• 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.

• The Journal of Pediatrics of Korean Medicine
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• v.20 no.3
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• pp.143-160
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• 2006

Objectives : As the side effect brought up by internet game addiction, many reports come out, but most of past articles are for middle or high school students. There is seldom a poisoning game treatise to a primary school student, if there is treatise, it is real condition that treatise for lead pipe with psychological reasons is seldom discussion about physical symptoms. This research searches high grade elementary students' game use actual conditions and when divide to general user group, latent danger use group, high dangerous use group, according to serious illness degree of game poisoning, three groups and game poisoning happens, recognized about body symptoms that happen much. Methods : Target population of these questionnaire are fifth and sixth grade elementary student of Seoul city 2 school. Chose 263 elementary students, 144 men, 119 women who understand purpose of research and admit participation is 25 October, 2006 since 1 September, 2006 Results : As poisoning serious illness degree is high, there are many number of game times, much more boys are addicted to internet game than girs, insomnia is apt to happen frequently in game poisoning danger group, and correlation is high by megrim, shoulder ache, digestive trouble. Insomnia, symptoms that show next even if some symptoms show first because there is high correlation between megrim, shoulder ache, digestive trouble is high possibility to happen among four symptoms. Insomnia, megrim, shoulder ache, digestive trouble that happen by internet game poisoning, is apt to increase by increasing addiction. Symptoms treatment can divide by internal treatment that treat insomnia, megrim, digestive trouble, external treatment that is typical symptoms of VDT syndrome shoulder ache, headache, fatigue persimmon. Root treatment is mind symptoms treatment. Game addiction treatment is relationship method 'seven emotions injury treatment' in oriental medicine. 'promote the normal flow of qi' and 'adjustment of suitable emotion' can talk as pivotal point of treatment.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.57-60
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• 2007

Cyanide has been well known from antiquity. Cyanide poisoning causes histotoxic hypoxia--inhibition of mitochondrial cytochrome oxidase with disruption of the ability of cells to use oxygen. The mortality rate is 95% within 30 minutes. Acute cyanide poisoning is mostly the result of attempted suicide, and because of the high doses typically employed it usually is lethal within minutes. Also acute cyanide poisoning leads to a very poor prognosis because medical personnel can't detect cyanide intoxication and so many hospital haven't antidote. We report two cases of cyanide poisoning which responded well to treatment with the Taylor cyanide antidote package.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.140-147
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• 2017

Purpose: This study was conducted to analyze the features of poisoning in individuals aged 0-18 years to understand the characteristics of potential victims and eventually prevent poisoning. Methods: We retrospectively analyzed poisoned children and adolescents (0-18 years) who visited the emergency department of one tertiary hospital from January 2003 through December 2013. We collected data including their age, sex, reason for poisoning, components and dose of poison, results of treatment, and psychiatric diagnosis. Results: During the study period, there were 436 cases of poisoning (male 47.2% (n=206); female 52.8% (n=230)). Subjects were classified into four groups (0-1 years, 2-5 years, 6-12 years, 13-18 years). The most common cause of poisoning in all age groups was accidental poisoning (72.9%), but intentional poisoning increased as age increased (p<0.001). Moreover, females were more often subject to intentional poisoning than males (p<0.001). The most common poisoning material was drugs (41.7%). Among intentional poisoning patients, 62.7% patients had consulted a psychiatrist, and their most common diagnosis was adjustment disorder (44.6%). Conclusion: The most common cause of poisoning in individuals aged 0-18 years was accidental poisoning, while intentional poisoning was most common among adolescents. Guardians should take care to prevent accidental poisoning, while psychiatric consultation and national moderation will be needed to prevent intentional poisoning.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.276-285
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• 2000

Paraquat is a very potent herbicide which causes fatal toxicity when ingested, and there is no specific antidote against it. Human ingestion induces acute renal failure, hepatic dysfunction and progressive respiratory failure with high mortality rate. Clinical investigation and medical treatment were done on two cases of acute renal failure caused by paraquat poisoning admitted to the Department of Internal Medicine, Wonkwang University Oriental Chonju Medical Hospital. We report two cases of patients who survived after acute paraquat intoxication, by means of oriental medicine such as Gamdutang, a typical antidote of toxins, chinese ink as an absorbent and burned powder of Rhei Radix et Rhizoma for laxative and so on, western medicine such as gastric lavage, diuretics and fluid therapy. We suggest more experiments and studies related to such treatment for paraquat poisoning be conducted.

• 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 The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.33-39
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• 2005

Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.39-44
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• 2022

N-Acetylcysteine (NAC) is the standard antidote treatment for preventing hepatotoxicity caused by acetaminophen (AAP) poisoning. This review summarizes the recent evidence for the treatment of AAP poisoning. Several alternative intravenous regimens of NAC have been suggested to improve patient safety by reducing adverse drug reactions and medication errors. A two-bag NAC infusion regimen (200 mg/kg over 4 h, followed by 100 mg/kg over 16 h) is reported to have similar efficacy with significantly reduced adverse reactions compared to the traditional 3-bag regimen. Massive AAP poisoning due to high concentrations (more than 300-lines in the nomogram) needs to be managed with an increased maintenance dose of NAC. In addition to NAC, the combination therapy of hemodialysis and fomepizole is advocated for severe AAP poisoning cases. In the case of a patient presenting with an altered mental status, metabolic acidosis, elevated lactate, and an AAP concentration greater than 900 mg/L, hemodialysis is recommended even if NAC is used. Fomepizole decreases the generation of toxic metabolites by inhibiting CYP2E1 and may be considered an off-label use by experienced clinicians. Since the nomogram cannot be applied to sustained-release AAP formulations, all potentially toxic sustained-release AAP overdoses should receive a full course of NAC regimen. In case of ingesting less than the toxic dose, the AAP concentration is tested twice at an interval of 4 h or more; NAC should be administered if either value is above the 150-line of the nomogram.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.94-101
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• 2019

Purpose: This study examined the clinical characteristics of severe elderly poisoning patients to determine the factors that can prevent them. Methods: Data were collected from patients over 65 years of age presenting to the emergency center with poisoning from 2013 to 2018. Their medical records were analyzed retrospectively, and patients with a poisoning severity score of three or more were defined as the severe poisoning group. The risk factors were evaluated by univariate and multivariate analysis. Results: This study analyzed 292 patients, of whom 37 (12.7%) belonged to the severe poisoning group. The severe poisoning group showed a significantly higher association with pesticide poisoning and intentional suicide attempts. Loneliness and somatization were the cause of the suicidal ideas. No significant differences in age, sex, drinking, ingestion time, poisonous materials other than pesticides, and neuropsychological consultation were observed between the two groups. Conclusion: The severe elderly poisoning patients were the result of intentional poisoning for suicide. Loneliness and somatization were the most influential causes of suicidal poisoning. Therefore, psychiatric screening and frequent medical treatment for elderly people are required to prevent severe poisoning in elderly patients.

• 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.