J Formos Med Assoc
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Few reports exist concerning the peak serum concentration of creatine kinase (CK) and the severity of crush syndrome, and the efficacy of fasciotomy in crush syndrome patients remains controversial. This study aimed to analyze and assess the clinical features, treatment, and outcome of patients with crush syndrome sustained in the Chi-Chi earthquake in September 21, 1999. ⋯ CK concentration is a good indicator of the occurrence of acute renal failure and the need for dialysis. The high infection rate and amputation rate after fasciotomy may be due to inadequate debridement. Fasciotomy in crush syndrome patients with high serum CK concentrations should be deliberated.
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Molecular variants (M235T and T174M) in the angiotensinogen (AGT) gene and a mutation in the promoter region that involves the presence of an adenine (A) instead of a guanine (G) 6 bp upstream from the transcription initiation site (G-6A) have been reported to have a positive correlation with hypertension. This study evaluated the association of the M235T, T174M, and G-6A mutations of the AGT gene with hypertension in Taiwanese aboriginals. ⋯ The prevalences of the 235T and -6A variants of the AGT gene in the Amis tribes of eastern Taiwan are high and are significantly associated with hypertension, whereas the 174M variant is not. The haplotype combining the 235T and -6A variants is also associated with hypertension. The prevalences of the 235T allele and -6A allele in this study and other studies in ethnic Chinese subjects are higher than those in Japanese.
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Many reports have confirmed that endoscopic ultrasonography (EUS) can differentiate gastric submucosal tumor from extragastric compression, but only a few specifically concentrated on EUS in identifying the causes of external compression. ⋯ When an extragastric compression mimicking submucosal tumor is detected by upper gastrointestinal endoscopy, EUS is indicated to identify the cause of extragastric compression.
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Advances in critical care medicine have increased the chances of survival for patients with severe illness or trauma. However, such patients consume a large proportion of medical resources. This study sought risk factors for mortality that have potential to be modified among patients treated in medical or surgical intensive care units (ICUs). ⋯ In addition to SIRS and the APACHE II and TISS scores, this study found that nosocomial Candida infection and parenteral nutrition were independently associated with mortality after control for admission conditions, severity of illness scores, and interventions.
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The significance of isolated systolic hypertension (ISH) has been well documented, particularly in the elderly. However, isolated diastolic hypertension (IDH) has not been formally recognized as a unique hypertension entity. This study compared the ages of onset and characteristics of ISH and IDH. ⋯ The results of this study indicate that ISH and IDH have different age incidence patterns and predictors, and suggest that the pathogenesis of ISH and IDH may be different.