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EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

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The Impacts of Social Support and Psychological Factors on Guild Members' Flow and Loyalty in MMORPG (MMORPG에서 길드 구성원들의 사회적 지지와 심리적 요인들이 플로우 및 충성도에 미치는 영향)

  • Kang, Ju-Seon;Ko, Yoon-Jung;Ko, Il-Sang
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.69-98
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    • 2009
  • We investigated what factors motivate gamers to participate in a guild and why they continue to be engaged as members of the guild. We find that, based on the result of focus group interviews with MMORPG gamers, social support and self-esteem factors play important roles. Considering both prior research and the focus group interviews we have conducted, we define social support and character control as independent variables. Character identity, guild identity, and self-esteem are proposed as mediating variables while guild flow and game loyalty as dependent variables. Accordingly, we develop the research model and hypotheses, and verify them empirically. Based on our experiences of playing the WoW game, we proposed a research model and conducted focus-group interviews (FGIs). FGIs involve formulating a hypothesis and then collecting some relevant data. FGIs were conducted face-to-face with students of C University in Korea. We formulated structured interview schedules, and the questions were based on our research variables and personal experiences. The questions for the interviews encompassed the following areas: (a) the demographic characteristics of the focus group; (b) the number of years for which respondents had played online games; (c) the motive for starting a game; (d) the number of game-characters assumed by each gamer; (e) the type of game played; and (f) other issues such as the reasons for involvement in the play, the willingness to reuse the game in case new versions were released, etc. On average, it took two hours to interview each of three groups. A primary set of FGIs was conducted with three groups on the premise that there would be some differences caused by character race (Horde vs. Alliance) or by playable server (Normal vs. Combat). With respect to the manner of playing, we found that guild members shared information, felt a sense of belonging, and played computer games for quite a long time through the guild; however, they did not undergo these experiences when playing alone. Gamers who belonged to a specific guild helped other players without expecting compensation for that, freely shared information about the game, gave away items for free, and more generous with other members who made mistakes. The guild members were aware of the existence other members and experienced a sense of belonging through interactions with, and evaluations from, other players. It was clear that social support was shown within the guild and that it played an important role as a major research variable. Based on the results of the first FGIs, a second set of in-depth FGIs was carried out with a focus on the psychology of the individual within the guild and the social community of the guild. The second set of FGIs also focused on the guild's offline meetings. Gamers, over all, recognize the necessity of joining a community, not only off-line but also online world of the guild. They admit that the guild is important for them to easily and conveniently enjoy playing online computer games. The active behavior and positive attitudes of existing guild members can motivate new members of the guild to adapt themselves to the guild environment. They then adopt the same behaviors and attitudes of established guild members. In this manner, the new members of the guild strengthen the bonds with other gamers while feeling a sense of belonging, and developing social identity, thereby. It was discovered that the interaction among guild members and the social support encouraged new gamers to quickly develop a sense of social identity and increase their self-esteem. The guild seemed to play the role of socializing gamers. Sometimes, even in the real world, the guild members helped one another; therefore, the features of the guild also spilled over to the offline environment. We intend to use self-esteem, which was found through the second set of FGIs, as an important research variable. To collect data, an online survey was designed with a questionnaire to be completed by WoW gamers, who belong to a guild. The survey was registered on the best three domestic game-sites: 'WoW playforum,' 'WoW gamemeca,' and 'Wow invent.' The selected items to be measured in the questionnaire were decided based on prior research and data from FGIs. To verify the content of the questionnaire, we carried out a pilot test with the same participants to point out ambiguous questions as a way to ensure maximum accuracy of the survey result. A total of 244 responses were analyzed from the 250 completed questionnaires. The SEM analysis was used to test goodness-of-fit of the model. As a result, we found important results as follows: First, according to the statistics, social support had statistically significant impacts on character control, character identity, guild identity and self-esteem. Second, character control had significant effects on character identity, guild identity and self-esteem. Third, character identity shows its clear impact on self-esteem and game loyalty. Fourth, guild identity affected self-esteem, guild flow and game loyalty. Fifth, self-esteem had a positive influence on the guild flow. These days, the number of virtual community is rising along with its significance largely because of the nature of the online games. Accordingly, this study is designed to clarify the psychological relationship between gamers within the guild that has been generally established by gamers to play online games together. This study focuses on the relationships in which social support influences guild flow or game loyalty through character control, character identity, guild identity, and self-esteem, which are present within a guild in the MMORPG game environment. The study results are as follows. First, the effects of social support on character control, character identity, guild identity and self-esteem are proven to be statistically significant. It was found that character control improves character identity, guild identity and self-esteem. Among the seven variables, social support, which is derived from FGIs, plays an important role in this study. With the active support of other guild members, gamers can improve their ability to develop good characters and to control them. Second, character identity has a positive effect on self-esteem and game loyalty, while guild identity has a significant effect on self-esteem, guild flow and game loyalty. Self-esteem affects guild flow. It was found that the higher the character and guild identities become, the greater the self-esteem is established. Contrary to the findings of prior research, our study results indicate that the relationship between character identity and guild flow is not significant. Rather, it was found that character identity directly affects game players' loyalty. Even though the character identity had no direct effect on increasing guild flow, it has indirectly affected guild flow through self-esteem. The significant relationship between self-esteem and guild flow indicates that gamers achieve flow, i.e., a feeling of pleasure and excitement through social support. Several important implications of this study should be noted. First, both qualitative and quantitative methods were used to conduct this study. Through FGIs, it was observed that both social support and self-esteem are important variables. Second, because guilds had been rarely studied, this research is expected to play an important role in the online community. Third, according to the result, six hypotheses (H1, H5, H6, H7, H8, and H11) setup based on FGIs, were statistically significant; thus, we can suggest the corresponding relationships among the variables as a guideline for follow-up research. Our research is significant as it has following implications: first, the social support of the guild members is important when establishing character control, character identity, guildidentity and self-esteem. It is also a major variable that affects guild flow and game loyalty. Second, character control when improved by social support shows notable influence on the development of character identity, guild identity and self-esteem. Third, character identity and guild identity are major factors to help establish gamers' own self-esteem. Fourth, character identity affects guild flow through self-esteem and game loyalty. The gamers usually express themselves through characters; the higher character identity is, the more loyalty a gamer has. Fifth, guild identity, established within the guild, has clear effects on self-esteem, guild flow and game loyalty. Sixth, qualitative and quantitative methods are employed to conduct this study. Based on the results of focus group interviews and SEM analysis, we find that the social support by guild members and psychological factors are significant in strengthening the flow of guild and loyalty to the game. As such, game developers should provide some extra functions for guild community, through which gamers can play online games in collaboration with one another. Also, we suggest that positive self-esteem which is built up through social support can help gamers achieve higher level of flow and satisfaction, which will consequently contribute to minimizing the possibility for the players to develop negative attitude toward the guild they belong to.

The Patterns of Change in Arterial Oxygen Saturation and Heart Rate and Their Related Factors during Voluntary Breath holding and Rebreathing (자발적 호흡정지 및 재개시 동맥혈 산소포화도와 심박수의 변동양상과 이에 영향을 미치는 인자)

  • Lim, Chae-Man;Kim, Woo-Sung;Choi, Kang-Hyun;Koh, Youn-Suck;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.379-388
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    • 1994
  • Background : In sleep apnea syndrome, arterial oxygen saturation($SaO_2$) decreases at a variable rate and to a variable degree for a given apneic period from patient to patient, and various kinds of cardiac arrythmia are known to occur. Factors supposed to affect arterial oxygen desaturation during apnea are duration of apnea, lung voulume at which apnea occurs, and oxygen consumption rate of the subject. The lung serves as preferential oxygen source during apnea, and there have been many reports related with the influence of lung volume on $SaO_2$ during apnea, but there are few, if any, studies about the influence of oxygen consumption rate of an individual on $SaO_2$ during breath holding or about the profile of arterial oxygen resaturation after breathing resumed. Methods : To investigate the changes of $SaO_2$ and heart rate(HR) during breath holding(BH) and rebreathing(RB) and to evaluate the physiologic factors responsible for the changes, lung volume measurements, and arterial blood gas analyses were performed in 17 healthy subjects. Nasal airflow by thermistor, $SaO_2$ by pulse oxymeter and ECG tracing were recorded on Polygraph(TA 4000, Gould, U.S.A.) during voluntary BH & RB at total lung capacity(TLC), at functional residual capacity(FRC) and at residual volume(RV), respectively, for the study subjects. Each subject's basal metabolic rate(BMR) was assumed on Harris-Benedict equation. Results: The time needed for $SaO_2$ to drop 2% from the basal level during breath holding(T2%) were $70.1{\pm}14.2$ sec(mean${\pm}$standard deviation) at TLC, $44.0{\pm}11.6$ sec at FRC, and $33.2{\pm}11.1$ sec at RV(TLC vs. FRC, p<0.05; FRC vs. RV, p<0.05). On rebreathing after $SaO_2$ decreased 2%, further decrement in $SaO_2$ was observed and it was significantly greater at RV($4.3{\pm}2.1%$) than at TLC($1.4{\pm}1.0%$)(p<0.05) or at FRC($1.9{\pm}1.4%$)(p<0.05). The time required for $SaO_2$ to return to the basal level after RB(Tr) at TLC was not significantly different from those at FRC or at RV. T2% had no significant correlation either with lung volumes or with BMR respectively. On the other hand, T2% had significant correlation with TLC/BMR(r=0.693, p<0.01) and FRC/BMR (r=0.615, p<0.025) but not with RV/BMR(r=0.227, p>0.05). The differences between maximal and minimal HR(${\Delta}HR$) during the BH-RB manuever were $27.5{\pm}9.2/min$ at TLC, $26.4{\pm}14.0/min$ at RV, and $19.1{\pm}6.0/min$ at FRC which was significantly smaller than those at TLC(p<0.05) or at RV(p<0.05). The mean difference of 5 p-p intervals before and after RB were $0.8{\pm}0.10$ sec and $0.72{\pm}0.09$ sec at TLC(p<0.001), $0.82{\pm}0.11$ sec and $0.73{\pm}0.09$ sec at FRC(p<0.025), and $0.77{\pm}0.09$ sec and $0.72{\pm}0.09$ sec at RV(p<0.05). Conclusion Healthy subjects showed arterial desaturation of various rates and extent during breath holding at different lung volumes. When breath held at lung volume greater than FRC, the rate of arterial desaturation significantly correlated with lung volume/basal metabolic rate, but when breath held at RV, the rate of arterial desaturation did not correlate linearly with RV/BMR. Sinus arrythmias occurred during breath holding and rebreathing manuever irrespective of the size of the lung volume at which breath holding started, and the amount of change was smallest when breath held at FRC and the change in vagal tone induced by alteration in respiratory movement might be the major responsible factor for the sinus arrythmia.

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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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An Empirical Study in Relationship between Franchisor's Leadership Behavior Style and Commitment by Focusing Moderating Effect of Franchisee's Self-efficacy (가맹본부의 리더십 행동유형과 가맹사업자의 관계결속에 관한 실증적 연구 - 가맹사업자의 자기효능감의 조절효과를 중심으로 -)

  • Yang, Hoe-Chang;Lee, Young-Chul
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.49-71
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    • 2010
  • Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

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Comparisons of Unicortical and Bicortical Lateral Mass Screws in the Cervical Spine : Safety vs Strength (경추부의 후관절 나사못 고정술에서 단피질삽입법과 양피질 삽입법 간의 특성에 관한 비교)

  • Park, Choon-Keun;Hwang, Jang-Hoe;Ji, Chul;Lee, Jae Un;Sung, Jae Hoon;Choi, Seung-Jin;Lee, Sang-Won;Seybold, Eric;Park, Sung-Chan;Cho, Kyung-Suok;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1210-1219
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    • 2001
  • Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

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Roles of the Insulin-like Growth Factor System in the Reproductive Function;Uterine Connection (Insulin-like Growth Factor Systems의 생식기능에서의 역할;자궁편)

  • Lee, Chul-Young
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.3
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    • pp.247-268
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    • 1996
  • It has been known for a long time that gonadotropins and steroid hormones play a pivotal role in a series of reproductive biological phenomena including the maturation of ovarian follicles and oocytes, ovulation and implantation, maintenance of pregnancy and fetal growth & development, parturition and mammary development and lactation. Recent investigations, however, have elucidated that in addition to these classic hormones, multiple growth factors also are involved in these phenomena. Most growth factors in reproductive organs mediate the actions of gonadotropins and steroid hormones or synergize with them in an autocrine/paracrine manner. The insulin-like growth factor(IGF) system, which is one of the most actively investigated areas lately in the reproductive organs, has been found to have important roles in a wide gamut of reproductive phenomena. In the present communication, published literature pertaining to the intrauterine IGF system will be reviewed preceded by general information of the IGF system. The IGF family comprises of IGF-I & IGF-II ligands, two types of IGF receptors and six classes of IGF-binding proteins(IGFBPs) that are known to date. IGF-I and IGF-II peptides, which are structurally homologous to proinsulin, possess the insulin-like activity including the stimulatory effect of glucose and amino acid transport. Besides, IGFs as mitogens stimulate cell division, and also play a role in cellular differentiation and functions in a variety of cell lines. IGFs are expressed mainly in the liver and messenchymal cells, and act on almost all types of tissues in an autocrine/paracrine as well as endocrine mode. There are two types of IGF receptors. Type I IGF receptors, which are tyrosine kinase receptors having high-affinity for IGF-I and IGF-II, mediate almost all the IGF actions that are described above. Type II IGF receptors or IGF-II/mannose-6-phosphate receptors have two distinct binding sites; the IGF-II binding site exhibits a high affinity only for IGF-II. The principal role of the type II IGF receptor is to destroy IGF-II by targeting the ligand to the lysosome. IGFs in biological fluids are mostly bound to IGFBP. IGFBPs, in general, are IGF storage/carrier proteins or modulators of IGF actions; however, as for distinct roles for individual IGFBPs, only limited information is available. IGFBPs inhibit IGF actions under most in vitro situations, seemingly because affinities of IGFBPs for IGFs are greater than those of IGF receptors. How IGF is released from IGFBP to reach IGF receptors is not known; however, various IGFBP protease activities that are present in blood and interstitial fluids are believed to play an important role in the process of IGF release from the IGFBP. According to latest reports, there is evidence that under certain in vitro circumstances, IGFBP-1, -3, -5 have their own biological activities independent of the IGF. This may add another dimension of complexity of the already complicated IGF system. Messenger ribonucleic acids and proteins of the IGF family members are expressed in the uterine tissue and conceptus of the primates, rodents and farm animals to play important roles in growth and development of the uterus and fetus. Expression of the uterine IGF system is regulated by gonadal hormones and local regulatory substances with temporal and spatial specificities. Locally expressed IGFs and IGFBPs act on the uterine tissue in an autocrine/paracrine manner, or are secreted into the uterine lumen to participate in conceptus growth and development. Conceptus also expresses the IGF system beginning from the peri-implantation period. When an IGF family member is expressed in the conceptus, however, is determined by the presence or absence of maternally inherited mRNAs, genetic programming of the conceptus itself and an interaction with the maternal tissue. The site of IGF action also follows temporal (physiological status) and spatial specificities. These facts that expression of the IGF system is temporally and spatially regulated support indirectly a hypothesis that IGFs play a role in conceptus growth and development. Uterine and conceptus-derived IGFs stimulate cell division and differentiation, glucose and amino acid transport, general protein synthesis and the biosynthesis of mammotropic hormones including placental lactogen and prolactin, and also play a role in steroidogenesis. The suggested role for IGFs in conceptus growth and development has been proven by the result of IGF-I, IGF-II or IGF receptor gene disruption(targeting) of murine embryos by the homologous recombination technique. Mice carrying a null mutation for IGF-I and/or IGF-II or type I IGF receptor undergo delayed prenatal and postnatal growth and development with 30-60% normal weights at birth. Moreover, mice lacking the type I IGF receptor or IGF-I plus IGF-II die soon after birth. Intrauterine IGFBPs generally are believed to sequester IGF ligands within the uterus or to play a role of negative regulators of IGF actions by inhibiting IGF binding to cognate receptors. However, when it is taken into account that IGFBP-1 is expressed and secreted in primate uteri in amounts assessedly far exceeding those of local IGFs and that IGFBP-1 is one of the major secretory proteins of the primate decidua, the possibility that this IGFBP may have its own biological activity independent of IGF cannot be excluded. Evidently, elucidating the exact role of each IGFBP is an essential step into understanding the whole IGF system. As such, further research in this area is awaited with a lot of anticipation and attention.

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Halitosis and Related Factors among Rural Residents (농촌지역 주민들의 구취실태와 유발요인)

  • Lee, Young-Ok;Hong, Jung-Pyo;Lee, Tae-Yong
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.157-175
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    • 2007
  • This study was conducted through an interview process in which questionnaires were administered to 293 people. The questionnaires related to the behaviors of oral hygiene care, and disease history related to halitosis, and status of halitosis, halitosis measurement, oral examination, and caries activity tests such as the snyder test, Salivary flow rate test, and Salivary buffering capacity test. Our sample was taken from 293 rural residents within the period from 4th to 21st of January 2006. This was done in order to provide basic data to prepare both policies of halitosis prevention and a device to efficiently measure halitosis status and investigate the factors related therein. The major findings of this study results are as follows: 1. As for frequency of tooth brushing, twice a day occupied the greatest portion at 46.1 % Women exceeded men in frequency of tooth brushing. Tongue brushing everyday produced a 25.6 % result among subjects and The use of auxiliary oral hygiene devices occupied 9.2 %. 2. As for degree of usual self-awareness of halitosis: 62.5 %. This result also demonstrate that the severest time of self-awareness in regards to halitosis is wake up time in the morning. The time period produced the highest portion of 72.7 % in times of self-awareness. In terms of the area in which halitosis was observed, gum resulted in 23.0 %. As for types of halitosis, fetid smell was the most frequent at 37.2 %. 3. As for the result of halitosis measurement, values of OG less than 50 ppm occupied 54.3 % and $50{\sim}100ppm$ occupied 41.6 %. As for $NH_3$ values, $20{\sim}60ppm$ showed the highest value range of 52.6 %. 4. As for OG per disease history related to halitosis, values of OG were significantly high in the ranges of $50{\sim}100ppm$ within family history groups of food impaction by dental caries, diabetes mellitus and halitosis. As for values of $NH_3$, there showed a significant difference in respiratory system disease groups. 5 Value range of OG per ordinary halitosis self-awareness degree: values ranging less than 50 ppm were recorded at 55.9 % from the group realizing not aware of smell. 57.5 % from groups only realizing sometimes, while values range of $50{\sim}100ppm$ were recorded at 52.0 % from groups always aware of smell. 63.6 % from groups always strongly aware of smell. Meanwhile as for the values ranges of $NH_3$, $20{\sim}60ppm$. they occupied high portions for all groups of exams. 6. Values of OG per oral examination: the more pulp-exposed teeth and food impaction and the higher the tongue plaque index, values of OG increased within the range of $50{\sim}100ppm$. As for values of $NH_3$, the more prosthetic teeth and the higher the tongue plaque index, this value increased significantly, and the values increased up to no less than 60 ppm for groups of mandibular partial denture. 7. Within the realm of caries activity test: as for the Snyder test, high activity was highest by 43.0 % wherewith the higher the activity of acidogenic bacteria the higher the OG values. As for the salivary flow rate test, the number of cases below 8.0 ml showed the highest tendency by 62.5 %. The larger the salivary flow rate the more decreased OG values distribution. As for the salivary buffering capacity test, $6{\sim}10$ drops of 0.1N lactic acid showed the overwhelming trend by 58.7 % whereby the higher the salivary buffering capacity the greater distribution occupancy ratio of OG values below 50 ppm which is scentless to on ordinary person. 8. As for the correlation between oral environment and halitosis, OG showed the positive correlation with pulp exposed teeth, filled teeth, present teeth, tongue plaque index, and food impaction, while the negative correlation with salivary flow rate and prosthetic teeth. $NH_3$ showed a positive correlation with prosthetic teeth and frequency of tooth brushing, while decayed teeth was negative correlation. 9. As for the multiple regression analysis result, there have been selected female, pulp exposed teeth, prosthetic teeth, food impaction, salivary flow rate, tongue plaque index and severe activities in the Snyder test as factors affecting OG wherein explanatory power on it was 45.1 %. There have been selected females, pulp exposed teeth, tongue plaque index, and prosthetic teeth as factors affecting on $NH_3$ wherein explanatory power on it was 6.6 %. With the aforementioned results in mind, the status of halitosis among rural residents is considered to bare a close relation with oral environments and other factors related to halitosis such as the Snyder test from caries activity test, and salivary flow rate test. For the prevention of halitosis of residents in rural areas, we have to focus on correct tooth brushing methods and tongue brushing, with using auxiliary oral hygiene devices to remove fur of tongue plaque and food impaction. Also, when the cause and ingredients of halitosis are diverse and complex, in order to analyze exactly the factors of individual halitosis development, we need continuous and systematic study in order to provide rural residents with programs of oral hygiene education and encourage the use of dental hygienists in public health centers.

A Study of Mac(脈)-Theory and Change of Mac(脈)-Diagnosis in Whang Di Nei Qing(黃帝內經) (황제내경(黃帝內經)의 맥(脈) 이론(理論)과 진맥법(診脈法)의 변화(變化)에 관(關)한 연구(硏究))

  • Ra, Kyoung-Chan;Park, Hyun Kook
    • The Journal of Dong Guk Oriental Medicine
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    • v.2 no.1
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    • pp.73-105
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    • 1993
  • To say nothing of the orient and the west, the human beings discover the method of Jin Mac(診脈) by the way that observe disease. But oriental medicine devise special method of Jin Mac(診脈) in the study of Kyoung Mac(經脈). Although sip-ei Kyoung Mac Jin(十二經脈診), Sam Bu Gu Who Jin(三部九候診), In Young Mac Gu Jin(人迎脈口診), Chon Kwan Chuck Jin(寸關尺診) namely Yuk Bu Jung Wee Jin Mac (六部定位診脈) that is used today are devised, it has changed naturally by the changing treatment and the introduction of Yuin Yang(陰陽) and five element(五行). Many methods dg Jin Mac(診脈), it had not developped successing alternative, it had developped of declined by it's own way. 1. Results for the birth of Mac(脈) 1) Mac(脈), it means Kyoung Mac(經脈), at first entirelly Mac(脈), is seized a blood vessel that flows in the body. As presumed today, after finding many acupunture point, a general idea of Mac(脈) is not maked by the line that connect point and point, it connect between acupunture point and acupunture point. 2) Like blood flows in Hyul Mac(血脈), Gie(氣) flows in Kyoung Mac(經脈). The two things relate deeply each other. In a general idea or actrally Kyoung Rak(經洛), the two things sometimes accord, sometimes seperate, sometimes mix alternative. 3) Hyul Mac(血脈) and Kyoung Mac(經脈), we call it Mac(脈) entirely Kyoung Mac(經脈), is a way that manifest disease through Kyoung Mac(經脈) or a boundary that disease belongs to it method of Mac Jin(脈診) individual that disease of Kyoung Mac(經脈) is diagnosed by the jumping situation of Hyul Mac(血脈). 4) In method of Moxa, athough the pathology and the diagnostic of Mac(脈) are created by finding Mac(脈). Finding acupunture have opportunitty fot Mac Jin(脈診) and treatment. 2. Results of Kyoung Mac Mac Jin(經脈脈診) 1) In theory of kyoung Rak(經洛), disease are resumed for malfunction of Young Wee(榮衛) that flows in Kyung Rak(經洛). So to speak, in treatment of Kyoung Rak area, the purpose of diagnosis observe the situation of disease and cause. For fitting the purpose of diagnosis, the dead had esatablised four-diagnosis method mangMunMnnJeul(望聞問切), in four-diagnosis(四診法), the core is Mac Jin(脈診). 2) sip-ei Kyoung Mac Mac Jin(十二經脈診) had existed as Kyoung Mac Mac Jin(經脈脈診), it precedes Sam Bu Gu Who Jin(三部九候診). In Young Ki Gu Mac(人迎脈口診). 3) Although Bu Yang Mac(趺陽脈), So Um Mac(少陰脈) is a part of Sip-ei Kyoung Mac(十二經脈診), they developped especially because they located in the point of Won Hyul(原穴) and they are convenient for diagnose. 4) Sip-ei Kyoung Mac Mac Jin(十二經脈診), which belongs to Bu Yang Mac(趺陽脈) and So Urn Mac(少陰脈), is not important for the comming age medical books compared with Mac Kyoung(脈經). 3. Results gor Sam Bu Gu Who Jin(三部九候診) 1) Mac Jin(脈診) of Sam Bu Gu Who(三部九候), which is noted in the theory of Sam Bu Gu Who(三部九候診) of So Mun(素問), belongs to Kyoung Mac Mac Jin's(經脈脈診) geneology, Sip-ei Kyoung Mac Mac Jin(十二經脈診) is arranged, simplicated by the idealogy three talents(三才思想) in the heaven and the earth. 2) What Sam Bu Gu Jin(三部九候診) is regardded as very important in So Mun(素問), the editor of So Mun(素問) recognize the meaning that one discover disease early in this method of diagnosis. 3) After Young chu(靈樞), Nan Kyoung(難經) it is lacked the method of Sam Bu Gu Who Jin(三部九候診) in the books that treatment has changed. Sam Bu Gu Who Jin(三部九候診) based on actually clinic appropriate. 4. results for In Young Mac Gu Jin(人迎脈口診) 1) In Young Mac Gu Jin(人迎脈口診) is the method of comparative Mac Jin(脈診) according to the theory of Yin Yang(陰陽), it is presumed after Sam Bu Gu Who Jin(三部九候診), it had perished in parallel with the development of the theory of five elelment(五行). The development of the acupunture, the perishment of the treatment of negative(刺絡). 2) In Young Mac Gu Jin(人迎脈口診), Wang Suk Wha(王叔和) recreated that the left is In Young(人迎), the right is Kie Gu(氣口). In future generations by Jin Mu Taek(陳無擇) who is the writer of Sam In Bang(三因方). In Young Mac Gu Jin(人迎脈口診) is a measure for disease which classify it's inside and outside cause. 5. Results for Chon Gu Mac Jin(寸口脈診) 1) What we say Mac Jin(脈診) of Chon Gu(寸口) two means are used in commn. First case, we simply say the area of Chon Gu(寸口), second case, we say Chon Kwan Chuk Jin(寸口尺診) reducingly. Chon Gu(寸口) is the area which is the radial artery of wrist joint. What we attemp diagnose by only Chon Gu Mac(寸口脈), it is clearly shoued in the method of Nan Kyoung, five Nan(難經五難). 2) Because Jin Mac(診脈) is made in only Chon Gu(寸口), that is the area in which is concentated Kyoung Kee(經氣). That is the birth of Jin Kee(眞氣) and Jin Kee(眞氣) is related with disease. We can diagnose disease by taking Chon Gu(寸口). 3) Chuk Jin(尺診) in Nae Kyoung(難經) have two things. One is Il Chuk(一尺), the other is Chon Kwan Chu(寸關尺). 4) Chuk Chon Jin(尺寸診) is the method which diagnose the difference of point and the condition of Mac(脈) by dividing a part of Chuk(尺) in the area of Chon Gu(寸口). In Chon Gu Jin(寸口診), by introducing the theory of Yin Yang(陰陽), the method of Chon Gu Jin(寸口診) is developed by chon Gu Jin(寸口診). 5) What Chuk Kwan Chon Jin(寸關尺診) is that area of the Chon Gu(寸口) are divided fot three point, we can diagnose. By consulting Sam Bu Gu Who Jin(三部九候診), developping of the method of acupunture, utilzing the theory of five element(五行) it is devised by concentrating way of thinking of the method mac Jin(脈診) exiting. 6) Chon Kwan Chuk Jin MaC(寸關尺診脈) begin from Nae Kyoung(內徑) exiting. After Nan Kyoung(內徑), spread out widely from Mac Kyoung(脈診) of Wang Suk wha(王叔和), the future medicins followed it. Yang Hyun Jo(楊玄操) and established Chon Kwan Chuk Jin(寸關尺診) which is used widely today. This right and left Chon Kwan Chuk Jin(寸關尺診), we call it method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 7) We can think the base which presume the arrangement of the viscera for Chon Kwan Chuk(寸關尺) of the right and the left. 8) The origin, which seperate the right and the left of Mac(脈), is showed at the treory of Ji Jin Yo Dae(至眞要大論) in So Mun(素問) which Chon Chuk(寸尺) seperate the right and the left. But the method of diagnosis in Nan Kyoung(難經) have no seperation the fight and the left. Otherwise this. there is clearly writtened the seperation for the right origin of the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈) seek for Cang Gong(倉公). 9) Yang Hyun Jo(楊玄操) notice that the Chuk(尺) is mentioned for Sam Cho(三焦) in the method of Mac Kyuong(脈經), Sim Po Kyung(心包經) which put together with Sam Cho(三焦) allot on this, he had established the method of Yuk Bu Jung Wee Jin Mac(六部定位診脈). 10) On the method of Paen Jak Yin Yang Mac(扁鵲陰陽脈) in Mac Kyoung(脈經), equal article exist with the theory of Pyung In Kee Sang(平人氣象論) in So Mun(素問). When Wang Suk Wha(王叔和) write Mac Kyung(脈經), we can presume that the book of Mac(脈) which Paen Jak(扁鵲) had experienced the origin have exited besides So Mun(素問), Young Chu(靈樞). If so he must be make Chon Kwan Chuk Jin(寸關尺診) very fairly standard. So Nae Kyoung(內經), which must be fllowed the method of Paen Jak Mac(扁鵲脈), do the method diagnosis of Chon Kwan Chuk(寸關尺), diagnise of disease and treat.

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