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The Result of Bone Grafting for Fibrous Dysplasia (섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석)

  • Jeong, Won-Ju;Kim, Tae-Seong;Cho, Hwan-Seong;Yoon, Jong-Pil;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.74-79
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    • 2014
  • Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.

An Analytical Study of the Relationship between Climacteric Symptoms and the Stress of Life Events (갱년기 증상과 생활스트레스의 관계에 관한 연구)

  • Im Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.8 no.2
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    • pp.1-34
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    • 1994
  • This study has been done in order to analyze the relationship between climacteric symptoms and the stress of life events. For the purpose of this study. objectives set up were as followings. : 1. Climacteric symptoms complained by middle aged women are studied. 2. The stress of life events experienced by middle aged women is studied. 3. The relationship between climacteric symptoms and the stress of life events is studied. 4. The relationship between climacteric symptoms and general characteristics is studied. and the relationship between the stress of life events and general characteristics is also studied. The sample size of this study was 462 cases. The subjects were middle-aged women. who were from 40 to 60 years old and resided in Seoul. Data were collected by using questionnaires which consisted of 122 questions from Jan. 1 to Feb. 7 in 1992. The questionnaires include questions about general characteristics. climacteric symptoms and life events. The measurement scales for this study were adopted from the climacteric symptoms scale developed by Chi. Sung-Ai and the measurement scale of stress related to life events devised by Lee. Pyoung Sook. The analysis of data collected was done by using SPSS-pc package. Firstly. general characteristics were analyzed by using descriptive statistical methods. Secondly. climacteric symptoms were analyzed by using descriptive statistical methods. the analysis of variance and correlation analysis. Thirdly. the stress of life events was studied by using descriptive statistical methods. the analysis of variance. and tests of independence. The results of this study are as followings. 1. General characteristics of the respondents are as followings: The average age is 49. 13. and the age group from 46 to 50 has $30.5\%$ in the respondents. Christianity is the major religion $(42.6\%)$. and the respondents with a high school diploma are $(43.1\%)$ of the respondents. $60\%$ of all respondents are housewives. and $90.5\%$ are married. The average number of children is 2.71. and the average number of family is 4.24 Monthly income of $39.1\%$ of the respondents is from l,010,000 Won to 2,000,000 Won. The premenopausal group is $4.9\%$. and $45.5\%$ of all respondents are satisfied with marrital life. $43.3\%$ of all feel happy. and $13.9\%$ feel economic frustration. $27.9\%$ of respondents are satisfied with sexual life. and $45\%$ of all report that the amount of recreational activities are more needed. 2. The average score of climacteric symptoms is 1. 8461 (The maximum score is 5.0). The symptoms complained frequently are nervousness. muscle-ache. fatigue. headache and knee-ache. Climacteric symptoms are significantly different in menopausal states. age groups. the number of children, marrital satisfaction. the feeling of life. self-reported health states and sexual satisfaction. 3. The life events occurred frequently were 'discord with husband', 'children's important exams', 'separation from husband related to works' and 'vacation'. When life events are analyzed by factors. the most frequently mentioned factor is 'marrital life'. The stress of life events is significantly different in a few general characteristics (age. the number of children, the number of family, monthly income, menopausal status, the feeling of life. self-reported health states, economic satisfaction). 4. The score of climacteric symptoms complained is significantly different according to the stress of life events (p<0.051, Especially, the difference is the widest in psychological symptoms according to the factor of 'couple. marrital life' among stressful life events. In Summary, climacteric symptoms complained by middle-aged women are related to the amount of the stress of life events. Whether life events are positive of negative is not important. Yet. climacteric symptoms and stressful life events are deeply related to general characteristics. so we can not insist strongly that one be directly related to the other.

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The Measurement of Normal Talus in Korean Cadaver (한국인 사체에서의 정상 거골의 실측)

  • Ha, Dong-Jun;Gwak, Heui-Chul;Kim, Jeon-Gyo;Kim, Jung-Han;Lee, Chang-Rak;Kim, Young-Jun;Lee, Jeong-Han;Ha, Byung-Ho;Kim, Ui-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.163-169
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    • 2016
  • Purpose: To investigate the measured values of the talus in Koreans. Materials and Methods: We measured 88 tali from 44 cadavers that have been donated between December 2012 and December 2015. Of the cadavers, 27 were male and 17 were female. Their mean age was 73 years. The length and width of the talus were measured using a digital goniometer and vernier caliper. Results: The values of cadaveric measurement, mean maximal width and length, width and length of the dome anterior, width and length of the posterior facet, height and length of the trochlear medial facet, and height and length of the trochlear lateral facet were $43.6{\pm}2.6mm$, $56.5{\pm}3.3mm$, $32.5{\pm}2.0mm$, $42.2{\pm}2.7mm$, $22.2{\pm}2.2mm$, $34.7{\pm}2.0mm$, $15.3{\pm}1.3mm$, $33.3{\pm}2.9mm$, $25.3{\pm}3.3mm$, and $30.8{\pm}2.4mm$ for men and $38.9{\pm}1.6mm$, $53.6{\pm}2.4mm$, $27.9{\pm}2.1mm$, $37.4{\pm}3.2mm$, $20.6{\pm}0.8mm$, $31.9{\pm}1.2mm$, $13.6{\pm}2.6mm$, $28.4{\pm}2.5mm$, $24.9{\pm}2.1mm$, and $28.9{\pm}1.4mm$ for women, respectively. The size of the talus showed an accuracy of 86% when anteroposterior diameter was greater than 59 mm. A difference in the size of the right and left talus was not observed. The mean inclination and declination angles were $24.4^{\circ}{\pm}4.2^{\circ}$ and $28.2^{\circ}{\pm}5.4^{\circ}$ for men, and $24.6^{\circ}{\pm}3.6^{\circ}$ and $24.7^{\circ}{\pm}6.7^{\circ}$ for women (p=0.980, p=0.018), respectively, at least $15^{\circ}$, which showed a big difference for every object up to $37^{\circ}$. Conclusion: This paper, to the best of our knowledge, is the first study to measure the talus in Koreans. There were differences by gender and ethnicity in the in measured talus values. The measurements were smaller than European-Americans and greater than Japanese.

LONGEVITY AND FAILURE ANALYSIS OF FIXED RESTORATIONS SERVICED IN KOREA (국내에서 제작된 고정성 보철물의 수명과 실패 요인 및 양상)

  • Shin Woo-Jin;Jeon Young-Sik;Lee Keun-Woo;Lee Ho-Yong;Han Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.2
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    • pp.158-175
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    • 2005
  • Statement of problem. Every effort has been continually made to obtain objectivity in measuring the longevity of fixed restorations, such as by establishing unified judgement standard for deciding success and adopting statistical method that analyzes the data of successful and failed cases at the same time. In Korea, however desired level of development has not to be made in this field yet. Purpose. This study, adopting California Dental Association (CDA) quality evaluation system, established objective standard for deciding success, and inferred the longevity of fixed restorations and their failure analysis through adopting Kaplan-Meier survival analysis. Material and method. In order to assess the longevity of flxed restorations serviced in Korea and causes of failure, a total of 1109 individuals (aged 15-74, 716 women and 393 men loaded with 2551 unit fixed restorations, and 1934 abutments) who lived in Kyung-In Province were examined and the findings were as follows : Results. 1. Length of service of fixed restorations serviced in Korea was 6.86$\pm$0.15 yr (mean), 5.5 yr (median), and the rate of success was 65.82% in 5 year survival, and 21.15% in 10 year survival. 2. When there was patient's need for replacing old prosthetics, longevity of fixed restorations was 7.51$\pm$0.27 yr (mean), 7 yr (median), and the rate of success was 61.08% in 5 year survival, and 17.57% in 10 year survival. 3. Longevity of fixed restorations was longest in the over-sixty age group(9.21$\pm$0.66) and that of the teen age group(3.39$\pm$0.28) was shortest (p<0.05). 4. Longevity of fixed restorations of women (7.38$\pm$0.18 years) was longer than that of men (6.00$\pm$0.26) (p<0.05). 5. As for the provider factor (such as unlicensed performers, university hospitals, and private clinic), there was no statistically significant difference in longevity of fixed restorations. 6. Defective margin (34.78%). periodontal disease (12.15%), periapical involvement (11.73%), was the most frequent causes of failure and poor esthetics group showed the longest life above all (p<0.05). Actual frequent causes of failure after removing old prosthetics were defective margin, periapical involvement, periodontal disease and uncemented restoration. In 75.67% of the cases, abutment state after removing old prosthetics was good enough for loading another prosthetics. 7. There was found to have statistically significant influence between longevity of single crown (6.35$\pm$0.20 yr) and that of 3 unit fixed restorations (7.60$\pm$0.30 y) (p<0.05). In each case the most frequent cause of failure was defective margin. 8. The number of cantilever pontic, pontic/abutment ratio, oral hygiene status were found to have no statistically significant influence on longevity of fixed restorations in all groups (p>0.05). 9. Longevity of fixed restorations made of non precious metal was longest (9.60$\pm$0.40 yr) semi precious and precious trailing behind(p<0.05). 10. Group function group (37.04%) and partial group function group (44.62%) were predominant in frequency but showed no correlation between them and among different types of occlusal plane and different types of occlusal surface (p>0.05). 11. Longevity of fixed restorations was longest in the centric interference group(9.35$\pm$0.62) (p<0.05) among different types of occlusal interference. Conclusion. We found that longevity of fixed restorations serviced in Korea is affected by age, gender and type of material, and that most frequent cause of failure is defective margin. In order to assess the accurate longevity of axed restorations, unified research design. overcoming inter-observer difference and establishing the objective research items are needed. Furthermore, it is thought that prospective approach through thorough study and regular follow-ups is needed just from the start of research. Nationwide detailed studies on length of service of fixed restorations manufactured in Korea are hoped to be conducted hereafter.

The influence of magnet on tissue healing after immediate implantation in fresh extraction sites in dogs (성견에서 발치 후 즉시 식립 임플란트에 설치한 자석이 주위 조직에 미치는 영향)

  • Yu, Seok-Min;Cho, In-Ho;Shin, Soo-Yeon
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.435-444
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    • 2009
  • Statement of problem: The clinical use of electric and electomagnetic fields for fracture healing applications began in the early 1970s. Since then, several technologies have been developed and shown to promote healing of fractures. Developments of these devices have been aided in recent years by basic research and several well controlled clinical trials not only in the medical field but in dentistry. Purpose: The purpose of this study was to compare alveolar bone reduction following immediate implantation using implants onto which magnets were attached in fresh extracted sockets. Material and methods: Four mongrel dogs were involved. Full buccal and lingual mucoperiosteal flaps were elevated and third and fourth premolars of the mandible were removed. Implants with magnets and implants without magnets were installed in the fresh extracted sockets and after 3 months of healing the animals were sacrificed. The mandibles were dissected and each implant sites were sampled and processed for histological examination. Results: The marginal gaps that were present between the implant and walls of the sockets at the implantation stage disappeared in both groups as a result of bone fill and resorption of the bone crest. The buccal bone crests were located apical of its lingual counterparts. At the 12 week interval the mean of marginal bone resorption in the control group was significantly higher than that of the magnet group. The majority of specimens in magnet group presented early bone formation and less resorption of the buccal marginal bone compared to the control group. Conclusion: Within the limitations of this study, it could be concluded that implants with magnets attached in the early stages of implantation may provide more favorable conditions for early bone formation and reduce resorption and remodeling of marginal bone.

Primary Adenosquamous Carcinoma of the Stomach (위에서 발생한 선-편평세포암종)

  • Cho, Yong-Kwon;An, Ji-Yeong;Hong, Seong-Kweon;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.31-35
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    • 2006
  • Purpose: A primary adenosquamous carcinoma of the stomach is relatively rare, accounting for only about 0.5% of all gastric cancers. However, its histopathologic characteristics are still unclear, and the most appropriate form of therapy has not been established yet. Materials and Methods: We retrospectively reviewed the clinicopathologic features of 8 patients with pathologically confirmed primary adenosquamous carcinomas out of 8,268 patients who underwent gastric cancer surgery at Samsung Medical Center between September 1994 and December 2004. Results: The median age of the 8 patients was 49 ($41{\sim}69$) years, and the male : female ratio was 5 : 3. In 3 patients, the tumor was located at the mid body of the stomach, and in 5 patients, at the lower body or antrum. The tumor sizes were $2.5{\sim}8cm$. Seven patients showed metastases to the regional lymph nodes. The UICC stage distribution were: 5 stage II, 2 stage III, and 1 stage IV. In the stage IV patient, a palliative gastrojejunostomy was performed, and he died 5 months after surgery. Of the 7 patients who underwent a radical gastrectomy and adjuvant chemotheratpy, the median survival was 34 ($12{\sim}66$) months, 2 patients died of cancer recurrence, and 4 patients are being followed up without evidence of recurrence. Conclusion: As for an adenocarcinoma of the stomach, a radical gastrectomy including regional lymph node dissection and postoperative adjuvant therapy should be performed for appropriate treatment of an adenosquamous carcinoma of the stomach.

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Development of B4C Thin Films for Neutron Detection (스퍼터링 코팅기법을 이용한 중성자 검출용 B4C 박막 개발)

  • Lim, Chang Hwy;Kim, Jongyul;Lee, Suhyun;Cho, Sang-Jin;Choi, Young-Hyun;Park, Jong-Won;Moon, Myung Kook
    • Journal of Radiation Protection and Research
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    • v.40 no.2
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    • pp.79-86
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    • 2015
  • $^3He$ gas has been used for neutron monitors as the neutron converter owing to its advantages such as high sensitivity, good ${\gamma}$-discrimination capability, and long-term stability. However, $^3He$ is becoming more difficult to obtain in last few years due to a global shortage of $^3He$ gas. Accordingly, the cost of a neutron monitor using $^3He$ gas as a neutron converter is becoming more expensive. Demand on a neutron monitor using an alternative neutron conversion material is widely increased. $^{10}B$ has many advantages among various $^3He$ alternative materials, as a neutron converter. In order to develop a neutron converter using $^{10}B$ (actually $B_4C$), we calculated the optimal thickness of a neutron converter with a Monte Carlo simulation using MCNP6. In addition, a neutron converter was fabricated by the Ar sputtering method and the neutron signal detection efficiencies were measured with respect to various thicknesses of fabricated a neutron converter. Also, we developed a 2-dimensional multi-wire proportional chamber (MWPC) for neutron beam profile monitoring using the fabricated a neutron converter, and performed experiments for neutron response of the neutron monitor at the 30 MW research reactor HANARO at the Korea Atomic Energy Research Institute. The 2-dimensional MWPC with boron ($B_4C$) neutron converter was proved to be useful for neutron beam monitoring, and can be applied to other types of neutron imaging.

Korean athlete's recognition of sports dentistry and condition of teeth wear (한국 운동선수의 스포츠 치의학에 대한 인지도 및 치아교모상태에 관한 연구)

  • Lee, Sung-Bok;Choi, Dae-Gyun;Han, Kwang-Heung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.18 no.4
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    • pp.235-249
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    • 2002
  • This study was accompolished to analyze and compare the number and area of the occlusal contact points in healthy volunteers and athletes with normal occlusion. Before the study, 89 athletes(sports career:8.6 years, average age 20) at Kyung Hee University were selected, and survey was accomplished for athlete's recognition about sports dentistry. For this study, 15 athletes(13 amles and 2 females with average age 20) and 21 healthy volunteers(14 mles and 7 females with average age 20.09) at Kyung Hee University were selected. The visual display acquired by scanning of occlusal record in maximal intercuspation was converted into 16 gray value image. Then, using computer program(J & Lee Occlusal Analyser), the pixel which was in definite range of the gray value was recognized, and the numbers of recognized pixel were calculated to area. The results were as follows : (1) On the survey about sports dentistry, 28% of 89 athletes didn't agree that human occlusion may be important, and 30% didn't have any idea of the influence of human occlusion during their sports activities. (2) The average numbers of total occlusal contact points were 31.05 in control group, and 34.67 in athlete group. The average area of total occlusal contacts was $100.25mm^2$ in control group, and $127.78mm^2$ in athlete group. (3) In control group, the average numbers of occlusal contact points were revealed in order as follows; the first molar(8.48), the second molar(8.24), the second premolar(4.71), the lateral incisor(2.90), the first premor(2.43), the central incisor(2.19), and the canine(2.1). The least average in canine(2.1) was similar to the average(2.19) in central incisor and (2.09) in lateral incisor. In athlete group, the average numbers of occlusal contact points were revealed in order as follows; the first molar(8.87), the second molar(8.47), the second premolar(5.60), the canine(3.80), the lateral incisor(3.33), the first premolar(2.67), and the central incisor(1.93). (4) In control group, the average areas of occlusal contact surface were revealed in order as follows; the first molar($39.47mm^3$), the second molar($37.54mm^3$), the second premolar($9.54mm^3$) the first premolar($6.18mm^3$), canine($3.49mm^3$), the central incisor($2.76mm^3$), and the lateral incisor($1.28mm^3$). In athlete group, the average areas of occlusal contact surface were revealed in order as follows; the first molar($44.11mm^3$), the second molar($40.69mm^3$), the second premolar($16.50mm^3$), the first premolar($9.39mm^3$), the canine($5.08mm^3$), the lateral incisor($3.7mm^3$), and the central incisor($2.25mm^3$). (5). With aging in both control and athlete group, there was a decreasing tendancy in average number of occlusal contact point, and was an increasing tendancy in average area of occlusal contact surface. In comparison at each age, both the numbers and area of occlusal contact were greater in athlete group than in control group. It was not significant in the numbers of occlusal contact points beween athlete and control group(p>0.1), but significant in the area of occlusal contact surface(p<0.05). (6) In comparision as to the kind of sports(Gymnastics:2, Rugby:3, Soccor:5, Ice hocky:5), the numbers of occlusal contact points were the most in ice hocky, and the area of occlusal contact surface was the greatest in gymnastics. With increasing a career in athlete group, there was a decreasing tendancy in average numbers of occlusal contact points, and was an increasing tendancy in average area of occlusal contact surface.

A Clinical Study of Pulmonary Tuberculosis in Diabetics (당뇨병에 동반된 폐결핵의 임상적 연구)

  • Jeong, In-Kyung;Yoo, Jee-Hong;Lee, Seon-Mee;Koh, Kwan-Pyo;Han, Min-Soo;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.705-713
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    • 1998
  • Background: An association between diabetes and tuberculosis has long been implied. The severity of diabetes appears to correlate with the degree of tuberculous activity. Methods: A retrospective chart review of 82 patients with active pulmonary tuberculosis in diabetics (DMTB) and 83 patients with active pulmonary tuberculosis in nondiabetics (Non-DMTB) admitted to the Kyung Hee Medical Center between January 1995 and December 1996 was underiaken. Results: The sex ratio of DMTB was 58 : 24, and that of Non-DMTB was 62 : 21. Male patients predominated in both groups. The highest incidence of DMTB was 6th and 7th decades and that of Non-DMTB was 3rd and 4th decades. In case which the tuberculosis developed after diagnosis of diabetes, the prevalence of pulmonary tuberculosis was the highest in diabetes for 5-10 years. On chest X-ray findings, the moderate advanced tuberculosis cases were the most common (60.9% in DMTTB and 50.6% in Non-DMTB). There was no relation between the degree of tuberculosis activity on chest x-ray(minimal, moderate, and far advanced tuberculosis) and presence of diabetes. The incidence of lower lung field tuberculosis in DMTB was significantly higher than Non-DMTB(p<0.05). The multiple lobe involvement was the predominant chest roentgenographic finding in both groups. There was no significant difference of treatment response between DMTB and Non-DMTB. There was no relationship between initial HbA1c and the severity of pulmonary tuberculosis on chest X-ray. During treatment of pulmonary tuberculosis in excellently and well controlled diabetes, the cure rate of pulmonary tuberculosis was significantly higher than the poorly controlled diabetes and the rate of treatment failure was significantly lower than poorly controlled diabetes. (p<0.05). Conclusion: Poor control of blood glucose is related with increased rate of treatment failure in pulmonary tuberculosis with diabetes mellitus. Further investigation will be needed to study the mechanisms of treatment failure in poorly controlled diabetics with pulmonary tuberculosis.

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A Study on Interdepartmental Organizational Effectiveness of Medium and Small Sized Hospitals (서울지역 중소병원의 부서간 조직효과성에 관한 연구)

  • Kim, Wook-Soo;Ha, Ho-Wook;Sohn, Tae-Yang
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.64-87
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    • 2002
  • The purpose of this study is aimed to grasp the factors, which may influence the harmonized organizational efficiency of the objects of hospital structure as well as its structural constituents of each departments of administration, nursing, and para-medical personnels, in order to provide basic data enable to contribute in the development of hospital. The survey data involved in the study was derived from 385 personnels working in 5 medium and small sized hospitals in Seoul area. The main finding of the study can be summarized as follows; 1. The organizational efficiency in accordance with the general characteristics of subjects in order of male, over 30 years of age, university graduates, long-term tenure and high position is higher, whereas, in as much as wage and well trained personnels in administration departments are higher, its organizational efficiency is higher in comparison with those of nursing and para-medical departments. 2. The organizational efficiency in accordance with satisfaction and the motive contributional factors is higher as much as the high satisfactory level in every departments in general. 3. The organizational efficiency in accordance with the factors of job characteristics is higher in as much as difficulty of the jobs is lesser, however there was not statically significance between administration and para-medical departments. In as much as the job circulation is intact, job standard level is higher and the more job responsibility the higher organizational efficiency, while the more workload and the more work feud resulted lower organizational efficiency. It was obvious that the higher professional expertise as well as the training and application level are improving the organizational efficiency. 4. The organizational efficiency in accordance with the factors of structural characteristics was higher in as much as the intercommunication was smooth and the structural formalization level are higher, however there was not statically significance between the participation level of decision making and the organizational efficiency. 5. In as much as higher educational level of over university graduates, management of organization and the job level are satisfied, the psychological motive contributional level is higher, while the lesser job difficulty, the smooth job performance, the higher level of professional expertise, the higher structural formalization level, the smooth intercommunication, have affected as major influence factors of the structural characteristics of organizational efficiency. 6. As the management of hospital organization, the job level and personal relation are satisfied or psychological motive is provided, especially when there are no difficult jobs or smooth job circulation and no job feud are prevailing, it was apparent that the organizational efficiency is improving accordingly. The nursing departments has high educational standard and is satisfied in the management and job level of hospital organization as there are no difficult jobs while the level of hospital's organizational formality is high and the intercommunication is smooth, which are improving the organizational efficiency. The para-medical departments is also satisfied the management and job level of hospital organization and it was apparent that the organizational efficiency is higher in as much as the level of job standardization is high and the intercommunication is smooth. As a result of this study, in order for improving the organizational efficiency of the medium and small sized hospitals, the management and job level as well as personal relation are preferably satisfied, whereas the level of job circulation, job responsibility, the expertise and formalization of organization, intercommunication and etc. should be satisfied, and, therefore, it is advisable to buildup discriminated organizational management and environment for different division on the basis above factors. Since this study is carried on several hospitals in Seoul area, there is a certain limit to generalize its result to all domestic hospitals, nevertheless the gallop poll was made by developing the questionnaires with reasonability and reliability. Especially, as the study was carried by analyzing the comparison of influence factors' difference of organizational efficiency in accordance with the divisional characteristics of the medium and small sized hospitals.

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