Delayed Esophageal Pseudodiverticulum after Anterior Cervical Spine Fixation: Report of 2 Cases

Introduction: Although perforation of the esophagus, in the anterior cervical spine fixation, is well established, cases with delayed onset, especially cases that present pseudodiverticulum, are not common. In addition, management of the perforation in this situation is debated.  Case Report:   Delayed esophageal pseudodiverticulum was managed in two patients with a history of anterior spine fixation. Patients were operated on, the loose plate and screws were extracted, the wall of the diverticulum was excised, the perforation on the nasogastric tube was suboptimally repaired, and a closed suction drain was placed there. The NGT was removed on the 7th day and barium swallow demonstrated no leakage at the operation site; therefore, oral feeding was started without any problem.  Conclusion:  In cases with delayed perforation, fistula, or diverticulum removal of anterior fixation instruments, gentle repair of the esophageal wall without persistence on definitive and optimal perforation closure, wide local drainage, early enteral nutrition via NGT, and antibiotic prescription is suggested

The role of effective Factors on Organizational Knowledge Sharing

AbstractNowadays, most of scholars believe that organizations should pursue effective methods for disseminating and sharing of organizational knowledge among different levels of organization's human resources. Bailey and Clarke (2001) believe that “by implementing knowledge management in organizations, managers are to improve knowledge sharing among people, between people and organization for creating competitive advantages”. Therefore, the necessity of identifying and applying effective methods for sharing and transferring internal knowledge of organization and knowledge management has been increasingly revealed. The current research has conducted with the aim of examining effective factors on knowledge sharing in the Institute for International Energy Studies. Based on Lin model(2008), in which three factors of (1) organizational structure (including complexity, officialism, centralization), (2) organizational culture (including bureaucratic, creative, innovative and supportive culture) and (3) interaction among departments, have effect on knowledge sharing. By using of correlation research method, in this study, 50 experts have been selected by purposive sampling. The collected data have been analyzed by using such statistical methods as Spearman Correlation Coefficient, U-man witny, Wilkakson and Freadman. The findings show that 1) the situation of knowledge sharing is rather desirable; 2) age, work experience, field of study, educational level and organizational position don’t have effect on knowledge sharing; 3) knowledge sharing has a positive relation with human factors (commitment and trust) and negative relation with structural factors (officialism, centralization and complexity); 4) there is positive relation among knowledge sharing, creative and supportive culture (elements of cultural factors), and negative relation between knowledge sharing and bureaucratic culture (the third element of cultural factors); 5) deterrent factors of knowledge sharing (bureaucratic culture and structural factors) have no meaningful difference in ranks, however in the facilitative factors (human factors (commitment and trust), organizational culture (creative, innovative and supportive culture), the creative and innovative culture has the highest rank and after that, other ranks are related to trust, supportive culture and commitmen