BACKGROUND: Blood pressures rneasured by a nurse at reception room as a part of routine physical examination are oft,en used as a indicator of medical care. Blood pressure at reception room and consultation room are, however, often different to each other and these differences are caused by various factors including difference of white coat effect by nurse and doctor. Thus, this study was performed in order to know whether blood pressure difference really exit, and its associated factors. METHODS: Two hundred ninety one patients who visited to one university hospital farnily practice were enrolled in this study. Blood pressure and pulse rate at reception room and consultation room, waiting t,ime, time interval between reception and consultation, smoking status, and intake of coffee and food were collected. Nine patients were excluded, because blood pressure either at reception room or at consulation room was not recorded. This study was performed by one nurse and two doctors. They defined the guideline for method of blood pressure measurement before the study, and used the same kind of indirect cuff sphygmomanometer. RESULTS: Two hundred eighty two patients were analyzed. The number of men was one hundred twenty five. Systolic blood pressure at consultation room was higher than that at reception room by 1.6+/-11.9mmHg (P<0.05). Sixty five cases(65%) in systolic blood pressure and 111 cases(40%) in diastolic blood pressure showed blood pressure differences more than 5mmHg. The group with systolic blood pressure difference between reception room and consultation room(SBP) in more than 5mmHg is more likely to be hypertensive than the group with SBP in less than 5mmHg(P<0.01). More female patients(66%) and hypertensive patients(59%) were belong to the group whose systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). Twenty four patients(30%) of the group whose systolic blood pressure at reception room were 5mmHg higher than at consultation room had cigarette smoking within 1 hour, and this ratio was significantly higher than the other groups whose systolic blood pressure difference was less than 5rnmHg or systolic blood pressure at consultation room were 5mmHg higher than at reception room(P<0.01). There was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site(Overall kappa, 0.747, P<0.01). CONCLUSIONS: Many patients showed blood pressure differences more than 5mmHg between reception room and consultation room. Systolic blood pressure at consultation room was higher than that at reception room, and there was relatively good concordance in classifying hypertension and normal blood pressure according to measurement site, but the adverse effect by misclassification should not be neglected. The importance as well as the limitation of blood pressure measurement at reception room should be considered in screening and treating hypertensive patient. Every time when blood pressure is taken, physicians should keep in mind to consider patients factors which may influence blood pressure level.
Blood Pressure* ; Coffee ; Female ; Heart Rate ; Humans ; Hypertension ; Male ; Mass Screening ; Outpatients* ; Physical Examination ; Smoke ; Smoking ; Sphygmomanometers

BACKGROUND: Hypertension is one of the frequent problems for which family physicians are well encountered to manage. Nonpharmacologic measures which include stress relaxation, low salt diet, weight reduction, moderation of alcohol intake, physical activity, tobacco avoidance are used as definitive or adjuvant therapy for hypertension. Family physicians should vigorously encourage their patients to adopt these life style modifications. This study was conducted to know how many nonpharmacologic treat,ment modalities are adopted by hypertensives and to find predicting factors. METHODS: A total of 100 of the hypertensive patients who are followed up via the department of family medicine, Hanyang University Hospital, from September 1995 through November 1995 are included in this study. A trained nurse interviewed patients according to the previously designed structured questionnaire. The overall response rate was 90% and the fill-up rate of the questionnaire was 100%. RESULTS: Sixty three patients were women. The mean age was 57.4 years(range, 20 to 84). Sixty one percent accompanied one or more other diseases, of which diabetes mellitus was the most common disorder. The mean systolic pressure was 143.9 mmHg and the mean diastolic blood pressure was 89.3mmHg. Ninty-three percent of patients received antihypertensives with compliance of 81 to 100%. Twenty four percent of patients adhered to regular exercise, 36 percent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent no smoking. Of those six non-pharmacological treatments, 3.6 behaviors were adhered. Male patients were more attended with the low salt diet. Eleven patients of 2S alcoholics(44.0%) reduced their amount of alcohol intake and 8 of 17 smokers quitted smoking (47.1%) after they were diagnosed as hypertension. The mean BEPSI score was 1.5. Fifty one percent of patients had stress within the last three months, 32 percent had cumulative fatigue. The occupational stress was the most common one. All exercise which patients reported were isotonic. Seventeen percent of the patients took certain herb medicine or folk medicine. CONCLUSIONS: Of those 100 hypertensives who were treated at the department of family medicine, Hanyang University hospital, 24% adhered to regular exercise, 36 per cent weight reduction, 48 percent low salt diet, 79 percent moderate drinking, 81 percent stress relaxation, and 87 percent quit smoking in order. Of those six non-pharmacological treatments, 3.6 behaviors were adhered on the average. Nonpharmacologic treatment should be promoted by family physician as an important strategy for treatment of hypertension.
Antihypertensive Agents ; Blood Pressure ; Compliance ; Diabetes Mellitus ; Diet ; Diet, Reducing ; Drinking ; Fatigue ; Female ; Humans ; Hypertension ; Life Style ; Male ; Medicine, Traditional ; Motor Activity ; Physicians, Family ; Relaxation ; Smoke ; Smoking ; Tobacco ; Weight Loss ; Surveys and Questionnaires

Continued improvements in treatments of the thoracolumber spine have occured in the last several years. The operative treatment of choice currently is short segment fusion(instrumentation one level above to one level below the injury). The development of pedicle screw systems has brought short segment fusion into clinical reality from the posterior approach. We analysed the clinical results of 20 patients with unstable fracture and fracture-dislocation of thoracolumbar spine who were treated with the posterior transpedicular screw system. The mean fol- low-up was 18 month. Ll was the most common injury level and the bursting fracture was the most common fracure type by Denis classification. The mean preoperative sagital index was 21.5。 and improved 8.1。 postoperatively. The mean preoperative anterior and posterior height of the vertebral height were 56.9% and 88.8% and improved postoperatively 94.7 and 88.8 respectively. The mean preoperative neural canal impingement in neural defici: patient was 47.2% and was improved 30.65% postoperatively. The mean prooperative ASIA motor was 34.1 and improved 41.7 postoperatively. There was no metal failure. These data suggested that the posterior transpedicular screw fixation, transpedicle bone graft, decompression and posterolateral bone graft was able to porvide sufficient stability and to achieve the neurologic improvement.
Asia ; Classification ; Decompression ; Humans ; Neural Tube ; Pedicle Screws ; Spine ; Transplants

Agrobacterium tumefaciens induces cancerous growths called crown galls at wound sites on dicotyledonous plants. A large plasmid called T1 plasmid is responsible for virulence. Upon tumor induction, part of the plasmid, termed T-DNA, becomes integrated into plant genome and its genetic sequences are expressed. These properties allow T1 plasmids to be used as gene vectors in plants. Several in vitro methods for the transfer of T1 plasmid into plant cell have been developed. One of them is the treatment of bacterial spheroplasts and plant protoplasts mixture with polyethylene glycol that is generally used as fusogen in cell-to-cell fusion. Several workers investigated the interaction of bacterial spheroplasts with plant protoplasts in the presence of polyethylene glycol and suggested that the interaction is not fusion but endocytosis. In this report we observed the interaction of Agrobacterium tumefaciens spheroplasts with Nicotiana tabacum protoplasts by electron microscope. Agrobacterium tumefaciens spheroplasts with Nicotiana tabacum protoplasts were prepared and mixed in the presence of polyethylene glycol and high pH-high Ca²⁺ buffer. Then the interaction of the spheroplasts with the protoplasts was examined by transmission electron microscope. After the treatment of polyethylene glycol the spheroplasts adhered to the surface of the protoplasts and then they were engulfed by the protoplasts. After the high pH-high Ca²⁺ buffer treatment the engulfed spheroplasts lost their cell integrity. No fusion process was observed. Thus all these observation suggest that the introduction process of Agrobacterium tumefaciens spheroplasts into Nicotiana tabacum protoplasts with the aid of polyethylene glycol is endocytosis.
Agrobacterium tumefaciens* ; Agrobacterium* ; Endocytosis ; Genome, Plant ; In Vitro Techniques ; Plant Cells ; Plant Tumors ; Plants ; Plasmids ; Polyethylene Glycols ; Protoplasts* ; Spheroplasts* ; Tobacco* ; Virulence ; Wounds and Injuries

BACKGROUND: Uterine leiomyoma is the most common pelvic tumor, occurring in 20-25% of women in reproductive age. Gonadotropin releasing hormone agonist (GnRHa) has been reognized as a temporary medical management for this disorder. The etiology of these tumors is unknown but it has been shown that the insulin-like growth factors (IGF-I, IGF-II) are promoters of growth in nongynecologic tumors. Several recent studies have suggested the possible role of IGFs in human leiomyoma growth. The IGF binding proteins (IGFBPs) are believed to modulate actions of IGF and to have IGF-independent actions. The purpose of this study was to evaluate the type of IGF and IGFBP which may be involved in leiomyoma growth and to investigate a possible IGF related mechanism of action of GnRHa. METHOD: The IGFs and IGFBPs were measured by double antibody radioimmunoassay, western ligand blot and immunoprecipitation in the tissue cytosols of normal uterine myometria (n=15), nontumorous myometria adjacent to a leiomyoma and leiomyoma from patients nontreated (n=15) and treated (n=10) with GnRHa. RESULTS: The mean IGF-I and IGF-II level were significantly higher in leiomyoma from untreated patients than in the adjacent myometrium and normal myometrium but no significant differences in these IGF levels between normal myometrium and adjacent myometrium were noted. The IGFBP-2, IGFBP-3 and 26kDa IGFBP were detected variably but IGFBP-4 was consistently present in all tissues. There were no significant differences in the relative intensity for IGFBP-4 and the frequency of IGFBPs between leiomyoma, adjacent myometrium and normal myometrium from untreated patients. The IGF-I, IGF-II levels and the relative intensity of IGFBP-4 in leiomyoma from GnRHa-treated patients were significantly lower than those in untreated patients, but these levels in the adjacent myometrium were comparable. The frequency of each IGFBP in leiomyoma and the adjacent myornetrium from GnRHa-treated patients did not significantly differ from untreated patients. CONCLUSION: Both IGF-I and IGF-II are involved in the growth of leiomyoma and GnRHa may in part act to decrease size of leiomyoma by regulating the local levels of IGF-I, IGF-II and IGFBP-4.
Animals ; Cytosol ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Immunoprecipitation ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Insulin-Like Growth Factor II ; Leiomyoma* ; Mice ; Myometrium ; Radioimmunoassay ; Somatomedins*

OBJECTIVE: Internal carotid artery (ICA) trunk aneurysms are rare constituting about 0.9 to 6.5% of all ICA aneurysms. They may arise from medial, lateral, ventral (posterior) or dorsal (anterior) walls of ICA. The most frequent site of origin is dorsomedial, followed by dorsal, dorsolateral and ventromedial wall. ICA dorsal wall aneurysms can be divided into the saccular type and blister type, which have different shapes, wall histological features and surgical tactics. The authors report an analysis of 27 cases of ICA trunk aneurysms treated with surgical clipping or GDC embolization. METHODS: Of 145 cases of ICA aneurysms from May 1998 to December 2005, we found 27 cases (17.5%) of such unusual aneurysms located at nonbranching sites of the intradural ICA. Features of neuroimagings and medical records were analyzed. RESULTS: Out of 27 aneurysms, 10 were located at ICA dorsal wall, 8 aneurysms were developed at ICA medialwall. Seven aneurysms originated from ICA ventral wall. Seven cases presented with subarachnoid hemorrhage and 20 cases were found unruptured. Two patients had blister-like aneurysm, and the others had saccular aneurysms. All patients were treated successfully with microsurgical clippings or GDC embolization. Microsurgical clipping were performed in 14 cases and among them, removal of anterior clinoid process was done in 12 cases. Eleven aneurysms were occluded with detachabel coil. Two patients underwent balloon occlusion of ICA. Blister aneurysm was clipped including a portion of the normal ICA wall. Good outcomes were obtained in 25 patients, and two patients were dead. CONCLUSION: ICA trunk aneurysms are developed at any site of ICA circumference. Therefore we consider a variety of treatment strategies. On clipping of aneurysms at proximal ICA trunk, removal of anterior clinoid process is important. Endovascular treatment may be good an alternative. However, surgical treatment is essential for blister like aneurysms.
Aneurysm* ; Balloon Occlusion ; Blister ; Carotid Artery, Internal* ; Humans ; Intracranial Aneurysm ; Medical Records ; Subarachnoid Hemorrhage ; Surgical Instruments

Injuries and pains of musculoskeletal joint in human body is common onset in industrialized world. However, muscle fatigue plays a very significant role in contributing causes of many pains associated with musculoskeletal joints. Based on this hypothesis, degree of muscle fatigue was investigated using electromyography measurement technique during isometric and concentric/eccentric muscle contractions. Different response of the muscle fatigue between two different muscle contractions (isometric and concentric/eccentric contractions) was examined by comparison of parameters which were median frequency, median power and RMS value. Healthy 16 young persons without previous musculoskeletal diesease history were tested with Noraxon Myosystem 2000 EMG measurement system. In this study, two different exercises were performed. First exercise was concentric/eccentric exercise. Second exercise was isometric muscle contraction. In the case of the isometric exercise, median frequency was decreased, but median power and RMS were increased. However, during the concentric/eccentric exercse, median frequency was increased, but median power and RMS were decreased. Both of those revealed that the pattern of the median frequency was W type, but median power and RMS were M type as time passed. In this study, the patterns of the muscle fatigue during concentric/eccentric exercise as well as isometric exercise were identified. It will be helpful to prevent musculoskeletal injury from over-working andexercising.
Electromyography* ; Exercise ; Human Body ; Humans ; Joints ; Muscle Contraction ; Muscle Fatigue*

No abstract available.

No abstract available.
Humans

The single enzyme P-450c17 hydroxylase catalyzes the 17a-hydroxylation of both pregnenolone and progesterone and the side-chain cleavage of 17a-hydroxypregnenolone and 17a-hydroxypro- gesterone to dehydroepiandrosterone and androstenedione. This enzyme is located in the endoplasmic reticulum and consists of a P-450c17 and a specific flavoprotein NADPH-cytochrome P-450 reductase. The clinical picture and hormonal pattern in 17a-hydroxylase deficiency have been consistent in both genotypic sexes with hypergonadotropic hypogonadism in whom the virtual absence of gonadal steroids results in a female phenotype with primary amenorrhea and pseudohermaphro- ditism in the male and underdeveloped secondary sex characteristics and hypermineralocorticoidism with hypertension, hypokalemia, suppressed renin-angiotensin system and extremely reduced aldo-sterone production. A 17-year-old girl visited endocrine clinic because of amenorrhea, absence of pubic and axillary hair, and hypertension. she had elevated levels of serum corticosterone, deoxycorticosterone(DOC), 18-hydroxycorticosterone(18-OHB). Stumulation with ACTH effected minimal increase in the elevated steroids and the ACTH-stimulated 18-OHB to aldosterone ratio was more than 280. These hormonal patterns appear to be homozygote in 17a-hydroxylase deficiency.
Adolescent ; Adrenocorticotropic Hormone ; Aldosterone ; Amenorrhea ; Androstenedione ; Corticosterone ; Dehydroepiandrosterone ; Endoplasmic Reticulum ; Female ; Flavoproteins ; Gonads ; Hair ; Homozygote ; Humans ; Hypertension ; Hypogonadism ; Hypokalemia ; Male ; Oxidoreductases ; Phenotype ; Pregnenolone ; Progesterone ; Renin-Angiotensin System ; Sex Characteristics ; Steroids