• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.241-247
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• 2020

Objectives: This study aims to present the case of poisoning associated with Phytolacca radix. Case Presentation: A 61-year-old male with nausea, vomiting, dizziness, and abdominal pain after ingesting about 10 centimeters of Phytolacca radix visited Korean medicine hospital. He began to show symptoms one hour after eating the plants. Methods: The patient was diagnosed with poisoning by Phytolacca radix. The patient received acupuncture, moxibustion, and herbal medicine treatment including Glycyrrhizae radix. laboratory test including complete blood count, biochemistry was also conducted. Results: Treatment, including acupuncture, moxibustion, and herbal medicine, improved his symptoms. His symptoms subsided within two hours. The laboratory test conducted on the next day show a slight increase in his white blood cell, blood urea nitrogen, urine ketone levels. There was no damage to the liver or kidneys. Conclusions: This report demonstrates the need for caution when consuming wild plants, which could lead to serious adverse effects. Patients should be alerted to the indiscriminate ingestion of wild plants. Further research on how to treat poisoning in Korean medicine needs to be considered to confirm these findings.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.15-24
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• 2018

Purpose: This study was conducted to analyze the factors associated with intoxicated patient's disposition in the pediatric emergency department. Methods: We retrospectively evaluated pediatric intoxicated patients visiting the pediatric emergency department of a hospital between January 1, 2011 and December 31, 2013. Specifically, we analyzed the association between hospitalization recommended rate and the following variables: patient age group, symptoms, intentional poisoning, decontamination and toxic level of substance. Results: We collected data from 345 patients. A high incidence was noted in the 1-4 years of age group and 10-15 years of age group. Unintentional poisoning occurred in 306 patients (88.7%). A total of 115 patients (33.3%) had symptoms when visiting. Forty three patients (12.5%) ingested cleaning substances, which was the most common agent. Potentially-toxic level was the most common level of the substance. The hospitalization recommended rate associated with visits in 2011 was 2.5 times greater than in 2012 and 2013, decontamination was 2.0 times greater than no decontamination, and poisoning with potentially-toxic substances was 2.6 times greater than poisoning with other toxic substances. Additionally, the hospitalization recommended rate associated with symptomatic patients was 2.4 times greater than that of asymptomatic patients and intentional poisoning was 2.4 times greater than unintentional poisoning. Conclusion: Patients with decontamination, ingestion of potentially-toxic substances, symptoms and intentional poisoning had increased hospitalization rates. In addition, the hospitalization rate for patients who visited in 2011 was greater than that of patients who visited in 2012 or 2013.

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.95-100
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• 2011

Purpose: Ingestion of puffer fish can be poisonous due to the presence of potent neurotoxins such as tetrodotoxin (TTX) found in its tissues. There are few clinical reports related to TTX. We performed this study to evaluate the clinical characteristics of TTX poisoning. Methods: We conducted a retrospective study of the 41 patients diagnosed with TTX poisoning who visited the Seoul Asan medical center from July 2004 and December 2010. A review of patients' electronic medical records and patient telephone interviews were conducted. Diagnosis of TTX poisoning was confirmed by observing the casual link between puffer fish consumption and the development of typical TTX intoxication symptoms. Results: The mean age of the patients included in the study was 46.6 years. The highest incidence of intoxication was observed in patients in their 50s (10 patients). Seasonal distribution of intoxication events included 10 in spring, 7 in summer, 10 in fall, and 14 in winter. In most cases, symptoms occurred within 1 hour of ingestion. A wide range of symptoms were associated with puffer fish ingestion affecting multiple body systems including neuromuscular (27 patients), gastrointestinal (19 patients), and cardiopulmonary/vascular (19 patients). All patients were treated with symptomatic and supportive therapy and recovered completely, without sequelae, within 48 hours. In three cases, ventilator support was required. Conclusion: TTX poisoning is not seasonally related, and patients admitted to the emergency room were observed with a wide range of symptoms. Where TTX poisoning is diagnosed, supportive therapy should be performed. Early intubation and ventilation is important, especially is cases of respiratory failure.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.1-6
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• 2019

Scombroid fish poisoning (SFP) is a form of histamine food poisoning caused by the ingestion of improperly stored fish. The term "scombroid" derives from the family name of the fish family first implicated, such as tuna and mackerel. On the other hand, non-scombroid fish species, such as sardine and herring, can also cause histamine poisoning. The histamine is converted from histidine by a bacterial enzyme in the causative fish. Because the symptoms of SFP can easily be confused with food allergies, it is believed to have been significantly under-reported. In 2016, an outbreak of SFP occurred among primary school students who had eaten yellowtail steak in Korea. The most common findings consisted of a rapid onset of flushing of the face and trunk, erythematous and urticarial rash, diarrhea, and headache occurring soon after consuming the spoiled fish. Usually, the course is self-limiting and antihistamines can be used successfully to relieve symptoms, but several life-threatening SFP cases have been reported. Clinical toxicologists should be familiar with SFP and have competency to make a differential diagnosis between fish allergy and histamine poisoning. SFP is a histamine-induced reaction caused by the ingestion of histamine-contaminated fish, whereas a fish allergy is an IgE-mediated reaction. This review discusses the epidemiology, pathophysiology, diagnosis, treatment, and preventive measures of SFP.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.41-45
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• 2012

Recently, some patients have visited the emergency department for treatment of different symptoms of acute poisoning after intake of unidentified herbs, which can be mistaken for wild edible greens, because wild edible greens are good for health and contain vitamins, enzymes, minerals, fibers, and anticancer materials. Winter or early spring, is extremely high, with rapid onset of severe symptoms of poisoning. There have been no reports of poisoning by SymplocarpusRenifolius in Korea, however, we report on three severe cases involving patients who experienced cardiogenic shock with nausea, vomiting, abdominal pain, chest discomfort, dizziness, numbness, and general weakness.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.66-69
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• 2016

Some carnivorous gastropods have heat stable tetramine toxins in their salivary glands. This toxin is an autonomic ganglionic blocking agent that enables them to catch the prey easily by paralyzing their targets. Acute tetramine toxin poisoning in humans from eating whelks has been well described based on numerous cases, but is rare in Korea. Symptoms of tetramine poisoning include eyeball pain, blurred vision, headache, dizziness, muscular twitching, tingling of hands and feet, weakness, paralysis and sometimes collapse. Gastrointestinal symptoms, such as abdominal pain, nausea, and vomiting can also occur. However, intoxication is self-limiting and patients will usually recover in about 24 hours. Herein, we report 2 cases of tetramine poisoning after ingestion of Buccinum striatissinum as meat and soup.

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.132-142
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• 1994

Paraquat has been widely used as a herbicide in Korea since 1970. Human ingestion results in transient impairment of liver and kidney function and a characteristically respiratory failure with a high mortality rate. Clinical investigation and Oriental Medical Treatment were done on 3 cases of paraquat poisoning admitted to the department of 1st Internal Medicine. Kyung San University Oriental Medical Hospital from August 1991 to December 1992. and following results were obtained. The symptoms of paraquat poisoning can be regarded as Sim hua chi song(心火熾盛), Kan hua sang yom(肝火上炎). um hu hua wang(陰虛火旺), Kan tam sup yol(肝膽濕熱), Yang myong yol tok(陽明熱毒) in Oriental Medicine. and the principle of treatment for paraquat poisoning can be applicable to Chong yol Ii sop(淸熱利濕), Chong yol hae tok(淸熱解毒). Sa ha hae tok(瀉下解毒). Ja um kang hua(滋陰降火) and so on. Three cases were treated by HuangYonHaeTokTang(黃蓮解毒湯) and KamDuTang(甘豆湯): all of them have survived without complications. According to the result above, it suggests that determination of treatment based on the differentiation of symptoms and signs(Pyon jung si chi ;辨證施治) of Oriental Medicine may prove to be helpful in saving lives of patients with paraquat poisoning.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.541-549
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• 2019

Objectives: This study aims to examine patients who developed acute pesticide poisoning while spraying or using pesticide and presented to the emergency department in hospitals in Chungcheongnam-do Province. Based on the findings, this study will provide implications for safety and health management pertaining to the use of pesticides. Methods: Pesticide poisoning data collected by the Chungnam Center for Farmers' Safety and Health from 2014 to 2018 was cross-sectionally analyzed. A total of 331 patients with pesticide poisoning presented to one of hospitals and four of medical centers in the region(Dankuk University Hospital, Gongju and Hongsung, Cheongyang, Cheonan Medical Center). Seventeen of these patients (15 men and two women) developed poisoning while spraying pesticide. The patients' charts were reviewed to collect data on pesticide poisoning, namely currently working in farming-related occupation, means of transportation to the hospital, place of poisoning, symptoms of acute pesticide poisoning, treatment, pesticide used when poisoning occurred, and classification by technical ingredients. Results: Fifteen out of 17 patients who developed poisoning while spraying pesticide were men. Insecticide was used in 35.3% of the cases, and herbicide was used in 29.4% of the cases, which was different from cases of poisoning from ingestion poisoning. The major symptoms were vomiting (35.3%), nausea (29.4%), dizziness (29.4%), and headache (23.5%). A total 11 ingredients were identified in 12 patients, and the most common ingredient was glyphosate, which is an herbicide. Most patients showed a state of mild toxicity, but two patients showed a state of severe toxicity. These patients respectively used glyphosate and paraquat. Conclusions: Our findings can be useful for suggesting the need for a national healthcare system to manage occupational pesticide poisoning among farmers. Further, these findings can be used to increase the awareness of the risk of acute poisoning during pesticide spraying and suggest the need for a safety health education to increase farmers' awareness of pesticide poisoning.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.2
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• pp.67-71
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• 2004

Arsenic poisoning has three types of poisoning. First, acute arsenic poisoning is usually caused by oral intake of large amount of arsenic compound with purpose of homicide or suicide. Second, chronic arsenic poisoning is caused by inhalation of arsenic in the occupational setting or by long-term oral intake of arsenic-contaminated well water. Third, arsine poisoning occurs acutely when impurities of arsenic in non-ferrous metal react with acid. Clinical manifestation of acute arsenic poisoning is mainly gastrointestinal symptoms and cardiovascular collapse. Those of chronic poisoning are skin disorder and cancer. Arsine poisoning shows massive intravascular hemolysis and hemoglobinuria with acute renal failure. Exposure evaluation is done by analysis of arsenic in urine, blood, hair and nail. Species analysis of arsenic is very important to evaluate inorganic arsenic acid and mono methyl arsenic acid (MMA) separated from dimethyl arsenic acid (DMA) and trimethyl arsenic acid (TMA) which originate from sea weed and sea food. Treatment with dimercaprol (BAL) is effective in acute arsenic poisoning only.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.36-42
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• 2007

Purpose: To assess the epidemiology and the clinical features of Glufosinate herbicide in Korea. Methods: Data was prospectively collected during 1 year since August 2005 from 38 hospital in Korea. We analyzed the epidemiologic characters and clinical manifestations of Glufosinate poisoning. In addition, the characteristics of patients with severe central nervous system toxicity were separately analyzed to find poor prognosis relating factors. Results: During study periods, there were 715 persons of poisoning of herbicides and insecticides. 6.3% (45 persons) of the agricultural chemicals poisoning had Glufosinate poisoning. There were 36 cases of suicide attempts and 7 cases of accidental exposure, The major of poisoning route was oral ingestion (44 cases). 28.9 % of the study patients had not toxic symptoms. The most common symptoms were gastrointestinal symptoms relating surfactant irritation. 67.7% of central nervous symptoms occurred lately. 10 persons showed severe central nervous system toxicity. 4 persons of them showed poor outcomes (1 death, 3 hopeless discharged). Complications of respiratory failure and renal failure related with poor outcome. Conclusion: Majority of patients ingested Glufosinate for suicide attempt. 22.2% of patients with Glufosinate poisoning showed delayed serious central nervous system toxicity. Early supportive care of altered mentality may prevent late respiratory complications and improve the outcomes.