• Journal of Chest Surgery
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• v.37 no.10
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• pp.817-826
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• 2004

Background: Several studies have demonstrated that conventional hypothermic cardiopulmonary bypass (CPB) causes cellular injury, abnormal responses in peripheral vascular beds and increased postoperative bleeding, whereas normothermic CPB provides protection of the hypothermic-induced effects and better cardiac recovery. The present study was prospectively performed to compare the effects of normothermic CPB to those of hypothermic CPB on the inflammatory and hematologic responses during cardiac surgery. Material and Method: Thirty-four adult patients scheduled for elective cardiac surgery were randomly assigned to hypothermic CPB (nasopharyngeal temperature $26～28^{\circ}C,$ n=17) or normothermic CPB (nasopharyngeal $temperature>35.5^{\circ}C,$ n=17) group. In both groups, cold $(4^{\circ}C)$ crystalloid cardioplegia was applied for myocardial protection. Blood samples were drawn from radial artery before (Pre-CPB), 10 minutes after starting (CPB-10) and immediately after ending (CPB-OFF) CPB. Total leukocyte and platelet counts, interleukin-6 (IL-6) level(expressed as percent to the baseline of Pre-CPB), D-dimer level, protein C and protein S activity were measured with the blood samples. The amount of bleeding for postoperative 24 hours and blood transfusion after operation were also assessed. All parameters were compared between the two groups. Result: The total leukocyte counts $(10,032\pm65/mm^3)$ and the increased ratio of IL-6 $(353\pm7.0%)$ at CPB-OFF in the normothermic group were higher than that $(7,254\pm48/mm^3$ and $298\pm7.3%)$ of the hypothermic group(p=0.02 and p=0.03). In the normothermic group, protein C activity $(32\pm3.8%)$ and protein S activity $(35\pm4.1%)$ at CPB-OFF were significantly lower than that $(45\pm4.3%$ and $51\pm3.8%)$ of the hypothermic group (p=0.04 and p=0.009). However, there were no differences in platelet counts and D-dimer concentration. In the normothermic group, the amount of bleeding for postoperative 24 hours $(850\pm23.2$ mL) and requirements for blood transfusion after operation such as packed cell $(1,402\pm20.5$ mL), fresh frozen plasma $(970\pm20.8$ mL) and platelet $(252\pm6.4$ mL) were higher than that $(530\pm21.5$ mL, $696\pm15.7$ mL, $603\pm18.2$ mL and $50\pm0.0$ mL) of the hypothermic group. Conclusion: These results indicate that normothermic CPB with cold crystalloid cardioplegia was associated with higher increase in inflammatory response, hemostatic abnormalities and postoperative bleeding problem than moderate hypothermic CPB.

• Journal of Intelligence and Information Systems
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• v.20 no.3
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• pp.151-171
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• 2014

Firms today have sought management effectiveness and efficiency utilizing information technologies (IT). Numerous firms are outsourcing specific information systems functions to cope with their short of information resources or IT experts, or to reduce their capital cost. Recently, Software-as-a-Service (SaaS) as a new type of information system has become one of the powerful outsourcing alternatives. SaaS is software deployed as a hosted and accessed over the internet. It is regarded as the idea of on-demand, pay-per-use, and utility computing and is now being applied to support the core competencies of clients in areas ranging from the individual productivity area to the vertical industry and e-commerce area. In this study, therefore, we seek to quantify the value that SaaS has on business performance by examining the relationships among firm strategies, SaaS technology maturity, and business performance of SaaS providers. We begin by drawing from prior literature on SaaS, technology maturity and firm strategy. SaaS technology maturity is classified into three different phases such as application service providing (ASP), Web-native application, and Web-service application. Firm strategies are manipulated by the low-cost strategy and differentiation strategy. Finally, we considered customer acquisition as a business performance. In this sense, specific objectives of this study are as follows. First, we examine the relationships between customer acquisition performance and both low-cost strategy and differentiation strategy of SaaS providers. Secondly, we investigate the mediating and moderating effects of SaaS technology maturity on those relationships. For this purpose, study collects data from the SaaS providers, and their line of applications registered in the database in CNK (Commerce net Korea) in Korea using a questionnaire method by the professional research institution. The unit of analysis in this study is the SBUs (strategic business unit) in the software provider. A total of 199 SBUs is used for analyzing and testing our hypotheses. With regards to the measurement of firm strategy, we take three measurement items for differentiation strategy such as the application uniqueness (referring an application aims to differentiate within just one or a small number of target industry), supply channel diversification (regarding whether SaaS vendor had diversified supply chain) as well as the number of specialized expertise and take two items for low cost strategy like subscription fee and initial set-up fee. We employ a hierarchical regression analysis technique for testing moderation effects of SaaS technology maturity and follow the Baron and Kenny's procedure for determining if firm strategies affect customer acquisition through technology maturity. Empirical results revealed that, firstly, when differentiation strategy is applied to attain business performance like customer acquisition, the effects of the strategy is moderated by the technology maturity level of SaaS providers. In other words, securing higher level of SaaS technology maturity is essential for higher business performance. For instance, given that firms implement application uniqueness or a distribution channel diversification as a differentiation strategy, they can acquire more customers when their level of SaaS technology maturity is higher rather than lower. Secondly, results indicate that pursuing differentiation strategy or low cost strategy effectively works for SaaS providers' obtaining customer, which means that continuously differentiating their service from others or making their service fee (subscription fee or initial set-up fee) lower are helpful for their business success in terms of acquiring their customers. Lastly, results show that the level of SaaS technology maturity mediates the relationships between low cost strategy and customer acquisition. That is, based on our research design, customers usually perceive the real value of the low subscription fee or initial set-up fee only through the SaaS service provide by vender and, in turn, this will affect their decision making whether subscribe or not.