The purpose of this study is to analyze a case of unit management system introduced and operated in a university hospital. The system was designed and applied to six clinical departments and centers to help to achieve the medical revenue and profit targets. The case hospital is now in the second year of the system operation. Major findings of the study are as follows; Firstly, the leadership style of the unit manager is the most important factor in management of the unit. The transformational leadership style was more effective than the transactional one. Secondly, unit manager's managerial ability is another key factor to the success or failure in achieving the responsibility targets. Thirdly, the degree of divisionalization and responsibility should be strengthened to activate both unit managers and medical specialists.
This study investigated the current status and characteristics of strategic alliances attempted by domestic internet businesses. Specifically, this study surveyed competitive environmental characteristics of partner companies involved, alliance period, types of partner companies, motives of alliances, types of alliances, success and failure factors and satisfaction toward the alliances. Major findings were: first, alliances between portal companies and content producers; portal companies and internet services; e-commercial sites and internet services were the most frequent partnerships engaged. Second, the most important motive for and type of the strategic alliance were: 'the commercialization and marketing of new product' and 'joint distribution and marketing agreement' respectively. Third, the most important factor for the successful alliance was 'a close examination of partners' core business value and competence'; and the factor most hindering the successful alliance was 'a discrepancy on capabilities of partners' core personnel. Finally types of internet business were significantly related to perceived satisfaction toward strategic alliance.
This study was conducted to determine the characteristics in breeding of the little tern Sterna albifrons in Shinja-do and Doyo-Deung in Nakdong estuary. The data was obtained in the middle and late 1990's and in the mid 2000's, which were analysed for the breeding information of the little tern. In Shinja-Do, a total of 638 nests were observed in 1995, and the average numbers of eggs laid per nest were 2.48. In 2004 and 2005, 94 and 456 nests were observed, and the average number of eggs laid per nest was 2.16 and 2.53, respectively. There was a significant difference between the average numbers of eggs laid per nest for the 3 respective years. In Doyo-Deung, a total of 269 nests were observed in 1998, and the average number of eggs laid per nest was 2.16. In 2004 and 2005, 1,023 and 1,123 nests were observed, and the average numbers of eggs laid per nest were 2.33 and 2.52, respectively. There was a significant difference (p<0.001) between the average number of eggs laid per nest as well. Hatching success rate by nesting site in Shinja-Do was calculated in 1995. Type A nest (nest located on dry sand land) showed a 56.8% success rate, and type B nest (nest located on the land with dwarf grass), type C nest (nest located on moist land) and type D nest (nest located on the land with shells) showed 55.3%, 36.6% and 59.3% success rates, respectively. The average hatching success rate in Shinja-Do was 54.5%. The most crucial factor for hatching failure was flood, especially, for the type C nests. The hatching success rate by the nesting site in Doyo-Deung showed an average of 73.2%. It was high in type D nest (83.8%) and type A nest (75.9%), and low in type C nest (59.7%). Again, the most crucial factor for hatching failure was flood, especially, for the type C nests. Nakdong estuary has been through many changes over time, particularly in recent. Therefore, continuous efforts to keep it a breeding place for the little tern are urgently required, including overall management of land, protection of reef and sand, etc.
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.
Background : The decision to institute mechanical ventilation for patients with COPD is very difficult. The accurate information regarding weaning success and long-term survival will improve communication with patients and family and enhance informed consent. The aims of this study are to describe outcomes and identify variables associated with survival for patients experiencing mechanical ventilation with an acute respiratory failure of COPD. Methods : The 53 cases of mechanical ventilation in the intensive care unit in the National Medical Center from 1989 to 1998 were included. Data were collected retrospectively from medical records. Weaning success rate and 3 month and 1 year survival rates were estimated. Factors associated with weaning success and survival were determined. Results : Weaning sucess was 55%. For success group with 29 cases, 3 months survival rate was 61% and 1 year survival rate 37%. APACHE II scores in weaning success group were significantly lower than those in the failure group. Factors such as age, sex, comorbid-illnes. previous steroid use, causes of respiratory failure, RVH or arrhythmia on EKG, serum albumin level, arterial blood pH, $PaO_2$, $PaCO_2$, $FEV_1$ duration of mechanical ventilation and steroid use during mechanical ventilation were not associated with weaning success. Only age and serum albumin level were associated with 3 month and 1 year survival. No COPD patients of age more than 75 years and serum albumin level less than 3g/dl had survived at 1 year after weaning success. Conclusion : While weaning success from mechanical ventilation can be predicted by APACHE II score in COPD patients, long-term outcomes of survivors may be influenced by nutritional status and age.
In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles. Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus. Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.
Busenlechner, Dieter;Furhauser, Rudolf;Haas, Robert;Watzek, Georg;Mailath, Georg;Pommer, Bernhard
Journal of Periodontal and Implant Science
/
v.44
no.3
/
pp.102-108
/
2014
Purpose: Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success. Methods: From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed. Results: Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001). Conclusions: Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses.
Lee, Yejin;Kim, Ji-yeon;Lee, Ju Hyun;Yoo, Ki-Bong;Noh, Jin-Won
Journal of the Korea Convergence Society
/
v.9
no.9
/
pp.285-292
/
2018
The purpose of this study is to analyze the association of smoking cessation attempts and the perceived stress level and to identify the factors affecting the perceived stress level of quit smoking. The study utilized the 2015 Korean National Health and Nutrition Examination Survey, and was applied an Ordinal Logistic Regression to examine the association of smoking cessation attempts and perceived stress level. The current smoker those who experience failure in smoking cessation, were more stressful than those who experience success in smoking cessation (OR=1.72, CI;1.41-2.08). This study identified smoking cessation failure as a major psychiatric factor associated with high perceived stress level, and suggests high stress after smoking cessation failure as one of the reasons why smokers do not reach complete smoking cessation. Also, in order to promote smoking cessation, it is needed to have political approach in reducing the psychiatric hurdle like high stress after smoking cessation failure.
Background and Objectives:Microvascular free flap reconstruction has been revolutionized in last two decades, and became a standard option in the reconstruction of head and neck defects. We intended to review our experiences of 51 microvascular free flap for head and neck defects during 5-year period and to analyze the types of flaps according to primary sites, success and complication rates. Subjects and Methods:From Oct. 2001 through Dec. 2005, fifty one free flap reconstructions were performed in forty nine patients at ENT department of Soonchunhyang university bucheon hospital. Primary sites, pathology, T-stage, operative time, time interval of oral feeding, and various reconstructive factors such as recipient and donor vessels, free flap related complications, failure rates and salvage rates were retrospectively analyzed. The relation between complication rates and preoperative risk factors were statistically analyzed. Results:Methods of reconstruction were radial forearm free flap(RFFF)(n=28, 54.9%), anterolateral thigh free flaps(n=9, ALTFF)(17.6%), rectus abdominis free flap(n=7, RAFF)(13.7%), jejunal free flap(n=5, JFF)(9.8%), and miscellanous(n=2, 4.0%) in order. In free flap related complications, failure of free flap occurred in seven cases(13.7%) and pharyngocutaneous fistula occurred in five cases(9.8%) among fifty one free flaps. The overall success rate of free flaps was 86.3%. Salvage of free flaps was possible only one among eight cases(12.5%). In positive preoperative risk factor groups, failure of free flap was higher than in negative risk factor group. However, it was not statistically significant. Conclusion:We confirmed that free flap reconstructions are highly versatile and reliable options for use in the reconstruction of various soft tissue defects of the head and neck. Free flaps have gained great popularity given its versatility, ability for a two-team approach, and minimal donor site morbidity. However, complications related to microvascular surgery may be overcome by increased surgical experience and by intensive flap monitoring in early postoperative period.
The purpose of this study was to provide fundamental information for success factors of techniques through kinematic analysis including coordination of lower extremities and landing stability according to the success and failure of $540^{\circ}$ Dwihuryeochagi in Taekwondo. Twenty Taekwondo athletes: ten success group (S, age: $22.3{\pm}1.8$ yrs, height: $172.1{\pm}5.4$ cm, body mass: $64.4{\pm}4.2$ kg) and ten failure group (F, age: $22.3{\pm}1.8$ yrs, height: $172.1{\pm}5.4$ cm, body mass: $64.4{\pm}4.2$ kg) participated in this study. Three-dimensional motion analysis using a system of 3 video cameras with a sampling of 60 fields/s was performed during the competition of $540^{\circ}$ Dwihuryeochagi. Motions were divided into five events: pivot foot landing (E1), pivot foot toe off (E2), COM max height (E3), kick impact (E4) and landing (E5). At E1, the stride width was greater for S than for F (p<.05) while the time was greater for S than for F during P4 (p<.05). At E4, knee angle was greater for S than for F (p<.05). At E5, hip angle was greater for S than for F (p<.05) while kick distance was greater for S than for F (p<.05). Furthermore, at P3, the time would be related to kicking velocity (p<.05), while at P4, the time, range of hip angle and knee angle would be related to kick distance (p<.05). At P1, COM horizontal velocity would be related to COM vertical velocity of P1 and P2 (p<.05). Based on the findings, success factors of $540^{\circ}\acute{y}$ Dwihuryeochagi were COM horizontal velocity of P1, COM vertical velocity of P2, the time, kick distance, velocity, angle of lower extremities and coordination of P3-P4.
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