우리나라 병원의 마케팅 활동수준과 재무성과

한창훈 ( Chang Hoon Han ),김원중 ( Won Joong Kim ) 한국병원경영학회 1999 병원경영학회지 Vol.4 No.2

The main objective oh this paper is to perform an empirical analysis on the relationship between various marketing activities and financial performance of Korean hospitals. A survey was conducted through structured questionnaire for 495 hospitals, and data from 218 hospitals were utilized in the final analysis. (response rate : 44%) Survey items include general characteristics of the hospitals (size, type, location), degree of competition, financial performance, marketing organization/ budget, and level of various marketing activities in service development, access improvement, promotion, and pricing. We examine descriptive statistics of the response scores on marketing activities to evaluate the current status of marketing management of Korean hospitals, compare the results across hospital size, type and location, and perform regression analysis to investigate the relationship between marketing and financial performance. Major findings are as follows : 1) About 46% of the responding hospitals gave marketing departments although they are named as 'planning' or 'PR' departments, and the marketing budget on average represents 1.74% of the total expenditures. 2) Average level of marketing activities is calculated to be about 3.32 on 5-point scale, meaning that Korean hospitals implement their marketing programs 'somewhat actively'; however, the scores on the areas of marketing planning and strategy are relatively low. 3) Large hospitals tend to be more active in marketing than small hospitals, and public hospitals' activities in marketing are not lower compared to private hospitals. 4) Level of overall marketing activities is positively related with financial performance measured by various financial indicators except for profitability, implying that marketing is successful in revenue generation but needs to be more cost-effective. Also, when the marketing variables are separately included in the regression, no significant relationship is found, which means that various marketing activities are more effective when they are collectively implemented.

感染性 疾患의 臨床疫學的 硏究

張友鉉,朴熙明,金漢壽,李承薰 現代醫學社 1969 現代醫學 Vol.10 No.4

The advancement of modern medicine, particularly the application of effective chemotherapeutics and preventive measures, have brought significant changes on the ecological aspect of microbial diseases of man. It was thought worthwhile to study the recent trends and present status of microbial infections in this country. Thus, the relative incidences and their etiological relationships of bacterial species, the pattern of drug sensitivities among the strains, and also the cases diagnosed by the serological methods were studied for the patients of SNU Hospital from January 1963 to December 1967. The results might be summarized as follows; 1. Relationships between bacteria and diseases (1) The species and their relative incidences of bacteria, isolated from various abscess, were α-hemolytic streptococcus 26.6%, Staphyloccus aureus 22.6%, paracolon bacilli 9.9%, coliform bacilli 8.1%, Klebsiella pneumoniae 7.6%, E. coil 6.9%, β-hemolytic streptococcus 5.9%. Staphylococcus albus 3.8%. Proteus 3.8%. Alkaligenes fecalis 2.1%, Diplococcus pneumoniae 1.8% and Pseudomonas aeruginosa 1.6%. (2) The species and their relative incidences of bacteria, isolated from the pyelonephritis cases, were E. coli, 39.5%, coliform bacilli 13.5%, Pseudomonas aeruginosa 9.3%, Proteus 7.4%, Staphylococcus albus 4.6%, α-hemolytic streptococcus 4.6%, Staphylococcus aureus 2.8%, Klebsiella pnemoniae 2.8%, and Alkaligenes fecalis 2.8%. (3) The species and their relative incidences of bacteria, isolated from the osteomyelitis cases, were Staphylococcus aureus 46.5%, β-hemolytic streptococcus 12%, Staphyococcus albus 12%, coliform bacilli 6.9%, α-hemolytic streptococcus 6.9%, paracolon bacilli 5.2% and E. coli 3.5%. (4) The species and their relative incidences of bacteria, isolated from the surgical infections were Staphylococcus aureus 33%, E. coli 15.1%, coliform bacilli 11.6%, Pseudomonas aeruginosa 10.7%, paracolon bacilli 9.8%, Proteus 7.1%, α-hemolytic streptococcus 3.5%, Klebsiella pneumoniae 2.7%, and Alkaligenes fecalis 0.9%. (5) The species and their relative incidences of bacteria, isolated from the pneumonia cases, were Diplococcus pneumoniae 14.4%, Klebsiella pneumoniae 9.6%, Staphylococcus aureus 10.3%, β-hemolytic streptococcus 4.8%, paracolon bacilli 4.8%, E. coli 3.4%, coliform bacilli 3.4%, α-hemolytic streptococcus 34.6% and Staphylococcus albus 13.6%. (6) 44 strains of Salmonella group D were isolated. (7) 207 cases of Salmonella typhosa infections, 39 cases of Salmonella paratyphi A infer ctions and 20 cases of Salmonella paratyphi B infections were diagnosed by Widal. Reactions. (8) No significant change in the yearly pattern between the bacterial species isolated and clinical cases was noticed. 2. Drug-sensitivities of the bacterial strains. (1) Percentage of Staphylococcus aureus strains sensitive to streptomycin, chloramphenicol. Or terramycin appeared to have fluctuated by year. Percentages of the strains sensitive to penicillin, erythromycin albamycin, and kanamycin were 25%, 85%, 99% and 99% respectively, without significant change by year. (2) Perentage of E. coil strain's sensitive to streptomycin, erythromycin, chloramphenicol albamycin and kanamycin were 30%, 9% 70%, and 70% respectively, without significant change by year. Percentage of the strains sensitive to terramjcin decreased from 33.3% in 1963 to 11.6% in 1967 to kanamycin increased from 72% in 1963 to 82% in 1967. None of the strains was sensitive to penicillin. (3) Percentage of proteus strains sensitive to penicillin, terramycin, streptomycin and chloramphenicol were 5%, 3%, 36% and 39%, respectively, without significant change by year. Percentage of the strains sensitive to albamycin decreased from 72.5% in 1963 to 50% in 1967 and to kaiiainycin increased from 72% in 1963 to 82% in 1967. None of the strain was sensitive to erythromycin. (4) Percentage of Pseudomonas strains sensitive to penicillin, streptomycin chloramphenicol, terramycin, erythromycin, albamycin and kanamycin were wider 20% (5) Percentage of coliform bacilli strains sensitive to penicillin, streptomycin, chloramn henicol, terramycin, erythromycin and albamycin were 10%, 24%, 28%, 20% and 10% respectively, without significant change by year. Percentage of the strains sensitive to albamycin appeared to have fluctuated by year. The strains sensitive to kanamycin decreased from 80% in 1963 to 56% in 1967. (6) Pereeentage of paracolon bacilli sensitive to penicillin, streptomycin, chloramphenicol, terrahiycin, erythromycin, kanamycin and albamycin were 3%, 27%, 33%, 20%, 8%, 80% and 65% respectively, without significant change by year.

출산에 따른 그레이브스병의 재발 및 관련이자

임창훈,최현아,한승석,김해성,이창욱,정호연,한기옥,장학철,박원근,윤현구,한인권 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2

Background: Pregnancy affects the course of Graves' Disease (GD), and patients who initially maintain euthyroid function into their middle trimester with minimum doses of antithyroid drugs become exacerbated after delivery. Even patients who are completely cured, requiring no treatment during pregnancy, can relapse after delivery. In this study, we examined the postpartum changes in the thyroid functions of patients with GD, and attempted to determine the factors contributing to these changes. Methods: The study subjects were recruited from pregnant women visiting our outpatient clinic for routine prenatal evaluations. 45 women previously diagnosed with GD, who had been treated and cured with hyperthyroidism, and were no longer taking any thyroid medications, were evaluated for 1 year post delivery. Results: Among 45 patients, 20 (44.4%) developed thyroid disorders following delivery. Postpartum thyroiditis (PPT) developed in 8 patients (17.8%), and GD developed in 12 (26.0%). The onset of the PPT disease 3.1 ± 1.4 months following delivery, which was significantly earlier than the 6.7 ± 2.7 months required for the post delivery onset of GD (p=0.003). The TBII values, measured during the thyrotoxic state in each womaen, were negative in women with PPT and positive in 71.4% of women with GD (p=0.030). The duration of treatment for hyperthyroidism prior or pregnancy, the number of recurrences, and the time interval without treatment, were not associated with the development of postpartum thyroid disorders. Whereas, the mean number of past pregnancies for women who developed PPT was 3.9 ± 2.1, and was significantly higher than the 2.2 ± 1.7 for women developing no thyroid dysfunctions (p=0.044). In 13 women their initial onset of GD occurred within one year postpartum, 7 (53.8%) having had a recurrence, which was significantly higher than in women whose disease onset occurred unrelated to delivery (5 of 32 women: 15.6%). Conclusion: Women with GD developed postpartum thyroid dysfunctions in 44.4% of cases. Women whose initial disease onset occurred within one year postpartum had higher recurrences of GD, and women who developed PPT had a history of higher gravidity compared to the euthyroid women postpartum. Therefore, if women with GD develop postpartum thyroid dysfunctions, the diagnosis should be made, and a treatment modality planned, following careful considerations of the patients' past obstetric history, changes in clinical manifestations and the TBII values

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Impact of urban warming on earlier spring flowering in Korea

Jeong, Jee‐,Hoon,Ho, Chang‐,Hoi,Linderholm, Hans W.,Jeong, Su‐,Jong,Chen, Deliang,Choi, Yong‐,Sang John Wiley Sons, Ltd. 2011 International journal of climatology Vol.31 No.10

<P><B>Abstract</B></P><P>Using long‐term (1954–2004) observations of four selected species in South Korea: goldenbell (<I>Forsythia koreana</I>), azalea (<I>Rhododendron mucronulatum</I>), cherry (<I>Prunus yedoensis</I>), and peach (<I>Prunus persica</I>), the impact of urban warming on spring flowering was investigated. Trends of early spring temperatures and first‐flowering dates (FFDs) of the four plants were cross‐compared among nine differently urbanized cities. It was clearly observed that urban warming has led to an advance in the timing of first‐flowering of several days to weeks during recent decades, while the intrinsic physiology of plants to sense thermal energy has not been changed. The degree of advancement of the FFD was observed to be roughly proportional to degree of urbanization. Moreover, the sensitivity of the FFD to urban warming was estimated to be higher for the shrub species (−9.07 and −6.64 days °C<SUP>−1</SUP> for goldenbell and azalea, respectively) than the tree species (−2.46 and −2.90 days °C<SUP>−1</SUP> for peach and cherry, respectively). Our results suggest that the impact of urban warming should be considered as an influential factor which drives changes in the regional natural environment, especially in regions of rapid urbanization. Copyright © 2010 Royal Meteorological Society</P>

Free Paper Presentation : OS-53 ; Factors Associated with Smokers` will for Smoking Cessation in Korea

( Ah Young Leem ),( Chang Hoon Han ),( Chul Min Ahn ),( Tae Hoon Jung ),( Yu Il Kim ),( Jae Yeol Kim ),( Sang Haak Lee ),( Eun Mi Chun ),( Kwang Ha Yoo ),( Ji Ye Jung ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-

Background: Smoking is known to increase the risk of chronic disease. Understanding of factors that contribute to smoking cessation may help to develop strategies for smoking behavior change. Methods: Pooled cross-sectional data of 11,924 subjects from the Korea National Health and Nutrition Examination Survey II-V were analyzed. The stages of change in smoking cessation were categorized into pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological characteristics, and tobacco-related factors were compared between the groups. Results: The study population consisted of 32.4% in pre-contemplation, 54.4% in contemplation, and 13.1% in preparation group. While the proportion for pre-contemplation group (37.4% to 28.4%) tended to decrease from 2001 to 2012, that of preparation group (6.4% to 18.1%) tended to increase. The mean age of pre-contemplation group (48.4±16.2) is higher than comtemplation and preparation group (42.2±13.9 and 44.4±15.3; P=0.02). As levels of education and income status increased, the proportion of pre-contemplation tended to decrease, and that of preparation tended to increase. Proportion of blue collar job in pre-contemplation group was higher than in preparation group (67.9% vs 58.1%; P<0.001). In pre-contemplation group, percentage of suicidal ideation within 1 year was higher than contemplation and preparation group (19.3% vs 16.0% and 16.1%). Upon adjusting analysis, the proportion of pre-contemplation group increased with increasing age (OR=1.01; 95%CI 1.01-1.02), and smoking amount (OR=1.04; 95%CI 1.03-1.05). People of pre-contemplation group (vs. preparation) are be less educated (OR=1.99; 95% CI 1.51-2.62), are in single marital status (OR=1.25; 95%CI 1.04-1.50), have lower prevalence of cardiovascular disease (OR=0.48; 95%CI 0.31-0.76), and do less exercise walking (OR=1.36; 95%CI 1.09-1.69) and weight training (OR=1.59; 95%CI 1.35-1.85). Conclusions: We demonstrated a significant association between the stages of change in smoking cessation and age, education, marital status, cardiovascular disease, and amount of exercise.

The Korean Academy of Tuberculosis and Respiratory Diseases : Slide Session ; OS-053 : COPD ; Factors Associated with Smokers` will for Smoking Cessation in Korea

( Ah Young Leem ),( Chang Hoon Han ),( Chul Min Ahn ),( Tae Hoon Jung ),( Yu Il Kim ),( Jae Yeol Kim ),( Sang Haak Lee ),( Eun Mi Chun ),( Kwang Ha Yoo ),( Ji Ye Jung ),( Korean Smoking Cessation Stud 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Smoking is known to increase the risk of chronic disease. Understanding of factors that contribute to smoking cessation may help to develop strategies for smoking behavior change. Methods: Pooled cross-sectional data of 11,924 subjects from the Korea National Health and Nutrition Examination Survey II-V were analyzed. The stages of change in smoking cessation were categorized into pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological characteristics, and tobacco-related factors were compared between the groups. Results: The study population consisted of 32.4% in pre-contemplation, 54.4% incontemplation, and 13.1% in preparation group. While the proportion for pre-contemplation group (37.4% to 28.4%) tended to decrease from 2001 to 2012, that of preparation group (6.4% to 18.1%) tended to increase. The mean age of pre-contemplation group (48.4±16.2) is higher than comtemplation and preparation group (42.2±13.9 and 44.4±15.3; P=0.02). As levels of education and income status increased, the proportion of pre-contemplation tended to decrease, and that of preparation tended to increase. Proportion of blue collar job in pre-contemplation group was higher than in preparation group (67.9% vs 58.1%; P<0.001). In pre-contemplation group, percentage of suicidal ideation within 1 year was higher than contemplation and preparation group19.3% vs 16.0% and 16.1%). Upon adjusting analysis, the proportion of pre-contemplation group increased with increasing age (OR=1.01; 95%CI 1.01-1.02), and smoking amount (OR=1.04; 95%CI 1.03-1.05). People of pre-contemplation group (vs. preparation) are be less educated (OR=1.99; 95% CI 1.51-2.62), are in single marital status (OR=1.25; 95%CI 1.04-1.50), have lower prevalence of cardiovascular disease OR=0.48; 95%CI 0.31-0.76), and do less exercise walking (OR=1.36; 95%CI 1.09-1.69)and weight training (OR=1.59; 95%CI 1.35-1.85). Conclusions: We demonstrated a signifi cant association between the stages of changesmoking cessation and age, education, marital status, cardiovascular disease, and amount of exercise.

PET/CT 검사에서 환자체형에 따른 적정검사 프로토콜에 관한 고찰

조석원,함준철,강천구,반영각,이승재,임한상,이창호,박훈희,Cho, Seok Won,Ham, Joon-Chul,Kang, Chun Goo,Bahn, Young Kag,Lee, Seung Jae,Lim, Han Sang,Lee, Chang-Ho,Park, Hoon-Hee 대한핵의학기술학회 2013 핵의학 기술 Vol.17 No.2

Purpose: Whole-body PET using radiopharmaceutical is one of the imaging study methods for physiological changes of body. High specificity of the PET-CT examination is used to detect an early stages of cancer and metastatic cancer by imaging a physiological changes. During the imaging process, PET image has been characterized by a relatively low image quality due to its low sensitivity and the acquisition of random and scatter coincidences as well as patients figure. Therefore, the image quality as the changes of the acquisition times of patient weight was evaluated in this study. Materials and Methods: Thirty patients who presented to our hospital were enrolled. They were divided to normal, overweight, and obese group using BMI index, respectively. The patients with a liver disease and diabetes were excluded. $^{18}F-FDG$ was administered to the patients as 5.2 MBq per kg. After an hour from an injection, image acquisition was obtained as List mode in a part of liver in 1 bed. SNR (signal-to-noise ratio) of each groups acquisition times were confirmed from the calculated radiation counts and random fractions. The statistical significance of three groups was confirmed through one-way ANOVA test. On the basis of the counts of 2 minutes on normal group, the SNR of overweight group and obese group were compared. Results: The SNR were increased with loger aquisition time in 3 groups. In the condition of same acquisition time, the SNR had a statistical significance (P<0.05). The SNR were decreased to the normal, overweight, and obese, respectively. Liver activity had no significance difference on each group and RF had the significance differences (P<0.05). On the basis of the counts of 2 minutes on normal group, there were no statistical significance in a three minute acquisitions of overweight group and two minute acquisitions of obese group (P=0.150). Conclusion: In this study, the administrated amount of radiation dose did not adjust as the change of the patients weight. Increasing the acquisition time when the administration of the same amount of dose was able to get a good result of SNR. When the Based 2 minute on normal group, if overweight and obese case the increased acquisition time of 3 minute was able to obtain a similar SNR. On the basis of the normal group, the acquisition times of overweight and obese group were increased to 3 minutes per bed and the SNR were similar to the normal group.

주름잡힌 板의 剛性에 대한 理論解析과 實驗的 硏究(山型)

韓秉基,張昌訓,宋東浩 弘益大學校 1986 弘大論叢 Vol.18 No.2

In this paper, the triangular-wave type corrugated plate, which is a kind of the stiffened plate-structures for increasing the load-carrying ability and optimizing the economy, is investigated. On the base of small displacement theory, analysis method for the theoretical investigation of such a plate is proposed, and using the aluminium specimen which is bend-formed to triangular-wave type, four point bending experiment and three point supporting-one point loading torsional experiment are carried out. Good experimental confirmation of the validity of the proposed analysis method is found.

환축부 불안정성에 대한 굴곡신전 자기공명 영상

장한,김윤수,정창훈,이재문 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.1

The atlantoaxial joint, provided with a relatively wide range of motion, is secured and supported chiefly by soft tissue such as ligaments and articular capsule with lit- tle bony support. Thus, relaxation or rupture of the soft tissue structures due to rheumatoid inflammation or trauma may easily cause instability or subluxation, resulting in compression of the spina cord and various degree of neurologic symp- toms. Although the degree of atlantoaxial instability can be assessed conveniently by flex- ion/extension lateral radiogram, it is difficult to recognize the cause of instability and quantify the cord compression during flexion/extension motion. This study has been carried out to prospectively diagnostic tool of atlantoaxial instability. We reviewed 17 patients with atlantoaxial instability who were taken MRI examina- tion and treated at St. Mary's Hospital, Catholic University Medical College between June,1991 and December,1993 and the following results were obtained: 1.Seventeen patients consisted of 5 men and 12 women aged 21 to 68 years(mean, 43 years) 2.Of 17 patients, 11 were rheumatoid arthritis; 4,trauma; one Os odontoideum; one dens nonunion. 3.The 11 patients with atlantoaxial instability of rheumatoid etiology could be clas- sified into three groups according to the cause of the instability and cord compres- sion as revealed by flexion/extension axial MRI: The first group (n=6) characterized by compression of the cord in flexion with relief in extension, was caused by lax transverse ligaments. In the second group (n=2), despite the instability from erosion of the dens, there was no direct cord compression because the transverse ligaments were intact. The third group (n=3) showed retrodental granulation tissue in addition to erosions in the dens and/ or ligaments laxity with resultant cord compression. 4.In the traumatic group, there were four patients with instability from lax or rup- tured transeverse ligaments and one case with cord compression due to instability accompanied by nonunion of the dens. 5.In the great majority of the patients, the degree of cord compression was propor- tional to atlantodental interval(ADI) both on flexion/extension lateral radiogram and MRI despite of the widening of ADI on radiogram. On the other hand, in group Ⅲ Rheumatoid arthritis, a marked cord compression was noted due to retrodental gran- ulation tissues in the absence of significant ADI change. In conclusion, flexon/extension sagittal and axial MRI was useful tor a qualitative and quantitative evaluation of atlantoaxial instability by noting the degree and cause of instability and cord compression on cervical motion.