Lee, Jeong Hwa;Choi, Sangchun;Yoon, Sang Kyu;Shin, Kyu Cheol
Journal of The Korean Society of Clinical Toxicology
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v.18
no.2
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pp.78-84
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2020
Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.
In spite of the radical increase of chemical poisoning cases caused by prevalent of oranic chlorine like endosulfan, the study of detection of chemical poisoning has seldom been attempted; the study of poisoning in teeth, which is more secure physiochemically, and in all the oral tissues has been even less attempted. The author has administered endosulfan into the month of a rabbit, causing its death, and tried to detect endosulfan in the teeth, jaws, and oral tissues through forensic chemical and histopathological tests. The result obtained is as follows : 1. By thin layer chromatography, endosulfan was detected in the jews, dental hard tissues, dental pulp, blood, and the liver. 2. By gas chromatography, it was also detected in the jaws, dental hard tissues, dental pulp, blood, and the liver. 3. The congestion and hemorrhage in buccal mucosa, palatal mucosa, and dental pulp was detected.
A patient (Pointer+Viszula mixed breed, 4 months old, male), with chief historic sign of acute vomiting, hemorrhagic diarrhea, anorexia and dyspnea during 4 days was admitted to College of Veterinary Medicine, Kyungpook National University. Necropsy findings were revealed ulcer and hemorrhage contained hemorrhagic diarrhea in gastrointestinal tract, severe emphysema and hemorrhage in the lung and kidney and cardiac hypertropy. Histopathological changes showed emphysema, hyperemia and hemorrhage in the lung, severe hyperemia, hemorrhage, hepatic vacuolation and cellular necrosis in the liver, hyperemia, hemorrhage, necrosis of tubular epithelium in the kidney, hemorrhage in cardiac muscle and hyperemia, necrosis and sloughing of epithelium in the intestine. Histopathological diagnosis was made as paraquat poisoning.
Journal of The Korean Society of Clinical Toxicology
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v.2
no.2
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pp.90-95
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2004
Purpose: The purpose of this study is to compare the toxicologic characteristics of two groups of patients with acute intoxication for two different time periods and to make recommendations based on the results of this study. Methods: We reviewed retrospectively the medical records of patients with acute intoxication in our emergency center from June 1997 to May 1998 (group A) and from June 2000 to May 2003 (group B), and we evaluated differences in the epidemiologic and the toxicologic characteristics between the two groups. Results: The ratios of the number of patients with acute intoxication to the total numbers of patients who visited our emergency department were $0.49\%$ and $0.52\%$ for groups A and B, respectively. In both groups many poisoned patients visited our emergency center from 4:00 pm to midnight. The interval between the time of intoxication and arrival at the hospital was significantly shorter in group B. The number of patients transferred to our emergency center was larger in group B. Attempted suicide was the major cause of acute intoxication in both groups. Major toxic substances in both groups were centrally active drugs and insecticides. The number of comatose and mechanically ventilated patients was larger in group B. However, there was no statistically significant difference in the mortality rates. Conclusion: Emergency physicians who manage intoxicated patients should recognize regional characteristics and differences in the toxicologic characteristics of poisoning. In addition, the establishment of a poisoning control center in the regional emergency center is necessary to integrate data control and to enhance specialized management of intoxicated patients.
An eight-week-old male ICR mouse, which was induced with acute alcohol and sub-acute alcohol poisoning condition, was administered with bohee tea(Camelia sinensis L) extract. Under the inducement of the sub-acute alcohol poisoning condition, no considerable differences could be found in the blood alcohol concentration of the positive control group and the bohee tea group(p<0.05). The GOT activity of the three groups: bohee tea, Drink, and Alcodex decreased than that of the normal control group(9.064±4.687 unit)(p<0.05). In addition, the blood GOT activity of the dark green tea group dropped by 81.44% compared with that of the positive control group. On the other hand, the blood GTP activity of the bohee tea group decreased by 5.2% as opposed to that of the positive control and the Drink that decreased by 7.5% as opposed to that of the positive control. The hepatic ADH activity of the bohee tea increased by 22.7%, as opposed to that of the positive control group. The Drink, however, had an increase rate of 33.6%. In the case of the hepatic ALDH activity of the liver, no significant differences were ever recorded among all groups, except for the positive control group. Due to an intake of bohee tea extract, the hepatic ALDH activity decreased by 77.27% which could not be seen in the positive control group. However, Drink and A1codex had a decrease could be seen(p<0.05).
An eight-week-old male ICR mouse, which was induced with acute alcohol and sub-acute alcohol poisoning condition, was administered with bohee tea(Camelia sinensis L) extract. After oral administration of bohee tea and inducement of acute alcohol poisoning condition, the mouses blood alcohol concentration became as low as that of the normal control group. Its decrease rate was 87.26%, in comparison with that of the positive control group. Moreover, its blood GOT activity decreased with a rate of 93.1 % until it reached the normal level, as opposed to that of the positive control group. In addition, the GOT activity, despite rising after the alcohol intake, decreased(p<0.05) significantly after administration of each sample and reached the normal level. The bohee tea group experienced a significant decrease in the GOT activity, compared with the A1codex group and the Drink group. The GPT activity of the Alcodex group decreased by 11 % compared with that of the positive control group. The CTP activity of the bohee tea group decreased by 8.2%, while that of the Drink group decreased by 6.5%(P<0.05). However, there were no significant differences between the results in the control group and those of the test group. The bohee tea group's hepatic ADH activity increased by 22.7% compared with that of the positive control group. On the other hand, the hepatic ADH activity of the Drink group increased by 33.6% while that of the A1codex group increased by 20.4%. On the contrary, the bohee tea extract, the hepatic ALDH did not manifest any significant difference as compared with the normal control group. However, its decrease rate was about 16.67% as compared with that of the positive control group. The Drink group, meanwhile, obtained a decrease rate of about 21.59%.
Jung, Young Yun;Ha, Chul Min;Jung, Sung Tae;Lee, Hyoung Ju
Journal of The Korean Society of Clinical Toxicology
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v.18
no.2
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pp.94-101
/
2020
Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.
Journal of agricultural medicine and community health
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v.8
no.1
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pp.28-34
/
1983
In spite of the world-wide increase of incidence of pesticide poisoning due to greater use of pesticides, the epidemiological study of pesticide poisoning in Korea has been grossly neglected. The author gained access to the medical records for two year period (1981 through 1982) from local clinics, hospitals and health centers of Kyungpook area to investigate the status of the pesticide poisoning. During these two years, there were 1,618 cases of documented pesticide poisoning, of which in 1981 were 765 and in 1982 were 853. Those in the twenties decade of age was the most frequent and the male(70%) was more liable than the female (30%). In view of manner of poisoning, occupational poisoning was 27.8%, accidental 5.6%, and suicidal 66.6%. There are three distinct groups which make up the large majority of both fatal and nonfatal cases; young children who accidentally ingest pesticides, young to middle age adult who are occupationally poisoned, and middle age to older adults who suicidally ingest pesticides. The seasonal distribution of these poisonings disclosed the peak month to be July, with August next, followed by June and September. Only 11% of cases occurred during the three-month winter season of December to February. Thus pesticide caused poison- ing was primarily a summer and early fall occurrence. During these two years, average of 67 cases of poisoning was observed monthly. Of the pesticide poisoning documented, 49% were treated with poisoning patients from local clinic and 43% from hospital. The case fatality rate of occupational poisoning was 0.9%, accidental 5.6% and suicidal 20.3%. The mean overall case fatality rate was 14.1%. Annual incidence of pesticide poisoning was 25.4 per 100,000 population in the study area. There is a nationwide need for more reliable date on pesticide poisoning. This need can only grow more acute with the passage of time because of the increasing importance of pesticides as a cause of morbidity and mortality.
Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.
Choi, Jiun;Ko, Dong Ryul;You, Je Sung;Chung, Sung Phil
Journal of The Korean Society of Clinical Toxicology
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v.15
no.1
/
pp.60-64
/
2017
Nicotine-poisoning related to the electronic cigarettes (e-cigarette) is increasing worldwide. Moreover, the American Association of Poison Control Centers has advised the public to use caution with e-cigarette devices and highly concentrated liquid nicotine after a surge in related poisonings. We report here the first case of nicotine poisoning from self-injected e-cigarette fluid in Korea. A 17-year-old male patient subcutaneously injected himself with 0.5 ml of nicotine solution for an electronic cigarette via the dorsum of his hand, after which he complained of nausea, vomiting, dizziness and dyspnea. His vital signs were within the normal range, but his mental status was drowsy. He was admitted for observation and the symptoms disappeared the following day. Sinus bradycardia with a rate of 45/min was observed on the third hospital day, but improved after 6 hours. He was discharged without complications.
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