Rapid death from thrombotic thrombocytopaenic purpura following caesarean section.

We report a case of rapid death from thrombotic thrombocytopaenic purpura (TTP) in a young pregnant lady who developed full blown symptoms soon after caesarean section. Extensive intramyocardial confluent haemorrhages and widespread microthrombi in heart, brain, adrenals and kidney were found at autopsy. Thrombotic thrombocytopaenic purpura is an uncommon condition, which carries a high fatality rate if untreated. Awareness of this syndrome together with its high risk of sudden death underlines the importance of rapid diagnosis and treatment.     

Determination of cocaine and benzoylecgonine in human amniotic fluid using high flow solid-phase extraction columns and HPLC.

A new solid-phase extraction procedure for the determination of cocaine and benzoylecgonine in amniotic fluid, using high flow co-polymeric sorbents is reported. The recoveries of cocaine and benzoylecgonine within the range 0.1-1 mg/l were 95.7% and 50.3%, respectively. The use of high-flow sorbents allowed the easy extraction of amniotic fluid regardless of sample viscosity or physical nature. The use of these solid-phase columns provided many advantages over the more commonly used solvent extraction, including an increase in extraction speed and efficiency, reduced operator time, reduced solvent use and disposal volumes and exceptional extract quality. Further, the determination of amniotic fluid obtained from pregnant cocaine users may provide important information about handling of cocaine by the fetus at various gestational ages. The procedure was successfully applied to amniotic fluid from suspected cocaine abusers.     

Trends in North Korean foreign policy

North Korea’s foreign policy track record in the post-cold war era is mixed. Most notable setbacks are the diplomatic normalization between the Soviet Union (now Russia) and South Korea; the reversal of its UN policy that paved the way for the simultaneous admission of the two Korean states to the world organization; and the diplomatic normalization between China and South Korea. On the credit side of Pyongyang’s diplomatic ledger are changes in its relations with Tokyo and Washington. While tangible results have yet to materialize, particularly in North Korea-Japan relations, the groundwork has nonetheless been laid for significant improvement. North Korea’s suspected nuclear weapons development program has played a major role in the unfolding of its relations with the United States. Conceptually, North Korean foreign policy can be explained in terms of its quest for three interrelated goals: security, legitimacy, and development. In the post-cold war era security appears to have emerged as the most important of the three goals. North Korea is at a crossroads. The choices it makes in foreign policy will determine not only the direction of its domestic policy but, ultimately, the survival of the regime itself. The external players in Seoul, Washington, Tokyo, Beijing, Moscow, and Vienna (the IAEA) have varying degrees of leverage over Pyongyang’s policy as well.