Clinical study of rhabdomyolysis developed after the training / 대한내과학회지

BACKGROUND: It is important to recognize rhabdomyolysis in clinical settings, because 10~30% of rhabdomyolysis patients develop acute renal failure as a complication and patients with such complication have risk of high mortality. Recently, there have been frequent reports about healthy people who developed rhabdomyolysis after heavy exercise, but few prospective studies on exercise-induced rhabdomyolysis have been reported. METHODS: To evaluate the degree of muscle cell necrosis during the regular combat-police training, we examined the level of creatine kinase, plasma myoglobin and bone scan in 173 combat-police before the training and on fourth day after the training. Average ambient temperature and humidity during the study were 25degrees C and 78%, respectively. RESULTS: From the laboratory findings, 98 out of 173 combat-police were diagnosed as having rhabdomyolysis. Upon regressional analysis, an increase in amount of exercise correlated with the elevation of the levels of plasma creatine kinase and myoglobin. Among variables related to rhabdomyolysis only the levels of myoglobin, aspartate aminotransferase were significantly elevated. The level of plasma creatinine was elevated along with the elevation of plasma myoglobin. Bone scan not only provided detailed information on the location and degree of muscle cell damage, but also could be of diagnostic value in patients whose creatine kinase had been normalized. CONCLUSION: In people who developed rhabdomyolysis after heavy exercise, the level of plasma creatinine was elevated along with the elevation of plasma myoglobin. So early diagnosis of rhabdomyolysis and early detection of acute renal failure may be useful with monitoring of plasma myoglobin level.

A Case of Unilateral Hypoplasia of the Optic Nerve

The authors had a chance to observe recently a case of unilateral hypoplasia of the optic nerve. The patient was 4 years old Korean boy who had been complained of visual disturbance and showed exotropia of the left eye since birth. The ophthalmological examinations revealed a typical picture of unilateral hypoplasia of the optic nerve in otherwise normally appearing eye externally. No other defective lesions are disclosed by clinical examinations including radiological study. The authors also attempted to review the literature concerning on this entity.