PURPOSE: The purpose of this study was to define and clarify the concept of developmental care for preterm infants. METHODS: The hybrid model method was used to identify the main attributes and indicators. In the field work stage, data were collected in Seoul and Cheonan, Korea. The participants were 5 nurses working in the NICU. RESULTS: The concept of developmental care was found to have six attributes and ten indicators in 2 dimensions. For the nursing practice dimension, four attributes were derived. They were being like intrauterine state, individualization, interaction, and integrative care with awareness of development. For the family centeredness dimension, supporting parental attachment and professional alliance were attributes of developmental care. CONCLUSION: Developmental focused care can facilitate the identification of behavioral responses of newborns and provide individualized interventions for fostering growth and development. This concept analysis could provide guidelines for "developmental care" nursing practice and be useful for research in the neonatal field.
Chungcheongnam-do ; Concept Formation ; Foster Home Care ; Growth and Development ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Korea ; Nursing ; Nursing Care ; Parents ; Seoul

PURPOSE: This study was done to evaluate the validity of Korean Denver II developmental screening test in screening children with developmental risk. METHOD: The participants in the study were 113 children referred for developmental assessment in the department of rehabilitation of D University hospital. They were examined with the BSID (Bayley Scales of Infant Development) II and Korean Denver II by one occupational therapist. The data was analyzed by Chi square test and discriminant analysis. RESULTS: There was a significant relationship between the Mental Developmental Index (MDI) of the BSID II and the result of the Korean Denver II. The sensitivity and specificity of Korean Denver II were 0.87 and 0.62 when abnormal MDI was defined as lower than 85 was used as a diagnosis of developmental delay. There was a significant relationship between the Psychomotor Developmental Index (PDI) of the BSID II and the result of Korean Denver II. The sensitivity and specificity of Korean Denver II were 0.83 and 0.51. The over-all hit ratio was 79.6%. CONCLUSION: The result showed that the Korean Denver II was valid and has good sensitivity and moderate specificity in screening developmental delay.
Child Development ; Child* ; Diagnosis ; Humans ; Infant ; Mass Screening* ; Rehabilitation ; Sensitivity and Specificity ; Weights and Measures ; Child Health

BACKGROUND: The insulin resistance is common in the patients with essential hypertension, even in the absence of non-insulin-dependent diabetes mellitus(NIDDM) or hyperlipidemia. It is well known that the offspring of patients with NIDDM have shown less insulin sensitivity compared with that of normal parents. But it is not yet known whether the insulin resistance is common in the offspring of patients with essential hypertension in Korea, who have no hypertension, NIDDM and hyperlipidemia. The aims of this study were to find out whether the insulin resistance exist in the middle aged normal offspring of the patients with essential hypertension and whether the insulin resistance is dependent on the metabolic abnormalities such as the body mass index(BMI), obesity and hyperlipidemia. METHODS: The serum lipid profiles and oral glucose tolerance test were performed. The anthropometrical measurement was done. The abdominal CT scan at umbilicus level and thigh CT was performed in the 11 offspring of parents with essential hypertension(group I;male : 7, female : 4)and 24 offspring of parents without essential hypertension, NIDDM, ischemic heart disease and hyperlipidemia(group II; male : 9, female : 15). RESULTS: The average age of group I was 44.1+/-6.9 years, and that of the group II was 47.5+/-9.5 years. There were no significant differences in the blood pressure, weight, BMI, waist to hip ratio, waist to thigh ratio. And there were no significant differences in the serum cholesterol, triglyceride, HDL-cholesterol, serum Na, and plasma renin activities between both groups. Fasting plasma insulin and 2 hour insulin after 75gm glucose ingestion were significantly higher in group I than in group II(8.5+/-3.0mU/mL versus 5.0+/-1.8mU/mL, 61.6+/-31.7mU/mL versus 33.3+/-16.8mU/mL, p<0.05). The insulin sensitivity index was significantly lower in group I than in group II(355.1+/-92.6 versus 451.8+/-88.1, p<0.05). The visceral fat area was wider in group I than in group II(102.0+/-30.7cm2 versus 64.5+/-28.5cm2, p<0.05). The multiple regression analysis with the fasting plasma insulin and insulin sensitivity index as the dependent variables and family history of essential hypertension, visceral fat area and BMI as the predictor variables revealed that only the family history was associated with the fasting plasma insulin and insulin sensitivity index. CONCLUSIONS: The offspring of the parents with essential hypertension showed the insulin resistance with increased visceral fat area in comparison with the offspring of the parents without essential hypertension.
Blood Pressure ; Cholesterol ; Diabetes Mellitus, Type 2 ; Eating ; Fasting ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance* ; Insulin* ; Intra-Abdominal Fat ; Korea* ; Male ; Middle Aged* ; Myocardial Ischemia ; Obesity ; Parents* ; Plasma ; Renin ; Thigh ; Tomography, X-Ray Computed ; Triglycerides ; Umbilicus ; Waist-Hip Ratio

PURPOSE: The aim of this study was to develop a substantive theory on self-management conducted by the adolescents with chronic kidney disease from their lived experience. METHODS: Data was collected through in-depth interviews from May to December in 2015 with thirteen adolescents with chronic kidney disease. The data collected were analyzed on the basis of Strauss and Corbin's grounded theory. RESULTS: The core of the category found in this study was “overcoming the unstable sense of self-control and integrating disease experience into their life”. The causal conditions triggering the central phenomenon were “restriction in daily life” and “manifestation and aggravation of symptom”. The central phenomenon in the experience of self-management within the adolescents with chronic kidney disease was “unstable sense of self control”. The intervening condition for unstable self control were “micro system support” and “motivational resources”. This study found that the adolescents with chronic kidney disease followed a series of strategies when they faced the central phenomenon, including; passive coping, reappraisal of illness, active coping, compliance with treatment, controlling physical activity, and adjusting school life. With these strategic approaches, the adolescents with chronic kidney disease could maintain their active lifestyles and achieve their health behaviors. The process of self-management by these adolescents passed through four phases; limited experience caused by diseases, effort for normalization, reorganizing their daily lives, and integration with daily lives and self-management. CONCLUSION: This Study explored the process and experience of self-management of adolescents with chronic kidney disease. These findings can be used for basis for developing substantive theory and nursing intervention strategy for adolescents with chronic kidney diseases.
Adolescent* ; Compliance ; Grounded Theory ; Health Behavior ; Humans ; Life Style ; Motor Activity ; Nursing ; Renal Insufficiency, Chronic* ; Self Care* ; Self-Control

Chemokine KC has been considered to be a murine homologue of human GRO/MGSA and was identified as chemoattractant for monocytes and neutrophils. This study examined the expression of KC mRNA in thioglycollate-elicited mouse peritoneal macrophages that were stimulated in vitro with Candida albicans (CA). Also examined were the inhibitory effects of IL-10 on the CA-induced expression of KC gene by Northern blot analysis. CA was found to induce chemokine gene expression in a gene-specific manner, CXC chemokine IP-10 mRNA expression was not detected in CA-stimulated macrophages. Maximum KC mRNA expression was observed approximately 2 hr after adding CA. The inhibitory action of IL-10 to CA-induced KC mRNA expression on mouse peritoneal macrophages was independent on concentration and stimulation time of IL-10 and was observed approximately one hour after adding IL-10 and CA simultaneously. IL-10 produced a decrease in the stability of KC mRNA, and CA-stimulated macrophages with cycloheximide blocked the suppressive effect of IL-10. These results suggest that CA also induces chemokine KC from macrophages, and IL-10 acts to destabilize CA-induced KC mRNA and de novo synthesis of an intermediate protein is a part of the IL-10 suppressive mechanism.
Animal ; Blotting, Northern ; Candida albicans/metabolism* ; Cells, Cultured ; Chemotactic Factors/genetics* ; Dactinomycin/pharmacology ; Dose-Response Relationship, Drug ; Gene Expression Regulation/drug effects* ; Growth Substances/genetics* ; Interleukin-10/pharmacology* ; Interleukin-10/metabolism ; Macrophages/physiology* ; Mice ; Mice, Inbred BALB C ; Nucleic Acid Synthesis Inhibitors/pharmacology ; RNA, Messenger/metabolism ; RNA, Messenger/drug effects

BACKGROUND: The present study aimed at identifying the difference in the risk of microalbuminuria among individuals with various obesity phenotypes in terms of metabolic health and obesity. METHODS: This cross-sectional study included 15,268 individuals and used data from the National Health and Nutrition Survey conducted from 2011 to 2014. Obesity was defined as body mass index ≥25 kg/m2. Metabolically unhealthy was defined as meeting two or more of the following criteria: systolic and diastolic blood pressure ≥130/85 mm Hg or current use of hypertensive drugs; triglyceride level ≥150 mg/dL; high-density lipoprotein level < 40/50 mg/dL (in both men and women); and fasting blood glucose level ≥100 mg/dL or current use of oral antidiabetic medications. The participants were further classified into four subgroups: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). RESULTS: A significant difference was observed in the microalbuminuria ratio among the four groups. The MHNO group was considered as the reference group, and the MHO, MUNO, and MUO groups were at an increased risk for microalbuminuria by 1.42 fold (95% confidence interval [95% CI], 1.03–1.96), 2.02 fold (95% CI, 1.61–2.53), and 3.40 fold (95% CI, 2.70–4.26), respectively, after adjusting confounding factors. CONCLUSION: The MUNO group had a higher risk of developing microalbuminuria than the MHNO group. Thus, based on this result, differences were observed in the risk of developing microalbuminuria among individuals with various obesity subtypes.
Albuminuria ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Creatinine ; Cross-Sectional Studies ; Fasting ; Humans ; Lipoproteins ; Male ; Metabolic Diseases ; Nutrition Surveys* ; Obesity* ; Phenotype* ; Triglycerides

This study was to investigate clinical characteristics and any differential trends in survival among renal replacement therapy (hemodialysis [HD], peritoneal dialysis [PD], and kidney transplantation [KT]) in Korean end-stage renal disease (ESRD) population. We tried to analyze retrospectively the survival rate adjusted by risk factors and the relative risk stratified by key risk factors among 447 ESRD patients who began dialysis or had a kidney transplant at Ajou University Hospital from 1994 to 2004. In adjusted Cox survival curves, the KT patients had the best survival rate, and the HD patients had better survival than PD patients. The consistent trends in different subgroups stratified by age and diabetes were as following: 1) The risk of death for PD and HD was not proportional over time, 2) The relative risk of PD was similar or lower than that of HD for the first 12 months, but it became higher at later period. The significant predictors for mortality were age (over 55 yr), presence of diabetes, cerebrovascular accident at ESRD onset, and more than one time of hospitalization caused by malnutrition. Further large-scaled, multicenter-based comparative study is needed in Korean ESRD patients and more meticulous attention is required in high-risk patients.
Survival Analysis ; Renal Replacement Therapy/*mortality ; Morbidity ; Middle Aged ; Male ; Kidney Transplantation ; Kidney Failure, Chronic/*mortality ; Humans ; Follow-Up Studies ; Female ; Aged ; Adult

BACKGOUND: The progression rate of IgA nephropathy is known to be variable. We tried to draw an equation that can predict the interval till end stage renal disease (ESRD). METHODS: We retrospectively checked the risk factors of the progression such as demographic, clinical, laboratory, and histologic data by using simple linear regression in eighty eight (M:F=53:35) patients with biopsy-proven IgA nephropathy from Oct 1994 to Aug 2004. By multiple linear regression, a semiquantitative equation estimating the rate of progression was developed. We also evaluated whether there is a "point of no return" that progresses to ESRD which was shown by D'Amico ('93) and Scholl ('99) by receiver operating characteristic (ROC) curve analysis. RESULTS: Mean age and follow-up period were 34.1+/-13.6 years and 55.7+/-31.4 months. Among the risk factors, spot urine protein to creatinine ratio and mean arterial pressure during the follow-up period were significantly associated with the rate of progression (p<0.05). A semiquantitative equation estimating the rate of progression using the two factors was developed as follow. (delta)CCr=2.206-(0.128 x PCR(follow-up))-(0.023 x MAP(follow-up)) (MAPfollow-up:mean arterial pressure; regression coefficient=-0.023, PCRfollow-up:spot urine protein/creatinine; regression coefficient=-0.128). By ROC curve analysis, all patients with maximum serum creatinine over 4.1 mg/ dL during follow-up were found to progress to ESRD. CONCLUSION: We conclude that in Korean IgA nephropathy patients we could predict the rate of decline in renal function for individual patients semiquantitatively and we could confirm the existence of a "point of no return" during the course of IgA nephropathy.
Arterial Pressure ; Creatinine ; Follow-Up Studies ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Kidney Failure, Chronic ; Linear Models ; Retrospective Studies ; Risk Factors ; ROC Curve

BACKGROUND: The question of which dialysis modality should be recommended to end-stage renal disease (ESRD) patients with a history of coronary artery disease (CAD) is encountered frequently in clinical practice, and the answer is still controversial. We tried to explore the patient's survival difference by the dialysis modality in incident ESRD patients with CAD. METHODS: We retrospectively analyzed survival differences by dialysis modality in 56 new ESRD patients with preexisting CAD (HD: PD=30: 26) at yearly intervals with Poisson regression from September 1994 to February 2000. We also investigated the predictors of mortality with multivariate analysis by time-dependent Cox regression. RESULTS: There were no significant differences in age, sex, diabetes, co-morbidity, severity of CAD on commencement of dialysis between HD and PD patients with CAD. Cardiovascular deaths were observed in only HD group. In the CAD group, the relative risk (RR) of mortality in HD patients was equal or higher than that in PD patients for the first 3 years, but RR became lower in HD patient after 3 years. The significant predictors of mortality in CAD group were age, diabetes, arrhythmia and history of cardiac arrest at the time of dialysis initiation. CONCLUSION: When we choose a dialysis modality in incident ESRD patient with preexisting CAD, we could consider an early survival benefit of PD over HD and integrated dialysis approach as a treatment option in this patient group. Further investigation including control group is needed to evaluate in the multicenter, large-scaled manner.
Arrhythmias, Cardiac ; Coronary Artery Disease* ; Coronary Vessels* ; Dialysis* ; Heart Arrest ; Humans ; Kidney Failure, Chronic* ; Mortality ; Multivariate Analysis ; Retrospective Studies

BACKGROUND: Diabetic nephropathy is the main cause of the end-stage renal disease in Korea. This study was performed to evaluate the progression pattern and risk factors of diabetic nephropathy in type 1 diabetes patients. METHODS: Total 64 patients who were registered in Ajou University Hospital since April 1994 till April 2004 were enrolled. We retrospectively analyzed the influence of systolic and diastolic blood pressure, serum creatinine, total cholesterol, albumin, HbA1c and urine albumin excretion on the rate of decline in creatinine clearance (CCr) by Cockcroft- Gault equation. RESULTS: The patients (27 males/37 females), aged 32.8+/-9.1 (mean+/-SD) years, with a mean duration of diabetes of 9.5+/-4.9 years, were followed more than 6 months. CCr were 113.0+/-20 mL/min/1.73m2 at diagnosis and a mean decrease rate was 3.8+/-3.6 mL/ min/1.73m2/year. Doubling time of serum creatinine was 13.1+/-3.2 year in patients who developed doubling of their creatinine (26.6%). Microalbuminuria and overt proteinuria developed at 8.1+/-2.5 year and at 11.4+/-1.5 year after the diagnosis of type 1 diabetes respectively. A mean decrease rate of CCr was 6.1+/-2.9 mL/min/1.73m2/year in patients who develop ESRD after 14.2+/-2.8 years. During the follow up, systolic and diastolic blood pressure, serum total cholesterol were significantly higher and the mean serum albumin and creatinine clearance were significantly lower in chronic renal failure (CRF) group compared to non-renal failure (non-CRF) group (p< 0.05). There was no significant difference in HbA1c between CRF and non-CRF groups. CONCLUSION: The results may suggest that Korean type 1 diabetes patients with diabetic nephropathy in Ajou hospital have a rather faster decline in kidney function compared with other reports. But we need further prospective study to confirm this findings.
Blood Pressure ; Cholesterol ; Creatinine ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies* ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney ; Kidney Failure, Chronic ; Korea* ; Proteinuria ; Retrospective Studies ; Risk Factors ; Serum Albumin