• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.363-371
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• 1999

Background: Because of the widespread use and availability of agricultural insecticides, acute organophosphate poisoning as a suicide or an accident is becoming the most common type of poisoning and serious problem in Korea. The mortality of organophosphate poisoning varied from 10 to 86 percent. The cause of death was thought to be a combination of excessive bronchial secretion, bronchospasm, respiratory muscle paralysis and depression of respiratory center, summarily respiratory failure. We evaluated the respiratory complications in patients with acute organophosphate intoxication to determine the predisposing, factors to respiratory failure and to reduce the incidence of respiratory failure or mortality. Method: We conducted a retrospective study of 111 patients with the discharge diagnosis of organophosphate poisoning who were hospitalized at Yenugnam University Hospital during the 5 years. The diagnosis of organophosphate poisoning has based on the followings (1) a history of exposure to an organophosphate compounds. (2) the characteristic clinical signs and symptoms. (3) decrease in the cholinesterase activity in the serum. Results: Respiratory failure developed in 31(28%) of 111 patients with acute organophosphate poisoning. All cases of respiratory failure developed within 96 hours after poisoning and within 24 hours in 23 patients. The 80 patients who did not develop respiratory failure survived. In 31 patients with respiratory failure, 15(44%) patients were dead. The patients with respiratory failure had more severe poisoning, that is, the lower level of serum cholinesterase activity on arrival, the higher mean dosage of atropine administered within first 24 hours. In 16 patients with pneumonia, 14 patients developed respiratory failure. In 5 patients with cardiovascular collapse, 2 patients developed respiratory failure. There was no correlation to between age, sex, the use of pralidoxime and respiratory failure. The serum cholinesterase level in survivors at time of respiratory failure and weaning was $66.05{\pm}85.48U/L$, $441{\pm}167.49U/L$, respectively. Conclusion: All the respiratory failure complications of acute organophosphate poisoning occurred during the first 96 hours after exposure. The severity of poisoning and pneumonia were the predisposing factors to respiratory failure. Aggressive treatment and prevention of the above factors will reduce the incidence of respiratory failure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.74-79
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• 2014

Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.52-56
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• 2008

Amitraz is used as farm-animal insecticide. Its side effects in humans are related to its pharmacological activity on alpha 2-adrenergic receptors. The case describes a previously healthy 46-year-old woman who intentionally ingested approximately 250mL of liquid amitraz. She presented with vomiting, altered mental status, miosis, dry mouth, hypopnea, metabolic and respiratory acidosis, hypotension, hypothermia, polyuria, metabolic acidosis, elevated serum aminotransferase and abdominal distension. Supportive treatments including mechanical ventilation, hydration, dopamine infusion, bicarbonate infusion and gastric decompression resulted in improvement. By hospital day 3, she recovered with resolution of abdominal distension. It is paramount to recognize amitraz poisoning when a pesticide-intoxicated patient presets with signs and symptoms consistent with organophosphate intoxicated patients but with greater alpha 2-adrenergic related symptoms such as decreased bowel motility and xerostomia.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.58-60
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• 2006

The venom gland of Toad contains large quantities of cardiac glycosides, and toad venom poisoning is similar to digitalis toxicity and carries a high mortality. Sometimes after ingestion of aphrodisiac pills which contain dried toad, a patient develops gastrointestinal symptoms and bradycardia, psychoneurologic symptoms. We have experienced 2 cases of toad venom intoxication, who ingested asian toads. Patients were presented to our ED with nausea, vomiting, and abdominal pain. The patients were peformed monitoring and conservative treatment and were fully recovered. Toad venom intoxication should be considered in patients with clinical manifestation of gastrointestinal irritation, cardiac arrhythmias, hyperkalemia, and detectable serum digoxin level without current medication of digoxin.

• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.131-137
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• 1982

For the purpose of the curative effects of oral D-penicillamine in lead poisoning, D-penicillamine was orally administered to 7 lead poisoned workers which were employed in glaze product industry dealing with the lead oxide ($Pb_3O_4$). The doses of D-penicillamine was 1,200mg per day which was administered by oral 7days schedules, taking for 5 days and stopping for the following 2days, repeatedly during 3 months period. (All the poisoned workers started working again in that industry after 1 month treatment, and were treated by oral D-penicillamine for 2 months still being exposed to contaminated environment.) In order to evaluate the curative effects of D-penicillamine, 10gm of whole blood and 24 hours urine were collected every 14 days during the curative period for laboratory analysis(hemoglobin, blood lead, urine $\sigma$-aminolevulinic acid, urine coproporphyrin, and urine lead levels) with the observation of the clinical symptoms. The results were as follows; 1. Oral D-penicillamine effected good curative results as that hemoglobin, blood lead, urine $\sigma$-aminolevulinic acid, and urine coproporphyrin levels were decreased below the critical level within 1 month treatment. 2. After re-exposure, oral D-penicillamine effected to some extent as that urine lead level was decreased below the critical level after 3 months treatment with disappearence of the clinical symptoms after 2 months treatment. However, the curative effects of oral D-penicillamine in the lead exposure state is questionable since increasement of blood lead level and remarkable decreasement of urine lead level after 3 months treatment can be observed.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.2
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• pp.130-132
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• 2013

Distinguishing wild plants in spring from ingestible plants is difficult. Differentiation of budding plants from other plants is particularly difficult. Many people want to find edible plants for health during the spring season. Scopolia japonica can cause symptoms of mania. The author experienced three cases of poisoning by Scopolia japonica. We reported on the cases with literature reviews.

• The Journal of the Society of Stroke on Korean Medicine
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• v.15 no.1
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• pp.50-56
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• 2014

The prevalence rate of plant poisoning is growing up gradually. However, it could be difficult to get proper treatment without detail medical history taking due to the diversity of poisonous plants and their various symptoms. Scopolia Japonica, which grows naturally in Korea, is reported to cause severe toxicity which could be lethal. A few therapeutic measures have been reported in Traditional Korean Medicine (TKM), but it has not been reported yet that those measures have been successfully proven in the clinical practice in modern times. This is a case report of toxicity caused by scopolia japonica ingestion. A 65years-old male patient with cognitive impairment, behavioral disorder, gait difficulty, dysarthria, dysphagia and abnormal pupil reflex recovered from those symptoms during taking Gamigamdu-tang and getting acupuncture. This study shows the clinical aspects of Scopolia Japonica toxicity and the possibility of TKM treatments as one of plant poisoning treatments.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.29-37
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• 2003

Objectives: This study was performed to evaluate the pesticide exposure status and acute pesticide poisoning symtoms among agricultural workers at Gangwon-do province alpine area. Alpine area was defined as the area higher than 400m. Methods: We analyzed 257 interviwed questionnaire about pesticide exposure, acute pesticide poisoning symptoms and other variables. Results: The result was shown that agricultural workers at alpine area used more pesticide than general agricultural workers for annual usage days(35.9 days vs 14.4 days), daily usage hours(6.7 hrs vs 2.8hrs, p<0.05). But there was no difference between general and alpine agricultural worker's herbicide exposure. Moreover, the alpine agricultural worker's acute pesticide poisoning symtom score was higher than general agricultural worker's. These difference was also found at result of regression analysis, under control the age, sex, monthly income. Most frequently suffered symptom was headache and dermatological problems. The symptom prevalence of dermatological problem, headache, general weakness, eye irritation, nausea were higher among alpine agricultural workers than general agricultural workers. Conclusions: As a result, agricultural workers at alpine area were more exposed to pesticide and suffered from pesticide poisoning symptoms. To prevent the symptoms and disease from pesticide exposure among agricultural workers at alpine area, more research and political effort will be needed.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.71-77
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• 2016

Purpose: No studies have been conducted to investigate the acute toxicity of aryloxyphenoxypropionate herbicides in humans following ingestion. Therefore, this study was conducted to investigate the clinical characteristics of aryloxyphenoxypropionate herbicide poisoning and provide guidance for physicians treating patients who have ingested these types of herbicides. Methods: A retrospective observational case series was conducted using ten patients with history of aryloxyphenoxy propionate herbicide. Data were collected for clinical manifestation, management and final outcome. Results: The most common symptoms were gastrointestinal irritation and an altered mental state (Glasgow Coma Scale<15). An elevated lactate level was a common laboratory abnormality, and prolonged QTc interval was commonly observed. These clinical features normalized within one day of supportive treatment. Conclusion: The acute toxicity of aryloxyphenoxypropionate herbicides in humans is manageable with supportive treatment. However, physicians should take into account depressed consciousness, the possibility of arrhythmia, and an elevated lactate level when planning their treatment strategy.

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