• Title/Summary/Keyword: focused treatments

검색결과 274건 처리시간 0.033초

국내 임상연구 문헌고찰을 통한 단일 관절 질환의 봉약침요법 응용례 분석 (A Rev iew of Bee Venom Acupuncture for Articular Diseases of Single Type Joint in the Journal of Korean Medicine)

  • 김효준;김국범;박주언;권용수;유재은;이희원;배준효;최규철;배지은;한수빈;김양선
    • 한방재활의학과학회지
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    • 제31권1호
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    • pp.119-135
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    • 2021
  • Objectives This review aims to analyze the current research trend in the usage of bee venom (BV) acupuncture for articular diseases of single type joint. Methods We collected 74 articles on BV acupuncture clinical study for articular diseases of single joint by searching Korean web databases 'Journal of Korean Medicine Rehabilitation', 'Oriental Medicine Advanced Searching Integrated System', 'Korean Traditional Knowledge Portal' from 1999 to 2020 August. Results We summarized the most frequent clinical treatment methods of BV acupuncture for articular diseases of single type joint. Research focused on specific diseases in application of BV acupuncture about some articular type diseases of single joint. It is assumed that the details of treatment for each joint are not related to the type of joint. In clinical study of BV acupuncture, reproducibility was mostly insufficient. Conclusions BV acupuncture clinical study for articular diseases of single joint should be proceed for a number of subjects, to treat various types of disease, by using more safe and detailed treatments.

다결정 금속 유기 골격체 분리막의 후처리 성능 제어기술 개발 동향 (Reviews on Post-synthetic Modification of Metal-Organic Frameworks Membranes)

  • 권혁택;엄기원
    • 멤브레인
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    • 제32권6호
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    • pp.367-382
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    • 2022
  • 유기 전구체와 금속 이온, 또는 금속-옥소 클로스터 간의 규칙적 배열을 통한 종의 다양성을 장점으로 하는 금속-유기 골격체(Metal-Organic Frameworks, MOFs)는 에너지 사용량이 높은 상변화 기반 분리공정을 대체할 수 있는 에너지 효율적인 막 기반 분리 기술의 개발 가능성을 열어주었다. 이에 최근 10년 동안 다결정 MOFs 분리막 합성 기술에서 상당한 진전이 있었지만, 매우 제한된 종류의 MOFs만이 활용되고 있다. 이러한 기술 개발의 정체는 다결정 분리막의 비 선택적인 확산 경로인 결정 사이 결함(intercrystalline defects)에 대한 명확한 해결법이 없기 때문이다. 후처리 성능 제어기술(postsynthetic modifications, PSMs)은 기존 분리막을 플랫폼으로 활용하고 이를 물리적 그리고/혹은 화학적으로 처리함을 통해 분리 특성을 개선 혹은 변경하는 기술을 말한다. PSMs 기술은 특정 분리막을 개발하는 데 있어서 새로운 MOFs를 설계하거나 막 합성 기술을 개발하지 않아도 된다는 장점이 있어서 다결정 MOF 분리막의 다양성을 제공하기 위한 새로 부상하는 전략으로 평가 된다. 본 총설에서는 PSMs 기술을 7개의 세부기술((1) 공유결합법, (2) 결정간 결함 플러깅법, (3) 결정 내부 결함 치유법, (4) 기공내 기능성 소재 함침법, (5) 기공 경화법, (6) 전구체 치환법 및 (7) 비정질화법)로 분류하고, 각 세부기술의 연구 동향 및 도전과제 그리고 향후 연구 방향에 대해 논의하고자 한다.

Evaluating the activity of N-89 as an oral antimalarial drug

  • Nagwa S. M. Aly;Hiroaki Matsumori;Thi Quyen Dinh;Akira Sato;Shin-ichi Miyoshi;Kyung-Soo Chang;Hak Sun Yu;Takaaki Kubota;Yuji Kurosaki;Duc Tuan Cao;Gehan A. Rashed;Hye-Sook Kim
    • Parasites, Hosts and Diseases
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    • 제61권3호
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    • pp.282-291
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    • 2023
  • Despite the recent progress in public health measures, malaria remains a troublesome disease that needs to be eradicated. It is essential to develop new antimalarial medications that are reliable and secure. This report evaluated the pharmacokinetics and antimalarial activity of 1,2,6,7-tetraoxaspiro[7.11]nonadecane (N-89) using the rodent malaria parasite Plasmodium berghei in vivo. After a single oral dose (75 mg /kg) of N-89, its pharmacokinetic parameters were measured, and t1/2 was 0.97 h, Tmax was 0.75 h, and bioavailability was 7.01%. A plasma concentration of 8.1 ng/ml of N-89 was maintained for 8 h but could not be detected at 10 h. The dose inhibiting 50% of parasite growth (ED50) and ED90 values of oral N-89 obtained following a 4-day suppressive test were 20 and 40 mg/kg, respectively. Based on the plasma concentration of N-89, we evaluated the antimalarial activity and cure effects of oral N-89 at a dose of 75 mg/kg 3 times daily for 3 consecutive days in mice harboring more than 0.5% parasitemia. In all the N-89-treated groups, the parasites were eliminated on day 5 post-treatment, and all mice recovered without a parasite recurrence for 30 days. Additionally, administering oral N-89 at a low dose of 50 mg/kg was sufficient to cure mice from day 6 without parasite recurrence. This work was the first to investigate the pharmacokinetic characteristics and antimalarial activity of N-89 as an oral drug. In the future, the following steps should be focused on developing N-89 for malaria treatments; its administration schedule and metabolic pathways should be investigated.

활성탄소섬유 표면의 염산처리효과와 TiO2 형성에 관한 분석 (The analysis for the HCl modification effect and formation of TiO2 on activated carbon fiber surface)

  • 오원춘;한상범;배장순
    • 분석과학
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    • 제20권4호
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    • pp.279-288
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    • 2007
  • 본 연구에서는 염산처리에 의하여 표면 개질된 활성탄소 섬유에 TNB (titanium n-butoxide) 용액을 침투시켜 $ACF/TiO_2$ 광촉매를 제조하였다. 염산 처리에 의하여 표면 기능기가 증가된 다공성 탄소에 형성된 $TiO_2$의 특성화에 연구의 관점을 두었다. TNB가 $TiO_2$로 변화되는 산처리 효과는 $ACF/TiO_2$ 광촉매제조에 상당히 중요한 요소임을 확인하였다. 표면 특성분석 결과로부터, BET 비표면적과 전체 동공부피는 산처리 양이 증가함에 따라 표면의 이산화티탄 화합물 형성과 함께 감소함을 나타내었다. 염산처리에 의해 형성된 $ACF/TiO_2$ 계에 대한 X-선 회절 변화로부터, 염산을 처리하지 않은 FT와 0.05, 0.1 M 처리된 FT1, FT2의 3가지 시료의 경우, 주요한 회절선의 피크는 아나타제의 결정상을 나타내었으며, 0.5M 처리된 FT3의 경우 아나타제와 루타일의 두 가지 형상이 나타났다. SEM 결과로부터, 전처리 하기전과 후에 활성탄소섬유 주변에 형성된 화합물들의 분포가 현저하게 다름을 알 수 있었으며, 이러한 현상은 산처리 효과의 우수성을 설명하고 있다. EDX 결과에 의하면, 모든 시료의 스펙트럼은 C, Ti와 O의 피크가 주요한 특징적 피크로 크게 나타났음을 보여 주고 있다. 마지막으로 MB (methylene blue)의 제거 효율에 근거하여, MB 농도 감소는 활성탄소섬유의 흡착효과와 $TiO_2$의 우수한 광분해 효과에 대한 두 가지 복합적인 결과로 설명할 수 있다.

성서에 언급된 채소류에 관한 연구 (A Study on the Vegetables Mentioned in the Bible)

  • 우자원
    • 한국식생활문화학회지
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    • 제22권1호
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    • pp.1-9
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    • 2007
  • This paper is intended to study what kinds of the vegetables are mentioned in the Bible and how they were used in those days. While one hundred and twenty-eight different plants are mentioned in the Bible, there are today 2,384 plant species in modem Israel, most of which have been introduced in recent centuries. These plants obviously did not exist there in biblical times and were only recently introduced from Australia and South America, respectively. This article will study only the vegetables mentioned in the Bible and known to have existed in the old and new testament times. Since the first book devoted exclusively to biblical botany was that of Levinus Lemmens in 1566, the modem systematic study of biblical plants, began with F. Hasselquist, a student of Linnaeus, the founder of modem botany. In 1928, Immanuel Loew approached the subject differently, reviewing all known data pertaining to biblical plants. His work not only discussed biblical plants, but also plants in later Jewish literature, particularly the Talmud. The British scholar G. E. Post provided a broad field study of modem plants in Palestine, Syria, Lebanon, and Jordan. More recent major treatments of the subject include those of A. and H. Moldenke (1952), M. Zohary (1982), N. Hareuveni (1984), and Y. J. Choi(1996). Today, articles on specific biblical plants listed in the Bible can be found in any number of encyclopedias. This study attempts to provide a synthesis of the work of a number of scholars who studied the vegetables and plants mentioned in the Bible. As a preliminary study on the culture of food in the biblical period, this study has focused on the identity and features of the vegetables of the Bible. In only a limited number of instances, because of the paucity of the informations and the broad and generic descriptions of the plants, we can't be certain about the identification of the vegetables named in the Bible. In many instances the traditions established by the Greek, Aramaic, and English translations are helpful, although sometimes they are misleading. This paper subdivides the vegetables into broad areas, the general vegetables and the flavoring herbs. Vegetables formed very important part of the diet in the biblical times. Two main types were used: those whose nutritious seeds could be easily stored and those which were eaten freshly gathered from gardens. Pulse seeds provided a useful source of vegetable protein, while fresh green vegetables were vitamin rich. Pulses could be eaten boiled, or their dried seeds could be ground up into flour and then made into nutritious soups. Fresh vegetables were eaten either raw or lightly cooked, usually by boiling in water. The general vegetables in the Bible are herbs(garden rocket), cucumber(snake cucumber), watermelon, leeks, chicory, and onions. Also the flavoring herbs in the Bible are rue, dill, cummin, black cummin, frankincense, cinnamon, cassia, myrrh, black mustard, coriander, mint, saffron, ginger grass, syrian hyssop, aloes(eagle wood), manna which have the flavor, aroma, and medical values.

바이오에너지생산을 위한 목질계 폐바이오매스의 발효 (Fermentation of Waste Woody Biomass for the Production of Bioenergy)

  • 조남석;최태호
    • Journal of the Korean Wood Science and Technology
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    • 제36권6호
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    • pp.147-158
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    • 2008
  • 본 연구는 시멘트 블록조 발효상을 축조하고, 산림 및 농산 폐바이오매스의 발효 특성을 구명하기 위하여 수행되었다. 활엽수(신갈나무가 중심이 되는 활잡목)톱밥, 침엽수(낙엽송)톱밥, 낙엽류(소나무 및 플라타너스 낙엽), 볏짚, 산야초류 등 5종의 발효재료를 사용, 발효첨가제로서 요소, 발효용 부숙비료, 석회 등을 첨가하였고, 전체의 함수율을 55~60%가 되도록 조절하여 발효시켰으며, 궁극적으로 최대 발효열 효율을 얻기 위한 재료의 배합비, 최적수분함량 등을 검토하였다. 발열온도는 활엽수톱밥(100%)가 가장 좋았고 침 활엽수톱밥(50:50)구도 비교적 좋은 편이었다. 발열온도가 가장 높았던 활엽수톱밥 단독의 경우, 최고온도 $60{\sim}90^{\circ}C$, 최저온도 $40^{\circ}C$전후, 평균온도 $50{\sim}60^{\circ}C$의 범위를 20~30일간 유지하였으며, 이 때 최적 배합비율은 발효재료 1 톤에 대하여 요소 15 kg, 발효용 부숙비료 20 kg, 석회 10 kg, 함수율 55%이었다. 최적발효조건에서 온수탱크의 수온을 측정한 결과, 활엽수톱밥과 산야초를 50 : 50으로 혼합한 경우, 측정부위에 따라 상당한 편차를 보였으며, 발효상 중부 및 상부의 온도가 대체적으로 높았고, 하부층의 온도가 낮았다. 발열온도는 최고 $65^{\circ}C$, 최저 $40^{\circ}C$ 전후, 평균온도 $60^{\circ}C$였으며, 온수탱크의 온도를 45일간 측정한 결과, $30{\sim}45^{\circ}C$ 범위를 나타냈으며 전 기간을 통하여 거의 유사한 결과를 보여주고 있다. 탱크출구의 수온은 $33{\sim}48^{\circ}C$ 범위로 탱크온도보다 약간 높았다. 본 실험에서 개발된 열교환기(HX-helical type)를 사용한 경우, $50{\sim}60^{\circ}C$의 발효열을 최대 3개월정도 이용 가능하였다.

3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구 (Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital)

  • 유호신
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 - (A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance -)

  • 박은숙;이숙자;박영주;유호신
    • 가정간호학회지
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    • 제7권1호
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 - (A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • 대한간호학회지
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    • 제30권6호
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    • pp.1488-1502
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    • 2000
  • This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

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의료서비스 마케팅을 위한 품질지각과 만족에 관한 연구 (A Study on Qulity Perceptions and Satisfaction for Medical Service Marketing)

  • 유동근
    • 간호행정학회지
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    • 제2권1호
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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.

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