진료과목별 병원 입지요인 및 의료서비스품질과 의료기관 만족도 간의 관계에 대한 연구 : 부산광역시 교정치과, 성형외과의원을 대상으로

공고은 부산대학교 2011 국내석사

As economy has been developed and gross income has been increasing, the interest for health also has been arousing. The interest has been coming out as welfare state-oriented policies at the nation level and to an individual and family at the personal level. Therefore, in order to get hold of public health, the study of public health care facility distribution is substantially meaningful. Referring to WHO constitution, health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. It also clearly states that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, and politicalbelief, economic or social condition. In other word, in the past health refers to the state that one has no disease and lives personal ordinary life nowadays, however, an individual tends to rely on social life, and the society expectation to an individual also has been increased and it results the above definitions. Therefore, this study is to identify and analyze the factors of location and the service quality elements of a plastic hospital and orthodontic center to accompany customer satisfaction and reasons for revisit and recommendation, and also to project suggestions and future research subjects. To brief the results and suggestions, they areas followings: First, in the location analysis, orthodontic center and a plastic hospital show differences in access and aggregation. Having a good visibility on the institutions affects both services; however, the access and aggregation have influenced more on plastic surgery. This may be due to the service specialty. In the case of orthodontic center, the surgeon’s ability, medical examination and treatment, is prior to the location comparing to a plastic hospital. Because orthodontics treatment requires 1 to 3 years for treatment, close access from home or work would have affected, but after taking survey, diagnosis affects on customer satisfaction more than the access does. Second, the analysis result of relationship between service quality and the services shows no difference between orthodontic center and a plastic hospital. It is considered that the service qualitytakes important parts in the both services. Maybe the result is obvious that there is no difference in the quality elements and the service. Just in the question if one have experienced the service more than what they have paid for, plastic surgery patient shows greater satisfaction, and this presents orthodontics needs further improvement on its service. Result of ranking the service quality elements by frequency analysis is that the most important area of service quality is diagnosis items in the both services. After reviewing the rank result, excepting top ranked item medical examination, people put the next most value on surgeon’s medical service quality in orthodontic center. For the plastic hospital, people think both service quality and environment are important. By the fact that people put the most value on medical service environment among others, orthodontics surgery is the service that people give higher grade on the quality of the service comparing to plastic surgery. Third, in the result of analysis on the relationship of location and customer satisfaction, it has shown that access and visibility are the factors, among other presented factors in location, whichcontribute to the customer satisfaction. If these factors are revised ahead when choosing the location of the new opening hospital, hospital can be located in where it has high customer satisfaction. Fourth, in the service quality and the satisfaction relationship, the study analyzes into four different parts: environment, doctors, employees, and the medical cost. As a result, satisfaction of all four parts is low as a whole, but the service quality has been considered as a quite important element. It has found that clean and tide hospital interior based on the most important quality, diagnosis and treatment, easy reservation, and being punctual, and employees education emphasizing on being kind to customer affect on the satisfaction. Summarizing the results, a plastic hospital initially has access and aggregation prior to others, and orthodontics surgery gives the priority on the quality of medical service. If the plastic hospital leaves the priority on the quality of customer service providing medical environment, medical service based on employee education, the customer satisfaction of the cost will lead patients to revisit, and that would insure the previous and new customers, being told by others, at the same time.

The effect of dodecylbenzene sulfonic acid on the behavior of asphaltene aggregation in a solvent deasphalting system

LIU, LINGYU 충남대학교 대학원 2018 국내석사

As the most problematic compound in petroleum, asphaltene causes a lot of problems on the petroleum transportation and refinery. Generally, surfactants are studied as asphaltene aggregation inhibitor. Their effect on asphaltene dispersion can be shown in the order like: tert-octyl phenol (TOP) > dodecylbenzene sulfonic acid (DBSA) > nonyl phenol (NP) > dodecyl phenol (DP) > nonyl phenol ethoxylated (6) (NPE6). On the other hand, the enhancement of asphaltene aggregation by DBSA has been reported by Goual and Firoozabadi. However, the mechanism has not been explained. In order to improve the Solvent Deasphalting (SDA) process, the effects of DBSA, triton X-100 (T), and DP on asphaltene removal ratio (ARR) were examined first, in which DBSA has been found to be the optimal additive. After fixing the optimal dosage of DBSA (1 wt.%), the optimal conditions were studied by changing temperature and solvent to oil ratio (SOR). The result shows except at SOR 3, ARR is increased by DBSA at all temperature range. The quality of deasphalted oil (DAO) supports that DBSA improved DAO quality by enhancing the precipitation of asphaltene. At last, the mechanism has been investigated by the study of resin content, asphaltene colloid size, the functional groups of asphaltene, the adsorption amount of DBSA on asphaltene surface and the level of self-aggregation of DBSA in a non-polar system. Based on the results of this study, a hypothetical adsorption mechanism of DBSA on asphaltene aggregation in the solvent deasphalting system was conceived and proposed.

U@ber die Umsetzung von Schichtsilicaten mit Phosphaten in Gegenwart von Kaliumionen

Goβner, Ursula 1995 국내박사

Use of an independent visual background to alleviate simulator sickness in the virtual environments that employ wide-field displays

Duh, Henry Been-Lirn University of Washington 2001 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Simulator sickness (or so-called Cybersickness) has been a significant problem since the development of virtual reality systems. Numerous studies have investigated this problem. However, there is currently no accepted solution. This dissertation addresses development of a possible approach to alleviate simulator sickness. Prior work has suggested the method of inserting an inertially-matched reference visual background grid into a visual scene as an intervention against simulator sickness, but little work has been done to evaluate or optimize such method. This dissertation describes a series of human factors studies to examine and optimize such an “independent visual background” (IVB). Four major components are included. The first part provides a background regarding simulator sickness. The second part examines the dynamics of sensory conflict theory which has been widely accepted as a model of simulator sickness. In this regard we identified and verified a motion frequency where the summed response from the visual and inertial self-motion systems was greatest. We also investigated the effects of field-of-view of the display. The third part explores the possible characteristics of the IVB including spatial, polarity, temporal and stereographic properties of the visual display. As a means of determining subjects' reactions to moving visual stimuli, postural stability, was measured. Postural stability has been proposed as an objective measurement for simulator sickness. The fourth part explores ways that the IVB may reduce subjects' simulator sickness symptoms during the virtual environment exposure. We also consider the relationship between sense of presence and simulator sickness. We conclude that the IVB could be a useful procedure to alleviate simulator sickness and recommend future experiments regarding how the IVB should be presented to enhance users' task performance and cognitive function.

Physics and simulation of nanoscale bio- and chemical sensors

Go, Jonghyun Purdue University 2012 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

The ability to detect biomolecules and chemicals accurately, effectively, and promptly in variety of environments including applications in homeland security, clinical diagnoses, environmental monitoring, food safety, etc. has always been an important issue. For each of these applications, it is highly desirable that a small, ultra-sensitive, versatile and robust sensor be created. During the last decade, enormous progress in the synthesis of 1-D nanostructured materials and nanoparticles has allowed the fabrication of nanometer-sized sensors. Such materials and devices, with large surface-to-volume ratios and Debye length comparable to their small size, have already displayed superior sensitivity for the detection of various chemical and biological species. Their extremely small-scale also enables the miniaturization of sensors (e.g., portable, handheld sensors) as well as their multiplexing functionality to achieve simultaneous detection of multiple target molecules in a given sample. In spite of huge existing research regarding the fabrication of nanoscale bio- and chemical sensors, the understanding of their sensing mechanism has been limited, confused, and contradictory. In this thesis, we develop a comprehensive theoretical framework to correlate the geometry and physical properties of nanoscale sensors to their sensing performance of target molecules. This framework provides the solution for the puzzles arising from the discrepancy in recent experimental results and the classical theory regarding sensor performance and give guidance for approaches about the sensor design and optimization.

Ventricular dyskinesis induced loss of contractile function and epicardial inflammation: Role of cellular adhesion molecules

Yamazaki, Katrina Go University of California, San Diego 2009 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Ventricular dyssynchrony as induced by epicardial ventricular pacing has been the subject of investigations for many years. It has been shown that dyssynchrony is characterized by regions of wall thinning and hypertrophy and is detrimental to left ventricular (LV) function. The mechanisms that trigger these changes are unknown. Therefore, I hypothesize that dyskinesis, secondary to LV pacing, triggers local inflammation, reactive oxygen species (ROS) generation, and matrix metalloproteinase (MMP) activation. To gain further mechanistic insight, I wish to determine two-dimensional and/or three-dimensional changes in myocardial function and inflammation induced by myocardial dyskinesis. I also want to determine if inflammatory responses induced by dyskinesis are mediated by a vascular event via cellular adhesion molecules (CAM). A canine model was used to determine regional and transmural differences in LV contractile function and inflammatory responses associated with local early contraction. Results investigating regional differences in LV contractile function demonstrate that local dyskinesis creates regions of early shortening at the pace site, as well as in areas immediately surrounding the pace site. Evaluation of inflammatory responses showed increases in neutrophil infiltration and in MMP-9 in regions undergoing early shortening. Results investigating the transmural differences in LV function indicate that 4 h of LV pacing results in a 30% local loss of endocardial wall thickening (p<0.01). Transmural assessment of neutrophil infiltration showed a significant 5 fold increase in myeloperoxidase (MPO) activity in the epicardium vs midwall/endocardium. Matrix metalloproteinase-9 (MMP-9) activity increased ∼2 fold in the epicardium and reactive oxygen species (ROS) generation ∼2.5 fold. In a mouse model, results showed a significant 3 fold increase in MPO, 2 fold increase in ROS, and 3 fold increase in MMP-9 activity in dyskinetic hearts vs controls. In canine subjects anesthetized with propofol, a known cardioprotectant, and ICAM-1 or p-selectin null mice, dyskinesis failed to increase neutrophil infiltration or MMP-9 activity in early activated dyskinetic LV. Early activated dyskinetic regions demonstrate depressed endocardial contractile function, and epicardial inflammation. The upregulation of CAM appears necessary to trigger these inflammatory responses, thus suggesting inflammation is induced by vascular events. Over the long-term, these events may contribute to adverse changes in LV structure/function.

Dynamic approach to the description of flow regime transition in stormwater systems

Vasconcelos Neto, Jose Goes University of Michigan 2005 해외박사(DDOD)

소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

Stormwater drainage systems are designed to operate in a free surface flow regime, however, transition into a pressurized flow regime may occur during intense rain events as the inflow exceeds the transport capacity of the system in free surface flow mode. The air phase within the sewers may then become pressurized, significantly altering the dynamics of the flow. Flow regime transitions have been linked to the occurrence of serious operational problems in stormwater systems, such as geysering and structural damage of sewers. While such flow conditions have been investigated previously, the current knowledge on this problem is still limited and fragmented, particularly regarding the role of the air phase in the filling process. The investigation presented in this thesis included experiments performed in reduced scale models representing stormwater storage tunnels, sewers and ventilation towers of stormwater systems. Numerical investigation was also performed to cre ate models to simulate flow regime transition caused by rapid filling of stormwater systems. The results of these investigations indicate that: (1) the magnitude of the surges caused by inflow bores in storage tunnels increase with the pressure head behind the pipe-filling bore front; (2) different new flow features caused by the air phase pressurization have been detected, which depend mainly on the ventilation degree provided in the system; (3) numerical models for the flow regime transition problem can be successfully modified to incorporate some the of newly identified air/water interactions in the predictions; (4) a new model concept for the flow regime transition was proposed, which overcomes the inability of Preissmann slot-based models to simulate sub-atmospheric, full pipe flows; (5) the numerical oscillations that contaminate the numerical predications of pipe-filling bores from shock-capturing models can be attenuated with judicious introduction of numerical diffusion; (6) new mechanisms for air pocket entrapment in stormwater storage tunnels undergoing rapid filling have been identified, and air pocket entrapment may relatively common; (7) the geysering caused by the release of large air pocket through water-filled ventilation towers can be minimized by appropriate selection of the ventilation tower diameter; (8) air phase pressurization caused by flow regime transition is also an important issue when the sewers are initially in steady flow conditions.

The role of small heterodimer partner after acute alcohol administration in mice

Go, Min-Jeong 忠南大學校 大學院 2018 국내석사

Alcohol is metabolized to acetaldehydes by alcohol dehydrogenase , cytochrome P450 2E1, catalase and then acetaldehyde is converted to acetate by aldehyde dehydrogenase (ALDH) in the liver. Alcohol induced liver injury mediated by the ethanol metabolites such as acetaldehyde adducts occur reactive oxygen species (ROS) and the endotoxin which come from gut because of altered intestinal permeability. Over the years, the harmful effects of binge drinking on health have been reported. Binge drinking is the most common pattern of alcohol consumption and results in various diseases, including liver disorders. It has been reported that natural killer T (NKT) cells induce alcoholic liver injury by promoting neutrophil infiltration. Here, we report the role of orphan nuclear receptor small heterodimer partner (SHP) in acute binge drinking-induced liver injury. SHP is generally known as a repressor in numerous metabolic pathways and they are expressed in various organs including intestine and spleen, especially liver. Shp-knockout (KO) and wild-type (WT) control mice were intragastrically administered a single dose of alcohol. The plasma levels of alanine aminotransferase and aspartate aminotransferase in Shp-KO mice increased significantly compared with those in the WT mice. However, acute binge drinking-evoked hepatic lipid accumulation and oxidative stress were comparable between WT and Shp-KO mice. Interestingly, Tnf-α expression level increased significantly in the liver of Shp-KO mice by alcohol injection. TNF-α is cytokines which involve apoptosis and inflammatory responses. However, apoptosis were comparable between WT and Shp-KO mice. Moreover, the gene expression levels of Ccl2, Cxcl1, and Il-4, potent chemoattractant of NKT cells, and neutrophil levels elevated significantly in the liver of alcohol-administered Shp-KO mice, followed by enhanced infiltration of NKT cells and neutrophils. These results suggest that SHP can play a key role in protecting the liver from damages caused by acute binge drinking via regulation of NKT cells and neutrophil migration to the liver. 과도한 음주는 신체의 여러 기관에 좋지 않은 영향을 주는 것으로 알려져 있다. 특히, 간은 알코올 대사가 이루어지기 때문에 그 손상 정도가 심하다. 알코올은 분해되면서 아세트알세히드를 생성하고 이는 화합물(acetaldehyde-protein adduct)를 생성하거나 지질과산화에 관여하여 간 손상을 일으킨다. 또한, 알코올은 분해되면서 활성산소를 만들어 산화적 손상을 일으키기도 하고 장벽의 투과성을 증가시켜 내독소의 흡수를 증가시킴으로써 염증반응을 유발하기도 한다. 알코올성 간 손상에 대한 여러 연구가 진행되어 왔고, 진행되고 있지만 아직 특별한 치료법은 개발되어 있지 않다. 고아 핵 수용체 중 하나인 SHP는 다른 핵 수용체와 다르게 DNA에 결합하는 부위인 DBD (DNA Binding Domain)을 갖고 있지 않다. SHP는 당 대사, 지질 대사 등 여러 대사기전에 관여하고 있는 것으로 알려져 있으며 주로 다른 핵수용체를 억제하는 작용을 한다. 본 연구는, SHP 유전자가 알코올에 의한 급성 간 손상으로부터 간을 보호하는 기전에 관여하고 있음을 밝혔다. 급성 알코올성 간 손상을 유도했을 때 간 손상지표인 ALT와 AST의 혈중 농도가 SHP가 결핍된 마우스에서 대조군에 비해 높게 나타났다. 그러나 H&E 염색을 해봤을 때 조직적으로 특별한 염증반응을 찾을 수는 없었다. 지방염색과 지방정량 결과에서도 SHP가 결핍된 마우스와 대조군 마우스 사이에 특별한 차이를 발견할 수 없었다. 알코올성 간 손상 원인으로 대표적인 산화적 손상을 측정해보기 위해 활성산소(ROS)를 측정해봤을 때 SHP 결핍군과 대조군 모두 증가하였으나 두 그룹간의 차이는 없었다. 이 외에도 산화적 손상 지표인 4-HNE, MDA 형성을 측정해보았지만 차이를 발견할 수 없었다. 이를 통해, SHP 결핍 마우스에서 더 심하게 급성 알코올성 간 손상이 일어난 원인은 지방축적이나 산화적 손상에 의한 것이 아니라는 결론을 얻었다. 그 다음, 여러 염증관련 인자들의 발현을 역전사-중합효소연쇄반응실험(RT-PCR)을 통해 관찰해 보았다. 그 결과, 대조군 마우스에 비해 SHP 결핍 마우스에서 Tnf-α가 많이 발현되었다. 급성 알코올성 간 손상이 일어난 상황에서의 면역세포 분포를 확인하기 위해 유세포분석(FACS, Fluorescence-activated cell sorting)을 실시하였다. 그 결과, 자연 살해 T 세포 (NKT, Natural killer T cell)가 대조군에 비해 SHP 결핍 마우스에서 매우 증가하였고, 호중구(Neutrophil) 또한 약간 증가한 것을 발견하였다. 그리고 자연 살해 T 세포나 호중구와 같은 면연세포들의 화학유인물질(chemoattractant) 역할을 하는 Ccl2, Cxcl1 그리고 Il-4의 발현이 대조군에 비해 SHP 결핍 마우스에서 증가한 것을 볼 수 있었다. 이러한 연구 결과들을 통해, 급성 알코올성 간 손상이 일어난 상황에서 간으로 면역세포가 이주하는 것에 SHP가 관여하여 간을 보호하는데 중요한 역할을 하고 있음을 알 수 있었다. 본 연구를 통해 SHP가 급성 알코올성 간 손상의 치료법에 가능성을 가지고 있음을 보여주고 있다.

Improvement of Mechanical Strength of NASICON Ceramic for its Application in Seawater Battery

Wooseok Go Ulsan National Institute of Science and Technology 2022 국내박사

While renewable energy is attracting attention, energy storage systems (ESSs) have been used to compensate for energy fluctuations in renewable energy. Currently, lithium-ion batteries (LIBs) are used as ESSs, but high prices and limited lithium sources are potential risks for LIBs. Seawater battery (SWB) have been developed as an alternative ESS. SWB utilizes sodium ions in natural seawater as an active material, providing the advantages of abundant raw materials, low price, and eco-friendliness. NASICON ceramic has been used as a solid electrolyte for the SWB, which exhibits good cycle performance. To improve the power output, the active area of the solid electrolyte should be increased. To form a large active area, small rectangular NASICON (4 cm2) ceramics are clustered using a polymer sealant and metal frame. Since the clustering induces a substantial inactive area (31%), a strategy to minimize the inactive area is required. A large-area NASICON (100 cm2) ceramic instead of clustering small NASICON ceramics is a prominent method. Then, the metal frame is not required, and the inactive area from the polymer sealant is minimized. However, the mechanical strength of the large-area ceramic becomes an important property, because the more amount of area is exposed to the potential mechanical force without metal frame. The mechanical strength of NASICON ceramic is determined by the largest defect which is determine by pore and fracture toughness. In this study, I improved mechanical properties of the NASICON ceramic by controlling size of defects and decreasing amount of ZrO2 phase so that the large-area NASICON ceramic can be a mechanically stable solid electrolyte for the seawater battery. In Chapter 2, the size of defect in the NASICON ceramic is controlled using spray-dried powder. The resulting large area NASICON ceramic exhibits improved mechanical strength and reliability, and its practical operation in an SWB is demonstrated. In Chapter 3, ZrO2-deficient NASICON ceramic is investigated to reduce amount of ZrO2 phase. The resulting reduced ZrO2 contents in microstructure of NASICON ceramic enhanced mechanical strength. Improved electrochemical performance of the SWB is also demonstrated. In Chapter 4, a tubular NASICON ceramic is developed for improving mechanical stability of the large-area NASICON ceramic. Owing to its shape, the NASICON ceramic endures higher external force. This demonstrates possibility of geometrical strategy for the large-area NASICON ceramic. Based on these results, the NASICON can be used as a mechanically stable solid electrolyte in the SWB. This research will contribute to the practical use and commercialization of SWB.

Modeling studies of power dissipation in the KSTAR upgrade tokamak and of terahertz radiation emission from an embedded plasma dipole oscillation

Kyu Been Kwon Ulsan National Institute of Science and Technology 2022 국내박사