• The korean journal of orthodontics
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• v.33 no.6 s.101
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• pp.485-497
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• 2003

The form and function of the craniofacial structure critically depend on genetic information. With recent advances in the molecular technology, genes that are important for normal growth and morphogenesis of the craniofacial skeleton are being rapidly uncovered, shaping up modem craniofacial biology. One of them is fibroblast growth factor receptor 2 (FGFR2). Specific point mutations in the. FGFR2 gene have been linked to Apert syndrome, which is characterized by premature closure of cranial sutures and craniofacial anomalies as well as limb deformities. To study pathogenic mechanisms underlying craniosynostosis phenotype of Apert syndrome, we used a transgenic approach; an FGFR2 minigene construct containing an Apert mutation (a point mutation that substitute proline at the position 253 to arginine; P253R) was introduced into fertilized mouse germ cells by DNA microinjection. The injected cells were then allowed to develop into transgenic mice. We used a bone-specific promoter (a DNA fragment from the type I collagen gene) to confine the expression of mutant FGFR2 gene to the bone tissue, and asked whether expression of mutant FGFR2 in bone is sufficient to cause the craniosynostosis phenotype in mice. Initial characterization of these mice shows prematurely closed cranial sutures with facial deformities expected from Apert patients. We also demonstrate that the transgene produces mutant FGFR2 protein with increased functional activities. Having this useful mouse model, we now can ask questions regarding the role of FGFR2 in normal and abnormal development of cranial bones and sutures.

• Journal of the Korean Society of Groundwater Environment
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• v.4 no.1
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• pp.41-53
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• 1997

Geochemical data of soil and water samples were presented in order to assess the environmental impart for drinking water sites. Microscopic observation of rock samples and physical and chemical analysis of soil and water samples were undertaken. The geology of study areas are classified into three groups such as granitic rocks, meta-sedimentary rocks and sedimentary rocks. Enrichment of heavy metals derived from those rocks is not found in this study areas. Soils were analyzed for Cu, Pb, Zn, Cd and Cr using AAS extracted by HNO$_3$+HClO$_4$ and 0.1 N HCl. Heavy metal concentrations in soils are within the range of those in uncontaminated soils. In comparison of metal contents extracted by 0.1 N HCl and HNO$_3$+HC1O$_4$, less than 10% of the heavy metals are present in the exchangeable fraction. In particular, an pollution index has been proposed to assess the degree of soil contamination. Pollution index in soils are between 0.03 and 0.47 therefore, soils are not polluted with heavy metals. Deep groundwaters within granitic rocks have been evolved into Na$\^$＋/-HCO$_3$$\^$-/ type, whereas other deep groundwaters evolved into Ca$\^$2＋/-HCO$_3$$\^$-/ type. The predominance of Na$\^$＋/ over Ca$\^$2＋/ in deep groundwaters within granitic rocks is a result of dissolution of plagioclase, but for sedimentary and meta-sedimentary rocks, dissolution of calcite is a dominant factor for their hydrogeochemistry. The pH, conductivity and contents of the most dissolved ions in the water increase with depth. Shallow groundwaters, however, are highly susceptible to pollution owing to agricultural activities, considering the fact that high contents of nitrate, chloride and potassium, and high K/Na ratio are observed in some shallow groundwaters. In a thermodynamic approach, most natural water samples are plotted within the stability fields of kaolinite and smectite. Therefore, microcline and other feldspars will alter to form clay minerals, such as kaolinite and smectite. From the modelling for water-rock interactions based on mass balance equation, models accord well with behavior of the ions and results of thermodynamic studies are derived.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• The Journal of Engineering Geology
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• v.7 no.3
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• pp.191-205
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• 1997

Measurements on subsurface movement of the Songsanri tomb site including the Muryong royal tomb was conducted using a tiltmeter system for the period of 15 months form July 7, 1996 to September 30, 1997. Two coordinate tilt monitoring data shows the biggest movement rate of 2.3mm/m/yr toward south in the frontal wall(N-S tilt) of the Muryong royal tomb. Southward tilting of bricks above the southern fire place in the western wall of the Muryong royal tomb is a proof of southward tilting of the royal tomb since its excavation in 1971. The eastern wall of the Muryong royal tomb is also tilting toward inside the tomb with the rate of 1.523mm/m/yr. Furthermore, tilting rate of wall increases twice in rainy season. It is interpreted tbat infiltration of water into the tomb and nearby ground in rainy season results in dangerous status for the safety of tomb structure. On the whole, normal component tilting of the walls of the 5th tomb is large than its shear component. It shows a small displacement toward one direction without no abrupt change in its direction and amount of tilting. The tilting rate of walls of the 6th tomb is about 8.8mm/m/yr in the dry season which is much bigger than those of other tombs in rainy season. Deformation events of walls of the tombs are closely related to amount of precipitation and variation of temperature. In comparison with different weather conditions, tilting is much bigger during the period of rainy weather than sunny weather. It is interpreted that rainwater flew into the turm through faults and nearby ground. High water content in nearby ground resulted strength of ground. The tilting event of walls shows a hysterisis phenomenon in analysis of temperature effect on tilting event. The walls tilt rapidly with steep rising of temperature, but the tilted walls do not come back to original position with temperature falling. Therefore, a factor of steep increase of the temperature must be removed. It means the tomb have to be kept with constant temperature. The observation of groundwater level using three boreholes located in construction site and original ground represented that groundwater level in construction site is higher than that of original ground during the rainy season from the end of June to August. It means that the drainage system of the Muryong royal tomb is worse than original ground, and it is interpreted that the poor drainage system is related to safety of tomb structure. As above mentioned, it is interpreted that artificial changes of the tomb environment since the excavation, infiltration of rainwater and groundwater into the tomb site and poor drainage system had resulted in dangerous situation for the tomb structure. According to the result of the long period observation for the tomb site, it is interpreted that protection of the tomb site from high water content should be carried out at first, and the rise of temperature by means of the dehumidifier inside the tomb must be removed.

• Journal of the Korean Society for Marine Environment & Energy
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• v.17 no.4
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• pp.283-296
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• 2014

The distribution of heavy metals in the stormwater runoffs from industrial sites around Shihwa Lake that implements the total pollutant load management system (TPLMS) was studied to characterize the temporal changes of metal concentrations and to assess the ecological risk in dissolved and particulate phases of the selected metals. The dissolved Co and Ni concentration demonstrated first flush and tended to decrease with increasing of the duration of rainfall. The intensity of precipitation was found to be the main controlling factor of particulate metals in the stromwater runoffs. The particulate concentration of Pb accounted for 97.2% so the particulate phase was its main form. Other metals followed the sequence: Pb>Cu>Cd>Co>Zn>Ni. The particulate-dissolved partitioning coefficient ($K_d$) indicated that the $K_d$ of Pb were bigger than that of other metals because the metal Pb in the stormwater runoffs is quickly removed into the particulate phase. In a single day rainfall event, total runoff fluxes for total metals as the sum of dissolved and particulate forms through only two sewer outlets were 2.21 kg for Co, 30.5 kg for Ni, 278.3 kg for Cu, 398.3 kg for Zn, 0.39 kg for Cd and 40.0 kg for Pb, respectively. Given the annual rainfall, the number of rain days and the basin area for total pollutant load management system (TPLMS) of Shihwa area, enormous amount of non-point metal pollutants were entered into Lake with any treatment. The dissolved metals (e.g., Ni, Cu and Zn) in the stormwater runoffs exceeded the acute water quality criteria. Additionally, all metals were significantly enriched in the particulate phase and exceeded the PEL criteria of sediment quality guidelines (SQGs). These results indicated that the heavy metals in the stormwater runoffs may pose a very high ecological risk to the coastal environments and ecosystem.

• Journal of Preventive Medicine and Public Health
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• v.30 no.1 s.56
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• pp.77-101
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• 1997

In September 1994, residents of Gozan-dong, Incheon City, made a petition to the government about their health problems which might be caused by previous glass fibre landfill nearby 'H' company. In february 1995, at regular academic meeting of occupational and environmental medicine, a research team of 'D' University presented that they had found glass fibres in groundwater of the area through their survey. They were suspicious of probable association between ingestion of groundwater contaminated with glass fibres and skin tumors among residents. A joint research team was formed and carried out the survey of environment concerning groundwater and its glass fibre existence, and health assessment of residents in the area and industrial workers of 'H' company during May to November, 1995. Analysis of groundwater flow system indicates that the flow lines from the glass fibre landfill pass through or terminate at the 6 houses around the landfill. This means that the groundwater of the 6 houses around the glass fibre landfill could be affected by some possible contaminants from the landfill, but the groundwater quality of the other houses was irrelevant to the landfill. The qualitative and qualitative analyses for glass fibres in 54 groundwater samples including those from the nearby 6 houses, were carried out using SEM equipped with EDS, resulting in no evidence for the presence of glass fibres in the waters. Major precipitates, formed in waters while boiling, were identified as calcium carbonates, in particulary, aragonites in needle form. The results of health assessments of 889 residents in Gozan-dong, participated in this study, showed statistically significant differences in past medical histories of skin tumor and respiratory disease between the exposed group (31 persons who inhabited in 6 houses around the landfill) and the control group, but no significant differences in past medical histories of other diseases, such as cancer mortality, current gastroscopic findings, current skin diseases and respiratory diseases, etc. Also, we could not prove any glass fibres in excised specimens of 9 skin tumors in both groups and there were no health problems possibly associated with glass fibres in employees of the 'H' company. After all, we could not authenticate the association, raised by prior investigators, between groundwater streams, assumedly contaminated with glass fibres or not, and specific disease morbidities or common disease/symptom prevalences. That is, we could not find any glass fibres in groundwater as the only exposure factor of this study hypothesis, and there were not enough certain evidences such as increasing disease prevalences, for examples, skin, respiratory and gastrointestinal diseases etc, possibly related to glass fibre exposure, in exposed group. As a matter of course, the conditions for confirming causal association, for example, strength of the association, consistency of the association, specificity of the association, temporality of the association and dose-response relationship etc, have not been satisfied. In conclusion, we were not able to certify the hypothesis that contamination of groundwater with glass fibres might cause any hazardous health effects in residents who used it for drinking.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.921-927
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• 2003

Arterial switch operation (ASO) has been the most effective surgical option for transposition of the great arteries. But, the inappropriate dilation of the neoaortic root has been reported and its effect on neoaortic valve function and growth of aorta has not been well documented. Material and Method: Forty-eight patients who underwent cardiac catheterization during follow up after arterial switch operation were included in this study. Arterial switch operation was performed at a median age of 18 days (range 1∼211 days). Preoperative cardiac catheterization was performed in 26 patients and postoperative catheterization was performed in all patients at 15.8$\pm$9.6 months after ASO. Postoperative ratios of the diameters of neoaortic annulus, root and aortic anastomosis against the descending aorta were compared to the size of preoperative pulmonary annular, root and sinotubular junction. Preoperative and operative parameters were analyzed for the risk factors of neoaortic insufficiency. Result: There were two clinically significant neoaortic insufficiencies (grade$\geq$II/IV) during follow up, one of which required aortic valve replacement. Another patient required reoperation due to aortic stenosis on the anastomosis site. Post-operatively, neoaortic annulus/DA ratio increased from 1.33$\pm$0.28 to 1.52$\pm$.033 (p=0.01) and neoaortic root/DA ratio increased form 2.02$\pm$0.40 to 2.56$\pm$0.38 (p<0.0001). However, the aortic anastomosis/DA ratio showed no statistically significant difference (p=0.06). There was no statistically significant correlation between the occurrence of neoaortic insufficiency and neoaortic annulus/DA ratio and neoaortic root/DA ratio. Non-neonatal repair (age>30days) (p=0.02), preopeative native pulmonaic valve stenosis (p=0.01), and bisuspid pulmonic valve (p=0.03) were the risk factors for neoaortic insufficiency in univariate risk factor analysis. Conclusion: After ASO, aortic anastomosis site showed normal growth pattern proportional to the descending aorta, but neoaortic valve annulus and root were disproportionally dilated. Significant neoaortic valve insufficiency rarely developed after ASO and neoaortic annulus and root size do not correlate with the presence of postoperative neoarotic insufficiency. ASO after neonatal period, preoperative native pulmonary valve stenosis, and bicuspid native pulmonic valve are risk factors for the development of neoaortic insufficiency.

• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.51-95
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• 2002

1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.

• Composites Research
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• v.15 no.4
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• pp.23-31
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• 2002

The two dimensional size effect of specimen gauge section ($length{\;}{\times}{\;}width$) was investigated on the compressive behavior of a T300/924 $\textrm{[}45/-45/0/90\textrm{]}_{3s}$, carbon fiber-epoxy laminate. A modified ICSTM compression test fixture was used together with an anti-buckling device to test 3mm thick specimens with a $30mm{\;}{\times}{\;}30mm,{\;}50mm{\;}{\times}{\;}50mm,{\;}70mm{\;}{\times}{\;}70mm{\;}and{\;}90mm{\;}{\times}{\;}90mm$ gauge length by width section. In all cases failure was sudden and occurred mainly within the gauge length. Post failure examination suggests that $0^{\circ}$ fiber microbuckling is the critical damage mechanism that causes final failure. This is the matrix dominated failure mode and its triggering depends very much on initial fiber waviness. It is suggested that manufacturing process and quality may play a significant role in determining the compressive strength. When the anti-buckling device was used on specimens, it was showed that the compressive strength with the device was slightly greater than that without the device due to surface friction between the specimen and the device by pretoque in bolts of the device. In the analysis result on influence of the anti-buckling device using the finite element method, it was found that the compressive strength with the anti-buckling device by loaded bolts was about 7% higher than actual compressive strength. Additionally, compressive tests on specimen with an open hole were performed. The local stress concentration arising from the hole dominates the strength of the laminate rather than the stresses in the bulk of the material. It is observed that the remote failure stress decreases with increasing hole size and specimen width but is generally well above the value one might predict from the elastic stress concentration factor. This suggests that the material is not ideally brittle and some stress relief occurs around the hole. X-ray radiography reveals that damage in the form of fiber microbuckling and delamination initiates at the edge of the hole at approximately 80% of the failure load and extends stably under increasing load before becoming unstable at a critical length of 2-3mm (depends on specimen geometry). This damage growth and failure are analysed by a linear cohesive zone model. Using the independently measured laminate parameters of unnotched compressive strength and in-plane fracture toughness the model predicts successfully the notched strength as a function of hole size and width.

• Journal of Korean Tunnelling and Underground Space Association
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• v.20 no.3
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• pp.543-560
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• 2018

With the increased development in downtown underground space facilities that vertically cross under a railway at a shallow depth, the demand for non-open cut method is increasing. However, most construction sites still adopt the pipe roof method, where medium and large diameter steel pipes are pressed in to form a roof, enabling excavation of the inside space. Among the many factors that influence the loosening region and loads that occur while pressing in steel pipes, the size of the pipe has the largest impact, and this factor may correspond to the magnitude of load applied to the underground structure inside the steel pipe roof. The super equilibrium method (SEM) has been developed to minimize ground disturbance and loosening load, and uses small diameter pipes of approximately 114 mm instead of conventional medium and large diameter pipes. This small diameter steel pipe is called an SEM pile. After SEM piles are pressed in and the grouting reinforcement is constructed, a crossing structure is pressed in by using a hydraulic jack without ground subsidence or heaving. The SEM pile, which plays the role of timbering, is a fore-poling pile of approximately 5 m length that prevents ground collapse and supports surface load during excavation of toe part. The loosening region should be adequately calculated to estimate the spacing and construction length of the piles and stiffness of members. In this paper, we conducted a comparative analysis of calculations of loosening load that occurs during the press-in of SEM pile to obtain an optimal design of SEM. We analyzed the influence of factors in main theoretical and empirical formulas applied for calculating loosening regions, and carried out FEM analysis to see an appropriate loosening load to the SEM pile. In order to estimate the soil loosening caused by actual SEM-pile indentation and excavation, a steel pipe indentation reduction model test was conducted. Soil subsidence and soil loosening were investigated quantitatively according to soil/steel pipe (H/D).