• 대한임상독성학회지
• /
• 제7권2호
• /
• pp.83-89
• /
• 2009

Purpose: Rhabdomyolysis is one of the most important complications of pesticide intoxication. It affects a patient's clinical prognosis and can cause acute renal failure. It is important that patients diagnosed with pesticide intoxication receive an accurate initial diagnosis and proper treatment to prevent significant complications. This study's objective was to investigate and confirm related factors causing acute renal failure by verifying clinical observations and laboratory findings collected following pesticide intoxication. Methods: A retrospective analysis was made of 734 patients who presenting to our emergency medical center after ingesting pesticides between January 2006 and December 2008, Of these, 513 patients were selected for the study. Two hundred and twenty-one patients were excluded because of paraquat intoxication, age (if under 18), or chronic renal failure. Seventy-four patients were diagnosed with rhabdomyolysis, based on serum creatinine phosphokinase levels were > 1,000U/L. Acute renal failure was diagnosed when creatinine levels were > 2.0 mg/dL. Results: Among the 74 patients diagnosed with rhabdomyolysis, 26 (35.1%) experienced acute renal failure. The most meaningful related factor in the prediction of acute renal failure was initial arterial pH and creatinine level. Conclusion: Initial arterial pH and creatinine level are predictors of complications such as acute renal failure in patients with rhabdomyolysis.

• Journal of Chest Surgery
• /
• 제25권11호
• /
• pp.1231-1235
• /
• 1992

Perforation of the esophagus is a rare complication of endotracheal intubation and usually occurs after hasty intubation. A 26-year-old female was transferred from other hospital for further management of empyema of the right lung. During admission, the empyema was found due to esophageal perforation, which had developed during the endotracheal intubation after acute poisoning of carbon monooxide 5 dayes prior to the transfer. The em-pyema and the esophageal perforation were successfully managed by conservative measures including effective drainage.

• 대한수의사회지
• /
• 제22권5호
• /
• pp.291-293
• /
• 1986

Severe nervous signs, including convulsions and death, occurred in young calves which were being fed with furazolidone (83mg/kgB. W./day) as feed additives. The drug was recommended by the manufacturer to use on the chicken and the pig. A diagnosis of acu

• 대한임상독성학회지
• /
• 제1권1호
• /
• pp.47-50
• /
• 2003

Endosulfan, one of organochlorine insecticides, is $\gamma$-aminobutyric acid (GABA) antagonist. In sufficient dose, this pesticide lower the seizure threshold and produce CNS stimulation, with resultant seizures, respiratory failure, and death. In patients with endosulfan intoxication, the first manifestation of toxicity is largely a generalized seizure without prodromal signs or symptoms. So the management of airway and seizure control are essential for survival and prognosis of intoxicated patients. We report two cases of acute endosulfan poisoning who manifest 'status epilepticus' similarly, but have different prognosis.

• Investigative Magnetic Resonance Imaging
• /
• 제20권3호
• /
• pp.175-180
• /
• 2016

Carbon monoxide (CO) intoxication is a leading cause of the variable neuropsychiatric impairment. Despite of widely known central nerve system complications after CO intoxication, peripheral neuropathy due to CO poisoning is rare and has been under-recognized. We report interesting case of a 29-year-old male who suffered from motor weakness and sensory abnormalities in his lower extremity following acute CO intoxication. The patient revealed direct and indirect signs of peripheral neuropathy of the left inferior gluteal and sciatic nerve on magnetic resonance imaging.

• Toxicological Research
• /
• 제13권3호
• /
• pp.183-186
• /
• 1997

Acute toxicity of pectenotoxin 2 (PTX2) was examined in mice. Treatment of mice with a toxic dose of PTX2 resulted in clinical signs such as ataxia, cyanosis and an abrupt decrease in body temperature. Histopathological studies revealed that the liver is the major target organ for PTX2. Activities of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and sorbitol dehydrogenase (SDH) were significantly elevated by PTX2 administration. Glucose-6-phosphatase activities were not changed by the treatment. The PTX2 treatment decreased relative liver weight without changing the body weight. The effect of PTX2 on hepatic drug metabolizing enzyme system was determined. An ip dose of PTX2 (200 $\mu$g/kg) induced a significant decrease in the hepatic microsomal protein content. Cytochrome P-450 content, cytochrome b$_5$ content, NADPH cytochrome c reductase, aminopyrine N-demethylase activities, or hepatic glutathione content were not altered by PTX2 treatment.

• Investigative Magnetic Resonance Imaging
• /
• 제18권4호
• /
• pp.352-356
• /
• 2014

본 증례의 51세 남자 환자는 글루포시네이트 암모니움을 과다 섭취한 후에 전향적 기억상실증이 발생하였다. 뇌 자기공명영상에서 양측 해마와 해마옆이랑, 오른쪽 후두엽에서 고신호강도 병변을 관찰할 수 있었다. 급성 글루포시네이트 암모니움 중독이 해마에 병변을 만드는 기전과, 양측성 해마에서 생길 수 있는 질환들의 감별진단에 대하여 논하고자 한다.

• 대한수의학회지
• /
• 제22권2호
• /
• pp.233-237
• /
• 1982

Pathological studies on 6 milk goats administrated with urea were carried out to determine the effects of acute and chronic poisonings on the animal. Clinical signs appeared about 10 minutes after ingestion of the urea and they consisted chiefly in dullness, staggering, uncontrolled urination, dyspnea, frothy salivation, bloating, muscular tremor, humping of back and tetanic spasms. Macroscopic lesions were failure of blood clot, frothy and bloody contents in the highly congested respiratory tract, pulmonary edema, rumenitis and abomatitis accompanying with petechiation of the upper small intestine. Microscopically, the liver showed vacuolar degeneration, fatty change and areas of necrosis and partial proliferation of the interlobular connective tissues in chronic crises. The renal epithelium displaced vacuolar degeneration, necrosis and hyaline casts in their lumens. In the lungs, there were hyperemia, edema, hemorrhages, and acute catarrhal bronchitis. Neuronal degeneration and necrosis in the central nervous system, catarrhal rumenitis, abomatitis, doudenitis and myocardial hemorrhage were also demonstrated.

• 한국산학기술학회논문지
• /
• 제21권5호
• /
• pp.384-390
• /
• 2020

유기인계 살충제를 음독하였을 경우 임상적으로 치명적인 결과를 가져올 수 있다. 이 연구는 유기인계 살충제 음독으로 인해 사망한 환자와 생존한 환자들의 내원 당시 중성구/림프구 비율을 비교 분석하여 사망률을 얼마나 예측할 수 있는지 알아보기 위해 시행되었다. 연구 자료는 전자의무기록에서 추출하였고, 2008년 1월부터 2018년 11월까지 유기인계 살충제를 음독하고 일개 응급실에 내원한 환자들(150명)을 생존 군(135명)과 사망 군(15명)으로 분류하고 후향적으로 비교 분석하였다. 환자들의 특성(나이, 성별, 기저질환 유무, 음독 후 병원까지 걸린 시간, 음독 양), 혈액검사 결과들과 의학적 중증도에 대한 개별 변수들을 먼저 비교한 후, 유의한 차이를 보이는 변수(나이, 혈중 백혈구 수, 아밀라아제 농도, 크레아티닌 농도, APACHE II점수 및 중성구/림프구 비율) 들에 대해 로지스틱 회귀분석을 시행하였다. 연구결과 나이, APACHE II 점수 및 중성구/림프구 비율이 사망 군에서 생존 군에 비해 유의하게 높았다. 이들 중 중성구/림프구 비율은 응급실에 내원하면 기본적으로 시행하는 전혈 검사를 통해 30분 이내에 신속하고 간단하게 얻을 수 있는 예측 인자이다. 본 연구를 통해 사망을 예측하는 도구로 중성구/림프구 비율이 유용하게 사용될 수 있으며, 특히, 수치가 10 이상으로 높은 경우 환자가 사망할 확률이 높음을 인지하고 집중 감시 및 치료를 해야 할 근거를 제시해 줄 수 있을 것으로 생각된다.

• 대한임상독성학회지
• /
• 제11권1호
• /
• pp.9-18
• /
• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.