An Integration of Kano's Model and Exit-Voice Theory : A Case Study

Lee, Yu-Cheng,Hu, Hsiu-Yuan,Yen, Tieh-Min,Tsai, Chih-Hung The Korean Society for Quality Management 2009 The Asian Journal on Quality Vol.10 No.2

The purpose of this study was to examine overall customer satisfaction associated with medical service quality in Taiwan by integrated Kano's model and customer satisfaction index model. Another purpose was to confirmed nonlinear and asymmetric relationship of Customer Satisfaction and Quality Performance by the research outcome. By analyzing 1,100 patients or their family members, this study used the structural equation model (SEM) with AMOS software for data analysis. The results show that must-be attributes, one-dimensional attributes and attractive attributes had a direct effect on overall customer satisfaction, Surprisingly, overall customer satisfaction had positively influenced customer loyalty customer satisfaction had negatively influenced customer complaints. The study also found that customer complaints have direct effect on customer loyalty. Importantly, the study found out the must-be attributes, the attractive attributes and one-dimensional attributes increased, the level of overall customer satisfaction also increased. The customer satisfaction positively influences customer loyalty in medical service quality in Taiwan. The findings might reveal new insights for researchers dealing with quality of medical service and for hospital managers who devote resources exclusively to achieving highest possible levels of patient satisfaction.

An Integration of Kano`s Model and Exit-Voice Theory: A Case Study

Yu Cheng Lee,Hsiu Yuan Hu,Tieh Min Yen,Chih Hung Tsai 한국품질경영학회 2009 The Asian Journal on Quality Vol.10 No.2

Ginseng essence, a medicinal and edible herbal formulation, ameliorates carbon tetrachloride-induced oxidative stress and liver injury in rats

Kuan-Hung Lu,Ching-Yi Weng,Wei-Cheng Chen,Lee-Yan Sheen 고려인삼학회 2017 Journal of Ginseng Research Vol.41 No.3

Background: Ginseng essence (GE) is a formulation comprising four medicinal and edible herbs including ginseng (Panax ginseng), American ginseng (Panax quinquefolius), lotus seed (Nelumbo nucifera), and lily bulb (Lilium longiflorum). This study was aimed at investigating the hepatoprotective effect of GE against carbon tetrachloride (CCl4)-induced liver injury in rats. Methods: We treated Wistar rats daily with low, medium, and high [0.625 g/kg body weight (bw), 1.25 g/ kg bw, and 3.125 g/kg bw, respectively] doses of GE for 9 wk. After the 1st wk of treatment, rats were administered 20% CCl4 (1.5 mL/kg bw) two times a week to induce liver damage until the treatment ended. Results: Serum biochemical analysis indicated that GE ameliorated the elevation of aspartate aminotransferase and alanine aminotransferase and albumin decline in CCl4-treated rats. Moreover, CCl4- induced accumulation of hepatic total cholesterol and triglyceride was inhibited. The hepatoprotective effects of GE involved enhancing the hepatic antioxidant defense system including glutathione, glutathione peroxidase, glutathione reductase, glutathione S-transferase, superoxide dismutase, and catalase. In addition, histological analysis using hematoxylin and eosin and Masson’s trichrome staining showed that GE inhibited CCl4-induced hepatic inflammation and fibrosis. Furthermore, immunohistochemical staining of alpha-smooth muscle actin indicated that CCl4-triggered activation of hepatic stellate cells was reduced. Conclusion: These findings demonstrate that GE improves CCl4-induced liver inflammation and fibrosis by attenuating oxidative stress. Therefore, GE could be a promising hepatoprotective herbal formulation for future development of phytotherapy.

Knock-out of Glucose Dehydrogenase Gene in Gluconacetobacter xylinus for Bacterial Cellulose Production Enhancement

Chia-Hung Kuo,Hsin-Yin Teng,Cheng-Kang Lee 한국생물공학회 2015 Biotechnology and Bioprocess Engineering Vol.20 No.1

Glucose dehydrogenase (GDH) locates in thecytoplasmic membrane of Gluconacetobacter xylinus oxidizesglucose to gluconic acid that decreases the conversion ofglucose to bacterial cellulose (BC). In this study, a mutantof G. xylinus was generated by knocking-out the membranebound GDH gene via homologous recombination of adefect GDH gene. The production of BC by G. xylinusmutant (GDH-KO strain) using glucose as a carbon sourcewas investigated. Without the membrane bound GDHactivity, the mutant strain still produces BC and increasesglucose utilization efficiency for cellulose biosynthesis. Incontrast, the wild-type strain oxidized a large fraction ofglucose to gluconic acid that decreased the conversionyield of glucose to BC. Our results showed that the BCproduction from GDH-KO strain was about 40 and 230%higher than that of wild-type strain in static and shakenculture, respectively.

The Evaluation of Geotube Behaviors on Muddy Beach: Field Monitoring and Numerical Analysis

Siew Cheng Lee,Roslan Hashim,Kim Hung Mo 대한토목학회 2018 KSCE JOURNAL OF CIVIL ENGINEERING Vol.22 No.11

The use of geotubes is now common in coastline protection due to notable advantages such as erosion prevention, competitive cost and speedy installation procedures. Previous researchers have presented analytical, empirical and numerical approaches for geotube design. However, design approach for geotube which functions as breakwater on deformable muddy foundation and subjected to hydrodynamic loads has not been well reported. Hence, this study evaluates the behavior of geotube breakwaters installed on a deformable muddy foundation based on field measurements and numerical analysis. The field measurements were carried out on quarter-yearly basis to assess the behavior of geotube under hydrodynamic forces. Two-dimensional finite element analysis was performed to simulate the deformation and the displacement of geotube breakwater subjected to hydrodynamic loads, taking into account of deformable foundation condition. The structural stability and structure’s height reduction due to foundation settlement are essential considerations in breakwater design. The agreements between field monitoring and numerical results were promising; therefore, the finite element models can be used to predict the behavior of geotube on those muddy coast areas with similar hydrodynamic and geological conditions.

Dynamic System Identification Using a Recurrent Compensatory Fuzzy Neural Network

Chi-Yung Lee,Cheng-Jian Lin,Cheng-Hung Chen,Chun-Lung Chang 대한전기학회 2008 International Journal of Control, Automation, and Vol.6 No.5

This study presents a recurrent compensatory fuzzy neural network (RCFNN) for dynamic system identification. The proposed RCFNN uses a compensatory fuzzy reasoning method, and has feedback connections added to the rule layer of the RCFNN. The compensatory fuzzy reasoning method can make the fuzzy logic system more effective, and the additional feedback connections can solve temporal problems as well. Moreover, an online learning algorithm is demonstrated to automatically construct the RCFNN. The RCFNN initially contains no rules. The rules are created and adapted as online learning proceeds via simultaneous structure and parameter learning. Structure learning is based on the measure of degree and parameter learning is based on the gradient descent algorithm. The simulation results from identifying dynamic systems demonstrate that the convergence speed of the proposed method exceeds that of conventional methods. Moreover, the number of adjustable parameters of the proposed method is less than the other recurrent methods.

Changes in prostate-specific antigen kinetics during androgen-deprivation therapy as a predictor of response to abiraterone in chemonaïve patients with metastatic castration-resistant prostate cancer

Chung-Lin Lee,Ying-Hsu Chang,Chung-Yi Liu,Ming-Li Hsieh,Liang-Kang Huang,Yuan-Cheng Chu,Hung-Cheng Kan,Po-Hung Lin,Kai-Jie Yu,Cheng-Keng Chuang,Chun-Te Wu,See-Tong Pang,I-Hung Shao 대한비뇨의학회 2022 Investigative and Clinical Urology Vol.63 No.5

Purpose: Metastatic castration-resistant prostate cancer (mCRPC) has a poor prognosis. Abiraterone acetate (AA), enzalutamide, and chemotherapy are first-line treatments for patients with mCRPC. This study examined prognostic factors for AA response in the form of prostate-specific antigen (PSA) kinetics throughout androgen-deprivation therapy (ADT) in chemonaïve patients with mCRPC. Materials and Methods: We retrospectively included data from 34 chemonaïve patients with mCRPC who had received AA at some point between January 2017 and December 2018. We separated patients into two study arms according to the decrease in PSA percentages after use of AA for 3 months. We correlated PSA kinetics parameters with response and compared the two study groups with respect to PSA kinetics. Results: The patients’ median age was 77 years. In the total group of patients, 64% had a response to AA, whereas 35% did not. The ratio of the PSA level at nadir to the level during ADT was significantly higher in the AA-sensitive group (19.78 vs. 1.03, p=0.019). Conclusions: Patients who experienced a dramatic change in PSA level during ADT were more likely to be resistant to AA after progression to mCRPC. Chemotherapy rather than AA might be more suitable as a first-line treatment for these patients.

A Systematic Classification of the Congenital Bronchopulmonary Vascular Malformations: Dysmorphogeneses of the Primitive Foregut System and the Primitive Aortic Arch System

Meng-Luen Lee,Hung-Chi Lue,Ing-Sh Chiu,Han-Yao Chiu,Lon-Yen Tsao,Ching-Yuan Cheng,Albert D. Yang 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.1

Purpose: We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). Materials and Methods: From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. Results: The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. Conclusion: Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.

Statin and the Risk of Ischemic Stroke or Transient Ischemic Attack in Head and Neck Cancer Patients with Radiotherapy

Bo-Ching Lee,Cheng-Li Lin,Hsin-Hsi Tsai,Chia-Hung Kao 대한뇌졸중학회 2018 Journal of stroke Vol.20 No.3

Ginseng essence, a medicinal and edible herbal formulation, ameliorates carbon tetrachloride-induced oxidative stress and liver injury in rats

Lu, Kuan-Hung,Weng, Ching-Yi,Chen, Wei-Cheng,Sheen, Lee-Yan The Korean Society of Ginseng 2017 Journal of Ginseng Research Vol.41 No.3

Background: Ginseng essence (GE) is a formulation comprising four medicinal and edible herbs including ginseng (Panax ginseng), American ginseng (Panax quinquefolius), lotus seed (Nelumbo nucifera), and lily bulb (Lilium longiflorum). This study was aimed at investigating the hepatoprotective effect of GE against carbon tetrachloride ($CCl_4$)-induced liver injury in rats. Methods: We treated Wistar rats daily with low, medium, and high [0.625 g/kg body weight (bw), 1.25 g/kg bw, and 3.125 g/kg bw, respectively] doses of GE for 9 wk. After the 1st wk of treatment, rats were administered 20% $CCl_4$ (1.5 mL/kg bw) two times a week to induce liver damage until the treatment ended. Results: Serum biochemical analysis indicated that GE ameliorated the elevation of aspartate aminotransferase and alanine aminotransferase and albumin decline in $CCl_4$-treated rats. Moreover, $CCl_4$-induced accumulation of hepatic total cholesterol and triglyceride was inhibited. The hepatoprotective effects of GE involved enhancing the hepatic antioxidant defense system including glutathione, glutathione peroxidase, glutathione reductase, glutathione S-transferase, superoxide dismutase, and catalase. In addition, histological analysis using hematoxylin and eosin and Masson's trichrome staining showed that GE inhibited $CCl_4$-induced hepatic inflammation and fibrosis. Furthermore, immunohistochemical staining of alpha-smooth muscle actin indicated that $CCl_4$-triggered activation of hepatic stellate cells was reduced. Conclusion: These findings demonstrate that GE improves $CCl_4$-induced liver inflammation and fibrosis by attenuating oxidative stress. Therefore, GE could be a promising hepatoprotective herbal formulation for future development of phytotherapy.