BACKGROUND: White coat effect (WCE) and white coat hypertension (WCH) are relatively prevalent in clinical situation (20 - 57% of WCH in the hypertensive population). The aim of this study was to analyze the determinant factors of WCE. METHODS: A prospective study was carried out in outpatient clinic in a consecutive hypertensives without receiving pharmacologic treatment. Twenty-four hour ambulatory blood pressure monitoring (ABPM) was performed following more than two resting blood pressure (BP) determinations carried out with the interval of 1 - 2 weeks by mercury sphygmomanometer. WCE was calculated for systolic and diastolic BP as the difference between a clinic BP (CBP) and an average daytime ambulatory BP (ABP). WCH was defined as;BP in the clinic > or = 140/90 mmHg with a mean daytime BP by ABPM < or =137/< or =89 mmHg. RESULTS: 1) Two hundred thirty-five patients (mean age 49.7 years, females 74%) were studied. Thirty-seven percent in male and forty-six percent in female patients fulfilled WCH criteria. 2) CBP was significantly correlated to daytime ABP (systolic BP;r=.47, p<.001 and diastolic BP;r=.65, p<.001). 3) The magnitude of WCE was greater in the group of WCH (28.9+14.6/19.3+6.9 mmHg) than ambulatory hypertensives (15.1+15.7/13.0+8.2 mmHg) (p<.001). 4) The magnitude of WCE is significantly correlated with female (r2=.12, p<.001) and the stage of CBP according to JNC-V (r2=.23, p<.001) in systolic BP, the stage (r2=.08, p<.001) in diastolic BP, and the stage (r2=.09, p<.001) and weight (r2=.15, p<.01) in mean BP. CONCLUSIONS: The magnitude of WCE in essential hypertension diagnosed at the clinic is significantly correlated with female, the magnitude of clinic BP, and weight.
Ambulatory Care Facilities ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension* ; Male ; Prospective Studies ; Sphygmomanometers ; White Coat Hypertension

No abstract available.
Female ; Humans ; Plasma* ; Pregnant Women*

No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

DSA(Digital Subtractin Angiography) is a valuable diagnostic imaging method in many clinical fields, includingranal-related conditons. Sixty four renal DSA examinations were performed in 59 patients with renal-relateddiseases from Jan. 1984 to Dec. 1985. Summary of these were as follows: 1. Intraarterial (IA)-DSA is performed in6 cases, intravenous(IV)-DSA in 58 cases. In 58 Examinations of IV-DSA, diagnostic image quality is obtained in 51cases(88%). 2. In investigations of a possible renovascular etiology of hypertension, IV-DSA,is a safe, sensitiveand accurate method. On screening for evaluation of renovascular hypertension, RSP should be replaced with IV-DSA,because IV-DSA is moe sensitive and accurate and can detect not only anatomic change of renal arttery but alsofunctional hemodynamic change. 3. IV-DSA is valuable in diseases with morphologic changes of vessels. Incharacterization of a known renal mass, and evaluation of hematuria, suspected aneurym and renal trauma, IV-DSA isvery useful diagnostic imaging modality. 4. In evaluation of potential renal donors, IV-DSA is an accurate andsafe method with 82.4% of accuracy. IV-DSA also is useful in follow-up of allograft recipients. 5. Ininvestigation of diabetic nephropathy, glomerulonephritis, pyelonephritis, IV-DSA is little helpful. 6. Theadvantages of DSA are well known, particularly post-procedure process using computer programs is helpful forobtaining informations of hemodynamic change or time-sequence-curve of density etc. More technical improvementwith this modality is required for improvement of the image quality and resolution. And more accumulation ofclinical experience is required in order to increase the diagnostic accuracy.
Allografts ; Angiography, Digital Subtraction ; Diabetic Nephropathies ; Diagnostic Imaging ; Follow-Up Studies ; Glomerulonephritis ; Hematuria ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Renovascular ; Mass Screening ; Methods ; Pyelonephritis ; Tissue Donors

PURPOSE: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. RESULTS: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). CONCLUSION: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
Biopsy ; Carcinosarcoma ; Follow-Up Studies ; Humans ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors

Barrett's esophagus is a metaplastic process in which the squamous epithelium of the lowet esophagus is replaced by columnar epithelium. Most cases are believed to be related to prolonged gastroesophageal reflux. Detection of Barretts esophagus is important in that it results in adenocarcinoma in about 10% of patients. We report a case of adenocarcinoma arising from Barrett's esophagus in a 56 year-old man, diagnosed incidentally at a physical check-up. Grossly, the esophagogastric junction was irregular and there were two small ulcers in the lower esophagus. Microscopically, ihe squamous epithelium of the lower hagus was replaced by specialized intesinal mucosa with a small focus of adenocarcinona confined to the submucosa in one area. Many separate dysplastic foci were also present in the nearby esophageal mucosa.
Adenocarcinoma* ; Barrett Esophagus* ; Epithelium ; Esophagogastric Junction ; Esophagus* ; Gastroesophageal Reflux ; Humans ; Intestines* ; Middle Aged ; Mucous Membrane ; Stomach* ; Ulcer

No abstract available.
Child* ; Evoked Potentials, Auditory, Brain Stem* ; Humans

BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

We report a caae of hepatic and intestinal infestation with paragonimus wewstermani complicating abscess formation. The pathway by which the paragonimus westermani reaehea liver and intestine is not well understood. However, there was possiblity that it may become lodged in other organs that the lung because of polonged larval migrations through the diaphragm or into various sites in the abdomen. The patient, 52-year-old female gave a history of having reyeatedly consumed raw crabs. An x-ray film of the chest showed clear lunga Skin test for paragonimus-westermani was positive. Abdominal ultrasonogram showed enlargement of the liver with multiple hypoechoic lesiona ERCP revealed multiple ie lesions in the right lobe of the liver. Abdaminal CT showed multifocal abscess cavities with slight rim enhancements. Above meetioned diagnostic procedures suggested liver abscess or hepatoma. Then, an exploratory laparotomy was done for a definite diagnosis, Frozen biopsy, from liver and surgically exe mass from ileocecal region revealed extrpulmonary paragnomiasis involving liver and cecum. Thus, the patient was treated with prasiquantel. Three months later, abdominal ultrasonogram demonstrated slight enlargement of the liver but no evidence of abnormal mass like lesions.
Abdomen ; Abscess ; Biopsy ; Carcinoma, Hepatocellular ; Cecum* ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diaphragm ; Female ; Humans ; Intestines ; Laparotomy ; Liver Abscess ; Liver* ; Lung ; Middle Aged ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Praziquantel ; Skin Tests ; Thorax ; Ultrasonography ; X-Ray Film

BACKGROUND: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia. METHODS: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer. RESULTS: The cumulative incidence rate increased with age, consuming > or =3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming > or =3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037). CONCLUSIONS: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.
Edible Grain ; Endoscopy ; Follow-Up Studies ; Gastritis, Atrophic ; Humans ; Incidence ; Life Style ; Metaplasia ; Multivariate Analysis ; Risk Factors ; Smoke ; Smoking ; Stomach ; Stomach Neoplasms