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

PURPOSE: This study was designed to explore the relationship of situational meaning with maternal self-esteem in mothers with high risk newborn. METHOD: The subjects of this study were 82 mothers with high risk newborn. Data were collected using a translated Family Meaning Attribution Scale and Maternal Self-Report Inventory. Data were analyzed using descriptive statistics, t-test, Pearson Correlation Coefficients and Stepwise Multiple Regression. RESULT: The average score of the situational meaning in high risk newborn mothers was 64.01(possible score is between 0-96) and the average score of each item was 1.98. The average score of the maternal self-esteem in high risk newborn mothers was 81.96(possible score is between 26-104) and the average score of each item was 3.15. No significant differences were found in situational meaning according to general characteristics except whether it was a planned pregnancy or not. No significant differences were found in maternal self-esteem according to general characteristics except disease or admission experience during pregnancy. There was significant positive correlation between situational meaning and maternal self-esteem. CONCLUSION: It is necessary for nurses to provide high risk newborn mothers with care for improving situational meaning that is attributed to the mothers. It can be helpful to improve maternal self-esteem and in the end it will facilitate the maternal transition in mothers with high risk newborn.
Adult ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/*psychology ; *Infant, Premature ; *Maternal-Child Nursing ; Mothers/*psychology ; Pregnancy ; *Self Concept ; Socioeconomic Factors

PURPOSE: The purpose of this study was a comprehensive understanding about maternal transition in mothers with high risk newborns according to the degree of situational meaning. METHOD: A methodological triangulation that combines qualitative and quantitative methods was used. The situational meaning of a high risk newborn mother was identified using a Family Meaning Attribution Scale. According to the degree of situational meaning, in-depth interviews were conducted at 3 time periods postpartum : between 3-10 days after childbirth, around the time of the newborn's discharge, and between 10-12 weeks after childbirth. Quantitative data was analyzed using descriptive statistics and t-test. Qualitative data was analyzed using Tutty, Rothery, & Grinnell's methodology. RESULT: The average score of the situational meaning in high the risk newborn mother was 53.57(possible score is between 0-96) and the average score of each item was 1.67. A Maternal transition process in the mother that has a positive situational meaning was conceptualized in three distinctive phases : confusion, accepting, and shaping phases. The Maternal transition process in the mother that has a negative situational meaning was also conceptualized in three distinctive phases : avoiding, conflicting, and accepting phases. CONCLUSION: It is necessary that the nurses provide high risk newborn mothers with individualized care considering both the situational meaning that is attributed to them and the maternal transition phase that they are faced with.
*Adaptation, Psychological ; Adult ; Female ; Humans ; Infant, Newborn ; *Infant, Newborn, Diseases ; Mothers/*psychology ; Risk Factors

The ideal breast reduction should create beautiful breasts with limited scars. Unfortunately, no surgeon has ever been able to produce such a result. Most recent breast reduction techniques tend to produce minimal breast scars and avoid the classic inverted-T incision. The vertical mammaplasty can be used in mild to moderate cases of breast reduction, producing consistently good, stable results with limited scars. This technique uses adjustable preoperative markings, an upper pedicle for the areola, and a central breast reduction with limited skin undermining. The shape of the breast is created by suturing of the gland and does not rely on the skin. The adjunctive use of liposuction in fatty breasts can be considered safe and efficient. We have performed reduction mammaplasty using the vertical mammaplasty technique in 12 patients. Overall number and extent of complications were small, and patient satisfaction was high for this procedures. The advantages of vertical mammaplasty technique compared with other methods are as follows ; 1. The markings are adjustable to nearly all patients. 2. Stable contours are produced because the gland is strongly sutured. 3. Few postoperative complications occur. 4. Limited scars(only vertical scars) are created 5. The procedure is easy to learn and perform.
Breast ; Cicatrix ; Female ; Humans ; Lipectomy ; Mammaplasty* ; Patient Satisfaction ; Postoperative Complications ; Skin

Since 1981 there have been many clinical and experimental reports of venous skin flap, which was nourished solely by venous blood, or by arteria1 blood flowing through the venous network. But, the mechanism of survival has not been completely understood. Unfortunately, partial flap necrosis and unstable postoperative recovery course make surgeons hesitant in choosing the venous flap. In order to increase the survival of a venous flap, surgical delay procedure or increasing the number of draining veins have been successfully tried. Historically, tissue expansion has the same effect on skin vascularity as delaying the area The increase in the caliber of the blood vessels and adequate neovascularization of the expanded tissue can increase the size and vascularity of the flap while allowing primary closure of the donor defect. In order to investigate the survival pattern of expanded arterialized venous flap, the author conducted the following study. The arterialized venous flaps were divided into control and two experimental groups. The conventional nonexpanded arterialized venous flap of 5x5 cm in size was used as control group On experimental group I, preoperative tissue expansion was performed during 3 weeks, and then arterialized venous flap with the same size was made. On experimental group II, expanded arterialized venous flap with 10x10 cm in size was made. The mean survival rate of control, experimental group I and II was 81.2%, 98.8% and 99.1%, respectively. The angiogram of expanded flap showed dilatation of the vessels and neovascularization with tortuous vessels to the peripheral area of the flap. In conclusion, the survival of expanded arterialized venous flap was superior than that of conventional arterialized venous flap. The expanded venous flaps appear to be useful in producing large flaps, in decreasing marginal necrosis of the flap as well as minimizing donor defect.
Blood Vessels ; Dilatation ; Humans ; Necrosis ; Skin ; Surgical Flaps ; Survival Rate ; Tissue Donors ; Tissue Expansion ; Veins

Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

Mesenteric lymphadenitis due to Yersinia enterocolitica infection is not common in Korea. Although most cases of Yersinia enterocolitica-induced mesenteric adenitis are self limited, cardinal features of Yersinia enterocolitica-induced mesenteric adenitis are so similar to those of acute appendicitis that some of the patients undergo laparotomy with suspected appendicitis. The findings on laparotomy in such patients are usually enlarged mesenteric nodes with a normal or slightly inflamed appendix. Because histologic examination of the removed mesenteric lymph nodes reveals reactive hyperplasia in most cases, it is usually difficult to suspect Yersinia enterocolitica infection on morphology of the resected nodes. But suppurative granulomata of mesenteric lymph nodes, uncommonly encountered in Yersinia enterocolitica infection, strongly suggest yersinial infection. We report a case of mesenteric lymphadenitis in a 10-year-old boy, who underwent laparotomy with suspected acute appendicitis. The removed lymph node showed several suppurative granulomata in the cortex, suggesting yersinial infection. Serologic study confirmed Yersinia enterocolitica serotype O:3 infection.
Appendicitis ; Appendix ; Child ; Humans ; Hyperplasia ; Korea ; Laparotomy ; Lymph Nodes ; Lymphadenitis ; Male ; Mesenteric Lymphadenitis* ; Yemen ; Yersinia enterocolitica* ; Yersinia*

Urine discoloration occurs in the intensive care unit (ICU) due to many causes such as medications, metabolic disorders, and infections. Propofol is advocated as one of the first line sedatives in the ICU, but it is not well known to the intensivists that propofol can induce urine color change. We experienced two cases of green urine after propofol infusion. Propofol should be warranted as the cause of urine discoloration during ICU stay.
Hypnotics and Sedatives ; Intensive Care Units* ; Propofol*

PURPOSE: This cross-sectional study was designed to identify anger-expression typesof adolescent women and investigate the relation between the identified anger-expression types and their problem behaviors and health status. METHOD: One hundred ninety nine high school freshmen were recruited from September to November, 2003. Data wasanalyzed using descriptive statistics, cluster analysis, chi-square-test, ANOVA, and Duncan's multiple comparison test. RESULT: Three anger-expression types in adolescent women were found; Anger-out/in, Anger-control/in, and Anger- control type. Adolescent women with frequently using the anger-out/in type and with higher state anger reported more delinquent behaviors, more health risk behaviors, and higher psychosomatic symptoms. However, adolescent women with lower state anger and frequently using the anger-control type reported more depression scores. CONCLUSION: There is a need to further clarify the relationship between anger-expression typesand depression in adolescent women. The findings suggest the necessity of a development of the program for lowering the anger level and controlling the unfavorable anger expression types such as the anger-out in.
Adolescent ; *Adolescent Behavior ; *Anger ; Cross-Sectional Studies ; *Expressed Emotion ; Female ; *Health Status ; Humans ; Male ; Risk-Taking

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs