Background: We investigated the changing patterns of insulin secretion and resistance and risk factors contributing to the development of post-transplant diabetes mellitus (PTDM) in kidney recipients under tacrolimus-based immunosuppression regimen during 1 year after transplantation. Methods: This was a multicenter prospective cohort study. Of the 168 subjects enrolled in this study, we analyzed a total 87 kidney transplant recipients without diabetes which was assessed by oral glucose tolerance test before transplantation. We evaluated the incidence of PTDM and followed up the index of insulin secretion (insulinogenic index [IGI]) and resistance (homeostatic model assessment for insulin resistance [HOMA-IR]) at 3, 6, 9 months, and 1 year after transplantation by oral glucose tolerance test and diabetes treatment. We also assessed the risk factors for incident PTDM. Results: PTDM developed in 23 of 87 subjects (26.4%) during 1 year after transplantation. More than half of total PTDM (56.5%) occurred in the first 3 months after transplantation. During 1 year after transplantation, insulin resistance (HOMA-IR) was increased in both PTDM and no PTDM group. In no PTDM group, the increase in insulin secretory function to overcome insulin resistance was also observed. However, PTDM group showed no increase in insulin secretion function (IGI). Old age, status of prediabetes and episode of acute rejection were significantly associated with the development of PTDM. Conclusion In tacrolimus-based immunosuppressive drugs regimen, impaired insulin secretory function for reduced insulin sensitivity contributed to the development of PTDM than insulin resistance during 1 year after transplantation.

Benzalkonium chloride, diazolidinyl urea, and imidazolidinyl urea are commonly used preservatives in cosmetics. Recent reports suggested that these compounds may have cellular and systemic toxicity in high concentration. In addition, diazolidinyl urea and imidazolidinyl urea are known formaldehyde (FA) releasers, raising concerns for these cosmetic preservatives. In this study, we investigated the effects of benzalkonium chloride, diazolidinyl urea, and imidazolidinyl urea on ROS-dependent apoptosis of rat neural progenitor cells (NPCs) in vitro. Cells were isolated and cultured from embryonic day 14 rat cortices. Cultured cells were treated with 1–1,000 nM benzalkonium chloride, and 1–50 μM diazolidinyl urea or imidazolidinyl urea at various time points to measure the reactive oxygen species (ROS). PI staining, MTT assay, and live-cell imaging were used for cell viability measurements. Western blot was carried out for cleaved caspase-3 and cleaved caspase-8 as apoptotic protein markers. In rat NPCs, ROS production and cleaved caspase-8 expression were increased while the cell viability was decreased in high concentrations of these substances. These results suggest that several cosmetic preservatives at high concentrations can induce neural toxicity in rat brains through ROS induction and apoptosis.
Animals ; Apoptosis* ; Benzalkonium Compounds ; Blotting, Western ; Brain ; Caspase 3 ; Caspase 8 ; Cell Survival ; Cells, Cultured ; Formaldehyde ; In Vitro Techniques ; Rats* ; Reactive Oxygen Species ; Stem Cells* ; Urea

PURPOSE: This study was done to identify the effectiveness of the 'intervention - mother's recorded song' on low-birth weight infants in an neonatal intensive care unit (NICU). METHODS: This study was conducted with a nonequivalent control group pre-posttest quasi-experimental design and the participant group was low-birth weight infants who were admitted to the NICU. Forty-eight infants, 24 in each from two groups, the experimental and control group, participated in the study. RESULTS: For physical response according to vital signs, there were no significant statistical differences in heart rate, respiration rate and pulse oximetry saturation between the experimental group and the control group. For behavioral state, there was a significant statistical difference between the experimental and control group. CONCLUSION: The study results indicate that the intervention using mother's song had some significance as a nursing intervention with positive impacts. Such an intervention can help pediatric nurses improve infants' stabilization of their vital signs and behavioral states. By showing the effectiveness of such an intervention, the results of this study provide further evidence-based information in developing the practice of pediatric nursing.
Heart Rate ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Clinical Trial ; Mothers ; Oximetry ; Pediatric Nursing ; Respiratory Rate ; Singing ; Vital Signs

PURPOSE: Instead of a chaotic non circadian environmental approach, continuing regular day-night rhythm in neonatal nurseries may benefit the development of preterm infants. The purpose of this study was to define the effects of cycled lighting on circadian rhythms of premature infants. METHODS: The experimental group included 15 preterm infants, and the control group, 15 premature infants in the NICU of a general hospital in Seoul. All infants were between 32 and 37 weeks' postconceptional age. The experimental group infants were provided with cycled lighting before discharge. The incubator or bassinet cover of the experimental group was off between 7 AM and 7 PM, and was covered between 7 PM and 7 AM. RESULTS: There were significant differences in the NNNS score (p=.039), and some significant differences in the sleep-activity pattern between the experimental group and the control group, but distinct differences in sleep-activity patterns between the two groups could not be defined. CONCLUSION: The results of this study suggest that cycled lighting can be helpful in the neurobehavioral development of preterm infants. By modifying the NICU environment to provide a more developmentally supportive milieu, nursing professionals can better meet the infants' physiologic and neurobehavioral needs.
Circadian Rhythm ; Hospitals, General ; Humans ; Incubators ; Infant ; Infant, Newborn ; Infant, Premature ; Light ; Lighting ; Nurseries ; Child Health

PURPOSE: This study was conducted to survey children's health status and need of customized visiting health care services in one province. METHODS: The participants in this study were 237 caregivers of infants and preschoolers. Data were collected at the participant's home or public health center. RESULTS: Many of the children did not receive developmental screening tests or dental examinations. In the beneficiary group, the prenatal checkup rate and children's vaccination rate were lower, and caregivers had more health problems than the other groups. On the assessment of home safety, unsafe conditions were more frequently found in the beneficiary group. The caregivers in the beneficiary group showed lower child rearing confidence than the other groups, and wanted customized visiting health care services most in the areas of developmental screening, regular health check-up and counseling, nutritional supplementation, and oral health care. CONCLUSION: These results indicate that it is necessary for children and parents in poverty to be provided with professional home visiting interventions for the promotion of child health and prevention of developmental problems and diseases. These findings can be used for developing future customized visiting health care service programs for infants and children in this community area.
Caregivers ; Child Rearing ; Child Health ; Child* ; Counseling ; Delivery of Health Care* ; House Calls ; Humans ; Infant ; Mass Screening ; Oral Health ; Parents ; Poverty ; Public Health ; Social Class* ; Vaccination

PURPOSE: To develop an Infant Developmental Assesment Scale appropriate for Korean infants that includes cultural context. METHOD: The total sample included 990 infants aged birth to 24months. The developmental tests were conducted at hospital well baby clinic, daycare centers, public health centers and homes located in city, urban and rural areas. Item analysis was done to examine content validity of the scale. Test responses were analyzed by SPSS to examine the inter-rater reliability, and construct validity. RESULTS: Based on the naturalistic observation and analysis of other developmental instruments, 260 Korean infant developmental items were created. The mean score of the developmental quotient of 966 infants was 101.63+/-10.89. Correlation coefficient of inter-rater reliability was .99. In addition, 84.6% of total items showed Kappa .70 and above. The development quotient was significantly different depending upon the residential area and father's occupation, therefore, construct validity using known group technique was supported. CONCLUSION: The developed instrument can be used to assess the development of handicapped infants, as well as normal infant's general abilities and to study individual differences within the normal range for Korean.
Child ; Child Development* ; Disabled Persons ; Equidae ; Health Promotion ; Humans ; Individuality ; Infant* ; Occupations ; Parturition ; Public Health ; Reference Values ; Child Health

PURPOSE: This study was conducted to identify behavioral items for Korean infants under 24months by naturalistic observation. These items will be the basis for developmental scale for Korean infants. METHOD: Data were collected by observing and interviewing fifty one infants and their mothers during the period from November 15 to December 14, 2003. Raw data in descriptive form were obtained by unstructured naturalistic observation, and were reformed to behavioral items through discussion with professors in pediatric nursing and experienced nurses in child care department. Also, behavioral items were classified into five developmental areas. RESULT: Total number of behavioral items was two hundreds and thirty eight. 52 items for motor development, 66 items for personal-social, 40 items for hearing and speech, 41 items for eye-hand coordination, and 39 items for performance. CONCLUSION: This is meaningful that fundamental items for Korean developmental scale for infants were identified by observing behaviors of Korean infants. On the basis of these items, average age will be calculated for passing each item by testing Korean infants. We hope to develop Korean infant developmental scale as a final outcome in the future research.
Child ; Child Care ; Child Development ; Hearing ; Hope ; Humans ; Infant Behavior ; Infant* ; Infant, Newborn ; Mothers ; Pediatric Nursing ; Child Health

BACKGROUND: The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea are limited. OBJECTIVE: The aim of this study was to document the relative occurrence, the clinical and histopathological features of cutaneous lymphomas in Korea. METHODS: The Korean Dermatopathology Research Group conducted a review of nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: Korea has a higher rate of T-cell lymphoma and NK/T cell lymphoma and a much lower rate of cutaneous B cell lymphoma. The relative frequency of the major diagnostic group according to WHO classification was as follows: mycosis fungoides/Sezary syndrome, 42.5%; anaplastic large cell lymphoma, 19%; nasal and nasal type NK/T cell lymphoma, 15%; subcutaneous panniculitis-like T cell lymphoma, 11%; peripheral T cell lymphoma, unspecified, 7.5%; follicular lymphoma, 3%; marginal zone lymphoma, 1%; angioimmunoblastic lymphadenopathy, 1%. Compared with Western countries, the rate of nasal and nasal-type NK/T cell lymphoma and subcutaneous panniculitis-like T cell lymphoma were much higher. Therefore, The EORTC classification is not effective in dealing with Korean cases of cutaneous lymphoma. We consider the principles of the WHO classification are applicable to the Korean cases of cutaneous lymphoma.
Academies and Institutes ; Classification ; Continental Population Groups ; Geography ; Humans ; Immunoblastic Lymphadenopathy ; Korea* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Follicular ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Pathology ; Retrospective Studies

BACKGROUND: Malignant melanoma in Korea has been increasing as in other countries, but there is no nationwide survey of malignant melanoma in Korea. OBJECTIVE: The aim of this study was to document the clinical and histopathological features of cutaneous melanoma in Korea. METHODS: The Dermatopathology Research Group conducted a review of nationwide collection of 109 primary cutaneous melanomas, diagnosed at 23 institutes over a recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: The peak age was the 7th decade with the mean age of 58.1 years. Korea has a higher rate of acral melanoma and much lower rate of lentigo maligna melanoma. .Major component tumor cell was spindle cell type. Clark level of tumor was III or more and Breslow depth was 2mm or more at the time of the first diagnosis in many cases (62%). Pre-existing melanocytic nevus was present in a few cases (3 cases). All these features suggest that the racial difference between the Korean and the Caucasian is evident. We also suggest that an early detection program is very important to cure this malignant tumor.
Academies and Institutes ; Diagnosis ; Humans ; Hutchinson's Melanotic Freckle ; Korea* ; Melanoma* ; Nevus, Pigmented ; Pathology ; Retrospective Studies

The in vitro blood-brain barrier (BBB) model was established with bovine brain microvessel endothelial cells (BBMECs). The characteristics of BBMECs were identified by morphological and functional studies. BBMECs began to grow as spindle shaped cells and distinctly formed the monolayer of whirling appearance by 6 to 7 days after plating. Transendothelial electrical resistance (TEER) of the monolayer increased through 11 days and then started to decrease. The gamma-GTP activity (1791.5+/-397.8 nmol/min/mg of protein) and alkaline phosphatase activity (15.0+/-7.8 micromol/min/mg of protein) were high. BBMECs in culture were characterized by the binding of anti-vWF, anti-ZO-1, anti-vimentin, and anti-fibronectin antibodies. They failed to react with anti-GFAP, anti-GalC, and antineurofilament 160/200 kD antibodies, markers for astrocyte, oligodendrocyte, and neuron, respectively. Decreasing order of the permeability through the BBMEC monolayers of paracellular transport model drugs was mannitol, sucrose, and PEG-4000. The permeability of transcellular transport model drugs, progesterone and propranolol was much higher than that of paracellular transport model drugs. The BBMECs cultured on porous membrane have been qualified as an in vitro BBB model and also can be used for the BBB transport study in the drug development and for the BBB transport mechanism of drugs.