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

Shaken baby syndrome refers to the group of nonaccidental injuries occuring in infants and children as a consequence of violent shaking. The characteristic injuries include subdural and subarachnoid hemorrhages, retinal hemorrhages, traction-typed metaphyseal fracture of long bone and fractures of the ribs. General physical findings may include bruising and burns, but sometimes no extracranial injuries are detected. Affected children are nearly always under 2 years of age or younger. Common symptoms include lethargy, irritability, seizures, increased or decreased muscle tone, poor feeding, impaired consciousness, vomiting and apnea. We experienced a case of shaken baby syndrome in a 3-month-old girl. Although the history of trauma(shaking) is little known, our findings of clinical and radiographic features corresponded to shaken baby syndrome. (J Korean Pediatr Soc 2000;43:851-855)
Apnea ; Burns ; Child ; Consciousness ; Female ; Humans ; Infant ; Lethargy ; Muscle Hypotonia ; Retinal Hemorrhage ; Ribs ; Seizures ; Shaken Baby Syndrome* ; Subarachnoid Hemorrhage ; Vomiting

No abstract available.
Tendon Injuries* ; Tendons*

No abstract available.
Humans ; Infant, Newborn*

No abstract available.

No abstract available.
Erythroblastosis, Fetal* ; Humans ; Immunoglobulin G* ; Infant, Newborn ; Infant, Newborn* ; Mothers*

Epstein's syndrome is a rare disease whish is characterized by the association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness. We experienced a case of Epstein's syndrome in a 12 years old male patient who was presented with a life long history of bleeding, usually as epistaxis, bilateral sensorineural deafness and hematuria with proteinuria starting in late childhood. Hematologic studies showed thrombocytopenia with giant platelets and anemia. A bone marrow aspirate revealed the megakaryocytes to be adequate in number and many giant size platelets. Platelet do not respond to addition of A and epinephrine; collagen and ristocetin induced agglutination response is decreased. It is difficult to be certain the association of thrombocytopenia with giant platelets, nephritis and deafness constitutes a new hereditary disease with a distinct pathogenesis or if it is an expansion of the well recognized Alport's syndrome of hereditary nephritis deafness. We report a case of Epstein's syndrome syndrome with brief review of related literatures.
Agglutination ; Anemia ; Blood Platelets ; Bone Marrow ; Child ; Collagen ; Deafness ; Epinephrine ; Epistaxis ; Genetic Diseases, Inborn ; Hematuria ; Hemorrhage ; Humans ; Male ; Megakaryocytes ; Nephritis ; Nephritis, Hereditary ; Proteinuria ; Rare Diseases ; Ristocetin ; Thrombocytopenia

OBJECTIVE: The present study was undertaken to examine the effects of magnesium ion in the culture medium on the development of mouse fertilized oocytes either before or after pronuclear formation, and to investigate whether the effect of magnesium ion is related with the redistributional change of mitochondria. METHODS: Fertilized oocytes obtained from the oviducts of mice at 15 hr after hCG injection before pronuclear formation (pre-PN) or 21 hr after hCG injection after pronuclear formation (post-PN) were used. The embryos were cultured for 3 days with basic T6 medium-magnesium free and various concentrations of magnesium ion, 0.0, 0.5, 1.0, 2.0, 4.0 or 8.0 mM, respectively. After culture, the developmental stages of embryos and the number of nuclei were evaluated. To observe the effects of magnesium ion on the mitochondrial distribution, fertilized oocytes were collected at 21 hr after hCG injection and cultured for 6 hr with various concentration of magnesium ion. As a control, fertilized oocytes with pronuclei at 27 hr after hCG injection were used. RESULTS: The concentration of magnesium ion to accelerate the in vitro development of mouse fertilized oocytes appeared to be at 2.0 mM for the pre-PN and the post-PN stage embryos. In the mitochondrial redistribution patterns, the embryos cultured in 2.0 mM concentration of magnesium ion showed the highest percentage (22.6%) of distinct perinuclear clustering pattern comparing to other experimental group. CONCLUSION: The effect of magnesium ion may be related to the cytoplasmic redistribution of mitochondria. This relationship seems to connect the developmental competence of preimplantation mouse embryos in vitro. These results can suggest that higher concentration of magnesium ion (2.0 mM) than those of conventional culture medium (0.2~1.2 mM) is more suitable for in vitro culture of preimplantation mouse embryos.
Animals ; Cytoplasm ; Embryonic Structures* ; Magnesium* ; Mental Competency ; Mice* ; Mitochondria ; Oocytes ; Oviducts

PURPOSE: Conventional MRI may not visualize the structural abnoramlity in large proportion of patients with intractable extratemporal lobe epilepsy. METHODS: Five patients with intractable extratemporal lobe epilepsy underwent resective surgery. Preoperatively, all patients underwent video-EEG monitoring using extracranial electrodes and MRI. Three had PET scans and four had MRS. 3D-reconstruction of the MRI was performed in all patients. Then, subdural grid electrodes were implanted on the suspected lesion in 3D-reconstructed brain; One had bitemporal depth electrodes insertion, and subdural grid electrodes implantation on bilateral frontal lobe. Two had frontal resection and including supplementary sensorimotor area in one. Parietal and parieto-temporal resection was performed in each. One had partial occipital lobe resection. RESULTS: All had complex partial seizures and four of them had lateralizing signs. Standard surface EEG recordings were not reliable in lateralizing or localizing the epileptogenic zone in any of patients. Conventional MRI revealed subtle abnormality in the superior parietal lobule, and atrophic changes in parietal lobe and posterior portion of the superior temporal gyrus, in each. Three did not show any structural abnormalities. MRS showed abnormal NAA/Ch: Cr ratio in two; one in the lesion and one in the bilateral hipocampus. PET showed hypometabolism in the extensive area in three with limitation in localizing the epileptogenic zone. All had abnormal gyral and sulcal paterns in 3D-reconstructed brain; two in the frontal lobe, superior parietal lobule, and inferior parietal and posterior portion of the superior temporal gyrus, in each, and one in the occipital lobe. Histopathologic findings revealed cortical dysplasia in all. Three were seizure free and two were class I in Engel's classification during follow-up between 4 to 24 months. CONCLUSIONS: This study suggests that in the surgical treatment of the extratemporal lobe epilepsy without prominent abnormalities in conventional MRI, 3D-reconstruction of the MRI may be of value in localizing the epileptogenic zone.
Brain ; Classification ; Electrodes ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Malformations of Cortical Development ; Occipital Lobe ; Parietal Lobe ; Positron-Emission Tomography ; Rabeprazole ; Seizures

No abstract available.
Leukemia* ; Sweet Syndrome*