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*

Red blood cells that agglutinate with most normal adult sera but never with own sera are termed polyagglutinable and can be separated by patterns of lectin reactivity into various types. Among these polyagglutination, activation of the T cryptantigen occurs when carbohydrate structures on glycophorins A and B lose sialic acid and express the disaccharide Gal beta-l-3 GalNac which reacts with the peanut agglutinin, a lectin from Arachis hypogaea. T activation is a temporary condition due to exposure of the membrane antigen to the action of microbial neuraminidase. In T activated red cells, the following hazards, which are theoretically possible, are spontaneous polyagglutination of red cells in vitro, in vivo and severe blood transfusion reactions. We experienced a case of T activation in 6 month old girl with bacterial meningitis caused by Streptococcus pneumoniae. The reactivity to lectins indicated the patient's red cells were T activated. We report a case of T activation in an infant with the review of literature.
Adult ; Arachis ; Blood Transfusion ; Erythrocytes ; Female ; Glycophorin ; Humans ; Infant ; Lectins ; Membranes ; Meningitis, Bacterial ; N-Acetylneuraminic Acid ; Neuraminidase ; Peanut Agglutinin ; Streptococcus pneumoniae

Apert described acrocephalosyndactyly as a clinical entity in 1906. At first he included a patient with craniofacial deformities combined with syndactyly of both the upper and lower extremities. This is a rare congenital disturbance in the growth of bone and soft tissue affecting principally the head, the hands and the feet. More than 200 cases have been reported in the world literature, and three cases in Korea. Authors experienced one case of the classic pattern of Apert's syndrome and treated surgically for syndsctyly.
Acrocephalosyndactylia ; Congenital Abnormalities ; Foot ; Hand ; Head ; Humans ; Korea ; Lower Extremity ; Syndactyly

No abstract available.
Diethylstilbestrol* ; Female ; Humans ; Lymphocytes* ; Siblings* ; Sister Chromatid Exchange*

The mandible has a smaller support area than the maxilla, and in particular, in patients with generalized alveolar bone resorption, the stability of the denture and the masticatory efficiency are significantly low in the case of conventional complete denture, due to the movement of the tongue and mandible. In these patients, implant overdenture is evaluated as a highly predictable treatment method with high retention and stability, and excellent pronunciation and masticatory force. In this clinical case, patient had an edentulous maxilla and generalized alveolar bone resorption in mandible. Therefore, complete denture was placed in the maxilla and implant overdenture using milled bar attachment on 4 implants was placed in the mandible. During the 12-year follow-up period, changes in periodontal tissue and denture around the implants were periodically managed and observed.

BACKGROUND: Urinary tract infections (UTIs) are the most frequent nosocomial infections and are frequently associated with indwelling urinary catheters. It is known that adherence to standard infection control measures for urinary catheters can reduce UTIs in hospitals. This study was performed to evaluate the effect of education in reducing catheter-related UTIs (CR-UTIs) in intensive care units (ICUs) of a university hospital. METHODS: CR-UTIs were prospectively monitored for all patients with indwelling urinary catheters in ICUs from July 2006 through December 2007. Recommendations based on previously known guidelines for catheter insertion, catheter management, and specimen collection to prevent CR-UTIs were formulated and educated in March 2007. Knowledge and adherence level were evaluated before and after educating healthcare workers about the recommendations using questionnaire. Changes in knowledge and adherence level before and after education were compared by Chi-square test. Changes in the rate of CR-UTIs and urinary catheter utilization ratios were also analyzed by Fisher's exact test. RESULTS: After education, knowledge level of and adherence level to most of the recommendations were improved significantly. The rate of CR-UTIs significantly decreased by 48% from 7.43/1,000 catheter-days before intervention to 3.87/1,000 catheter-days after intervention (P=0.02). CONCLUSION: Surveillance for nosocomial infections and education for standard infection control measures are very important in preventing CR-UTIs in ICUs.
Catheters ; Cross Infection ; Delivery of Health Care ; Humans ; Infection Control ; Critical Care ; Intensive Care Units ; Prospective Studies ; Specimen Handling ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections ; Surveys and Questionnaires

No abstract available.
Cerebrospinal Fluid* ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Mycobacterium tuberculosis* ; Mycobacterium* ; Tuberculosis, Meningeal*

MR finding of melanoma shows peculiar signal intensity based on paramagnetic effect of melanin or intratumoral hemorrhage, which displays decreased T1 and T2 relaxation times in many cases. Authors report MR findings in two cases of intracranial metastatic melanoma, which is pathologically confirmed by operation.
Hemorrhage ; Magnetic Resonance Imaging* ; Melanins ; Melanoma* ; Relaxation

We report a case of congenital giant pigmented nevus with malignant melanoma of brain in a 14-year-old male patient. He had giant pigmented nevus on the back and neck, and multiple satellite lesions over the whole body since birth. One year prior to visit to our hospital, the patient suffered from various neurologie symptoms including headache, nausea, vomiting, seizure and right side motor weakness. Flistologic findings of skin lesions were benign nevocytic nevi. Computed tomogram of brain demonstrated increased densities in the both fronto-parietal leptameninges and brain parenchyme. Histologic findings of brain parenchyme by stereotaxic long needle biopsy showed the infiltration of melanin containing atypical melanocytes. There was no evidence of malignant melanoma at other organs. All of these findings suggested that origin of malignant melanoma of brain parenchyme was leptomeninges rather than skin.
Adolescent ; Biopsy, Needle ; Brain* ; Headache ; Humans ; Male ; Melanins ; Melanocytes ; Melanoma* ; Nausea ; Neck ; Nevus ; Nevus, Pigmented* ; Parturition ; Seizures ; Skin ; Vomiting