Kim, Hyuk;So, Eunsun;Karm, Myong-Hwan;Kim, Hyun Jeong;Seo, Kwang-Suk
Journal of Dental Anesthesia and Pain Medicine
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v.17
no.4
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pp.297-305
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2017
Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation. If the general method of intubation was expected to be difficult, awake intubation was performed. The degree of nasal bleeding during intubation was also evaluated. Results: The mean age of the operators (11 men, 7 women) was 27.8 years. FNI was performed in a total of 716 patients. The success rate was 88.3% for the first attempt and 94.6% for the second attempt. The failure rate of intubation in anesthetized patients was 4.9%, and 13.6% in awake patients. When intubation was performed in anesthetized patients, the failure rate from the first to fifth trial was 9.6%, which decreased to 0.7% when the number of trials increased to > 30 times. In terms of awake intubation, there was no failed attempt when the resident had performed the FNI > 30 times. The number of FNIs performed and nasal bleeding were important factors influencing the failure rate. Conclusion: The success rate of FNI increased as the number of FNI performed by residents increased despite the nasal bleeding.
Purpose - This study is to propose a creative idea for constant business growth and development by examining characteristics of business outcomes by phase, which are "growth" and "erosion and stagnation," respectively. Research design, data, methodology - It is necessary to identify an occurrence of crisis and its diffusion with a dynamic model in order to identify a success and failure of businesses in an organic way, not on a binary structure. The static perspective is to understand a crisis as a simply one-time event or as a linear causation. Thus, it has a limited understanding of the overall situation and has limits to investigating a foundational cause and developing long-term countermeasures. On the contrary, the dynamic perspective is to understand the crisis as circulation process of the overall system. Thus, it divides elements of the crisis as external and internal ones to understand it as the causal relationship of each element. Results - During the growth period of Burger King, the company promoted its brand very successfully with aggressive and creative marketing activities. However, due to the founder's disposal of management rights and the following changes in the management, the company had no choice but to lose focus on its business philosophy and brand management, and eventually it had to face the big crisis (resonance) which was delisting from the stock market because of the external threat; well-being trend. However, Burger King resumed lifting on the stock exchange by making great efforts to clearly identify the current issues and seek solutions. Under the spirit of "perseverance" and its slogan "Have it your way" the company is now going head to head with McDonald's in the North American region and emerging countries. Conclusions - Then, what is the most crucial factor in the success and failure of businesses? Answers may vary, however, as learned from the case study of Burger King, corporations should inspect the present and focus on developing a long-term strategy for the future and actively fulfill the actions. McDonald's may not be able to innovate by itself in the future as it may become routinized to the growth. There will be chances of winning if we change conditions of individuals or organizations to an organic system in terms of being creative. There is a hopeful message here that an individual or small business may have more advantages in the era of the idea and innovation.
Kim, Sol;Chung, Jae Sik;Jang, Sung Woo;Jung, Pil Young
Journal of Trauma and Injury
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v.33
no.3
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pp.153-161
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2020
Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure and extremely time-dependent, and the proficiency of the physician is important. Due to a lack of REBOA education programs in Republic of Korea, few physicians have been trained in the procedure. In this study, we examined how REBOA education affects clinical outcomes in a single center. Methods: A retrospective study conducted from February 2017 to June 2020 at a regional trauma center. We collected data of patients who underwent REBOA and analyzed the factors that influenced the outcome. The patients were divided into the educated and non-educated groups (based on REBOA training received by their physicians), and the success and failure groups. Results: A total of 24 patients underwent REBOA during the study. There were eight patients in the success group and 16 patients in the failure group. There are no significant differences between the educated and non-educated groups in sex, age, ISS, shock, injury-to-REBOA time, injury mechanism, injury sites, arrest, access site, type of catheter, type of REBOA, target Zone, mortality, and the result of REBOA. The non-educated group had a higher risk for failure compared to the educated group in multivariate analysis (odds ratio [OR] 154.64, 95% confidence interval [CI] 1.11-22.60). Conclusions: Failure in REBOA is harmful to patients. The risk of failure is increased in the non-educated group. Physicians working in the trauma center or emergency department need to complete the REBOA education program.
This study aims to analyze the association between the center of mass(C.O.G) and ocular movement(E.O.G) according to the success and failure in the left turn motion on the balance beam, targeting three female gymnasts. When successful, the left-right C.O.G was moved to the left, which was a rotational direction until such time as the body rotated $180^{\circ}$, whereas there appeared to be a greater movement during failure; thus, it was shown to affect the maintenance of dynamic postural control. In case of the subsequent left-right turning motion of E.O.G, this matches the previous theory that the eyeball moves against the direction of rotation of the body. However, there was a difference at the time of movement, and a clear difference emerged in the success and failure in this study. Also, in the E.O.G in the up-down direction, a movement during failure showed a pattern of down direction in most cases; thus, it is deemed to affect the failure. Therefore, the kinetic postural control and E.O.G are supposed to affect the success and failure in a landing, which is the most importantly evaluated movement on the balance beam, in mutual association.
Kim, Jae-Seung;Chang, Hyun-Ho;Chang, Cheol-Ho;Rhyu, Sung-Ho;Kang, Jae-Hyun
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.27
no.2
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pp.178-183
/
2001
Since the introduction of the concept of osseointegration, the success rate of dental implant has increased dramatically. So, the uses of dental implant in the treatment of partially or fully edentulous patients have played an important role in dental rehabilitation. Regardless of high success rate of dental implant, some amounts of fixtures cannot help failing. We can classify dental implant failure according to timing, causative factor, etc. This study is focused on dental implant fixture failure, occurring during preprosthetic stage. There are various reasons that cause implant failure on this periods, such as improper patient selection, poor bone quality, and periimplantitis, etc. We investigate the survival rate of 1058 fixtures, which installed in 306 patients in our clinic from January 1997 to December 1999, according to type, sex, location, fixture length and width, using Kaplan-Meier product-limit method and to compare each other with log-rank test. Overall survival rate was 96.80%, and 33 implants failed over the preprosthetic stage. Our survey data identified posterior location of mandible as being associated with implant failure(P<0.05).
This study examines the failure experience and aspirations for future among Korean adolescents and their parents using indigenous psychological analysis. The first part of this paper reviews the achievement literature that has used indigenous psychological analysis. The second part of this paper provides an empirical analysis of 482 students (primary=117, middle school=88, high school=72, and university=205) and 507 parents of the adolescents (fathers= 236, mothers=271). The open-ended questionnaire developed by Park and Kim (1999) was adopted for the study that asked the respondents to list the most painful experience, the person that was the most responsible for the failure, and the most important reason for the failure. The section on aspirations for the future asked the respondents to list the achievement that they would most likely to succeed, the person that they need assistance from, the type of support they need from the person, and the most important factor that would lead to them to success. The results indicate that for students the most painful failure was related to academic failure and for adults, it was related to family life. The person that was most responsible for the failure was reported by both samples be themselves. As for the most important factor that influenced their failure was a lack of self-regulation, such as a lack of effort and persistence. For the aspiration for future, students listed academic and occupational success and for adults listed harmonious family life as the most important. For social support, the adolescents listed their parents and adults listed their spouse as the person that they need assistance from. As for type of support, they listed emotional support to be the most important. As for the most important factor that would contribute to their success, majority of students and adults listed self-regulation. Based on these results and previous indigenous studies indicate, the following four conclusions could be drawn: (1) the emphasis of self-regulation as the most important reason for their past achievement, the future success and the lack of self-regulation for their failure; (2) the importance of receiving emotional support from family members; (3) the importance of educational aspiration and achievement for providing the basis of economic development; and 4) the importance goal of achieving harmonious family life.
The Korean government has implemented the policy for merging 141 health insurers into Korean Unified Health Insurer (KUHI) in July of 2000. The unification of multiple insurers will definitely effect the stability of financial management, equity of premium burdens and efficiency of administrative management. However, it is difficult to predict what forms the far-reaching effects of the unification would take. Thus, pursuing the unification may be express as a huge policy experiment. In order to lead the unification, which lies on a crossroad between success and failure, to the road of success, we need to infer the problems and obstacles predicted in the step-wise processes of merging organizations, finances and the systems of computing premium, and come up with the effective means to maintain the stability of financial management, to improve the equity of premium burdens and to increase the efficiency of administrative management. Thus, I first described the changes of the Korean medical insurance system, and analyzed the performances of self-employed medical insurance 1 year after the integration of societies in October of 1998. At the base of examining the stability of financial management, equity of premium burdens and efficiency of administrative management, I predicted the problems and obstacles that could occur after the unification of the multiple medical insurers, and proposed a few ways of leading the unification of the multiple medical insurers in Korea to success. The most worried factor is that insurance finance would become unstable since the expansion of premium revenues is not easy because raising the premium for all Koreans is to be difficult. In addition, the unification of insurance finance could weaken the insurer's efforts for declaring real incomes of the self-employed and increasing the collection rate of premiums from them. This weakening would be the decisive factor of lowering the equity of premium contributions between the self-employed and employees. And bureaucratization and rigidity that are unavoidable in a gigantic unified organization could lower the efficiency of administrative management. Furthermore, by having 3 labor unions in the unified organization, it is possible to experience frequent difficulties and discords among the unions and between the unions and organization. Thus, when smooth pursuing of the unification of multiple insurers gets difficult, the social expenses derived from the failure would eventually end up on all Koreans. The unification is to be performed after coming up with the ways to eradicate these worries, so that the unification of multiple insurers would step onto the road of success.
Jessica Gabriele da Rocha;Isabella Marian Lena;Jessica Lopes Trindade;Gabriela Salatino Liedke;Renata Dornelles Morgental;Carlos Alexandre Souza Bier
Restorative Dentistry and Endodontics
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v.47
no.3
/
pp.34.1-34.12
/
2022
Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.
Background : As the pleural inflammation progresses, exudative pleural fluid becomes loculated rapidly with pleural thickening. Complete drainage is important to prevent pleural fibrosis, entrapment and depression of lung function. Intrapleural urokinase instillation therapy has been advocated as a method to facilitate drainage of gelatinous pleural fluid and to allow enzymatic debriment of pleural surface. This study was designed to investigate the predictors of effectiveness of intrapleural urokinase in the treatment of loculated pleural effusion. Method : Thirty-five patients received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. Twenty-two patients had tuberculous pleural effusions, and 13 had non-tuberculous postpneumonic empyemas. A total of 240,000 units of urokinase was dissolved in 240 ml of normal saline and the aliquots of 80mL was instilled into the pleural cavity via pig-tail catheter per every 8hr. Effectiveness of intrapleural urokinase instillation therapy was assessed by biochemical markers, ultrasonography, and technical details. A greater than 50% improvement on follow-up chest radiographs was defined as success group. Result : Twenty-seven of 35 (77.1%) patients had successful outcome to urokinase instillation therapy. Duration of symptoms before admission was shorter in success group ($11.8{\pm}6.9day$) than in failure group ($26.62{\pm}16.5day$) (P<0.05). Amount of drained fluid during urokinase therapy was larger in success group ($917.1{\pm}392.7ml$) than in failure group ($613.8{\pm}259.7ml$) (P<0.05). Pleural fluid glucose was higher in success group ($89.7{\pm}35.9mg/dl$) than in failure group ($41.2{\pm}47.1mg/dl$) (P<0.05). Pleural fluid LDH was lower in success group ($878.4{\pm}654.3IU/L$) than in failure group ($2711.1{\pm}973.1IU/L$) (P<0.05). Honeycomb septated pattern on chest ultrasonography was observed in six of eight failure group, but none of success group (P<0.05). Conclusion : Longer duration of symptoms before admission, smaller amount of drained fluid during urokinase therapy, lower glucose value, higher LDH value in pleural fluid examination, and honeycomb septation pattern on chest ultrasonograph were predictors for failure group of intrapleural urokinase instillation therapy.
Background: The success rate of intubation under direct laryngoscopy is greatly influenced by laryngoscopic grade using the Cormack-Lehane classification. However, it is not known whether grade under direct laryngoscopy can also affects the success rate of nasotracheal intubation using a fiberoptic bronchoscpe, so this study investigated the same. In addition, we investigated other factors that influence the success rate of fiberoptic nasotracheal intubation (FNI). Methods: FNI was performed by 18 anesthesiology residents under general anesthesia in patients over 15 years of age who underwent elective oral and maxillofacial operations. In all patients, the Mallampati grade was measured. Laryngeal view grade under direct laryngoscopy, and the degree of secretion and bleeding in the oral cavity was measured and divided into 3 grades. The time required for successful FNI was measured. If the intubation time was > 5 minutes, it was evaluated as a failure and the airway was managed by another method. The failure rate was evaluated using appropriate statistical method. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were also measured. Results: A total of 650 patients were included in the study, and the failure rate of FNI was 4.5%. The patient's sex, age, height, weight, Mallampati, and laryngoscopic view grade did not affect the success rate of FNI (P > 0.05). BMI, the number of FNI performed by residents (P = 0.03), secretion (P < 0.001), and bleeding (P < 0.001) grades influenced the success rate. The AUCs of bleeding and secretion were 0.864 and 0.798, respectively, but the AUC of BMI, the number of FNI performed by residents, Mallampati, and laryngoscopic view grade were 0.527, 0.616, 0.614, and 0.544, respectively. Conclusion: Unlike in intubation under direct laryngoscopy, in the case of FNI, oral secretion and nasal bleeding had a significant effect on FNI difficulty than Mallampati grade or Laryngeal view grade.
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