• Journal of The Korean Society of Clinical Toxicology
• /
• v.20 no.2
• /
• pp.58-65
• /
• 2022

Purpose: Alcohol is one of the most commonly co-ingested agents in deliberate self-poisoning (DSP) cases presenting at the emergency department (ED). The increased impulsivity, aggressiveness, and disinhibition caused by alcohol ingestion may have different clinical features and outcomes in cases of DSP. This study investigates whether alcohol co-ingestion affects the clinical features and outcomes of DSP patients in the ED. Methods: This was a single-center retrospective study. We investigated DSP cases who visited our ED from January 2010 to December 2016. Patients were classified into two groups: with (ALC+) or without (ALC-) alcohol co-ingestion. The clinical features of DSP were compared by considering the co-ingestion of alcohol, and the factors related to discharge against medical advice (AMA) of DSP were analyzed. Results: A total of 689 patients were included in the study, with 272 (39.5%) in the ALC+ group. Majority of the ALC+ group patients were middle-aged males (45-54 years old) and arrived at the ED at night. The rate of discharge AMA from ED was significantly higher in the ALC+ group (130; 47.8%) compared to the ALC- group (p=0.001). No significant differences were obtained in the poisoning severity scores between the two groups (p=0.223). Multivariate analysis revealed that alcohol co-ingestion (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.01-1.98), alert mental status (OR=1.65; 95% CI, 1.17-2.32), past psychiatric history (OR=0.04; 95% CI, 0.01-0.28), age >65 years (OR=0.42; 95% CI, 0.23-0.78), and time from event to ED arrival >6 hrs (OR=0.57; 95% CI, 0.37-0.88) were independent predictive factors of discharge AMA (p=0.043, p=0.004, p=0.001, p=0.006, and p=0.010, respectively). Conclusion: Our results determined a high association between alcohol co-ingestion and the outcome of discharge AMA in DSP patients. Emergency physicians should, therefore, be aware that DSP patients who have co-ingested alcohol may be uncooperative and at high risk of discharge AMA.

• YAKHAK HOEJI
• /
• v.34 no.5
• /
• pp.323-333
• /
• 1990

To study influence of carbonmonoxide (CO) poisoning on the content of amino acid neurotransmitter in brain, male rat was exposed to CO 5000 ppm for 30 minutes (60-75% HbCO). Aspartic acid and glutamic acid level in the cerebral cortex and aspartic acid level in the striatum were significantly decreased. GABA level in the cerebral cortex was significantly increased after the 30 and 60 minutes of CO intoxication. Taurine level in both the cerebral cortex and the striatum was increased although nonsignificant. Consequently, the CO-induced hypoxia brain showed lower level of excitatory neurotransmitter, aspartic acid and glutamic acid and higher level of inhibitory neurotransmitter, GABA and taurine. These results suggest that the change in content of amino acid neurotransmitter in the rat brain may be concerned with several CO poisoning symptoms.

• Toxicological Research
• /
• v.29 no.2
• /
• pp.129-135
• /
• 2013

Salmonella is one of the major pathogenic bacteria that cause food poisoning. This study investigated whether heat-killed as well as live Lactobacillus protects host animal against Salmonella infection. Live and heat-killed Lactobacillusacidophilus was administered orally to Sprague-Dawley rats for 2 weeks before the rats were inoculated with Salmonella. Rise in body temperature was moderate in the group that was treated with heat-killed bacteria as compared to the Salmonella control group. The mean amount of feed intake and water consumption of each rat in the heat-killed bacteria group were nearly normal. The number of fecal Salmonellae was comparable between the live and the heat-killed L. acidophilus groups. This finding shows that L. acidophilus facilitates the excretion of Salmonella. Moreover, the levels of pro inflammatory cytokines, including tumor necrosis factor (TNF)-alpha and interleukin (IL)-1 beta, in the heat-killed L. acidophilus group were significantly lower when compared to the levels in the Salmonella control group. These results indicate that nonviable lactic acid bacteria also could play an important role in preventing infections by enteric pathogens such as Salmonella.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.12 no.2
• /
• pp.46-53
• /
• 2014

Purpose: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. Methods: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. Results: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), $PaCO_2$<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and $PaCO_2$<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). Conclusion: Overall, dizziness, time interval between onset of symptoms and ingestion, ${\Delta}DBP$ and $PaCO_2$<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and $PaCO_2$<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.

• Journal of Preventive Medicine and Public Health
• /
• v.5 no.1
• /
• pp.9-15
• /
• 1972

Carbon monoxide poisoning is one of the most serious health problems in Korea, because we have been encountered with the highest incidence of CO poisoning in the world due to the unique heating system in home called 'ondal'. We opened Hyperbaric chamber unit in the Seoul National University Hospital last Jan, 1969. We have treated 848 patients as of Sept. 30., 1972, around 44 months period. We collected the informations on the environmental conditions of the place where CO intoxication actually occured by filling up the questionaire from 505 patients. The following findings were obtained. 1. Age distribution showed that the highest incidence was found in the younger age group between age of 10 to age of 29 in both sex. 2. Sex ratio of the patients was 1:1.14. 3. The socio-economic level of the patient was relatively low. 4. Housewife & housemaid were the major victims of the intoxication in the female patients & in the case of the male patient, occupational backgrounds were diverse. 5. Many patients from the middle class experienced the intoxication by sleeping at newly built room. 6. Many intoxication has been occured in the structure of houses where communicating doors are existing between living room & kitchen. 7. All findings obtained taught us again that CO poisoning is the serious by-product of the national fuel policy which put emphasis on the use of coal & socio-economic status is a very important parameter in this hazards.

• 한국정보디스플레이학회:학술대회논문집
• /
• 2002.08a
• /
• pp.371-375
• /
• 2002

Emissions of thermionic cathodes and field emitters were studied using a cathode emission profiler which works based on the anode scanning method. Findings about impregnated cathodes in thermal activation and gas poisoning processes are shown. Effects of surface treatments for field emitters are studied from the viewpoint of emission profiles and characteristics of the emitters.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.14 no.2
• /
• pp.92-99
• /
• 2016

Purpose: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. Methods: A retrospective chart review study was conducted for patients whose final diagnoses were "poisoning" and "benzodiazepine" or "sedatives-hypnotics" from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. Results: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. Conclusion: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.

• Journal of Environmental Health Sciences
• /
• v.38 no.6
• /
• pp.451-459
• /
• 2012

Background: In Korea, a healthy 36-year-old man developed acute interstitial pneumonitis soon after inhaling a waterproofing spray which he had applied at home to his outdoor jacket. Objectives: The objectives of this study were to review cases of varying degrees of respiratory toxicity and poisoning in connection with the use of waterproofing spray and summarize major reasons for cases of poisoning. Methods: We searched articles reporting on a combination of a waterproofing agent and/or respiratory symptoms, including acute respiratory syndrome, lung injury, pneumonia, pulmonary toxicity, and respiratory disease. Results: We reviewed a number of cases of varying degrees of respiratory toxicity and poisoning resulting from inhalation of waterproofing spray containing fluorocarbon co-polymer, solvents and propellants reported in a variety of countries. The literature searches concluded that among the ingredients of waterproofing agents, fluorinated polymer may cause acute respiratory health effects. Conclusion: Environmental policy should be implemented in order to prevent consumers from using household and industrial products including waterproofing agents. In addition, a national surveillance system should be created to collect cases of poisoning caused by the use of consumer products.

• Bulletin of the Korean Chemical Society
• /
• v.20 no.12
• /
• pp.1413-1417
• /
• 1999

Chemical poisoning of Ni/MgO catalyst was induced by hot alkali carbonate vapor in molten carbonate fuel cell (MCFC), and the poisoned (or contaminated) catalyst was characterized by TPR/TPO, FTIR, and XRD analysis. Carbonate electrolytes such as K and Li were transferred to the catalyst during DIR-MCFC operation at 650 ℃. The deposition of alkali species on the catalyst consequently led to physical blocking on catalytic active sites and structural deformation by chemical poisoning. TPR/TPO analysis indicated that K species enhanced the reducibility of NiO thin film over Ni as co-catalyst, and Li species lessened the reducibility of metallic Ni by chemical reaction with MgO. FTIR analysis of the poisoned catalyst did not exhibit the characteristic ${\vector}_1$$(D_{3h})$ peaks (1055 $cm^{-1},\;1085\;cm{-1})$ for pure crystalline carbonates, instead a new peak (1120 $cm^{-1})$ was observed proportionally with deformed alkali carbonates. From XRD analysis, the oxidation of metallic Ni into $Ni_xMg_{1-x}O$ was confirmed by the peak shift of MgO with shrinking of Ni particles. Conclusively, hot alkali species induced both chemical poisoning and physical deposition on Ni/MgO catalyst in DIR-MCFC at 650 ℃.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.10 no.2
• /
• pp.73-79
• /
• 2012

Purpose: The purpose of this study was to identify the changes in the characteristics of patients with carbon monoxide (CO) poisoning, as well as the distinctive differences in intentionally exposed patients. Methods: The medical records of CO poisoning patients, who visited nine emergency departments between January 2010 and December 2011, were reviewed retrospectively. The clinical information including age, gender, hospitalization, type of discharge, cause and location of exposure, site of onset, concentration of initial blood carboxyhemoglobin (COHb), methods of treatment and presence of neurological complications was examined. The subjects were divided into an intentional and non-intentional group and the differences between them was compared. Results: A total 209 subjects were recruited. The median age was 38 years (29~49.5 years). They frequently complained of nausea and vomiting, and the most common exposures occurred in winter, normally in the home. The cause of exposure was usually fire, followed by incomplete combustion of fuels. The median initial blood COHb was 13.15%. The proportion of intentionally exposed patients was 21%. They were significantly younger, more frequently discharged against medical advice, and showed a higher initial blood COHb level (22.85%) than the non-intentional group. Conclusion: This study suggests that those with intentional CO poisoning are normally discharged against medical advice even when they have a higher initial COHb level. An adequate explanation of the delayed neurologic sequelae and short term follow-up observation is recommended for those patients with intentional exposure.