Facing a complex environment driven by a decade, many companies are adopting new strategic frameworks such as Customer Relationship Management system to achieve sustainable profitability as well as overcome serious competition for survival. In many business areas, CRM system advanced a great deal in a matter of continuous compensating the defect and overall integration. However, pharmaceutical companies in Korea were slow to accept them for usesince they still have a tendency of holding fast to traditional way of sales and marketing based on individual networks of sales representatives. In the circumstance, this article tried to empirically address current status of CRM system as well as the effects of the system on the performance of pharmaceutical companies by applying BSC method's four perspectives, from financial, customer, learning and growth and internal process. Survey by e-mail and post to employers and employees who were working in pharma firms were undergone for the purpose. Total 113 cases among collected 140 ones were used for the statistical analysis by SPSS ver. 15 package. Reliability, Factor analysis, regression were done. This study revealed that CRM system had a significant effect on improving financial and non-financial performance of pharmaceutical companies as expected. Proposed regression model fits well and among them, CRM marketing information system shed the light on substantial impact on companies' outcome given profitability, growth and investment. Useful analytical information by CRM marketing information system appears to enable pharmaceutical firms to set up effective marketing and sales strategies, these result in favorable financial performance by enhancing values for stakeholderseventually, not to mention short-term profit and/or mid-term potential to growth. CRM system depicted its influence on not only financial performance, but also non-financial fruit of pharmaceutical companies. Further analysis for each component showed that CRM marketing information system were able to demonstrate statistically significant effect on the performance like the result of financial outcome. CRM system is believed to provide the companies with efficient way of customers managing by valuable standardized business process prompt coping with specific customers' needs. It consequently induces customer satisfaction and retentionto improve performance for long period. That is, there is a virtuous circle for creating value as the cornerstone for sustainable growth. However, the research failed to put forward to evidence to support hypothesis regarding favorable influence of CRM sales representative's records assessment system and CRM customer analysis system on the management performance. The analysis is regarded to reflect the lack of understanding of sales people and respondents between actual work duties and far-sighted goal in strategic analysis framework. Ordinary salesmen seem to dedicate short-term goal for the purpose of meeting sales target, receiving incentive bonus in a manner-of-fact style, as such, they tend to avail themselves of personal network and sales and promotional expense rather than CRM system. The study finding proposed a link between CRM information system and performance. It empirically indicated that pharmaceutical companies had been implementing CRM system as an effective strategic business framework in order for more balanced achievements based on the grounded understanding of both CRM system and integrated performance. It suggests a positive impact of supportive CRM system on firm performance, especially for pharmaceutical industry through the initial empirical evidence. Also, it brings out unmet needs for more practical system design, improvement of employees' awareness, increase of system utilization in the field. On the basis of the insight from this exploratory study, confirmatory research by more appropriate measurement tool and increased sample size should be further examined.
Purpose : This research evaluates the effect of the use of absorbable membrane barrier with deproteinized bovine bone (Bio-$Oss^{(R)}$, Switzerland) on bone healing in surgically created critical-sized defects in rat calvaria. Materials and Methods : Two standardized transosseous circular calvarial defects (5 mm in diameter) are made in each calvarium of 30 rats. These rats are divided into negative control group(n=15), positive control group(n=15) and two experimental groups(n=15). In the negative control group, defects are only filled with blood clots. In the positive control group, defects are filled with autogenous bone obtained from calvarium; in the experimental group 1, defects are filled with deproteinized bovine bone; and in the experimental group 2, defects are filled with deproteinized bovine bone with absorbable membrane. At the postoperative 1 week, 3 weeks. and 6 weeks, clinical. histologic and histomorphometric evaluations of the defects are performed. Results : 1. The grafted bone without membrane in the calvarial bone defect was scattered but, the grafted bone with membrane was stable. 2. $BioMesh^{(R)}$ membrane was absorbed beginning at 3 weeks, and was absorbed considerably at 6 weeks while maintaining the structural form of the membrane. 3. The use of membrane blocked soft tissue invasion. 4. In histomorphometric analysis. it showed the greatest amount of new bone formation in the positive control group. The amount of new bone formation was greater in the experimental group 2 than experimental group 1. At 6 weeks. the amount of new bone formation was greater in the positive control group than experimental group l(p<0.005). Conclusion : These results suggest that membrane increase the stability of grafted bone and protects from soft tissue invasion, and the use of the membrane may promote new bone formation in deproteinized bovine bone graft area.
One-dimensional cubic phase silicon carbide nanowires (${\beta}$-SiC NWs) were efficiently synthesized by thermal chemical vapor deposition (TCVD) with mixtures containing Si powders and nickel chloride hexahydrate $(NiCl_2{\cdot}6H_2O)$ in an alumina boat with a carbon source of methane $(CH_4)$ gas. SEM images are shown that the growth temperature (T) of $1,300^{\circ}C$ is not enough to synthesize the SiC NWs owing to insufficient thermal energy for melting down a Si powder and decomposing the methane gas. However, the SiC NWs could be synthesized at T>$1,300^{\circ}C$ and the most efficient temperature for growth of SiC NWs is T=$1,400^{\circ}C$. The synthesized SiC NWs have the diameter with an average range between 50~150 nm. Raman spectra clearly revealed that the synthesized SiC NWs are forming of a cubic phase (${\beta}$-SiC). Two distinct peaks at 795 and $970 cm^{-1}$ in Raman spectra of the synthesized SiC NWs at T=$1,400^{\circ}C$ represent the TO and LO mode of the bulk ${\beta}$-SiC, respectively. XRD spectra are also supported to the Raman spectra resulting in the strongest (111) peaks at $2{\Theta}=35.7^{\circ}$, which is the (111) plane peak position of 3C-SiC. Moreover, the gas flow rate of 300 sccm for methane is the optimal condition for synthesis of a large amount of ${\beta}$-SiC NW without producing the amorphous carbon structure shown at a high methane flow rate of 800 sccm. TEM images are shown two kinds of the synthesized ${\beta}$-SiC NWs structures. One is shown the defect-free ${\beta}$-SiC NWs with a (111) interplane distance of 0.25 nm, and the other is the stacking-faulted ${\beta}$-SiC NWs. Also, TEM images exhibited that two distinct SiC NWs are uniformly covered with $SiO_2$ layer with a thickness of less 2 nm.
Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.
This experiment was performed to evaluate the morphological responses of the gastric epithelial cells of the mouse, inoculated with Ehrlich carcinoma cells in the inguinal area, following administration of BCG. Healthy adult ICR mice weighing 25 gm each were divided into normal and experimental groups (tumor control group and BCG-treated group). In the experimental groups, each mouse was inoculated with $1{\times}10^7$ Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day after inoculations, 0.2 mL of saline or BCG (0.5 mL/25 g B.W.: $0.03{\times}10^8{\sim}0.32{\times}10^8$ CFU) were injected subcutaneously to the animals every other day, respectively. The day following the 7th injection of saline or BCG, each mouse was injected with a single dose of 0.7 ${\mu}Ci/g$ of methyl-$^3H$-thymidine (25 Ci/mmol, Amersham Lab., England) through tail vein. Seventy minutes after the thymidine injection, animals were sacrificed, and gastric tissues were taken and fixed in 10% neutral formalin. Deparaffinized sections were coated with autoradiographic emulsion EM-1 (Amersham Lab., England) in a dark room. The number of labeled epithelial cells in the gastric mucosae (mean number of labeled epithelial cells per 3.5 mm length of mucosa) were observed and calculated. And for electron microscopic observation, gastric tissues were prefixed with 2.5% glutaraldehyde-1.5% paraformaldehyde solution, followed by post-fixation with 1% osmium tetroxide solution. On the light microscopic study, gastric mucosae had no morphological changes following the injection of BCG. On the electron microscopic study, in the BCG-treated mice, myelin figures and multivesicular bodies within the gastric epithelial cells were observed more frequently than in those of the normal control ones. On the autoradiographic study, number of the labeled cells of normal control, tumor control and BCG-treated mice were 380.2 (${\pm}31.35$), 426.1 (${\pm}28.43$) and 301.8 (${\pm}34.63$), respectively. In the BCG-treated mice, poorly-labeled cells containing only a few silver grains of 3H-thymidine were observed more frequently as compared in those of the normal control and tumor control ones. From the above results, BCG may suppress the DNA synthesis of the gastric epithelial cells, but does not results severe fine structural defect on the gastric epithelial cells. These results suggest that BCG is expected as one of the effective supplemental anticancer drugs.
A high sugar rice cultivar 'Danmi' which has been recently developed and released in the Functional Crop Resource Development Division, Department of Functional Crop, National Institute of Crop Science, has high glucose and sucrose contents but has a poor seed development. This defect poses some problem in ensuring stable seedling establishment in the nursery bed. We examined the germination and seedling emergence characteristics of 'Danmi' and determined an optimum seeding rate for seedling establishment. 'Danmi' seeds has a light 1,000-grain weight of 18.2g compared with Ilmibyeo's 26.7g. The 97.4% of 'Danmi' seeds has specific gravity below 1.0 while only 2.0% of seeds was fully developed with specific gravity above 1.12. However, the reverse is true in the Ilmibyeo seed used as a control cultivar. Although the seed germination of Danmi was 89-91% regardless of seed specific gravity but at a slower rate than Ilmibyeo regardless of water soaking temperatures of $20-30^{\circ}C$ because of high seed amount of specific gravity below 1.0 in 'Danmi'. It took 2~4 days longer of seed soaking in the Danmi seeds than Ilmibyeo before germination. 'Danmi' has low normal seedling emergence rate than Ilmibyeo in the seedbed soil due to high percentage of abnormal seedlings like stunting and incomplete growth. Normal seedling emergence rate of 'Danmi' in the seedbed was 62.6~64.9% for 10-day old seedling and 83.5~86.7% for 30-day old seedling which is lower by 29.6~30.0% and 11.3~12%, respectively than Ilmibyeo. Although 'Danmi' has low normal seedling emergence rate, but it has greater seed number per weight basis. Therefore, based on the normal seedling number per unit area of Ilmibyeo(control cultivar) for seedling rate of 10-day and 30-day old seedlings, the recommended seeding rate of 'Danmi' for transplanting rice is 220g seeds for 10-day old seedling and 130g for 30-day old seedling per nursery box, which is equivalent to 1.5 times seed volumes of Ilmibyeo.
Background: The fixed dose regimen with activated coagulation time(ACT) is the most commonly employed method for determining the required dosage of heparin and protamine during cardiopulmonary bypass(CPB). Material and Method: We performed a prospective study on a fixed dose regimen for analyzing adequate dosages of heparin and protamine, the incidence of heparin resistance and heparin-induced thrombocyt openia, factors affecting ACT during CPB, and changes of ACT during aprotinin usage. 300 units/kg of heparin were administered to patients, and ACTs were measured after 5 mins. ACTs were checked at 10 mins and 30 mins after the onset of CPB, and then at 30 min intervals thereafter. If the measured ACT was under 400 secs, we added 100 units/kg of heparin. The heparin was reversed with 1 mg of protamine for each 100 units administered. If the measured ACT was longer than 130 secs 30 mins after protamine administration or if there was definitive evidence of a coagulation defect, we administered a further 0.5 mg/kg of protamine. Result: We studied 80 patients(50 adults and 30 children) who underwent open heart surgery(OHS) at Seoul National University Hospital. Preoperative ACT was 114.3${\pm}$19.3 secs in adults, and 119.5${\pm}$18.2 secs in children. There were no differences in preoperative ACT due to age, body weight, body surface area, or sex. The preoperative ACT was not influenced by a positive past history of OHS. Ten adults(20%) and 3 pediatric patients(10%) needed additional doses of heparin to maintain the ACT above 400 secs. Additional protamine administration was needed in 9 adults(18%) and 10 children(33%). Heparin resistance was found in only two adults. Heparin-induced thrombocytopenia was detected in 2 adults and 1 child. During CPB, ACT was prolonged. 12 adult patients received a low dose of aprotinin and showed longer celite activated ACT compared to the control group.The kaolin activated ACT showed a lower tendency than the celite activated ACT in aprotinin users. Conclusion: In conclusion, fixed dose regimen of heparin and protamine can be used without significant problems, but the incidence of need of additional dosage remains unsatisfactory.
Background: The late results of repair of tetralogy of Fallot(TOF) are favorable in most patients. Some portion of the patients with tetralogy, however, require reoperation for residual lesions or result in late death. The outcome of patients after tetralogy repair performed during the past 13 years was studied, with an emphasis on postrepair survival and problems including reoperations. Material and Method: A retrospective review of clinical, echocardiographic and catheterization data was performed in 569 of 775 patients with TOF who underwent corrective repair between 1983 and 1995 at Sejong General Hospital, Buchon, Korea. Result: Of 28(4.9%) early deaths(defined as 30 days postrepair), 12 deaths(42.9%) were <1 year of age, with an operative mortality of 15.4%. The surviving 541 patients(age 2.8 months to 43.4 years, median 23 months) have been followed up from 1 month to 12.6 years(median 35 months) postoperatively. Most patients were in good functional class and had normal right ventricular(RV) function. Postrepair results were compared between the transatrial-transpulmonary approach and the conventional right ventriculotomy. The former technique provided a lesser incidence of significant pulmonary regurgitation(P<0.001) and alesser degree of RV dysfunction(P<0.05) compared with those in the latter. There were 10(1.8%) late deaths during the follow-up period and 6 of the deaths were directly related to reoperation or ventricular dysfunction. The 10-year actuarial survival rate was 96.7%. There were 44 reoperations(8.1%) in 39 patients(7.2%), with an operative mortality of 10.3%. The main indications or reoperation included residual ventricular septal defect(VSD) (n=6), pulmonary stenosis(PS) (n=11), VSD with PS(n=17), pulmonary regurgitation(n=7), and tricuspid regurgitation(n=2). The 5- and 10-year freedom from reoperation were 89.4% and 76.1%, respectively. Conclusion: Although the majority of patients with repaired TOF are clinically well, with a high rate of survival, approximately 7% of patients have residual lesions that require surgical therapy. Therefore, the timely and meticulous corrective repair is mandatory to avoid reoperation, and continued close surveillance is also needed for the early detection of residual problems.
This study was carried out to evaluate the shear bond strength and adhesive bond durability of structural glued laminated timber (glulam) manufactured with mixed species lumber of Korean red pine, Korean pine and Japanese larch, using resorcinol adhesive and water-based polymeric-isocyanate adhesive (WPI). Each board used as a glulam lamina was graded by visual inspection. The visual lumber grade of the all species was very low due to the large size and number of knots and the steep slope of grain. In view of the results, appropriate pruning, sawing and drying processes might be needed to produce high grade lamina lumber with small knot size and drying defect free. Shear bond strength of every tested glulam specimen ranged between 7.9 and $9.9N/mm^2$, and much higher than the Korean Standard (KS) for glulam shear bond strength, $7.1N/mm^2$. There was not much shear bond strength difference between wood/resorcinol and wood/WPI. The resorcinol adhesive bond durability exceeded KS requirements. However, delamination on the end-grain surfaces of WPI glulam submerged in both room temperature and boiling water severely occurred, and its durability did not meet KS requirements. Further investigations may be required, and special care should be taken, to ensure long service life of WPI glulam used for exterior application. Results of this study are expected to be useful for improvement of mechanical properties and structural performance of mixed species glulam.
The presentation of this paper was triggered by the spread of MERS in Korea in the year 2015. The analysis of the present acts related with MERS is necessary in order to cope efficiently with any probable spread of such infectious diseases as MERS in future. The acts that should be analyzed in this paper include 'Medical Service Act' and 'Infectious Disease Control And Prevention Act' (hereafter, IDCAPA). At first the classification of the infectious diseases in IDCAPA should be referred to. The Act does not properly classify them because the scope of concept of each group of the infectious diseases overlaps each other. This overlap should be removed. The present system in IDCAPA is not proper for the efficient notification and reporting of the infectious disease patients. This is so in some viewpoints including the persons obligated to make the notification and reporting, the persons to whom they should notify and report such patients, and the process of notification and reporting. The efficient approach to the information related with the infectious disease is necessary for the rapid prevention of its spread. Cohort isolation and quarantine of the infectious patients and exposed contacts are the strongest and most efficient steps for the prevention of spread of the infectious diseases. One of the great problems related with such steps would be the conflict of powers or attributions, the likelihood of which is inevitable under the present system of IDCAPA. The IDCAPA distributed the power or attribution to take the steps to the three governments including the central government, the metropolitan government and the primary local government. The power should be concentrated in the central government, which could afford financially to compensate for the huge amount of damages caused likely by the steps. The power to take the steps would be actually just a useless thing for its holder without such financial capacity. The remedy for the victims by the fault of spreader should be approached to in the sense of national wealth. The general principle of tort law could not supply the victims with the sufficient remedy because the damages would be likely too huge for the wealth of such spreader to cope with. In future another parliamentary inspection could reveal another problems in the administration by the government of the MERS event in the year 2015. Any problem caused by defect in the legal system of the control and prevention of the infectious diseases should be taken into consideration when the legal system would be reformed in future.
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