• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.141-148
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• 2018

Purpose: The Korean government approved selected nonprescription drugs (Over-The-Counter drug; OTC drug) to be distributed in convenience stores from 15. Nov. 2012. This study examined the changes in the incidence and the clinical outcome of acute pharmaceutical drug poisoning after the deregulation of OTC drug sales. Methods: This study analyzed the data of Emergency Department based Injury In-depth Injury Surveillance (EDIIS), Korea Centers for Disease Control and Prevention, from 2011 to 2014. The following items were examined: age, gender, intention, alcohol association, pharmaceutical drugs resulting acute poisoning, the clinical outcomes in emergency department, and the admission rate of intensive care unit (ICU). This is a retrospective cross section observational study. Results: A total of 10,162 patients were subject to pharmaceutical drug poisoning. Acute poisoning by acetaminophen and other drugs were 1,015 (10.0%) and 9,147 (90.0%) patients, respectively. After the deregulation of OTC drug sales, acute poisoning by other drugs increased from 4,385 to 4,762 patients but acute poisoning by acetaminophen decreased from 538 to 477 patients (p<0.05). The rate of admission of acetaminophen poisoning increased from 36.1% (194/538) to 46.8% (223/477). The admission rate to the ICU by acetaminophen poisoning increased from 4.6% (25/538) to 11.3% (54/477) after the deregulation of OTC drug sales (p<0.05). Conclusion: Since the deregulation of OTC drugs sales, pharmaceutical drug poisoning has increased but acetaminophen poisoning has decreased. The rate of hospitalization and ICU admission by pharmaceutical drug poisoning with or without acetaminophen has also increased.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.393-398
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• 2023

Patients transported from fire sites may exhibit various injury patterns. Major trauma, skin burn, inhalation burn, and carbon monoxide poisoning are typical injuries. However, most physicians may be unfamiliar that cyanide poisoning can frequently occur due to combustion. Cyanide poisoning is highly significant owing to high mortality and the existence of antidotes. I present a 35-year-old man who was transported from a burning building and suffered severe metabolic acidosis despite no major bleeding as well as mild carbon monoxide poisoning. I suspected cyanide poisoning and administered the antidote; subsequently, the patient showed improvement. The next day, sudden airway obstruction developed, and emergency endotracheal intubation was performed. The inhalation damage was detected only in the lower airway tract and not in the upper airway. Physicians should be aware of cyanide poisoning and inhalation burn to avoid missing treatment opportunities.

• Journal of Environmental Health Sciences
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• v.37 no.1
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• pp.22-28
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• 2011

This study aimed to determine the feasibility of survey questionnaires for pesticide poisoning. We conducted a pilot study to develop a questionnaire for evaluating pesticide poisoning symptoms and to examine the validity of self-reported information for individual pesticides used. In December 2010 we interviewed 20 farmers with self-reported pesticide poisoning histories residing in Gyeonggi Province. For validity of pesticide information, the purchased pesticide lists from the agricultural cooperative federation were compared with individual self-reported pesticides used. Neurological symptoms were the most common among clinical symptoms related to pesticide poisoning, followed by gastrointestinal, dermal and eye symptoms. Insecticides were the main causative pesticide class for poisoning. Twenty one major symptoms were selected for screening for acute pesticide poisoning in a field study based on the pilot results and literature reviews. Substantial under-reporting was found in data on self-reported individual pesticides used (9.2%), as well as low accuracy (36%) compared with their actual purchase lists. In this pilot study, we suggest the selected symptom lists may apply to a field survey of pesticide poisoning. However, the self-reported information on individual pesticides may not be valid and alternative methods need to be developed.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.47-53
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• 2016

Purpose: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. Methods: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. Results: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). Conclusion: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.

• Journal of Environmental Health Sciences
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• v.45 no.6
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• pp.622-629
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• 2019

Objectives: The occurrence of norovirus food poisoning in South Korea has been reported since 2003. This study was performed to investigate the characteristics of norovirus food poisoning outbreaks in Korea from 2006 to 2015 and to analyze the relationship between these outbreaks and climate factors. Methods: Data on norovirus food poisoning outbreaks were obtained from the Korea Ministry of Food and Drug Safety. Data on climate factors were obtained from the Korea Meteorological Administration. Frequency analysis and Pearson's correlation analysis were adopted for this study. Results: During the study period, norovirus was the greatest contributing factor of food poisoning outbreaks. Approximately half of the outbreaks of norovirus food poisoning occurred in winter. Average temperature, highest and lowest temperatures, precipitation, number of days with rainfall, and humidity all had a significant negative correlation with monthly number of outbreaks of norovirus food poisoning (p<0.05). Among these, the lowest and average temperature showed higher correlation coefficients. However, the sum of the outbreaks in spring and autumn was similar to that of winter, and more than one-third occurred in group meal-service settings, including school lunches. This was strongly assumed as the use of norovirus-contaminated groundwater for preparation of meals in some settings. Conclusion: The cold and dry of the winter season in Korea may assist the transmission of norovirus. Also, the use of groundwater in group meal service is suspected of inducing a larger scale of norovirus food poisoning. Both health authorities and community-based prevention and control measures are required to respond to these complex etiological outbreaks.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.126-131
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• 2019

Purpose: Herbicide-related mortality has decreased since the complete ban of paraquat product sales in 2012, but there still have been other herbicides intoxications with relatively severe complications. Glyphosate and glufosinate herbicides are used widely, and considerable research has been conducted. Chlorophenoxy herbicide is another major herbicide that has shown poor outcomes and mortality without proper management, but research in this area is lacking. Therefore, this study compared the clinical features of chlorophenoxy herbicide with those of other herbicides. Methods: The medical records of patients exposed to herbicides at a tertiary academic university hospital in Korea from May 2014 to April 2019 were reviewed retrospectively. The demographic and clinical data of 135 patients were then analyzed to identify the recent herbicides intoxication trends after the paraquat sales ban, focusing mainly on chlorophenoxy herbicide poisoning. Results: Of the 135 patients, 13 patients (9.6%) had chlorophenoxy herbicide poisoning. No significant differences in all the variables were observed between the chlorophenoxy herbicide poisoning group and non-chlorophenoxy herbicides poisoning groups. Toxic symptoms after poisoning varied from nothing noticeable to confusion; none of the patients had severe complications after their treatments. Conclusion: Acute chlorophenoxy poisoning is relatively less severe, with lower mortality rates than glyphosate and glufosinate poisoning.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.51-56
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• 2020

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.

• Journal of The Korean Society of Clinical Toxicology
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• v.22 no.1
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• pp.1-9
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• 2024

Purpose: Nutritional therapy is a crucial component of therapy for critically ill patients, but there is a lack of nutritional support guidelines for organophosphate (OP) poisoning, likely due to the gastrointestinal effects of atropine, the main antidote for OP. This study investigated whether enteral nutrition (EN) during atropinization is acceptable for mechanically ventilated patients after OP poisoning. Methods: This retrospective study classified 82 patients with OP poisoning according to whether they were fed during atropinization while on mechanical ventilation (MV). Data on the baseline characteristics, nutritional support, and clinical outcomes were compared. Univariate and multivariate regression models were constructed to analyze the associations between atropine administration for OP poisoning and feeding intolerance-related EN after adjustment for risk factors. Results: Eighty-two patients received EN after 72 hours on MV, and 40 of them simultaneously received 2 mg/hr atropine for the first 120 hours after EN initiation. The overall incidence of feeding intolerance was 57.3% during the first 12 days after EN initiation and did not differ according to atropine administration. Appropriate atropinization during EN in regression model 1 and the dosage of atropine administered during EN and the duration of EN during atropinization in model 2 were not associated with feeding intolerance in patients on MV after OP poisoning. Conclusion: Appropriate atropinization is not associated with feeding intolerance after EN provision in patients on MV after OP poisoning. This study will help establish nutritional guidelines for OP poisoning patients. More research on nutritional support is needed to validate our results.

• Journal of the Korean Applied Science and Technology
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• v.28 no.1
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• pp.57-63
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• 2011

Polymer electrolyte membrane fuel cell (PEMFC) performance degrades when hydrogen sulfide ($H_2S$) is present in the fuel hydrogen gas; this is referred to as $H_2S$ poisoning. This paper reveals $H_2S$ poisoning on PEMFC by measuring electrical performance of single cell FC under various operating conditions. The severity of $H_2S$ poisoning depended on $H_2S$ concentration under best operating conditions($65^{\circ}C$ of cell temperature and 100% of anode humidification). $H_2S$ adsorption occured on the surface of catalyst layer on MEA, but not on the gas diffusion layer(GDL) by analyzing SEM/EDX data. In addition, MEA poisoning by $H_2S$ was cumulative but reversible. After poisoning for less than 150 min, performance of PEMFC was recovered up to 80% by just inert nitrogen gas purging.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.116-122
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• 2020

Acute respiratory failure is an important risk factor for mortality in patients with acute pesticide poisoning. Therefore, it is necessary to investigate the risk factors to predict respiratory failure in these patients. This study retrospectively investigated the clinical features of respiratory failure among patients with acute pesticide poisoning requiring mechanical ventilation. This study included patients who were admitted with intentional poisoning by pesticide ingestion from January 2017 to December 2019. Paraquat intoxication was excluded. Among 469 patients with acute pesticide poisoning, 398 patients were enrolled in this study. The respiratory failure rate was 30.4%. The rate of respiratory failure according to the type of pesticide was carbamate (75.0%), organophosphate (52.6%), glufosinate (52.1%), glyphosate (23%), pyrethroid (8.9%), and others (17%). The mortality was 25.6% in the respiratory failure group. The risk factors for respiratory failure were old age, low body mass index, and ingestion of more than 300 mL. In conclusion, respiratory failure is a risk factor for mortality in pesticide poisoning. Old age, low body mass index, and ingestion of more than 300 mL are the risk factors for predicting respiratory failure.