• Toxicological Research
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• 제17권
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• pp.37-39
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• 2001

As the preliminary data collection for further chemical risk assessment. toxicants rating works is now rather extensively implemented in China. It consists of two parts, ie., rating of the hazard level of the exposed toxicant and that of the toxicant's profession. In the first part, the rating are based on six criteria, ie., acute toxicity, incidence of acute poisoning, prevalence of chronic poisoning, consequence of chronic poisoning, carcinogenecity and MAC level. Four hazardous levels are to be classified as extreme, high, medium, mild. In the second part. three determinants as weighted coefficients are taken into account, ie., toxicant's hazard level. exposure time and folds of MAC surpassing. Eventually, the index of classification C by which the work with toxic hazard can be classified is able to be calculated and assessed. Several comments were discussed and new recommendations were demonstrated.

• 한국환경보건학회지
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• 제27권4호
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• pp.115-122
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• 2001

The purpose of this study was to investigate the metallothionein of acute cadmium poisoning mice as a Cadmium index. Forty male ICR mice were injected with cadmium chloride solution from 1/8LD50 to 1/2LD50 dose. At 24 hours after exposed Cd, I examined Cd and metallothionein (MT) intissues(liver and kidney) and fluids(whole blood and urine) and also measured low molecular proteins, N-acetyl-D-glucosaminidase(NAG) and 2- microglobuline (2-MG) in urine. The concentration of Cd and MT of liver kidney whole blood and urine were increased with dose dependent manner. Urinary Cd and urinary MT and very good significance (p<0.01) and urinary MT had good significance with kidney Cd and NAG but not 2-MG Conclusionally MT in urine was very correlated with kidney Cd and urine Cd, So MT maybe useful as a Cd poisoning index.

• Journal of Medicine and Life Science
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• 제18권2호
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• pp.31-34
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• 2021

The pharmacokinetic properties of transdermal nicotine patches (TNPs) are different from those of other routes of nicotine administration; further, acute nicotine poisoning by TNPs may present with different clinical features. In the present report, we describe the case of a 23-year-old woman who was admitted to emergency department (ED) at Jeju National University Hospital with loss of consciousness. Five hours before the ED visit, she used multiple TNPs to attempt suicide. Initially, nausea and vomiting occurred, and the symptoms worsened over time. We immediately removed the TNPs, and the application sites were gently washed with sterile water. The patient's level of consciousness gradually improved, and she fully recovered an altered mental status 5 hours later. Her initial urinary cotinine level was 324 ng/mL. Physicians should be aware that acute nicotine poisoning by TNPs can cause various toxic symptoms.

• 대한신경과학회지
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• 제36권4호
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• pp.358-362
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• 2018

Delayed anoxic encephalopathy after carbon monoxide (CO) poisoning is characterized by neurological deterioration that occurs after recovery from acute CO intoxication. There has been no established therapy. We report a patient recovered from acute CO intoxication developed various neurological symptoms. After the administration of high dose prednisolone and anticholinesterase inhibitor, the therapeutic effect was remarkable and confirmed by quantitative analysis of diffusion-tensor imaging (DTI). DTI could be used to evaluate the therapeutic effect for delayed anoxic encephalopathy after CO poisoning.

• 대한임상독성학회지
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• 제12권1호
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• pp.14-21
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• 2014

Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

• 대한임상독성학회지
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• 제4권2호
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• pp.113-121
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• 2006

Purpose: Previous studies have reported that plasma cholinesterase (AchE) concentration can serve as a useful prognostic parameter in cases of acute organophosphate (OP) poisoning. However, there has been considerable disagreement regarding the degree of its prognostic value. Earlier cross-sectional and one- time point studies were plagued with methodologic flaws, making it difficult to interpret their results. The purpose of this study was to clarify the prognostic value of time-variable cholinesterase levels and their relationship with clinical outcomes in OP poisoning. Methods: We reviewed medical and intensive care records of patients with acute OP poisoning admitted to our emergency department between March 1998 and Sep 2006. We collected patient information regarding poisoning, clinical, and demographic features. Patients were assessed for clinical outcomes and AchE concentrations on days 1, 2, 3, 5, and 7 and on the final day. Results: During the study period, 58 patients were enrolled in this study. There was a statistically significant difference in the AchE differentials on 1-3 days for patients requiring mechanical ventilation and for patients with mild poisoning (p<0.05). Also, the decrease in the log AchE concentration correlated with longer durations of mechanical ventilation (r=-0.411, p=0.002). Conclusion: In severe OP poising, measurements of time-variable AchE concentrations can be helpful in the prediction of mortality, the development of intermediate syndrome, and duration of mechanical ventilation.

• 대한임상독성학회지
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• 제12권1호
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• pp.31-34
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• 2014

We report on a patient who developed acute hepatic failure despite intravenous N-acetyl cysteine therapy who was treated with the Molecular Adsorbents Recirculating System (MARS). She presented 20 hours after the ingestion of 13 g of acetaminophen. The MARS is based on albumin dialysis principle which can be applied for patients with acute poisoning from drugs that have high protein-binding capacity because of its ability to selectively remove from circulation protein-bound toxins. The clinical toxicologist should be consider this technology when treating patients with hepatic failure following acetaminophen poisoning.

• 대한임상독성학회지
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• 제10권2호
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• pp.118-121
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• 2012

Chromic acid is a strong metal acid and acute poisoning is very rare. However, chromic acid causes serious complications, such as skin injuries, as well as renal and hepatic failure. We report on a case of a 47-year-old male who accidentally had chromic acid spilled over his nose and face. For the first few days, he was treated with ascorbic acid and massive hydration. However, after three days, his condition began to worsen. He was treated with hemodialysis for anuria and acute renal failure, and antibiotics for pneumonia. On day 10 of hospitalization, he expired of multi-organ failure. We suggest firm control and close supervision of chromic acid in the work place, and, considering severe complications of chromic acid, we propose a nearly and aggressive treatment.

• 대한임상독성학회지
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• 제9권2호
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• pp.88-94
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• 2011

Purpose: Delayed neuropsychological sequelae (DNS) commonly occurs after recovery from acute carbon monoxide poisoning. The aim of this article is to identify the factors associated with DNS development. Methods: We retrospectively evaluated patients, admitted to the medical center emergency department from June 2005 to March 2011, who were suffering from acute carbon monoxide (CO) poisoning. We categorized the patients into two groups - those with DNS, and those without DNS. Multiple regression analysis was performed to identify the factors related to manifestation of DNS. Results: Of the total one hundred fifty seven patients (157) recruited for the study, twenty two (22) developed DNS. Longer CO exposure times and lower GCS scores were positively associated with development of DNS symptoms. Conclusion: Our study identified two potential factors which are predictive of DNS development in CO intoxication, however, more studies are needed. Adequate follow-up after hospital discharge to monitor for and accurately identify manifestation of DNS, is also important.

• 한국환경보건학회지
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• 제37권2호
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• pp.81-93
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• 2011

Although pesticides have increased crop production and controlled disease, they have produced a number of adverse health effects. Pesticides have potential human toxicity and a variety of groups, such as farmers or industrial workers, as well as the general population, are exposed to pesticides. The purpose of this article, therefore, is to provide an overview of pesticide exposure and health through a literature review, focusing on exposure assessment, acute poisoning, chronic health effects, and future research needs. The exposure types and levels of pesticides vary by study subjects and need to be assessed by integrating several methods focused on the epidemiological purpose. Acute pesticide poisoning is a major public health problem in the world. Paraquat is the main causative pesticide for acute poisoning in Korea and should be banned in order to save several thousands of lives every year. Occupational pesticide exposure also causes numerous chronic diseases among farmers and industrial workers, including cancers, respiratory diseases, depression, retinal degeneration, diabetes, and abnormal menstrual cycle. However, controversy exists regarding the long-term effects of low-dose environmental pesticide exposure. The area of pesticide study is relatively new with broad study populations and it has received little academic and policy attention, particularly in Korea. More detailed studies investigating the risk of pesticide-related health effects and intervention efforts to reduce the problems are needed in Korea.