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.
Aneurysm* ; Hydrocephalus*

Background: Cerebral palsy is due to static encephalopathy during perinatal period. Selective dorsal rhizotomy (SDR) involves selective division of posterior nerve roots to reduce spasticity and improve function in children with spastic cerebral palsy. Anesthesia during SDR must preserve muscle contraction in response to direct electrical stimulation of the dorsal nerve roots. We did this study to get the better management of anesthesia for SDR. Methods: Anesthetic records were reviewed for 16 patients who underwent SDR during January 1996 to August 1997. Demographic data; anesthetic drugs and doses; changes of vital signs and end tidal CO2; dorsal root stimulation; postoperative pain control were analysed. Results: The mean age of patients was 4.9+/-1.7 years old. The mean weight was 16.3+/-4.0 kg. The under 1 MAC concentration of isoflurane and 2~3 mcg/kg/hr fentanyl did not interfere with electrophysiologic monitoring. Esophageal temperature was increased significantly during electrical stimulation of dorsal roots. End tidal CO2 concentration had a tendency to increase after electrical stimulation too. Direct installation of 10~15 mcg/kg intrathecal morphine prior to dural closure, and postoperative 0.5 mcg/kg/hr fentanyl had a good postoperative analgesia without complication. Conclusions: Isoflurane and fentanyl during anesthesia, and intrathecal morphine with continuous infusion of fentany postoperatively are suggested a good anesthetic method for SDR.
Analgesia ; Anesthesia ; Anesthetics ; Cerebral Palsy ; Child ; Electric Stimulation ; Fentanyl ; Humans ; Isoflurane ; Morphine ; Muscle Contraction ; Muscle Spasticity ; Pain, Postoperative ; Rhizotomy* ; Spinal Nerve Roots ; Vital Signs

This study was conducted to determine the impacts of perceived stress and self-compassion on the quality of life of nursing students. Methods: Data were collected from 180 nursing students between 11 October and 26 October 2018 from a college in A city. A total of 157 questionnaires were analyzed using descriptive statistics, t-tests, a one-way ANOVA, Pearson correlation, and stepwise multiple regression. Results: The findings show that perceived stress had a significant negative correlation with quality of life (r=-.73, p<.001). However, self-compassion showed a significant positive correlation with quality of life (r=.66, p<.001). The factors influencing quality of life included perceived stress, self-compassion, state of health, and satisfaction with school life, with perceived stress being the most influential factor (β=-.42), followed by self-compassion (β=.30), which together had an explanatory power of 64.0%. Moreover, there was a mediating effect of self-compassion in the relationship between perceived stress and quality of life. Conclusion: The results of this study indicate that nursing college students should search for ways to reduce their perceived stress as well as increase self-compassion with meditation programs in order to improve their quality of life.

No abstract available.
Ciprofloxacin* ; Mycobacterium tuberculosis* ; Mycobacterium*

No abstract available.
Blister ; Humans ; Necrosis ; Rhabdomyolysis

No abstract available.
Drug Hypersensitivity ; Isoxazoles

BACKGROUND: Ultraviolet B (UVB) irradiation is an important inducer of several biological changes in skin, including sunburn, premature skin aging, and skin cancer, and these changes are mediated mainly by direct DNA damage or production of reactive oxygen species. Chemoprevention with an antioxidant, such as melatonin, may be a useful method to reduce skin damage induced by UVB. These processes are closely related with changes in expressions of many genes in cells. However, the expression profiles of genes in UVB-irradiated fibroblasts, with or without melatonin treatment, is largely unknown. OBJECTIVE: To investigate the expression profiles of genes in UVB-irradiated fibroblasts, with or without melatonin treatment, thereby evaluating the possibility of melatonin for the use as a promising antioxidant. METHODS: We cultured human skin fibroblasts in the presence and abscence of melatonin. Cells were irradiated with UVB (100 mJ/cm2), and the expression profiles of genes in the cells were then evaluated using a cDNA microarray, representing 25,000 genes, and by the RT-PCR method. RESULTS: The expressions of 652 genes with melatonin and 597 genes without melatonin were changed by UVB, and the major genes modified by UVB could be grouped into 4 categories: (1) cell cycle-related genes, (2) genes for structural, extracellular matrix proteins, and cell adhesion-related genes, (3) inflammation-related genes, and (4) oxidation-related genes. CONCLUSION: These results provide the basis for understanding the effect of UVB on human skin fibroblasts and give a new insight into melatonin as an antioxidant.
Chemoprevention ; DNA Damage ; Extracellular Matrix Proteins ; Fibroblasts* ; Gene Expression* ; Humans* ; Melatonin* ; Oligonucleotide Array Sequence Analysis ; Reactive Oxygen Species ; Skin Aging ; Skin Neoplasms ; Skin* ; Sunburn ; Transcriptome*

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

PURPOSE: The incidence of clinical nephritis is much higher especially in younger ages and in about one half of the cases, it also shows nephrotic syndrome. Thus, we examine the clinical and pathologic consideration of children with lupus nephritis and their treatment modality to improve the prognosis. MATERIAL AND METHOD: Among 67 cases of children under eighteen who were diagnosed SLE, 50 patients with hematuria and proteinuria from Jan. 1980 to Dec. 1996 were selected for the review. RESULTS: The ratio of the male to female patient was 1:3.5 and the average age at the diagnosis was 11.85+/-3.2 years old. Most common clinical manifestations at the time of the diagnosis were fever and skin rashes and the common laboratory results were proteinuria, hematuria, Out of 50 cases, 33 cases had renal biopsy. The results were 17 cases of Class IV, 7 cases of Class lll, 5 cases of Class lll, 3 cases of Class V and 1 case of Class l. Different treatment modalities were carried out; Corticosteroid only 21 cases, Corticosteroid+Azathioprine 25 cases, Corticosteroid+Cyclophosphamide 3 cases, and Corticosteroid+Cyclosporine A 1 case. However, there were no significant difference in the recurrence and complete remission rate of lupus nephritis in between each treatment groups. Average follow-up period was 37+/-23 months. Of all the follow-ups, 7 patients were dead. CONCLUSION: Early diagnosis should be carried out with renal biopsy, and should be considered for vigorous therapy, which currently includes high doses of corticosteroids and immunosuppressive drugs. Among these immunosuppressive agents, azathioprine has a lower incidence of long-term complications and low costs might be recommended. In addition, regular check-up for anti-DNA antibody, serum complement concentration and appropriate moniroting and management for the adverse effects of the treatment should enable to reach the continuous remission.
Adrenal Cortex Hormones ; Azathioprine* ; Biopsy ; Child* ; Complement System Proteins ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Follow-Up Studies ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Lupus Nephritis* ; Male ; Nephritis ; Nephrotic Syndrome ; Prognosis ; Proteinuria ; Recurrence