• Title/Summary/Keyword: Acute Poisoning

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Investigation of a Staphylococcal Food Poisoning Outbreak Among School Children (수학여행중 국민학교학생의 포도구균식중독 발생에 대한 역학적조사)

  • Loh, In-Kyu
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.111-114
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    • 1972
  • There was an outbreak of food poisoning on the 17 October, 1970 among the primary school children who came from a rural area, Yeongi-gun, Choongcheongnam-do to Seoul City on an educational trip. Of the 199 children participating in the trip, 149 cases of food poisoning developed a 74.9% attack rate. The acute onset of symptoms, of abdominal pain, diarrhea, vomiting and headache which occurred 1-5 hours after eating their lunch suggests that the outbreak was due to staphylococcal food poisoning. The common source of food was identified as the lunch packed in a chip-box which were eaten on October 17 during the trip. Most probable kind of food of the lunch as the cause was the favoured fish paste. The lunch were prepared at restaurant A in Seoul City. One of the personnel of the restaurant had a unhealed cut wound on the third finger tip of the left hand, from which it was considered that the food was contaminated with Staphylococcus during preparation. The chance of multiplication of Staphylococcus to produce enterotoxin in the food might be existed during flavouring the food with some degree of heat, and also during about 10 hours elapsed before serving the food after preparation.

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Three Cases of Cardiac Toxicity after Intake of Symplocarpus Renifolius (앉은 부채 섭취 후 발생한 심장독성 3예)

  • Kim, Tae-Hoon;Kim, Hyun;Kim, Oh-Hyun;Cha, Yong-Sung;Cha, Kyoung-Chul;Lee, Kang-Hyun;Hwang, Sung-Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.1
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    • pp.41-45
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    • 2012
  • Recently, some patients have visited the emergency department for treatment of different symptoms of acute poisoning after intake of unidentified herbs, which can be mistaken for wild edible greens, because wild edible greens are good for health and contain vitamins, enzymes, minerals, fibers, and anticancer materials. Winter or early spring, is extremely high, with rapid onset of severe symptoms of poisoning. There have been no reports of poisoning by SymplocarpusRenifolius in Korea, however, we report on three severe cases involving patients who experienced cardiogenic shock with nausea, vomiting, abdominal pain, chest discomfort, dizziness, numbness, and general weakness.

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Prognostic Value of Blood Lactate for Mortality of Acutely Poisoned Patients in Emergency Department (응급실내 급성 중독 환자들의 예후 예측에 대한 혈액 젖산 수치의 유용성)

  • Kim, Hye Ran;Kang, Mun Ju;Kim, Yong Hwan;Lee, Jun Ho;Cho, Kwang Won;Hwang, Seong Youn;Lee, Dong Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.1
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    • pp.16-25
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    • 2016
  • Purpose: Patients suffering from acute poisoning by different substances often visit the emergency department (ED) and receive various prognoses according to the toxic material and patients' condition. Hyperlactatemia, which is an increased blood lactate level that generally indicates tissue hypoperfusion, is commonly utilized as a prognostic marker in critically ill patients such as those with sepsis. This study was conducted to investigate the relationships between blood lactate and clinical prognosis in acute poisoned patients. Methods: This retrospective study was conducted from January 2013 to June 2014 at a single and regional-tertiary ED. We enrolled study patients who were examined for blood test with lactate among acute intoxicated patients. The toxic materials, patient demographics, laboratory data, and mortalities were also reviewed. Additionally, we analyzed variables including blood lactate to verify the correlation with patient mortality. Results: A total of 531 patients were enrolled, including 24 (4.5%) non-survivors. Patient age, Glasgow coma scale (GCS), serum creatinine (Cr), aspartate transaminase (AST), and serum lactate differed significantly between survivors and non-survivors in the binary logistic regression analysis. Among these variables, GCS, AST, and lactate differed significantly. The median serum lactate levels were 2.0 mmol/L among survivors and 6.9 mmol/L among non-survivors. The AUC with the ROC curve and odds ratio of the initial serum lactate were 0.881 and 3.06 (0.89-8.64), respectively. Conclusion: Serum lactate was correlated with fatalities of acute poisoning patients in the ED; therefore, it may be used as a clinical predictor to anticipate their prognoses.

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Outcomes of Acute Liver Injury from Accidental Mushroom Poisoning (급성 버섯중독으로 인한 간손상의 추적 조사)

  • Oh, Bum-Jin;Kim, Won;Lim, Kyoung-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.116-122
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    • 2004
  • Purpose: Several risk factors related with chronic complications and mortality related with liver injury of mushroom poisoning were reported. But, there were few reports about the long term outcomes. The aim was to evaluate the long term clinical outcomes in mushroom poisoning regarding the risk factors. Methods: Clinical data were reviewed and outcomes were evaluated with medical records and/or telephone interviews. The patients who had one or more risk factors such as markedly elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT), prolonged prothrombin time (PT) were classified into high risk group. Patients had no risk factor classified into low risk group. Results: From June 1989 to December 2003, nineteen mushroom poisoning patients admitted to Asan Medical Center, seven were male, and mean age was $58\pm9$ years old. All the patients accidentally ingested and the interval from ingestion to symptom onset was $9\pm4$ hours. There were four patients in high risk group, and fifteen in low risk group. In high risk group, peak AST was $2,263.3\pm1,303.0IU/L$most prolonged PT was $38.0\pm27.4\%$, and stuporous mental status was shown in one patient. In low risk group, laboratory values returned to the normal values but histological evaluation revealed specific features of toxic hepatitis on sixth hospital day. Chronic complications such as persistent or chronic hepatitis, mortality was not occurred during follow up period (from 10 months to 16 years) in both groups. Conclusion: Although the number of patients were small, there were no chronic complications or mortality related with liver injury after mushroom poisoning regardless risk factors of chronic complications and mortality.

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Different Clinical Outcomes by Subgroups in Organophosphorus Poisoning (유기인계 농약 중독 환자에서 약물의 종류에 따른 임상 양상 및 예후의 차이)

  • Lee, Duk-Hee;Jung, Jin-Hee;Jung, Koo-Young;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.1
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    • pp.8-14
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    • 2007
  • Purpose: Organophosphorus insecticides tend to be regarded as a homogeneous single entity. We aimed to determine whether organophosphate poisoning differs by subgroups in clinical features and severity. Methods: We retrospectively reviewed medical records of all patients with acute organophophorus poisoning from January 1998 to December 2006. We investigated clinical features, Glasgow coma scale (GCS), laboratory findings, QTc intervals, management, and outcomes. Results: A total of 109 patients were included. The dimethoxy group experienced significantly longer times than the diethoxy group for ventilation duration (0.6 day vs. 0.2 day, p=0.006), ICU duration (2.0 day vs. 0.8 day, p=0.037), and total admission duration (2.8 day vs. 0.9 day, p=0.008), except in cases of dichlorvos poisoning. Also, the GCS of the dimethoxy group (except with dichlorvos) was significantly lower than for the diethoxy group (dimethoxy, $11.2{\pm}5.2$ vs. diethoxy, $13.8{\pm}2.4$, p= 0.021). QTc intervals for the dimethoxy group (except with dichlorvos) tended to be somewhat greater than for the diethoxy group (dimethoxy, $452.9{\pm}16.1\;msec$ vs. diethoxy, $429.6{\pm}40.9\;msec$). There were 65 patients with dichlorvos ingestion, and 2 of these patients (3%) died. Conclusion: When compared to the diethoxy group, the dimethoxy group of organophosphates (with the exception of dichlorvos) were associated with poorer prognostic value for indicators such as GCS, QTc interval, requirement for intubation, ICU duration, and total admission duration. Within the dimethoxy group, patients with dichlorvos poisoning had relatively better prognoses than for the other dimethoxy group organophosphates studied.

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Histopathological Study on Teeth, Jawbone, and Oral Tissues in Poisoned Rabbit (독극물중독 가토의 치아 및 악골조직의 병리조직학적 변화에 관한 연구)

  • 김종열
    • Journal of Oral Medicine and Pain
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    • v.9 no.1
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    • pp.11-22
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    • 1984
  • The authors administered KCN, NaF,AS2O3 orally to rabbits and caused acute and chronic poisoning, then studied the teeth, jaw bones, and other oral tissues histopathologically. The results were as follows : 1. There was no significant difference between acute poisoned group by NaF and control group. But, vasodilatation in the connective tissues, esepcially marginal area of jaw bone, atrophy and destrution of glandualr cells was observed. 2. Chronic poisoned group by NaF showed degeneration and thicking of subcutanece fibrosis ective tissues, atrophy and degeneration of subcutaneous connective tissues, atrophy and degeneration of muscle fibers, vasodilation of subcutaneous in bone cavities(lacunae), and degeneration of odotlblasts in pulp tissue. 3. Acute poisoned group by KCN showed almost similar appearances as control group, and chronic poisoned group showed hyperplasia of baal layer in epitheilium, degeneration of subcutaneous connective tissues, vasodilation and huperemia, severe hemorrhage of marginal area of jaw bone. hyperplasia of salivary gland ducts, but normal arrangement of muscle fibers and narrow bone carity(lacunae) due to active osteoblastic action, osteodentin were observed. 4. Acute poisoned group by AS2O3 showed degeneration of basal cell, atrophy of blood vessels in palatal muscosa. Chronic poisoned group showed irregular cell arrangement and degeneration, reduction of capillaries in palatal mucosa. Osteoclasts in jaw bone were observed. 5. In Masson's Trichrome and Van Gieson Staining, chronic poisoned group by NaF showed thicking and loosening of subcutaneous connective tissues. Hyperplasia of intermuscular connective tissue was observed in chronic poisoning by KCN and NaF. In PAS staining, negative reation in outer layer of palatalmucosa, positive reaction in keratin layer and mild reaction of basal layer in palate and tongue mucosa was observed.

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The Clinical Investigation of Gastric Lavage in Patients with Acute Poisoning (급성 약물 중독 환자에서 위세척의 치료 실태)

  • Ok Taek Geun;Cho Jun Hwi;Park Chan Woo;Cheon Seung Whan;Lee Seung Yong;Kim Sung Eun;Choi Ki-Hoon;Hae Ji Hoon;Seo Jeong Yeul;Ahn Hee Cheol;Ahn Moo Eob;Cho Byung Ryul;Kim Yong Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.22-26
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    • 2005
  • The majority of acute toxic poisoning occur via oral route. The most important emergency treatment of acute poisoning are gastric lavage. Gastric lavage should be considered a patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 mins of ingestion. But, gastric lavage does not consist properly in the cases of emergency situation or an inexperienced doctors treat. The purpose of this study was to determine whether gastric lavage is performed properly. Eighty patients were enrolled in the study in 12-month period from January to December 2002. A retrospective chart review was performed on patients identified as drug overdose who admitted to ER. To assess whether there was a subgroup of patients who may have been candidates for the initiation of gastric lavage in the ER, the patients divided in two groups by time interval from toxin ingestion to ER arrival. The group 1 that admit within 60 minutes after drug ingestion was 38 cases ($47.5\%$), and the group 2 patient who admitted after 60 minutes was 42 cases ($52.5\%$). The average age was $44\pm19$ years in group 1, and $48\pm24$ years in group 2. There were no differences in sexual distribution of two groups. The mean time interval was $49\pm20$ minutes in the group $1,258\pm190$ minutes in the group 2. Only thirty ($37.5\%$) of the patients had an overdose for which the treatment of gastric lavage was potentially feasible according to guideline. The correctly performed gastric lavage was 18 ($47.4\%$) in group 1, 12 ($28.6\%$) in group 2. We must enforce education about the gastric lavage, and do so that may treat according to guideline.

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Clinical Characteristics of Patients after Aryloxyphenoxy Propionate Herbicide Ingestion (Aryloxyphenoxy propionate 계열 제초제 중독환자의 임상 양상)

  • Lim, Junyeong;Moon, Jeongmi;Chun, Byeongjo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.71-77
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    • 2016
  • Purpose: No studies have been conducted to investigate the acute toxicity of aryloxyphenoxypropionate herbicides in humans following ingestion. Therefore, this study was conducted to investigate the clinical characteristics of aryloxyphenoxypropionate herbicide poisoning and provide guidance for physicians treating patients who have ingested these types of herbicides. Methods: A retrospective observational case series was conducted using ten patients with history of aryloxyphenoxy propionate herbicide. Data were collected for clinical manifestation, management and final outcome. Results: The most common symptoms were gastrointestinal irritation and an altered mental state (Glasgow Coma Scale<15). An elevated lactate level was a common laboratory abnormality, and prolonged QTc interval was commonly observed. These clinical features normalized within one day of supportive treatment. Conclusion: The acute toxicity of aryloxyphenoxypropionate herbicides in humans is manageable with supportive treatment. However, physicians should take into account depressed consciousness, the possibility of arrhythmia, and an elevated lactate level when planning their treatment strategy.

Survival after Cardiac Arrest due to Acute Methamphetamine Poisoning: A Case Report (메스암페타민(필로폰) 급성 중독으로 유발된 심정지 후 생존한 1례)

  • Mun, You Ho;Kim, Jung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.176-180
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    • 2018
  • Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

Case Study of Soyangin Patient with Delayed Encephalopathy after Carbon Monoxide Intoxication (일산화탄소 중독 지연성 뇌손상 소양인 환자 치험 1례)

  • Suhyun Kim;June Yong Park;Jong Cheon Joo
    • Journal of Sasang Constitutional Medicine
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    • v.35 no.3
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    • pp.1-11
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    • 2023
  • Objective This case report is to show the effectiveness of Sasang Constitutional Medicine treatment on the patient with delayed encephalopathy after acute carbon monoxide intoxication. Methods A 40-year-old female patient diagnosed with delayed encephalopathy after carbon monoxide poisoning 2 weeks ago before visiting our hospital. The patient suffered gait disturbance and cognitive disorder. She was identified as Soyangin and treated with Sasang constitutional Herbal Medicine(Yangkyuksanwha-tang and Hyungbangjihwang-tang). Improvement of symptoms was evaluated through Korean Version of Mini Mental Status Examination score(MMSE-K), Modified Barthel Index(MBI), Manual Muscle Testing(MMT), Range of Motion(ROM) and Hand Function Test. Results After 7 weeks of treatment, total score of MMSE-K increased from 0 to 26, the patient could walk by herself and had no trouble carrying out her daily life. Conclusions This case showed the effectiveness of Sasang constitutional medicine treatment for delayed encephalopathy after acute carbon monoxide intoxication.