• Title/Summary/Keyword: Acute Poisoning

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A Survey of Drug Intoxication Patients Transferred by 119 Ambulance Service - Seocho area in Seoul - (일 지역 119구급대를 통한 약물중독 사례 고찰 - 서울시 서초지역 중심 -)

  • Cho Wonsun
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.106-117
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    • 1996
  • This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

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Effect of Ethanol Extracts of Raw and Boiled Bracken on Blood Pressure in Cats (고사리 (Pteridium aquilinum) Ethanol 추출액(抽出液)에 의한 혈압강하작용(血壓降下作用))

  • Koh, Sang-Don;Kim, Kee-Soon
    • The Korean Journal of Physiology
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    • v.18 no.2
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    • pp.171-180
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    • 1984
  • The death of cattle from acute bracken poisoning has been recognized for many years. Acute bracken poisoning is characterized by mucoidal nasal and anal hemorrhage, severe anorexia. pyrexia, gastric ulcer and myocardial damage. In 1958 Evans first suggested that clinical picture of bracken poisoning was very much similar to that of radiation injuries such as aplastic anemia, leucopenia, thrombocytopenia and increased capillary fragility. Bracken has been clearly demonstrated to contain a carcinogen as well as thiaminase. However, the nature of carcinogen in bracken has not definetely elucidated. Also it was warned by several workers that bracken could be a causative factor for stomach cancer in Korean and Japanese. It appears that little is known on the e(feet of bracken on the function of cardiovascular system. Therefore the present study was designed to explore effects of ethanol extract of raw and toiled bracken (RBEE:BBEE) on blood pressure in cats. Also studied was the mechanism underlying changed in blood pressure of cats by bracken. The result obtained were as follows; 1) Mean arterial blood pressure was invariably decreased following administration of either RBEE or BBEE. Tn general depressor responses to RBEE persisted longer than that to BBEE. Generally, depressor responses were proportional to debases of RBEE and BBEE administered. 2) After administration of 60 mg/kg RBEB and BBEE, blood Pressure decreased by $62.1{\pm}1.7mmHg$ and $68.0{\pm}3.0mmHg$, respectively. No change was observed between depressor responses to RBEE and that to BBEE. 3) Depressor responses to BBEE and RBEE were not affected by vagotomy, propranolol and regitine. 4) In atropinized animal depressor responses to BBEE and RBEE were reduced by 30-40% showing part of depressor response was resulted from cholinergic effect of bracken.

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The Clinical Investigation of Drug Intoxication in the North-Youngseo District of Kangwon Province (강원 영서 북부 지역의 약물 중독 실태)

  • Ok, Taek-Gun;Cho, Jun-Hwi;Park, Chan-Woo;Kim, Sung-Eun;Choi, Ki-Hoon;Bae, Ji-Hoon;Seo, Jeong-Yeul;Chung, Jae-Bong;Ahn, Hee-Cheol;Ahn, Moo-Eob;You, Ki-Cheol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.83-89
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    • 2004
  • Acute poisoning is one of the diseases which need the most fastest emergency measures at the very beginning. However, at present, The Korea doesn't manage the toxication all over the country, and in particular, there is no guide to medical cure paying due regard to the traits of each area. This paper focused on the issue that the necessary data in preparing the facilities for the treatment of the poisoned patients and materials for medical treatment including antidote would have to be collected, after finding the special features of the symptoms by searching the present conditions of the poisoning in small towns next to farm villages in the North area of Youngseo, Kangwon province. This study was based on the questionnaires from 111 patients who were carried into the emergency room by the poisoning in two university hospitals of the North area of Youngseo, Kangwon, for one year, 2002. Upon investigation, the patients(111) visiting emergency room by the acute poisoning during the research period was found to be 0.37 percent of all patients(30,085) visiting emergency room. Among them, the most high percentage was given in their twenties and thirties at the rate of $39.6\%$, and the ratio($40.5\%$) of the poisoned patients after their fifties was much higher than a research($10\%$) of other areas. Many poisoned patients came to their rescue in an emergency room generally in spring and in winter, from 7 a.m. to 3 p.m. Agricultural chemical of the toxic materials had a majority at a ratio of $57.7\%$, and paraquat of the agricultural chemicals was found to have a lot of toxicity by $31.7\%$. As the trace of the toxication, the oral poisoning was common by $89.2\%$, and $55.9\%$ in the case of operating gastric lavage and nasogastric irrigation, but only $14.4\%$ for prescribing antidote. The mortality of the acute poisoned patients was $17.2\%$, and the toxication by paraquat held a majority. As a result, the acute poisoning of the North area in Youngseo, Kangwon had both of the characteristics of the rural and the city, and the patients over their fifties by the population aging had more attack of the disease than other regions. Also, with the high ratio of the toxication by the agricultural chemicals, especially, the lethal agricultural chemical was used frequently. Therefore, these dangerous situations need to find the ways to cope with.

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Two Cases of Respiratory Failure After Recovery of Cholinergic Crisis in Organophosphate Poisoning: The Intermediate Syndrome (유기인제 중독에서 콜린성 위기 회복후 급성 호흡부전을 보인 Intermediate Syndrome 2예)

  • Cho, Dae-Kyoung;Lee, Seung-Eun;Baik, Jae-Joong;Chung, Yeon-Tae;Chung, Keun-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.247-254
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    • 1999
  • Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

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A Preliminary Study for Effect of High Flow Oxygen through Nasal Cannula Therapy in Carbon Monoxide Poisoning (일산화탄소 중독 환자에서 고유속 비강 캐뉼라 산소치료 효과에 대한 예비 연구)

  • Kim, Young-Min;Kim, Sang-Chul;Park, Kwan-Jin;Lee, Seok-Woo;Lee, Ji-Han;Kim, Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.102-107
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    • 2019
  • Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

A Systematic Review of Injury or Poisoning Related to Mercury Thermometer (수은 체온계와 관련된 손상 및 중독에 대한 체계적 고찰)

  • Lee, Yo Seop;Joo, Young Seon;You, Je Sung;Chung, Sung Phil;Chung, Hyun Soo;Lee, Hahn Shick
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.1
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    • pp.22-30
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    • 2014
  • Purpose: The purpose of this systematic review was to evaluate the evidence regarding injury and poisoning associated with the clinical mercury thermometer. Methods: Electronic literature searches were conducted for identification of relevant studies and case reports of injury and poisoning associated with the clinical mercury thermometer. The search outcomes were limited to literature with English and Korean languages published from 1966. Studies related to occupational mercury exposure, or mercury exposure from sphygmomanometer, barometer, and fluorescent light were excluded. Results: A total of 60 reports, including 59 case reports, were finally included. Of those, nine cases pertained to an intact thermometer as a foreign body, 25 injuries were related to a thermometer, and 26 cases involved exposures to mercury from a broken thermometer. Case reports were classified according to severity into 16 mild, 41 moderate, and two severe cases. Two cases of mortality were reported, one was deliberate intravenous injection of mercury and the other was acute vapor inhalation of mercury from broken thermometers. Conclusion: Findings of this systematic review suggested that the mercury thermometer could cause various forms of poisoning and injury. In particular, inhalation of mercury vapor from a broken thermometer can lead to systemic toxicity requiring chelating therapy.

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Rhabdomyolysis and Acute Renal Failure Following an Intentional Overdose of Stacker 3 (A Caffeine-Containing Weight-Reduction Supplement)

  • Lee, Mi-Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.1
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    • pp.46-49
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    • 2010
  • "Stacker 3" is one of the most popular caffeine-containing weight-reduction supplements and it has ephedra-free properties as "Stacker 2 Ephedra-Free" in many countries, including Korea. We describe here a 26-year-old woman who took an acute intentional overdose of "Stacker 3"(approximately 50 capsules, total amount: 25 grams, as caffeine 250 mg/kg) and who had delirium, rhabdomyolysis and acute renal failure. She had to be treated by forced diuresis and urine alkalinization, and she subsequently recovered. This is the first such case report in the medical literature.

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Acute Oral Toxicity Test in Japanese Quail (일본 메추리를 이용한 급성 경구독성시험법의 확립)

  • 최은실;박종환;홍정주;박재학
    • Toxicological Research
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    • v.17 no.4
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    • pp.287-296
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    • 2001
  • The acute oral LD5O toxicity values of isazofos, pyraclofos, diazinon and methomyl were determined for Japanese quail based on OECD guideline. The $LD_{50}$ of isazofos, pyraclofos and diazinon was 16.26 mg/kg, and 7.11mg/kg body weight In female respectively. And the $LD_{50}$ of each chemical in male was 21.44, 35.64, 8.28 mg/kg body weight respectively. Diazinon was the most susceptible compounds to Japanese quail in both sexes. The $LD_{50}$ of methomyl was 21.24 mg/kg body weights in female, and 28.28 mg/kg body weight in male respectively. Diazinon, isazofos and methomyl were more toxic In the female than male. The symptoms of poisoning were similar in quails administrated with each chemicals. The clinical sign in Japanese quail were ataxia, salivation, diarrhea, ruffled feather and convulsion at dead point. There were severe hemorrhage and catarrhal inflammation from duodenum to ileum In all compounds. In Japanese quail treated with organophosphorus and carbamate compounds, brain acetylcholinesterase was inhibited by 88-96. The recovery was not observed after 5 h in sublethal dose.

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A Case of Colchicine Intoxication Presenting as Acute Gastroenteritis (위장관염으로 오인된 콜히친 중독 1례)

  • Ahn, Ji-Yun;Sohn, You-Dong;Kwon, Hyuk-Sool;Ahn, Hee-Chol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.138-141
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    • 2008
  • A 47-year-old woman ingested about 12 mg of colchicine with suicidal intent. Colchicine, a highly poisonous alkaloid, is a commonly used treatment for gout, Bechet's disease, and familial Mediterranean fever. Despite the knowledge of its side effects, the risk of a significant overdose is under-appreciated. She suffered from acute multisystem toxicity, including gastrointestinal disorders, bone marrow suppression, alopecia, and probable pancreatitis, but she ultimately recovered with supportive therapy. We report a case of acute colchicine toxicity from a single overdose with a review of the literature.

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A Case Study of Patient with Delayed Post-Anoxic Encephalopathy Improved by Korean Traditional Treatment, Especially Jowiseungchungtang (조위승청탕(調胃升淸湯)등 한방치료로 호전된 급성 일산화탄소 중독의 지연성 후유증 환자)

  • Kim, Yun-Yong;Kim, Ji-Young;Cho, Hye-Young;Cho, Seung-Hun;Hwang, Wei-Wan
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.205-217
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    • 2008
  • After recovery from acute carbon monoxide poisoning, some patients suffer from neuropsychiatric problems such as cognitive impairement, movement disorder, change of personality and mental disorder after lucid interval in which the patient has no symptom. This sequela of carbon monoxide poisoning is called delayed post-anoxic encephalopathy(DPE). No neuroprotective drug has yet demonstrated ecfficacy and hyperbaric oxygen treatment's effect have little scientific evidence in preventing and improving DPE. In such situation, korean traditional treatment may be helpful in treating the patient suffering from DPE. In this case report, we will describe the patient that has suffered from severe DPE involving cognitive impairment, gait disturbance and incontinence but has been improved successfully by korean traditional medicine treatment, especially Jowiseungchungtang. This case could present how we will study about DPE.

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