OBJECTIVES: The purpose of this study was to investigate the differences of capacity of local health organization to regional characteristics and the influence of organizational capacity on organizational performance. METHODS: The study used the secondary data for 160 local public health organizations from 5th Community Health Plans and 2009 Community Health Survey. The collected data were analyzed using one-way ANOVA and multiple regression analysis. RESULTS: Work force and budget showed differences in regional size and elderly population rate. And consumer satisfaction and health care utilization showed differenced in work force and budget. The regression model with total number of employee, number of registered nurses, number of doctors and budget against consumer satisfaction was statistically significant (F=14.70, p=<.001), and number of registered nurses was identified as a factor influencing consumer satisfaction. This model also explained 20.5% of service satisfaction. The regression model for consumer satisfaction was statistically significant (F=45.98, p=<.001), and total number of employee nurses was identified as a factor influencing health care utilization. This model also explained 53.1% of utilization. CONCLUSIONS: The findings of this study imply that organizational capacity as work force and budget should be increased to improve the organizational performance as consumer satisfaction and health care utilization.
Aged ; Budgets ; Consumer Behavior ; Health Surveys ; Humans ; Korea* ; Nurses ; Patient Acceptance of Health Care ; Public Health*

BACKGROUND: Vertical reduction mammaplasty has been criticized for its inability to address larger cases of mammary hypertrophy, with a relatively high frequency of sensory loss reported. This article describes our single-institution experience with modified vertical reduction mammaplasty for varying degrees of breast reduction. METHODS: Thirty-three patients underwent breast reduction using the modified vertical reduction mammaplasty technique with a superomedial dermoglandular pedicle and modifications involving breast parenchyma excision. The degree of sensory preservation in the nipple-areola complex (NAC) was compared with preoperative sensation using an ordinal scale (0, insensate; 10, unchanged). Postoperative outcomes were evaluated through a photogrammetric analysis. Satisfaction with postoperative outcomes was assessed using a telephone questionnaire survey (1, very poor; 5, very good). RESULTS: The modified vertical mammaplasty technique allowed for reductions of up to 1,800 g per side. The mean resection weight was 459.24 g per breast (range, 76-1,800 g). Of the 59 operations, 9 involved complications without significant morbidity. The sensibility of the NAC recovered in most patients by 5 months after the operation. The mean satisfaction score was 3.4, which was between 'no change' and 'satisfied.' CONCLUSIONS: Modified vertical reduction mammaplasty allows a single surgeon to address varying degrees of breast hypertrophy.
Breast ; Female ; Humans ; Hypertrophy ; Mammaplasty* ; Nipples ; Sensation ; Telephone

This study evaluated the short-term outcome of treating fractures of the mandible with bioabsorbable plates. Thirty-four fractures of the mandible in 27 patients were treated by open reduction and internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm, and 1.5-mm pre-tapped screws. The duration of intermaxillary fixation ranged from 0 to 23 days, with a mean of 5.3 days. Patients were evaluated for complications during the follow-up period, which ranged from 2 to 18 months. Five patients (18.5%) experienced complications. These included infection (four patients), and premature occlusal contact (one patient). Except for one case, all complications were minor and adequately managed with incision and drainage, elastic traction, and medication. Delayed infection (osteomyelitis) developed in a symphysis fracture and was treated by saucerization and antibiotics. The fracture line subsequently showed complete consolidation. Bioabsorbable plates can be selectively used for internal fixation in mandibular fractures with the advantage that they do not need to be removed.
Anti-Bacterial Agents ; Drainage ; Follow-Up Studies ; Humans ; Mandible* ; Mandibular Fractures ; Traction

While oral and maxillofacial surgery such as orthognathic surgery, TMJ surgery is in progress, there always exists a risk of bleeding from maxillary artery, and this perplexes the surgeon in operation. In case of massive bleeding, it is mostly very difficult or even impossible to take an immediate action in order to stop bleeding. Even when hemostasis is possible by applying such methods as the use of local hemostatics, pressing, electrocoagulation or direct ligation, there is a high risk of secondary bleeding. Therefore, in case there is bleeding from maxillary artery, it is the best to restrain bleeding completely either by the ligation of the artery in bleeding in operation fields or by the ligation of the external carotid artery.
Arteries ; Carotid Artery, External ; Electrocoagulation ; Hemorrhage* ; Hemostasis ; Hemostatics ; Ligation ; Maxillary Artery ; Orthognathic Surgery ; Surgery, Oral ; Temporomandibular Joint

Changes of human pulse rates are influenced by psychological factor as well as systemic disease. Pulse rates tend to increase in the state of fear, pain, anxiety, and excitement. We performed this study for the evaluation of psychological state during the surgical extraction of mandibular impacted 3rd molar. Total 42 patients without systemic compromised condition were selected and pulse rates were checked with pulse oximeter(Nellcor, N-180) during the initial sitting state at dental unit chair, local anesthesia, draping and operation(5-minute interval). Male patients were 22, female 20. Age ranged from 13 to 57, with a mean of 26.9. Operative time(from incision to end of suture) ranged from 4 minutes to 32 minutes, with a mean of 11.1 minutes. The most significant elevation of pulse rates were observed during draping, the next at 10 minutes after incision(P< 0.05). Elevation of pulse rates during the anesthesia was not more than preoperative state and variable(P> 0.05).
Anesthesia ; Anesthesia, Local ; Anxiety ; Female ; Heart Rate* ; Humans ; Male ; Molar* ; Psychology

Chronic Periodontitis ; Female ; Humans ; Male ; Mucocele ; Surgery, Oral ; Temporomandibular Joint Disorders

This study evaluated the use of endoscopy to examine jaw cysts during the operation. Fifteen jaw cysts were explored with a endoscope immediately before and after enucleation. Endoscopic findings were evaluated and recorded with video tape. Before enucleation, there were many white fibrous floating materials within the cystic cavity. Cystic lining showed smooth and regular appearance with capillary network. However, there were some fibrous scar tissues and irregular architecture in preoperative infection. After enucleation, there were white shiny bony surfaces with fresh vascular network. In some cases, floating fibrous tissues remained after removal.
Capillaries ; Cicatrix ; Endoscopes ; Endoscopy* ; Jaw Cysts* ; Jaw*

It is important to fast diagnosis and management of the pediatric patients of the endocrine metabolic emergencies because the signs and symptoms of these disorders are nonspecific. Delayed diagnosis and treatment may lead to serious consequences of the pediatric patients, for example, cerebral dysfunction leading to coma or death of the patients with hypoglycemia, hypocalcemia, adrenal insufficiency, or diabetic ketoacidosis. The index of suspicion of the endocrine metabolic emergencies should be preceded prior to the starting nonspecific treatment. Importantly, proper diagnosis depends on the collection of blood and urine specimen before nonspecific therapy (intravenous hydration, electrolytes, glucose or calcium injection). At the same time, the taking of precise history and searching for pathognomonic physical findings should be performed. This review was described for fast diagnosis and proper management of hypoglycemic emergencies, hypocalcemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis.
Acidosis* ; Adrenal Insufficiency* ; Calcium ; Child* ; Coma ; Delayed Diagnosis ; Diabetic Ketoacidosis* ; Diagnosis ; Electrolytes ; Emergencies* ; Glucose ; Humans ; Hypocalcemia* ; Hypoglycemia*

The incidence of small for gestational age (SGA) births is frequent, accounting for 2.3% to 8% of all live births. Several childhood and adult diseases are related to early postnatal growth and birth size, and 10% of children born SGA may have a short stature throughout postnatal life. Additionally, they may have abnormal growth hormone (GH)-insulin like growth factor axis, HPA axis, and gonadal function. Permanent changes are detrimental in an environment of nutritional abundance, and predispose SGA children to an array of diseases in adolescence and adulthood. Such changes may also cause premature pubarche, adrenarche, and precocious puberty. The varying results from clinical studies necessitate more prospective case control studies. Reproductive tract abnormalities and reproductive dysfunction are related to SGA births. GH treatment is required for SGA infants who do not experience catch-up growth.
Accounting ; Adolescent ; Adrenarche ; Adult ; Axis, Cervical Vertebra ; Case-Control Studies ; Child ; Gestational Age ; Gonads ; Growth Hormone ; Humans ; Incidence ; Infant ; Live Birth ; Parturition ; Puberty, Precocious ; Sex Differentiation

Knowledge regarding the physiological role and dietary requirements of vitamin D has dramatically expanded over the past several decades. The "new" vitamin D is not only a mediator of calcium homeostasis, it also has important immunomodulatory, antimicrobial, and antiproliferative actions. In spite of the interest in vitamin D as a mediator in many chronic diseases of adulthood such as cancer and type II diabetes, less attention has been given to the implications of the new understanding of vitamin D for child and adolescent health. Recently, rickets caused by vitamin D deficiency is resurging in developed countries. Therefore, pharmacokinetic studies and epidemiologic research that incorporates clinical and functional outcomes are needed to clarify the role of vitamin D in growth and development in Korean children and adolescents and to determine vitamin D dietary requirements.
Adolescent ; Calcium ; Child ; Chronic Disease ; Developed Countries ; Growth and Development ; Homeostasis ; Humans ; Nutritional Requirements ; Receptors, Calcitriol ; Rickets ; Vitamin D ; Vitamin D Deficiency ; Vitamins