• Title/Summary/Keyword: Shin Kim

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Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Research on The Utility of Acquisition of Oblique Views of Bilateral Orbit During the Dacryoscintigraphy (눈물길 조영검사 시 양측 안 와 사위 상 획득의 유용성에 대한 연구)

  • Park, Jwa-Woo;Lee, Bum-Hee;Park, Seung-Hwan;Park, Su-Young;Jung, Chan-Wook;Ryu, Hyung-Gi;Kim, Ho-Shin
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.76-81
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    • 2014
  • Purpose: Diversity and the lachrymal duct deformities and the passage inside the nasal cavity except for anterior image such as epiphora happens during the test were able to express more precisely during the dacryoscintigraphy. Also, we thought about the necessity of a method to classify the passage into the naso-lachrymal duct from epiphora. Therefore, we are to find the validity of the method to obtain both oblique views except for anterior views. Materials and Methods: The targets of this research are 78 patients with epiphora due to the blockage at the lachrymal duct from January 2013 to August 2013. Average age was $56.96{\pm}13.36$. By using a micropipette, we dropped 1-2 drops of $^{99m}TcO4^-$ of 3.7 MBq (0.1 mCi) with $10{\mu}L$ of each drop into the inferior conjunctival fold, then we performed dynamic check for 20 minutes with 20 frames of each minute. In case of we checked the passage from both eyes to nasal cavity immediately after the dynamic check, we obtained oblique view immediately. If we didn't see the passage in either side of the orbit, we obtained oblique views of the orbit after checking the frontal film in 40 minutes. The instrument we used was Pin-hole Collimator with Gamma Camera(Siemens Orbiter, Hoffman Estates, IL, USA). Results: Among the 78 patients with dacryoscintigraphy, 35 patients were confirmed with passage into the nasal cavity from the anterior view. Among those 35 patients, 15 patients were confirmed with passage into the nasal cavity on both eyes, and it was able to observe better passage patterns through oblique view with a result of 8 on both eyes, 2 on left eye, and 1 on right eye. 20 patients had passage in left eye or right eye, among those patients 10 patients showed clear passage compared to the anterior view. 13 patients had possible passage, and 30 patients had no proof of motion of the tracer. To sum up, 21 patients (60%) among 35 patients showed clear pattern of passage with additional oblique views compared to anterior view. People responded obtaining oblique views though 5 points scale about the utility of passage identification helps make diagnoses the passage, passage delayed, and blockage of naso-lachrymal duct by showing the well-seen portions from anterior view. Also, when classifying passage to naso-lachrymal duct and flow to the skin, oblique views has higher chance of classification in case of epiphora (anterior:$4.14{\pm}0.3$, oblique:$4.55{\pm}0.4$). Conclusion: It is considered that if you obtain oblique views of the bilateral orbits in addition to anterior view during the dacryoscintigraphy, the ability of diagnose for reading will become higher because you will be able to see the areas that you could not observe from the anterior view so that you can see if it emitted after the naso-lachrymal duct and the flow of epiphora on the skin.

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A Comparative Study of the Standard Uptake Values of the PET Reconstruction Methods; Using Contrast Enhanced CT and Non Contrast Enhanced CT (PET/CT 영상에서 조영제를 사용하지 않은 CT와 조영제를 사용한 CT를 이용한 감쇠보정에 따른 표준화섭취계수의 비교)

  • Lee, Seung-Jae;Park, Hoon-Hee;Ahn, Sha-Ron;Oh, Shin-Hyun;NamKoong, Heuk;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.235-240
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    • 2008
  • Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of $^{18}F$-FDG and were scanned about 60 min after injection. All patients had a whole body PET/CT performed without IV contrast media followed by a contrast-enhanced CT on the Discovery STe PET/CT scanner. CT data were used for AC and PET images came out after AC. The ROIs drew and measured SUV. A paired t-test of these results was performed to assess the significance of the difference between the SUV obtained from the two attenuation corrected PET images. Results: The mean and maximum Standardized Uptake Values (SUV) for different regions averaged over all Patients. Comparing before using Contrast Media and after using, Most of ROIs have the increased SUV when it did Contrast Enhanced CT compare to Non-Contrast enhanced CT. All regions have increased SUV and also their p value was under 0.05 except the mean SUV of the Heart region. Conclusion: In this regard, the effect on SUV measurements that occurs when a contrast-enhanced CT is used for attenuation correction could have significant clinical ramifications. But some submitted thesis insisted that the percentage change in SUV that can determine or modify clinical management of oncology patients is small. Because there was not much difference that could be discovered by interpreter. But obviously the numerical change was occurred and on the stage finding primary region, small change would be base line, such as the region of liver which has greater change than the other regions needs more attention.

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Korean-Style No-tillage Organic Agriculture on Recycled Ridge IV. Changes in Soil Microorganisms and Enzymes by Split Irrigation and Organic Matter Application in Organic Farming of Red Pepper in Plastic Film Greenhouse (두둑을 재활용한 한국형 무경운 유기 농업 IV. 분할관수와 유기물처리에 의한 시설 고추 유기재배 토양 미생물상과 토양 효소의 변화)

  • Yang, Seung-Koo;Shin, Kil-Ho;Song, Yong-Su;Kim, Kil-Yong;Jung, Woo-Jin
    • Korean Journal of Organic Agriculture
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    • v.25 no.2
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    • pp.311-328
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    • 2017
  • This study was carried out to investigate the changes in soil microorganisms and soil enzymes by split irrigation and organic matter application under no-tillage green house conditions. Soil bacteria and fungi abundances were higher in soybean cake fertilizer than in the soil without the soybean cake fertilizer under whole quantity irrigation. Bacteria and fungi abundances in soil increased with increasing organic fertilizer application rate. Bacteria and fungi amount in the soil increased at half division irrigation in no-treatment of soybean cake fertilizer compared with whole quantity irrigation. Actinomycete amount in the soil decreased with increasing soybean cake fertilizer with whole quantity irrigation while clearly increased in no-treatment of soybean cake fertilizer. Actinomycete amount in soil clearly increased with increasing organic fertilizer input at half division irrigation. Chitinase activity in the soil decreased in soybean cake fertilizer with increasing organic fertilizer input, while increased in no-treatment of soybean cake fertilizer. Chitinase activity in the soil increased at half division irrigation compared with whole quantity irrigation regardless of soybean cake fertilizer input. ${\beta}$-Glucosidase activity in the soil was higher in soybean cake fertilizer than in no-treatment of soybean cake fertilizer with whole quantity irrigation. ${\beta}$-Glucosidase activity in the soil increased with increasing organic fertilizer input, but decreased in above the standard level 66%. ${\beta}$-Glucosidase activity in the soil clearly increased in no-treatment of soybean cake fertilizer at half division irrigation compared with whole quantity irrigation. N-acetyl-${\beta}$-D-glucosaminidase activity was higher in soybean cake fertilizer than in no-treatment of soybean cake fertilizer with whole quantity irrigation. N-acetyl-${\beta}$-D-glucosaminidase activity in the soil increased with increasing organic fertilizer input, but decreased in above the standard level 66%. N-acetyl-${\beta}$-D-glucosaminidase activity in the soil was not significantly different at half division irrigation and whole quantity irrigation in organic fertilizer input, while increased at half division irrigation in no-treatment of soybean cake fertilizer. Acid phosphatase activity increased at standard level 66% in soybean cake fertilizer, while was not significantly different in no-treatment of soybean cake fertilizer. Spore density of Arbuscular Mycorrhizal Fungi (AMF) in the soil increased with increasing organic fertilizer input at whole quantity irrigation in no-treatment of soybean cake fertilizer, while decreased above the standard level 66% in organic fertilizer input. However, spore density of AMF in the soil was not significantly different in soybean cake fertilizer regardless of input amount of organic fertilizer. Root colonization rate of AMF in red pepper roots was not significant difference at two irrigations regardless of soybean cake input.

Clinical Outcomes of Off-pump Coronary Artery Bypass Grafting (심폐바이패스 없는 관상동맥우회술의 임상성적)

  • Shin, Je-Kyoun;Kim, Jeong-Won;Jung, Jong-Pil;Park, Chang-Ryul;Park, Soon-Eun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.34-40
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    • 2008
  • Background: Off-pump coronary artery bypass grafting (OPCAB) shows fewer side effects than cardiopulmonary by. pass, and other benefits include myocardial protection, pulmonary and renal protection, coagulation, inflammation, and cognitive function. We analyzed the clinical results of our cases of OPCAB. Material and Method: From May 1999 to August 2007, OPCAB was performed in 100 patients out of a total of 310 coronary artery bypass surgeries. There were 63 males and 37 females, from 29 to 82 years old, with a mean age of $62{\pm}10$ years. The preoperative diagnoses were unstable angina in 77 cases, stable angina in 16, and acute myocardial infarction in 7. The associated diseases were hypertension in 48 cases, diabetes in 42, chronic renal failure in 10, carotid artery disease in 6, and chronic obstructive pulmonary disease in 5. The preoperative cardiac ejection fraction ranged from 26% to 74% (mean $56.7{\pm}11.6%$). Preoperative angiograms showed three-vessel disease in 47 cases, two-vessel disease in 25, one-vessel disease in 24, and left main disease in 23. The internal thoracic artery was harvested by the pedicled technique through a median sternotomy in 97 cases. The radial artery and greater saphenous vein were harvested in 70 and 45 cases, respectively (endoscopic harvest in 53 and 41 cases, respectively). Result: The mean number of grafts was $2.7{\pm}1.2$ per patient, with grafts sourced from the unilateral internal thoracic artery in 95 (95%) cases, the radial artery in 62, the greater saphenous vein in 39, and the bilateral internal thoracic artery in 2. Sequential anastomoses were performed in 46 cases. The anastomosed vessels were the left anterior descending artery in 97 cases, the obtuse marginal branch in 63, the diagonal branch in 53, the right coronary artery in 30, the intermediate branch in 11, the posterior descending artery in 9 and the posterior lateral branch in 3. The conversion to cardiopulmonary bypass occurred in 4 cases. Graft patency was checked before discharge by coronary angiography or multi-slice coronary CT angiography in 72 cases, with a patency rate of 92.9% (184/198). There was one case of mortality due to sepsis. Postoperative arrhythmias or myocardial in-farctions were not observed. Postoperative complications were a cerebral stroke in 1 case and wound infection in 1. The mean time of respirator care was $20{\pm}35$ hours and the mean duration of stay in the intensive care unit was $68{\pm}47$ hours. The mean amounts of blood transfusion were $4.0{\pm}2.6$ packs/patient. Conclusion: We found good clinical outcomes after OPCAB, and suggest that OPCAB could be used to expand the use of coronary artery bypass grafting.

The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

  • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.671-682
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    • 1996
  • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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Oxidative Inactivation of Peroxiredoxin Isoforms by H2O2 in Pulmonary Epithelial, Macrophage, and other Cell Lines with their Subsequent Regeneration (폐포상피세포, 대식세포를 비롯한 각종 세포주에서 H2O2에 의한 Peroxiredoxin 동위효소들의 산화에 따른 불활성화와 재생)

  • Oh, Yoon Jung;Kim, Young Sun;Choi, Young In;Shin, Seung Soo;Park, Joo Hun;Choi, Young Hwa;Park, Kwang Joo;Park, Rae Woong;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.31-42
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    • 2005
  • Background : Peroxiredoxins (Prxs) are a relatively newly recognized, novel family of peroxidases that reduce $H_2O_2$ and alkylhydroperoxide into water and alcohol, respectively. There are 6 known isoforms of Prxs present in human cells. Normally, Prxs exist in a head-to-tail homodimeric state in a reduced form. However, in the presence of excess $H_2O_2$, it can be oxidized on its catalytically active cysteine site into inactive oxidized forms. This study surveyed the types of the Prx isoforms present in the pulmonary epithelial, macrophage, endothelial, and other cell lines and observed their response to oxidative stress. Methods : This study examined the effect of exogenous, excess $H_2O_2$ on the Prxs of established cell lines originating from the pulmonary epithelium, macrophages, and other cell lines, which are known to be exposed to high oxygen partial pressures or are believed to be subject to frequent oxidative stress, using non-reducing SDS polyacrylamide electrophoresis (PAGE) and 2 dimensional electrophoresis. Result : The addition of excess $H_2O_2$ to the culture media of the various cell-lines caused the immediate inactivation of Prxs, as evidenced by their inability to form dimers by a disulfide cross linkage. This was detected as a subsequent shift to its monomeric forms on the non-reducing SDS PAGE. These findings were further confirmed by 2 dimensional electrophoresis and immunoblot analysis by a shift toward a more acidic isoelectric point (pI). However, the subsequent reappearance of the dimeric Prxs with a comparable, corresponding decrease in the monomeric bands was noted on the non-reducing SDS PAGE as early as 30 minutes after the $H_2O_2$ treatment suggesting regeneration after oxidation. The regenerated dimers can again be converted to the inactivated form by a repeated $H_2O_2$ treatment, indicating that the protein is still catalytically active. The recovery of Prxs to the original dimeric state was not inhibited by a pre-treatment with cycloheximide, nor by a pretreatment with inhibitors of protein synthesis, which suggests that the reappearance of dimers occurs via a regeneration process rather than via the de novo synthesis of the active protein. Conclusion : The cells, in general, appeared to be equipped with an established system for regenerating inactivated Prxs, and this system may function as a molecular "on-off switch" in various oxidative signal transduction processes. The same mechanisms might applicable other proteins associated with signal transduction where the active catalytic site cysteines exist.

Effects of Size and Environmental Condition on Burrowing of Artificial Seedling of Ark Shell, Scapharca broughtonii (Schrenck) (피조개, Scapharca broughtonii (Schrenck) 인공치패의 크기 및 환경조건이 잠입에 미치는 영향)

  • Kim, Byeong-Hak;Shin, Yun-Kyung;Choi, Nack-Joong;Oh, Bong-Se;Sohn, Sang-Gyu;Jung, Choon-Goo;Son, Tai-Sun;Kang, Kyoung-Ho
    • The Korean Journal of Malacology
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    • v.23 no.1
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    • pp.1-8
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    • 2007
  • The influence of individual size, sediment, gain size, water temperature, salinity and air exposure on burrowing rate was investigated in order to obtain the basic biological data on applying shellfish farm for a sustainable production of ark shell, Scapharca broughtonii (Schrenk). The burrowing rate on individual size 300 minutes after starting the experiment was the highest in the shell length $16.3\;{\pm}\;1.2\;mm$, 97.7%. The highest burrowing rates were 97.0% in $12.8\;{\pm}\;0.8\;mm$, 96.7% in $9.2\;{\pm}\;1.0\;mm$, and 96.3% in $5.9\;{\pm}\;0.7\;mm$. The clams over 6 mm of shell length had burrowing ability and the burrowing rate was not related to the shell size. The burrowing rate depending on the kind of grain at the bottom after 300 minutes was the highest, 98.3%, in the mixture of sand and silt with a ratio of 75:25. The rates were 98% in silt (100%), 97.3% in mixture sand and silt with a ratio of 50:50, 97.3% in sand and silt ratio of 25:75, and 86.3% in sand (100%) in this specific order. On grain size of the soil in the seafloor, the burrowing rates after 300 minutes was at its highest in the group of sand in pore size 1 mm with 85.0%, and the $12\;{\mu}m$ to 1 mm in the grain size was fitted to burrowing of artificial seed. In the case of water temperature, the burrowing rates were at its highest after 300 minutes. In $30^{\circ}C$ group, the rate was 96.7% and in $25^{\circ}C$ and $20^{\circ}C$, 90.0%. The rates decreased as the water temperature decreased below $15^{\circ}C$. The burrowing rates on salinity were the highest in 30 psu with 93.3% and at 15 psu and below, there was no noticeable change in the burrowing rate. On air exposure, the burrowing rates after 300 minutes were the highest in 1 hour with 93.3%, and remarkably decreased as air exposure time is longer after 12 hours of air exposure.

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Fracture load and marginal fitness of zirconia ceramic coping by design and coloration (유색 및 백색 지르코니아 세라믹 코핑의 코핑 디자인에 따른 파절 하중과 변연 적합성)

  • Shin, Mee-Ran;Kim, Min-Jeong;Oh, Sang-Chun
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.406-415
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    • 2009
  • Purpose: The purpose of this study was to compare the marginal fitness and fracture load of the zirconia copings according to the design with different thickness and coloration. Material and methods: The evaluation was based on 80 zirconia copings. Zirconia copings were fabricated in design with different thicknesses using CAD/CAM system (Everset, KAVO dental GmbH, Biberach, Germany). The designs of copings were divided into four groups. The first group consisted of copings with uniform thickness of 0.3 mm. The thickness in the second group was 0.3 mm on the buccal surface and 0.6 mm on the lingual surface. The third group consisted of coping with uniform thickness of 0.6 mm. The thickness in the fourth group was 0.6 mm on the buccal surface and 1mm on the lingual surface. Each group consisted of 10 colored and 10 uncolored copings. Half of the copings (40) processed with a milling system according to the specific design were sent to be given a color (A3) through saturation in special dye by a manufacturing company. Just after sintering, the marginal discrepancies of copings were measured on the buccal, lingual, mesial and distal surfaces of metal die, under a Video Microscope System (sv-35, Sometech, Seoul, Korea) at a magnification of $\times$ 100. It was remeasured after the adjusting of the inner surface. Next, all copings were luted to the metal dies using reinforced cement {GC FujiCEM (GC Corp. Tokyo, Japan)} and mounted on the testing jig in a Universal Testing Machine (Instron 4467, Norwood, MA, USA). The results were analyzed statistically using the one-way ANOVA test. Results: The obtained results were as follow: 1. The measured value of marginal discrepancy right after sintering was the greatest in the contraction of the buccal area in all groups, except for group I2. 2. There was no significant difference of marginal fitness among the groups in the colored zirconia group (P<.05). 3. When the marginal fitness among the groups in the uncolored zirconia group was considered, group II2 had the smallest marginal discrepancy. 4. When the colored and uncolored groups with the same design were compared, there was a significant difference between I1 and II1 groups. In group 2, 3, and 4, the uncolored zirconia had the greatest marginal fitness (P<.05). 5. After adjustment of inner surface, there was no significant difference in the marginal fitness in all groups when color and design of the zirconia coping were compared. 6. The fracture load of CAD/CAM zirconia copings showed significant difference in group 1, 2, 3, and 4. I4 and II4 had the strongest fracture load. 7. When groups with different color and same design were compared, all colored groups showed greater fracture load (P>.05), with no significance. Conclusion: There was difference in the marginal fitness according to the design and coloration of zirconia copings right after sintering, but it was decided that the copings may well be used clinically if the inner surface are adjusted. The copings should be thick enough for the reinforcement of fracture strength. But considering the esthetics of the visible surfaces (labial and buccal surface), the thickness of copings may be a little thin, without giving any significant effect on the fracture strength. This type of design may be considered when giving priority to preservation of tooth or esthetics.

Measuring Consumer-Brand Relationship Quality (소비자-브랜드 관계 품질 측정에 관한 연구)

  • Kang, Myung-Soo;Kim, Byoung-Jai;Shin, Jong-Chil
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.2
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    • pp.111-131
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    • 2007
  • As a brand becomes a core asset in creating a corporation's value, brand marketing has become one of core strategies that corporations pursue. Recently, for customer relationship management, possession and consumption of goods were centered on brand for the management. Thus, management related to this matter was developed. The main reason of the increased interest on the relationship between the brand and the consumer is due to acquisition of individual consumers and development of relationship with those consumers. Along with the development of relationship, a corporation is able to establish long-term relationships. This has become a competitive advantage for the corporation. All of these processes became the strategic assets of corporations. The importance and the increase of interest of a brand have also become a big issue academically. Brand equity, brand extension, brand identity, brand relationship, and brand community are the results derived from the interest of a brand. More specifically, in marketing, the study of brands has been led to the study of factors related to building of powerful brands and the process of building the brand. Recently, studies concentrated primarily on the consumer-brand relationship. The reason is that brand loyalty can not explain the dynamic quality aspects of loyalty, the consumer-brand relationship building process, and especially interactions between the brands and the consumers. In the studies of consumer-brand relationship, a brand is not just limited to possession or consumption objectives, but rather conceptualized as partners. Most of the studies from the past concentrated on the results of qualitative analysis of consumer-brand relationship to show the depth and width of the performance of consumer-brand relationship. Studies in Korea have been the same. Recently, studies of consumer-brand relationship started to concentrate on quantitative analysis rather than qualitative analysis or even go further with quantitative analysis to show effecting factors of consumer-brand relationship. Studies of new quantitative approaches show the possibilities of using the results as a new concept of viewing consumer-brand relationship and possibilities of applying these new concepts on marketing. Studies of consumer-brand relationship with quantitative approach already exist, but none of them include sub-dimensions of consumer-brand relationship, which presents theoretical proofs for measurement. In other words, most studies add up or average out the sub-dimensions of consumer-brand relationship. However, to do these kind of studies, precondition of sub-dimensions being in identical constructs is necessary. Therefore, most of the studies from the past do not meet conditions of sub-dimensions being as one dimension construct. From this, we question the validity of past studies and their limits. The main purpose of this paper is to overcome the limits shown from the past studies by practical use of previous studies on sub-dimensions in a one-dimensional construct (Naver & Slater, 1990; Cronin & Taylor, 1992; Chang & Chen, 1998). In this study, two arbitrary groups were classified to evaluate reliability of the measurements and reliability analyses were pursued on each group. For convergent validity, correlations, Cronbach's, one-factor solution exploratory analysis were used. For discriminant validity correlation of consumer-brand relationship was compared with that of an involvement, which is a similar concept with consumer-based relationship. It also indicated dependent correlations by Cohen and Cohen (1975, p.35) and results showed that it was different constructs from 6 sub-dimensions of consumer-brand relationship. Through the results of studies mentioned above, we were able to finalize that sub-dimensions of consumer-brand relationship can viewed from one-dimensional constructs. This means that the one-dimensional construct of consumer-brand relationship can be viewed with reliability and validity. The result of this research is theoretically meaningful in that it assumes consumer-brand relationship in a one-dimensional construct and provides the basis of methodologies which are previously preformed. It is thought that this research also provides the possibility of new research on consumer-brand relationship in that it gives root to the fact that it is possible to manipulate one-dimensional constructs consisting of consumer-brand relationship. In the case of previous research on consumer-brand relationship, consumer-brand relationship is classified into several types on the basis of components consisting of consumer-brand relationship and a number of studies have been performed with priority given to the types. However, as we can possibly manipulate a one-dimensional construct through this research, it is expected that various studies which make the level or strength of consumer-brand relationship practical application of construct will be performed, and not research focused on separate types of consumer-brand relationship. Additionally, we have the theoretical basis of probability in which to manipulate the consumer-brand relationship with one-dimensional constructs. It is anticipated that studies using this construct, which is consumer-brand relationship, practical use of dependent variables, parameters, mediators, and so on, will be performed.

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