies concerning its prognostic value. We wanted to know whether the APACHE III scores have prognostic value in discriminating survivors from nonsurvivors in sepsis. Methods: In 48 patients meeting the Bones criteria for sepsis, we retrospectively surveyed the day 1(D1), day 2(D2) and day 3(D3) scores of patients who were admitted to intensive care unit. The scores of the sepsis survivors and nonsurvivors were compared in respect to the D1 score, and also in respect to the changes of the updated D2 and D3 scores. Results: 1) Of the 48 sepsis patients, 21(43.5%) survived and 27(56.5%) died. The nonsurvivors were older($62.7{\pm}12.6$ vs $51.1{\pm}18.1$ yrs), presented with lower mean arterial pressure($56.9{\pm}26.2$ vs $67.7{\pm}14.2\;mmHg$) and showed greater number of multisystem organ failure($1.2{\pm}0.8$ vs $0.2{\pm}0.4$) than the survivors(p<0.05, respectively). There were no significant differences in sex and initial body temperature between the two groups. 2) The D1 score was lower in the survivors (n=21) than in the nonsurvivors ($44.1{\pm}14.6$, $78.5{\pm}18.6$, p=0.0001). The D2 and D3 scores significantly decreased in the survivors (D1 vs D2, $44.1{\pm}14.6$ : $37.9{\pm}15.0$, p=0.035; D2 vs D3, $37.9{\pm}15.0$ : $30.1{\pm}9.3$, p=0.0001) but showed a tendency to increase in the nonsurvivors (D1 vs D2 (n=21), $78.5{\pm}18.6$ : $81.3{\pm}23.0$, p=0.1337; D2 vs D3 (n=11), $68.2{\pm}19.3$ : $75.3{\pm}18.8$, p=0.0078). 3) The D1 scores of 12 survivors and 6 nonsurvivors were in the same range of 42~67 (mean D1 score, $53.8{\pm}10.0$ in the survivors, $55.3{\pm}10.3$ in the nonsurvivors). The age, sex, initial body temperature, and mean arterial pressure were not different between the two groups. In this group, however, D2 and D3 was significantly decreased in the survivors(D1 vs D2, $53.3{\pm}10.0$ : $43.6{\pm}16.4$, p=0.0278; D2 vs D3, $43.6{\pm}16.4$ : $31.2{\pm}10.3$, p=0.0005), but showed a tendency to increase in the nonsurvivors(D1 vs D2 (n=6), $55.3{\pm}10.3:66.7{\pm}13.9$, p=0.1562; D2 vs D3 (n=4), $64.0{\pm}16.4:74.3{\pm}18.6$, p=0.1250). Among the individual items of the first day APACHE III score, only the score of respiratory rate was capable of discriminating the nonsurvivors from the survivors ($5.5{\pm}2.9$ vs $1.9{\pm}3.7$, p=0.046) in this group. Conclusion: In sepsis, nonsurvivors had higher first day APACHE III score and their updated scores on the following days failed to decline but showed a tendency to increase. Survivors, on the other hand, had lower first day score and showed decline in the updated APACHE scores. These results suggest that the first day and daily updated APACHE III scores are useful in predicting the outcome and assessing the response to management in patients with sepsis.

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