• 대한정형외과학회지
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• 제55권3호
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• pp.276-280
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• 2020

49세 남자 환자가 숙박업소에서 의식을 잃은 채 발견되어 응급실로 내원하였다. 환자는 조현증 및 주요우울증으로 항정신병 약물 및 항우울증 약물(vortioxetine hydrobromide, mirtazapine, sertraline hydrochloride, quetiapine, alprazolam)을 복용 중이었으며 환자 주변에 상기 약물들을 과량 복용한 흔적이 남아있었다. 신체검사에서 좌측 둔부 및 가측 대퇴부로 동통, 창백 및 부종 관찰되었으며 좌측 족관절 이하의 능동 관절운동이 불가하였다. 그리고 경골 및 비골신경 영역의 감각이 소실되어 있었다. 가장 종창이 심했던 가측 대퇴부에서 측정한 둔부 구획 내 압력은 42 mmHg 이었으며 자기공명영상에서 좌측 둔부 근육 및 주변 연부 조직의 부종 및 고강도 신호를 보이고 있었다. 응급 근막절개술을 시행하였고 24시간 이후 하지 감각 및 근력이 일부 회복되었다.

• Mycobiology
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• 제42권3호
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• pp.215-220
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• 2014

Mushrooms are a recognized component of the human diet, with versatile medicinal properties. Some mushrooms are popular worldwide for their nutritional and therapeutic properties. However, some species are dangerous because they cause toxicity. There are many reports explaining the medicinal and/or toxic effects of these fungal species. Cases of serious human poisoning generally caused by the improper identification of toxic mushroom species are reported every year. Different substances responsible for the fatal signs and symptoms of mushroom toxicity have been identified from various poisonous mushrooms. Toxicity studies of mushroom species have demonstrated that mushroom poisoning can cause adverse effects such as liver failure, bradycardia, chest pain, seizures, gastroenteritis, intestinal fibrosis, renal failure, erythromelalgia, and rhabdomyolysis. Correct categorization and better understanding are essential for the safe and healthy consumption of mushrooms as functional foods as well as for their medicinal use.

• 대한핵의학회지
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• 제26권1호
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• pp.106-110
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• 1992

외상, 만성간질환, 화상 및 전신성경련등의 원인으로 발생한 횡문근융해증 9예의 $^{99m}Tc-MDP$ 골스캔을 분석하여 다음과 같은 성적을 얻었다. 동통부위보다 넓은 전신성 병변이 44%에서 확인되었으며 나머지 56%는 국소 동통부위의 근육에만 Bone-seeking agent가 침착되는 것이 확인되있고, 골스캔만으로도 44%에서 신부전증이 동반되었음을 확인할 수 있었다. 전신성 병변은 원인과는 관계없이 출현하였고, 신부전증도 원인질환에는 관계없이 발생하였다. 1예에서 실시한 CT는 국소성 병변만을 보여 주었으나골스캔은 전신성 병변을 나타내어 주었다. 따라서 횡문근융해증의 진단에는 골스캔이 중요함을 확인해주었다.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.237-237
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• 2002

Creatine phosphokinase (CPK) was a marker in diagnosis of rhabdomyolysis. The CPK abnormality could be induced by intake of HMG CoA reductase inhibitors (statins). The objective of this study was to estimate the incidence rate of CPK abnormality by each statin. (omitted)

• 한국임상수의학회지
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• 제23권4권
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• pp.469-471
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• 2006

노책성 횡문근융해증의 재발을 보이는 거세된 4세령 Paint horse가 다당류저장성근질환으로 진단되었다. 말이 폐사하기전 보인 임상증상으로는 근약화, 근손실, 운동불내성, 장제시 사지를 들어올리는데 어려움이 있었고, grooming 시 민감한 반응, 이동 혹은 기립시 장애였다. 골격근 샘플의 조직검사를 통해서 말의 다당류저장성근질환으로 확진되었다.

• Annals of Clinical Neurophysiology
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• 제14권2호
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• pp.76-79
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• 2012

Statin is commonly used for lowering cholesterols and can be myotoxic to cause drug-induced necrotizing myopathy. Statin-induced myopathy ranges from asymptomatic hyperCKemia to lethal rhabdomyolysis but is usually reversed by withdrawal of causative drugs. The patient in this study presented with statin-induced necrotizing myopathy, which was finally improved with immunosuppressive therapy, but not just with drug withdrawal. Since statin can induce myopathy through autoimmune processes, we should consider using immunomodulating agents in cases with statin-induced myopathy, which is refractory to drug withdrawal.

• Biomolecules & Therapeutics
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• 제20권3호
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• pp.268-272
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• 2012

Nephrotoxicity occurs when kidney-specific detoxification and excretion do not work properly due to the damage or destruction of kidney function by exogenous or endogenous toxicants. Exposure to drugs often results in toxicity in kidney which represents the major control system maintaining homeostasis of body and thus is especially susceptible to xenobiotics. Understanding the toxic mechanisms for nephrotoxicity provides useful information on the development of drugs with therapeutic benefits with reduced side effects. Mechanisms for drug-induced nephrotoxicity include changes in glomerular hemodynamics, tubular cell toxicity, inflammation, crystal nephropathy, rhabdomyolysis, and thrombotic microangiopathy. Biomarkers have been identified for the assessment of nephrotoxicity. The discovery and development of novel biomarkers that can diagnose kidney damage earlier and more accurately are needed for effective prevention of drug-induced nephrotoxicity. Although some of them fail to confer specificity and sensitivity, several promising candidates of biomarkers were recently proved for assessment of nephrotoxicity. In this review, we summarize mechanisms of drug-induced nephrotoxicity and present the list of drugs that cause nephrotoxicity and biomarkers that can be used for early assessment of nephrotoxicity.

• 대한임상독성학회지
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• 제19권1호
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• pp.51-54
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• 2021

Chlorfenapyr is a widely used insecticide, that is very lethal if ingested. It exhibits delayed toxicity in which there are few symptoms at first which suddenly worsen after a few days. A 66-year-old female patient ingested about 90 mL of chlorfenapyr liquid hydrating agent (Chlofenapyr 10%) and showed stable vital signs with no specific symptoms and findings other than a mild fever, vomiting, and nausea. From the 3rd day of ingestion, creatine kinase was high, and rhabdomyolysis was suspected. From the 4th day of ingestion, pancreatic enzymes began to gradually increase. A diffusion-weighted image showed a multifocal high signal intensity in the white matter and corpus callosum area. On the 8th day after ingestion, she suffered a high fever and a heart attack and died. Thus, if a patient is suspected of taking chlorfenapyr, he/she needs active treatment and monitoring even if he/she does not exhibit any symptoms.

• 대한유전성대사질환학회지
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• 제22권1호
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• pp.21-27
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• 2022

Very long-chain acyl-coenzyme A dehydrogenase (VLCAD) deficiency (VLCADD) leads to a defective 𝛽-oxidation, specifically during prolonged fasting, infection, or exercise. Patients with VLCADD usually suffer from cardiomyopathy, hypoketotic hypoglycemia, hepatic dysfunction, exercise intolerance, muscle pain, and rhabdomyolysis, and sometimes succumb to sudden death. VLCADD is generally classified into three phenotypes: severe early-onset cardiac and multiorgan failure, hypoketotic hypoglycemia, and later-onset episodic myopathy. Diagnostic evaluation comprises acylcarnitine analysis, genetic analysis, and VLCAD activity assay. In the acylcarnitine analysis, the key metabolites are C14:1, C14:2, C14, and C12:1. A C14:1 level >1 mmol/L strongly suggests VLCADD. Various treatment recommendations are available for this condition. Dietary management includes decreasing fat content, increasing medium-chain triglyceride levels, and decreasing fasting periods. Supplementation with L-carnitine is controversial. Triheptanoin (a seven-carbon fatty acid triglyceride) treatment demonstrates improvement of cardiac functions. Bezafibrate may improve the quality of life of patients with VLCAD.

• Tuberculosis and Respiratory Diseases
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• 제60권5호
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• pp.548-553
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• 2006

연구배경 : 알코올성 케톤산증은 대부분 예후가 양호하나 여러 장기부전을 동반한 경우 중환자실 치 료가 필요하다. 이런 중증환자에 대한 보고가 부족하여 저자들은 중증 알코올성 케톤산증의 증례를 분석하였다. 방 법 : 2000년 1월 1일부터 2005년 6월 30일까지 서울아산병원 중환자실에서 입원하여 치료받았던 합병증을 가진 알코올성 케톤산증 10례를 선정하여 분석하였다. 결 과 : 모두 남자환자였고, 평균 나이는 $52.7{\pm}12.4$ 세, 평균 $20{\pm}13$년의 음주력이 있었다. 내원시 주증상은 복통,구토등의 소화기증상이 50%로 가장 많았다. 주요 검사실 소견상 Lactic acid (mmol/L) $57.89{\pm}55.35$, 동맥혈 pH $6.828{\pm}0.139$, Osmolar Gap (mOsm/L) $37.28{\pm}24.55$, Anion Gap (mOsm/L) $31.43{\pm}11.61$이었다. 동반된 주된 합병증으로 횡문근 융해증(80%), 패혈증(20%), 췌장염(10%) 순이었다. 70% 환자에서 투석이 80% 환자에서 기계환기가 실시되었다. 사망자 (60%) 들은 모두 3일이내에 쇼크로 인해서 사망하였다. 생존자들은 12시간안에 동맥혈 pH 7.15 이상으로 회복되었다. 결 론 : 중증 알코올성 케톤산증은 횡문근 융해증 및 급성 신부전이 주된 합병증으로 동반되며 사망률이 높다.