OBJECTIVES: In the third trimester hypertensive pregnancies, we would like to evaluate effects of white coat hypertension, severity of hypertension and diurnal variation of blood pressure on the fetal outcome by using 24- hour ambulatory blood pressure monitoring. METHODS: Hypertensives(n=50) and normotensives (n=14) in the third trimester of the pregnancy underwent 24-hour ambulatory blood pressure monitoring. We excluded hypertensives(n=5) who became pre-eclampsia patients. Hypertensives(n=45) were classified as white coat hypertensives(n=14, mean ambulatory blood pressure <139/87mmHg) and sustained hypertensives(n=31). Sustained hypertensives(n=31) were divided as moderate to severe hypertensives(n=5, systolic blood pressure >160 mmHg or diastolic blood pressure >100mmHg) and mild hypertensives(n=26). Sustained hypertensives were also divided into two groups which had diurnal variation of blood pressure or not. To exclude effects of hypertension severity, effects of diurnal variation were evaluated in hypertensives with similar mean arterial blood pressure. Gestational age, body weight, body weight for gestational age were used as parameters of the fetal outcome. RESULTS: 1) The prevalence of white coat hypertension was 28%(14/50). 2) There were no significant differences in the fetal outcome between normotensives(n=14) and white coat hypertensives(n=14). 3) Body weight of fetus and body weight for gestational age in moderate to severe hypertensives(n=5) were less than those of mild hypertensives(n=26), but gestational age was not significantly different between two groups. 4) Body weight of fetus and body weight for gestational age in sustained hypertensives without diurnal variation(n=10) were less than those with diurnal variation(n=8), but gestational age was not significantly different between two groups. 5) All hypertensives who became pre-eclampsia (n=5) were severe hypertensives and had no diurnal variation of blood pressure. CONCLUSION: White coat hypertension in the third trimester was quite often and did not affect on the fetal outcome. The more severe hypertension and/or absence of diurnal variation of blood pressure caused poor fetal outcome. Patients who became pre-eclampsia were severe hypertensives and had no diurnal variation of blood pressure. Ambulatory blood pressure monitoring may have several roles in the antenatal management of hypertenison.
Arterial Pressure ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Body Weight ; Female ; Fetus ; Gestational Age ; Humans ; Hypertension ; Pre-Eclampsia ; Pregnancy Trimester, Third ; Pregnancy* ; Prevalence ; White Coat Hypertension

PURPOSE: The purpose of this study was to assess the current management status of patients with urological issues and to examine the level of knowledge and practice behaviors regarding urinary incontinence (UI) among Korean healthcare providers in long-term care hospitals. METHODS: This study used a cross-sectional descriptive design with a written questionnaire to assess knowledge and practice behaviors of 756 healthcare providers in 11 long-term care hospitals in Korean metropolitan areas. RESULTS: A total 42.6% of participants reported that more than 50% of patients had urologic issues, and that 68.1% of patients were regularly sent to urologists; no participants reported an on-site urologist in their facility. Participants identified collaboration with other hospitals and regular consultations by urologists as important factors in improving urologic care. Although the overall UI knowledge score was upper intermediate, a knowledge deficit was found for risk factors of UI. The knowledge level of physicians was significantly higher than that of other healthcare providers. Practice behaviors of nurses seemed to be better than those of other healthcare providers. CONCLUSIONS: Systematic collaboration between healthcare providers and urologic specialists, enhancing staff competence, and patient-tailored intervention should be recommended to improve quality of care for patients with urologic issues in long-term care hospitals.
Cooperative Behavior ; Delivery of Health Care* ; Health Personnel* ; Humans ; Long-Term Care* ; Mental Competency ; Professional Practice ; Referral and Consultation ; Risk Factors ; Specialization ; Urinary Incontinence*

PURPOSE: Stress urinary incontinence (SUI) commonly occurs in women, and it has an enormous impact on quality of life. Surgery, drugs, and exercise have been recommended for the treatment of this disease. Among these, exercise is known to be effective for the relief of symptoms of SUI; however, the efficacy and underlying mechanisms of the effect of exercise on SUI are poorly understood. We investigated the effect of swimming the symptom of SUI in relation to the expression of nerve growth factor (NGF) in rats. METHODS: Transabdominal urethrolysis was used to induce SUI, in Sprague-Dawley rats. The experimental groups were divided into the following three groups: sham-operation group, transabdominal urethrolysis-induced group, and transabdominal urethrolysis-induced and swimming group. The rats in the swimming group were forced to swim for 30 minutes once daily starting 2 weeks after SUI induction and continuing for 4 weeks. For this study, determination of abdominal leak point pressure and immunohistochemistry for NGF in the urethra and in the neuronal voiding centers (medial preoptic nucleus [MPA], ventrolateral periaqueductal gray [vlPAG], pontine micturition center [PMC], and spinal cord [L4-L5]) were performed. RESULTS: Transabdominal urethrolysis significantly reduced the abdominal leak point pressure, thereby contributing to the induction of SUI. Abdominal leak point pressure, however, was significantly improved by swimming. The expression of NGF in the urethra and in the neuronal voiding centers (MPA, vlPAG, PMC, and L4-L5) relating to micturition was enhanced by the induction of SUI. Swimming, however, significantly suppressed SUI-induced NGF expression. CONCLUSIONS: Swimming alleviated symptoms of transabdominal urethrolysis-induced SUI, as assessed by an increase in abdominal leak point pressure. The underlying mechanisms of these effects of swimming might be ascribed to the inhibitory effect of swimming on NGF expression.
Animals ; Female ; Humans ; Immunohistochemistry ; Nerve Growth Factor ; Neurons ; Periaqueductal Gray ; Quality of Life ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; Swimming ; Urethra ; Urinary Incontinence ; Urination

In this study, we tried to confirm clinically applicable applicability by comparing the difference in 3 point flexural strength and shade of the prosthesis depending on microwave sintering time of dental CAD / CAM zirconia. 3 Point flexural strength specimens (n=30) and shade measurement specimens (n=28) were prepared and sintered at different sintering times. 3 point flexural strength and shade were measured and analyzed by independent t-test (α=0.05). Measurement result of 3 point flexural strength the average of short-term sintering (STS) was 245.47±29.89 MPa, the average of long-term sintering (LTS) was 284.27±31.56 MPa, and there was a statistically significant difference (p < 0.05). The shade measurement result ⊿E*(ab) showed the average STS of 1.51±0.48 and the LTS of 1.52±0.41, but there was no statistically significant difference (p>0.05). The 3 point flexural strength of the zirconia restorations fabricated by short time and long time was high in long time sintering. However, other conditions may be required for clinical applications. Since the shade test did not show any significant color difference according to sintering time, it is considered to be sufficient for clinical application.
Microwaves ; Prostheses and Implants

Small bowel hemangioma is a rare benign lesion, and it usually presents with bleeding or as a leading point of an intussusception. However, obstruction due to intramural hematoma by this lesion is unusual. Intramural hematoma of the duodenum is also an uncommon lesion, and it is usually a complication of blunt abdominal trauma in children and young adults. We present here a case of an intramural hematoma that was caused by spontaneous bleeding of a hemangioma, and this caused duodenal obstruction.
Child ; Duodenum ; Hemangioma ; Hematoma ; Hemorrhage ; Humans ; Intussusception ; Young Adult