J Formos Med Assoc
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Catecholamines have a deleterious effect on the traumatized brain. Propranolol, a beta-adrenergic blocker, can act on the vasomotor centers within the hypothalamus and brain stem to reduce the activity of the sympathetic nerves and the cerebral metabolic need for oxygen and glucose. This study investigated the effects of racemic (d,l) propranolol on the neurologic recovery of mice with head-injuries. ⋯ Small pieces of brain parenchyma were used to check the water content by gravimetric method. The treatment group showed better neurologic recovery than the placebo group by both the string test scoring system and grip test time. The brain edema was significantly reduced at the temporal lobes in the treatment group as compared to the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Review Case Reports
Hypoglycemia following ethanol ingestion in children: report of a case.
Ethanol is present in a large number of pharmaceuticals, cosmetics, detergents and beverages. Without adequate safety measures, the accidental ingestion of such products by children is possible. Ethanol ingestion by children is known to cause various metabolic and neurologic disorders, including hypoglycemia, metabolic acidosis, seizures or coma. ⋯ Prompt recognition and treatment with intravenous glucose are essential and may be life-saving. Pediatricians need to be aware of the devastating impact of ethanol. Preventive measures, such as child-proof packaging and parent education, are required if ethanol intoxication in children is to be avoided.
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Case Reports
Frequency distribution of hypervariable VNTRs in Apo B, HVR-Ig and COL2A1 loci in Taiwan: forensic application.
By use of a simple, rapid and reliable polymerase chain reaction (PCR)-based method, we analyzed three hypervariable tandem repeats in the 3'-Apo B, 5'-HVR-Ig and 3'-COL2A1 loci. As accurate data of allele frequency of genetic markers is a prerequisite for forensic application, the allele frequency distribution of the three variable number of tandem repeats (VNTR) among the Chinese population in Taiwan were studied. In a total of 123 unrelated Chinese subjects, the Apo B VNTR demonstrated a heterozygosity of 68.2% with 9 alleles, 0.85 of the power of discrimination (PD) value and 0.74 of the allelic diversity (h) value. ⋯ The high sensitivity and inexpensive nature of this approach make it superior to the traditional method of DNA fingerprinting for forensic typing. With the use of this PCR-VNTR system, many forensic cases have been successfully identified. The value of this system is illustrated in the investigation of a rape and murder case.
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Intermittent positive pressure ventilation via tracheostomy has been the most common method of providing ventilatory support for patients with respiratory failure since the late 1950s. It is the standard procedure for individuals who suffer from acute respiratory failure, impaired consciousness, and severe restrictive lung disease. However, numerous adverse complications from these invasive techniques have been reported in those who are long-term ventilator users. ⋯ In this way, it can prevent patients from requiring either tracheostomy or endotracheal tube, but is not effective enough to ventilate patients with markedly decreased lung compliance because the high airway resistance provides air leakage from the non-invasive interface. Non-invasive respiratory aids should be the first choice to maintain ventilation for patients with respiratory failure secondary to neuromuscular disorder, because of their benefits of easy application, satisfactory results, fewer complications and early active rehabilitation. Increased understanding of non-invasive respiratory aids should assist in the management of patients with chronic respiratory failure.
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This study evaluates the prognostic factors and causes associated with mortality in Chinese diabetic patients after lower extremity amputations. Medical records of all diabetic patients admitted to the National Taiwan University Hospital for leg amputations from 1982 to 1991 were reviewed. Demographic data, medical history, amputation levels and admission routines, including fasting plasma glucose, cholesterol, triglycerides, blood urea nitrogen, creatinine, urine protein and electrocardiograms, and bacterial culture done during the admission period were recorded. ⋯ A history of hypertension and coronary heart disease were found to be the best indicators for predicting a fatal outcome with rate ratios of over two-fold. This study shows that post-amputational mortality is high in diabetic patients and that the major cause of death is cerebral infarction. The major cause of death in this study differs from that reported for Caucasians, for whom cardiovascular disease is the most important cause of death.