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.
Chondrosarcoma*

No abstract available.
Humans

No abstract available.
Fibroma*

Three cases of spondyIolysis were experienced and treated by anterior interbody fusion of the involved spines at the department of orthopaedic surgery in the Taegu Hospital One case was accompanied with severe lumbago with radiating pain and other two cases with lumbago significantly. Review of literature was done with report of three cases of spondylolysis.
Daegu ; Low Back Pain ; Spinal Fusion ; Spine ; Spondylolysis

No abstract available.

No abstract available.
Heart Valve Prosthesis* ; Heart Valves*

Several techniques are now avallable for the treatment of fractuers of the shaft of the femur. We must be aware of the advantages, disadvantages and Ilmitation of each if we are to select the proper treatment for each patient. During last decades treatment had been varied markedly from time to time and from place to place. Before Word War II, most fractures of the femoral shaft were treated conservatively either by skeletal traction or by manipulation and immobilization in a spica cast. After medullary fixation was Introduced during that war, it became popular, and until 1960 many surgeons considered it as the treatment of choice for most of these fractures. If the case is properly selected the medullary fixation is almost perfect, provlded no complications develop; convalescence can be shortened and resldual disability can be decreased. We had experienced 14 complications among the 78 cases of Kuntscher nailing from may, 1974, to May, 1980. The results are as follows: 1. We operated 78 cases with Kuntscher nail among the 121 femoral shaft fractures. 2. 14 (17.95%) complications developed among the 78 cases of the Kuntscher nailing. 3. Technical errors were incarcerated nailing with thick nail, too long nail and thin nailing. 4. Early postoperative complications within a year were infection, bendlng, bursitis, angulation and rotation. 5. Late complications after one year were proximal or distal migration and refracture.
Bursitis ; Convalescence ; Femur ; Humans ; Immobilization ; Postoperative Complications ; Surgeons ; Traction

Cushing's syndrome associated with nodular adrenal glands will be divided into four main categories: adrenal adenoma, adrenal carcinoma, primary pigmented nodular adrenal dysplasia (PPNAD) and macronodular adrenal hyperplasia(MAH). The term macronodular adrenal hyperplasia is restricted to the presence of multiple nodules visible to the naked eye, ranging in size from 0.5 to 7.0 cm. We report a case of Cushings syndrome caused by bilateral macronodular adrenal hyperplasia (MAH). A 45-year-old man presented with Cushingoid features, hypertension and diabetes mellitus. Urine free cortisol was 449.9 mmol/day(27-276) and were not suppressed after administration of low-dose and high-dose dexamethasone. Plasma ACTH was very low(1.87 pmol/L(18)) and was not stimulated by administration of ovine CRH. In abdominal CT, both adrenal glands were markedly enlarged and nodular in appearance. Pituitary MRI showed no abnormal finding. Bilateral adrenalectomy was done. Histologic examination revealed multiple nodules and internodular hyperplasia. This case and other reports suggested that because of variable biochemical, radiologic and pathologic findings, macronodular adrenal hyperplasia represents a heterogeneous group of patients with varying degrees of adrenal autonomy.
Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome ; Dexamethasone ; Diabetes Mellitus ; Humans ; Hydrocortisone ; Hyperplasia ; Hypertension ; Magnetic Resonance Imaging ; Middle Aged ; Plasma ; Tomography, X-Ray Computed

Background: Whole body scan using 131-iodine is performed to detect local recurrence or metastasis after thyroidectorny in differenciated thyroid cancer patients. The sensitivity of this procedure is related to the dose of radiopharmaceutical administered. It was reported that 131I posttreatment whole body scan demonstrate foci of tracer uptake not previously observed in diagnostic scan in 10~30% of cases. Posttreatment scans were most likely to reveal new foci in young patients(<45) and patients who had previously received radioactive iodine therapy. Method: We observed the frequency of discordant posttreatment scans and analysed the clicnical significance in 33 differenciated thyroid cancer patients who were admitted for radioiodine ablation from June, 1995 to April, 1996. Results: In 7 cases(21.2%), post treatment scan demonstrated cme or more foci of uptake and revealed less sites of uptake than diagnostic scan in 3 cases(9.1%). In one case with elevated thyroglobulin level and negative diagnostic scan, post treatment scan revealed new uptake sites with thyroid bed and cervical 1ymph node. The sites of discordant uptake were cervical lymph nodes in 4 cases and rnediastinal lymph node in one case, lung in one case, thyroid bed and cervical lymph nodes in one case, 3 cases of 7 pts(43%), demonstrated ane or more foci of uptake in post treatment scan, had history of previous radioiodine treatent. Conclusion: Post treatment scan confirmed uptake into remnant and metaststic tissues identified on the corresponding low dose diagnostic scans. Scanning after high dose radioiodine treatment frequently demonstrated one or more foci of uptake, especially in patients with previous radioiodine treatment, which were not visualized on the diagnostic low dose scan. Treatment scan may be useful for detection of remnant tissue or metastatic lesion in patients with elevated thyroglobulin and negative diagnostic scan.
Humans ; Iodine ; Lung ; Lymph Nodes ; Methods ; Neoplasm Metastasis ; Recurrence ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Whole Body Imaging