We report a case of non-traumatic rhabdomyolysis after overdose of doxylamine succinate. A 22-year-old woman with reactive depression had an overdose of doxylamine with suicidal intent. She had decreased mental state, confusion, convulsion, vomiting, tachycardia, pupil dilatation, and ocular flutter. Serum creatine phosphokinase concentra-tion was 6,752 IU/L initially, increased to maximum (165,590 IU/L) at the third day, and then rapidly decreased and returned to normal 2 weeks after intoxication. Acute renal failure occurred but was resolved without hemodialysis. Rhabdomyolysis associated with renal failure is a rare but serious complication after doxylamine overdose.
Acute Kidney Injury ; Adjustment Disorders ; Creatine Kinase ; Dilatation ; Doxylamine* ; Female ; Humans ; Pupil ; Renal Dialysis ; Renal Insufficiency ; Rhabdomyolysis* ; Seizures ; Succinic Acid ; Tachycardia ; Vomiting ; Young Adult

We report a 37-year-old man with adrenomyeloneuropathy who presented as progressive gait disturbance. He had spastic paraparesis, hyperreflexia with Babinski's signs, a sensory level at T-4, and loss of the vibration sense in the legs. No adrenal insufficiency was noted. There were frontal white matter abnormalities but no cervical spinal lesions on MRI. A nerve conduction study showed distal axonal neuropathy predominantly in the lower extremities. The plas-ma level of the saturated very long chain fatty acids was elevated. (J Korean Neurol Assoc 19(4):431~434, 2001)
Adrenal Insufficiency ; Adrenoleukodystrophy* ; Adult ; Axons ; Fatty Acids ; Gait ; Humans ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Neural Conduction ; Paraparesis, Spastic ; Reflex, Abnormal ; Reflex, Babinski ; Vibration

BACKGROUND: Women with end-stage renal disease have low fertility. Following renal transplantation, the reproductive function returns to normal, and pregnancy becomes possible. METHOD: At our medical center, between June 1990 and February 1998, 263 female patients underwent renal transplantations, and 14 of them later became pregnant. The outcomes from 23 pregnancies in these 14 kidney transplant recipients were analyzed. RESULT: Forty-three percent (43%) of the pregnancies ended in artificial (9 cases) or spontaneous abortion (1 case), and 11 of 13 deliveries were successful. A vaginal delivery was performed in 9 cases (69%) and a cesarian section was done in 4 cases (31%). All of the 11 pregnancies that continued over 30 weeks ended successfully. The mean age of the recipients at the first pregnancy was 29.4 +/- 4.6 years (23-37). The mean time to first pregnancy since renal transplantation was 22.6 +/- 12.3 months (1-50). Thirteen (13) recipients were maintained on cyclosporin-based immunosuppressive regimens before and during pregnancy. One recipient, who was considered to have developed immune tolerance later, stopped the immunosuppressive drug at 3 months prior to the first pregnancy. The renal function remained stable and unchanged in all the recipients, and no rejection episodes occurred during and after pregnancy in any of the recipients. Preeclamsia occurred in 8 cases (35%) and a previous rupture of membrane in 1 case (4%). Of the 11 live births, 4 (36%) were premature (<37 weeks), 1 (9%) had a lowbirth-weight (<2500 gm), 1 (9%) had transient apnea, and 3 (27%) had transient neutropenia. The mean Apgar score at 1 minute was 7.8 (7-9), with only 2 children having a score below 7. No congenital anomalies were documented. The later development and health of all of the children were good during a mean follow-up of 16.6 +/- 10 (1-38) months. Two (2) recipients who had a successful first pregnancy had a second baby. CONCLUSION: From these results, we can conclude that pregnancy does not adversely affect graft function and fetal development, provided that the graft function was stable at the time of conception and prudent fetal monitoring could be done.
Abortion, Spontaneous ; Apgar Score ; Apnea ; Child ; Female ; Fertility ; Fertilization ; Fetal Development ; Fetal Monitoring ; Follow-Up Studies ; Humans ; Immune Tolerance ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Live Birth ; Membranes ; Neutropenia ; Pregnancy* ; Rupture ; Transplantation ; Transplants

Since the development of magnetic stimulation as a way of assessing the functions of corticospinal pathways, diseases involving central motor pathways have been investigated by motor evoked potentials(@). However, studies correlating MEP findings and the neurological deficits were rarely carried out in patients with stroke. In this study, transcranial magnetic stimulation of the motor cortex and lower cervical area was performed in 50 patients with acute stroke and 23 healthy volunteers. Follow-up tests were performed in 22 patients about I month@ later. The amplitudes of @ were significantly reduced (P=0.0001), and central motor conduction time (CMCT) was significantly delayed (P=0.0004) in stroke patients compared to the normal controls. The abnormalities of MEP were closely related to the initial motor deficits. The cortical MEP findings in patients with cortical infarction and pontine infarction were more severe than those obtained in patients with subcortical I lesion. Initial MEP findings showed good correlation with the final functional outcome of the patients. The shortened latencies of follow-up MEP were significantly (P=0.0266) related to the improvement of the patients' motor deficit. These results illustrate that the results of magnetic stimulations are related to the prognosis of patients with stroke, and suggest that MEP may be I used in the monitoring their neurological or functional progress.
Efferent Pathways ; Evoked Potentials, Motor* ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Infarction ; Motor Cortex ; Prognosis ; Stroke* ; Transcranial Magnetic Stimulation

OBJECTIVE: To assess the pre-pregnancy and pregnancy factors influencing pregnancy outcome in renal transplanted women Materials and METHODS: This retrospective study included all pregnancies in renal transplanted women in Asan Medical Center between June 1996 and February 1998. We collected data from the medical records of allograft recipients. Pre-pregnant status and pregnancy outcome were described. RESULTS: Seventeen pregnancies in 13 allograft recipients resulted in 7 term deliveries, 4 preterm births, 2 spontaneous abortions, and 4 therapeutic abortions. All but one patient received immunosuppressive therapy with cyclosporin A, azathioprine, and prednisolone during pregnancy. The mean interval from the time of transplantation to conception was 28.8+/-14.3 months(range 6-60 months). In live birth group, the mean gestational age at delivery was 37.7+/-1.2 weeks and the mean birth weight of their offspring was 2.85+/-0.37 kilogram. Apgar scores at 5 minutes were 8 or more in all of them. The obstetric complications were distributed as follows: pregnancy induced hypertension in 6 cases(55%), pregnancy aggravated hypertension in 2 cases(18%), fetal growth restriction in 1 case(9%), prematurity in 4 cases(36%). Cesarean sections were done in 4 cases(36%) because of previous Cesarean section(3 cases) and uncontrolled hypertension(1 case). Neonatal complication, transient tachypnea of the newborn, was found in one case. Graft rejection after transplantation occurred in 4 cases: 3 cases in preterm births and 1 case in therapeutic abortions. Maternal renal functions were normal during pregnancy and postpartum period whose pre-pregnant renal functions had been normal. No patient experienced any rejection episode or graft loss during pregnancy. CONCLUSION: Successful pregnancy can be expected in women with a renal transplant, although there was high incidence of pregnancy-related complications, especially hypertensive disorders. Pregnancy can be encouraged to these allograft recipients if they have good renal function.
Abortion, Spontaneous ; Abortion, Therapeutic ; Allografts* ; Azathioprine ; Birth Weight ; Cesarean Section ; Chungcheongnam-do ; Cyclosporine ; Female ; Fertilization ; Fetal Development ; Gestational Age ; Graft Rejection ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Incidence ; Kidney Transplantation ; Live Birth ; Medical Records ; Postpartum Period ; Prednisolone ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Retrospective Studies ; Transient Tachypnea of the Newborn ; Transplants

Intracranial hemorrhage is a rare complication of amphethamine abuse, and cerebral vasculitis as a cause of the hemorrhage has been demonstrated by arteriography or autopsy findings. We report a 22-year-old female, an occasional methamphetamine abuser over 1 to 2 months, who presented with the sudden onset of bifrontal headache, nausea and vomiting immediately after an intravenous injection of methamphetamine. Imaging studies demonstrated intracerebral hemorrhage and subdural hemorrhage associated with cerebral vasculitis. To our knowledge, this entity has not been previously reported in Korea.
Angiography ; Autopsy ; Cerebral Hemorrhage ; Female ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Injections, Intravenous ; Intracranial Hemorrhages* ; Korea ; Methamphetamine* ; Nausea ; Vasculitis, Central Nervous System* ; Vomiting ; Young Adult

Intracranial hemorrhage is a rare complication of amphethamine abuse, and cerebral vasculitis as a cause of the hemorrhage has been demonstrated by arteriography or autopsy findings. We report a 22-year-old female, an occasional methamphetamine abuser over 1 to 2 months, who presented with the sudden onset of bifrontal headache, nausea and vomiting immediately after an intravenous injection of methamphetamine. Imaging studies demonstrated intracerebral hemorrhage and subdural hemorrhage associated with cerebral vasculitis. To our knowledge, this entity has not been previously reported in Korea.
Angiography ; Autopsy ; Cerebral Hemorrhage ; Female ; Headache ; Hematoma, Subdural ; Hemorrhage ; Humans ; Injections, Intravenous ; Intracranial Hemorrhages* ; Korea ; Methamphetamine* ; Nausea ; Vasculitis, Central Nervous System* ; Vomiting ; Young Adult

BACKGROUND: We found that intensive and long-term plasmapheresis might be responsible for iron depletion of donors in our previous study. So we examined 88 multi-time and 44 first-time donors to investigate the effects of long-term plasmapheresis on the iron status of the body. METHODS: Eighty eight donors who had never donated whole blood or donated plasma only regularly over a period of 5 years were selected. They were divided into group 1, 2 and 3 by donation interval and group A, B and C by the number of plasmapheresis per year. Fifty eight of them had follow-up data after the donation. Whole blood was taken from the donors before plasmapheresis by the Fenwal Autopheresis-C system. Each sample was assayed for serum ferritin, iron, TIBC and transferrin saturation. RESLUTS: For serum ferritin, iron, TIBC and transferrin saturation, the mean values of multi-time donors were in the normal range but significantly lower than those of first-time donors. Twenty four (27.3%) multi-time donors had either less than 10 ng/mL of serum ferritin or less than 16% of transferrin saturation. Six donors had the lower values of both serum ferritin and transferrin saturation. Among 88 multi-time donors, there were significant differences between groups. Group 1 with the shortest donation interval had significantly lower ferritin value than the other groups. Group C with the highest donation frequency had significantly lower ferritin, TIBC and transferrin saturation values than the other groups. The results for the follow-up data of 58 donors were similar to those for the initial data. CONCLUSION: The donation intervals and the frequency of plasmapheresis influence body iron status of donors. So intensive and long-term plasmapheresis may result in iron depletion in donors. Consequently, a more sophisticated donor screening system to prevent iron depletion in intensive and long-term plasmapheresis donors should be established.
Donor Selection ; Ferritins ; Follow-Up Studies ; Humans ; Iron* ; Plasma ; Plasmapheresis* ; Reference Values ; Tissue Donors* ; Transferrin

Antithrombin III deficient individuals have an increased risk of venous thrombosis and thromboembolism at a young age. To our knowledge, cerebral venous thrombosis associated with antithrombin III deficiency has not yet been reported in Korea. A 27-year-old pregnant woman without any known stroke risk factors was admitted to our hospital because of convulsions. Brain MRI and MR venography showed dural sinus thrombosis of the superior sagittal sinus, straight sinus, and left lateral sinus with venous hemorrhagic infarctions in both frontal and parietal lobes. Antithrombin III concentrations were decreased to 37%. We speculated that the etiology of the cerebral venous thrombosis in this patient was associated with antithrombin III deficiency. We suggest that antithrombin III deficiency should be considered as a possible cause of cerebral venous thrombosis.
Adult ; Antithrombin III Deficiency* ; Antithrombin III* ; Brain ; Female ; Humans ; Infarction ; Korea ; Magnetic Resonance Imaging ; Parietal Lobe ; Phlebography ; Pregnant Women ; Risk Factors ; Seizures ; Sinus Thrombosis, Intracranial* ; Stroke ; Superior Sagittal Sinus ; Thromboembolism ; Transverse Sinuses ; Venous Thrombosis

No abstract available.
Trisomy* ; Ultrasonography*