BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

OBJECTIVE: The aim of this study is to explore the variation in perceptions about problem-based learning(PBL) according to the level of academic achievement and learning attitude in the nursing students of a junior college (3-year program). METHOD: Students (n=39) learned the respiratory and cardiac system with seven PBL packages and group-based learning for a semester in 2002. Students were asked to write reflective journals that focused on their learning perception after an experience with each learning package. A total of 208 journals were used for analysis. RESULT: Students positively perceived that PBL making them increase their sense of responsibility for learning and felt satisfaction with the learning process, and had a confidence in the use of clinical nursing interventions. On the other hand, they negatively perceived that PBL was a burden because it took more time than traditional learning tasks, and they experienced an anxiety about regular tests and felt conflicts and diffidences in the learning process. The negative perceptions were expressed more often from students with a low academic achievement and low learning attitude compared to others. CONCLUSION: Students perceived the PBL as effective in understanding the learning concepts in the clinical practice environment. PBL need to be supplemented by feedback-based lecture and facilitative strategies for academically low-achieved students.
Students, Nursing/*psychology ; *Problem-Based Learning ; Humans ; Female ; *Education, Nursing, Baccalaureate ; *Attitude ; Adult

This study has been conducted for the purpose of identifying the levels of knowledge and attitude about dementia, and exploring the degrees of practice and the relationship among these variables in nursing assistants caring institutionalized demented elders. The subjects were 87 formal caregivers from 3 dementia-specialized nursing facilities, 2 dementia-specialized hospitals, 1 general psychiatric hospitals, and 3 general nursing homes. The data were gathered from July 10th to August 5th, 1998 through interviews by questionnaires. The measuring instruments of this study were developed by the researcher and proven for their reliability and validity. The collected data were analyzed using SAS program. 1) The lowest score among 6 sub-areas about practice showed on this subarea of maintenance of remained ADL function, offering stimuli and activities to demented elders was the second. 2) The third hypothesis of "the higher the attitude score they have, the higher the practice score they do" was supported (r=.370, p=.025). 3) The influencing factors significantly on knowledge were educational status, learning experience about taking care of patients, learning experience about dementia during last a year. 4) A factor of the period of taking care demented elders have significantly influenced on the attitude about dementia. 5) The influencing factors significantly on practice were age, marital status, learning experience about taking care of patients, learning experience about dementia during the last a year. 6) The most difficult situation the subjects perceived in taking care of demented elders was managing the aggressive and resistive behaviors of demented elders.
Activities of Daily Living ; Caregivers ; Dementia* ; Educational Status ; Hospitals, Psychiatric ; Humans ; Learning ; Marital Status ; Nursing Homes ; Nursing* ; Reproducibility of Results ; Surveys and Questionnaires

Distributions trends were examined in 9159 malocclusion patients had been examined and diagnosed at Department of Orthodontics, College of Dentistry, Yonsei University over a 6 year-period from 1992 to 1997. The results were as follows: 1. The total number of orthodontic patients in 1997 increased in comparing with that of 1992(86%)and after 1995, the number of annual patients showed an increase. 2. Age distribution had shown over-19 year-old group being the largest(39.9%) but percentages of pre-adolescent patients had been decreasing while that of adult patient had gradually increased. 3. Distributions in the types of malocclusion, the Angle's Classification had shown : 33. 3% for Class I, 28.6% for ClassII and the largest 38.1% for Class III. 4. Among Class I patients, crowding showed the largest(32.6%) and protrusion group had gradually increased to 33.9% in 1996. Otherwise openbite and groups tend to decrease, annually. 5. Geographic distribution showed a majority of patients from Seoul(above 70%). Among the patients from Seoul, group within the distance 3-6km from Yonsei dental hospital was the largest(32.3%) and group within 9km showed 69% of total patients.
Adult ; Age Distribution ; Crowding ; Dentistry* ; Epidemiologic Studies ; Humans ; Malocclusion* ; Open Bite ; Orthodontics* ; Seoul

PURPOSE: The aim of this study was to compare the color stability, water sorption and cytotoxicity of thermoplastic acrylic resin for the non-metal clasp dentures to those of thermoplastic polyamide and conventional heat-polymerized denture base resins. MATERIALS AND METHODS: Three types of denture base resin, which are conventional heat-polymerized acrylic resin (Paladent 20), thermoplastic polyamide resin (Bio Tone), thermoplastic acrylic resin (Acrytone) were used as materials for this study. One hundred five specimens were fabricated. For the color stability test, specimens were immersed in the coffee and green tee for 1 and 8 weeks. Color change was measured by spectrometer. Water sorption was tested after 1 and 8 weeks immersion in the water. For the test of cytotoxicity, cell viability assay was measured and cell attachment was analyzed by FE-SEM. RESULTS: All types of denture base resin showed color changes after 1 and 8 weeks immersion. However, there was no significant difference between denture base resins. All specimens showed significant color changes in the coffee than green tee. In water sorption test, thermoplastic acrylic resin showed lower values than conventional heat-polymerized acrylic resin and thermoplastic polyamide resin. Three types of denture base showed low cytotoxicity in cell viability assay. Thermoplastic acrylic resin showed the similar cell attachment but more stable attachment than conventional heat-polymerized acrylic resin. CONCLUSION: Thermoplastic acrylic resin for the non-metal clasp denture showed acceptable color stability, water sorption and cytotoxicity. To verify the long stability in the mouth, additional in vitro studies are needed.
Cell Survival ; Coffee ; Denture Bases ; Dentures* ; Immersion ; Mouth ; Nylons ; Water*

An unusual case of homicide of a 21-year-old man who was smothered with a hot steam towel by his mother and a pastoress in the name of exorcism. Homicidal smothering in adults is rare, but does occur when the victims are not capable of defending themselves in situations such as chronic illness, old age, drug intoxication or when restrained by other people. In this case, distinct facial scalding was a clue to smothering with a hot steam towel.
Adult ; Chronic Disease ; Homicide ; Humans ; Mothers ; Steam

Kawasaki disease, an acute febrile vasculitis of unknown etiology, is usually treated with high doses of immunoglobulin (IVIG) and aspirin. However, 20% of children show persistent or recurrent fever despite IVIG, and coronary artery aneurysm progression. In such cases of resistance to IVIG treatment, repeated IVIG administration or the initiation of steroid therapy, and the use of cyclophosphamide have been reported. We aimed to show in this study that methotrexate (MTX) may be used as a treatment for Kawasaki disease resistant to IVIG treatment. We report the case of a 6-year old boy who was admitted at another hospital with an initial complaint of a fever for 5 days and skin rashes for 3 days. The patients fever persisted despite three courses of IVIG (2 gm/kg, 1 gm/kg, 1 gm/kg, respectively) over a 14-day period. On day 14 of his illness he showed a dilated right coronary artery, and on day 19 dexamethasone, at a daily dose of 0.3 mg/kg, was given but this resulted in defervescence. However, upon stopping the dexamethasone treatment, his fever recurred and he was transferred to our hospital. On days 31 and 38 of his illness, IVIG (400 mg/kg for 5 days, twice) was administered and from day 38 onwards the patient was given dexamethasone (0.6 mg/kg, daily) and MTX (10 mg/BSA, once weekly) whereupon his fever subsided and did not recur. On day 48 dexamethasone was replaced with prednisolone, which was subsequently tapered. The patient is now taking MTX and being observed on an outpatient basis. We report the case of a boy with IV-globulin resistant Kawasaki disease, who after repeated infusions of IVIG and steroid therapy showed fever recruuence, which that subsided after MTX treatment.
Case Report ; Child ; Human ; Immunoglobulins, Intravenous/*therapeutic use ; Male ; Methotrexate/*therapeutic use ; Mucocutaneous Lymph Node Syndrome/complications/*drug therapy

OBJECTIVES: This study compared attitudes toward antipsychotic treatment according to awareness of the name of their illness in patients with schizophrenia. METHODS: Information on sociodemographic and clinical characteristics, including awareness of the importance of antipsychotic treatment, was obtained through a self-report questionnaire. The Drug Attitude Inventory (DAI) was administered. The data were compared according to awareness of the name of their illness. RESULTS: The study analyzed data for 199 patients with schizophrenia. Of these, 115 patients (57.8%) were aware that their illness was called schizophrenia, while 84 patients (42.2%) knew it by their psychotic symptoms or as another mental illness, such as depression. The patients aware of the name of their illness had significantly longer durations of illness and higher scores on the DAI. They were significantly more likely to have stopped taking medication on their own accord and to agree with the importance of antipsychotic treatment. Statistical significance was sustained in a logistic regression analysis after adjusting for the duration of illness and study site, except for the DAI score, which had borderline significance (p=0.055). In subjects with duration of illness > or =5 years, patients aware of the name of their illness had significantly higher scores on the DAI. CONCLUSION: Awareness of the name of their illness was associated with awareness of the importance of, and a positive attitude toward, antipsychotic treatments in patients. Psycho-education, including telling the patient the correct name of his or her illness, might be needed for maintaining antipsychotic treatment in patients with chronic schizophrenia.
Antipsychotic Agents ; Depression ; Humans ; Logistic Models ; Surveys and Questionnaires ; Schizophrenia

PURPOSE: This study aimed at developing the problem-based learning packages on the respiratory and cardiac system of an adult- health nursing course, and to examine the effect of PBL on the knowledge, learning attitude and motivation in nursing students. METHOD: A total of 7 PBL packages were developed through the analysis of learning contents and integration of concepts. Clinical scenarios used in 7 PBL packages were selected and composed at a respiratory and a cardiovascular unit, a medical ICU and a chest-surgery unit of C university hospital in G-city. The PBL method was implemented 3 hours a week for 12 weeks to 35 students of an experimental group, and the conventional lecture was implemented to 38 students at C college of C province from Sept. to Dec. 2002. A pretest-posttest experimental design was used. RESULT: The PBL students (n=35) scored significantly higher knowledge than conventional students (n=38) in the area of problem solving (t=3.418, p=. 001). But, there is no significant difference in the memory-dependent knowledge. Also, The level of learning attitude (t=3.570, p=. 001) and learning motivation (t=3.446. p=. 001) was significantly higher in PBL students. CONCLUSION: PBL method appears to be effective in improving nursing students' problem-solving knowledge and positive learning attitude and motivation.
Humans ; Learning ; Motivation ; Nursing ; Problem Solving ; Problem-Based Learning* ; Research Design ; Students, Nursing

PURPOSE: An inexperienced mother depends on the recommendation by an experienced person on how to bring up her child. Therefore, we performed a study to evaluate the wrong methods of childcare and to establish effective childcare counselling. METHODS: Two thousand eighty questionnaires filled out by mothers who visited local pediatric clinics and medical centers in Chonbuk, from March 2001 to April 2001, were analyzed according to the distribution of location, age of infant, maternal age and the question of each field. RESULTS: Many mothers have been known to squeeze the breast causing hypertrophy of the neonate. Most infants are placed on their side or supine for sleep. The most common reason for stopping breast feeding was insufficient amount of breast milk. The appropriate age to start whole cow's milk is after the first year of life. The main food used for weaning was commercial baby food. The main oral hydration solution for diarrhea has been boiled water. The main reasons for using a pacifier were to help the mother. The most common reason to use herbs was for the prevention of disease. The use of infant walkers has been widespread among infants and young children. The most common reason was to keep the infant quiet and happy. Most mothers did not use car safety seats for young children. CONCLUSION: The findings of this study revealed that many mothers were misinformed concerning childcare, so pediatricians should make more efforts and perform more studies to establish rational methods of childcare.
Breast ; Breast Feeding ; Child ; Diarrhea ; Humans ; Hypertrophy ; Infant ; Infant Equipment ; Infant, Newborn ; Jeollabuk-do ; Maternal Age ; Milk ; Milk, Human ; Mothers ; Pacifiers ; Surveys and Questionnaires ; Water ; Weaning