• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.161-165
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• 2006

Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.2
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• pp.91-96
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• 2012

Purpose: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. Methods: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. Results: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was $55{\pm}23.5$, and the mean volume of the acid was $84.5{\pm}71.3$ ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. Conclusion: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.71-76
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• 2011

Purpose: The Rumack-Matthew nomogram cannot be applied in managing overdose by extended release (ER) preparation acetaminophen (AAP). This study analyzed the clinical characteristics of ER preparation AAP overdose in order to develop a treatment recommendation. Methods: We retrospectively reviewed the medical records of patients presented to the emergency department as a result of AAP overdose from Jan 2008 to Dec 2010. Only those patients who ingested an ER preparation of AAP were included in the study. Their blood AAP concentrations were measured at 4 and 8 hours after ingestion. Clinical variables related to AAP intoxication were analyzed. Results: Of the total 108 AAP overdose patients identified during the 3-year period, 20 suffered specifically with ER preparation AAP overdose. The mean estimated ingestion amount was 167.5 mg/kg. Treatments including gastric lavage, activated charcoal, and N-acetyl cysteine (NAC) were performed on 10, 14, and 11 patients, respectively. Hepatotoxicity was diagnosed in only one patient who was then successfully treated with NAC. In another case, blood AAP concentration continued to increase until at least 11-hours after ingestion. Conclusion: This study suggested that blood AAP concentrations associated with ingestion of ER formulations of AAP, may increase in an extended manner. Therefore, multiple sampling and longer periods between samples assessing AAP blood concentration may be required for incidences of extended release overdose.

• Journal of Environmental Health Sciences
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• v.14 no.1
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• pp.103-113
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• 1988

This experiment was performed to study the sequential accumulation of mercury in selected tissues of gold fish (Carassius auratus) exposed to 2, 6, 30, 120 and 300 $\mu$g Hg/1 as HgCl$_2$. In order to prepare treatment groups suitable for the present study, one control and five experimental groups, which were composed of I (2 $\mu$g/l), II (6$\mu$g/l), III (30$\mu$g/l), IV (120$\mu$g/l), V (300 $\mu$g/l), were used in 180 liter glass aquaria. The experiment was started by transfering 20 fish of average total length 140 $\pm$ 20 mm to each of the six tanks and allowing the uptake to take place for 12 weeks period. Fish were killed after time periods of 1, 2, 4, 8, and 12 weeks, and samples were disected by five parts gill, kidney liver, muscle and egg. The summarized results were as follows: 1. In control group, low concentrations of mercury(range 0.01-0.11 $\mu$g/g)were determined in the all selected tissues. 2. In experimental group, the average levels of mercury residues in the gill, kidney, liver muscle and egg were 3.61-189.54 $\mu$g/g, 13.91-182.58 $\mu$g/g, 8.56-66.49 $\mu$g/g, 0.30-20.33 $\mu$g/g, and 1.63-23.76$\mu$g/g, respectively. 3. The mercury residues in selected tissues of the experimental group were generally 230-9100 times higher than those of the control group. 4. The amounts of methylmercury per total mercury in the muscle after 12 weeks were 0.10/0.30 $\mu$g/g(33.33%) in the I group, 0.14/1.18$\mu$g/g(11.86%) in the II group, 0.25/5.76 $\mu$g/g(4.34%) in the III group, 0.39/11.48$\mu$g/g(3.40%) in the IV group and 0.40/20.33 $\mu$g/g(1.97%) in the V group.

• Biomedical Science Letters
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• v.13 no.1
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• pp.47-53
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• 2007

Due to wide abuse of antibiotics both in human and livestock use, the advent and spread of multidrug resistant (MDR) pathogens becomes a serious health problem all over the world. Since the development of new antibiotics is at a standstill in pharmaceutical industry, the choice of therapeutic antibiotics is getting narrower. In this study, in an effort to search new antibiotics, the antimicrobial activity of Paenibacillus DY1 isolated from Korean soil was characterized on its growth inhibition spectrum against various health threatening MDR strains, with its stability and chemical structure. Extracellular culture filtrate of Paenibacillus DY1 effectively inhibits the growth of all the tested MDR enteropathogenic Eshcherichia coli, enterohemolytic E. coli, and enterotoxigenic E. coli strains, at a similar level to that on the nonresistant control E. coli strains. It showed significant growth inhibition effect against the causative agents of class one legal communicable disease, MDR Salmonella typhi, MDR Salmonella paratyphi A, food poisoning bacteria, MDR Salmonella typhimurium, and other MDR Salmonella spp. The growth of all of 10 different MDR Shigella spp. strains and 6 different Vibrio spp. strains tested was also inhibited. The antimicrobial activity of Paenibacillus DY1 was well preserved after heat treatment, and was also stable in both alkaline and acidic environment. The antimicrobial activity was partially purified with Diaion HP20 column and TLC. By NMR study, the putative structure of the activity was postulated as an alkane having hydroxyl groups.

• Journal of Preventive Medicine and Public Health
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• v.7 no.2
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• pp.377-381
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• 1974

Determination of lead in urine is important in industrial hygiene and toxicology. Dithizone method has been principally used for the determination of lead in urine, which gives accurate results in skilful hands but is usually complex and time-consuming. Atomic absorption spectrophotometry is a new simple method and several procedures have been described. However, the influences of pH and the presence of chelating agents during treatment of lead poisoning are not clear. The purpose of this study was to find out the effect of pH and chelating agents on the determination of lead using Shimadzu atomic absorption/flame spectrophotometer, model AA-610. The results obtained were as follows: 1. The atomic absorption spectrophotometry(AAS) could be applied without prior acid digestion to specimens in the absence of chelating agents. The absorbance at $2,170\;{\AA}$, though more sensitive, was more noisy electronically. Therefore, we selected the wavelength of $2,833\;{\AA}$ plus scale expansion. 2. The optimal pH was in the range from 2 to 3. 3. The sensitivity was $0.075{\mu}g/ml/%$ and detection limit was about $0.2{\mu}g/ml$. 4. In the presence of EDTA, lead could not be completely determined without prior acid digestion. 5. On specimens from patients receiving penicillamine therapy, a comparison was made between the values obtained with dithizone method and AAS method with prior acid digestion. The results of comparison showed a very good agreement.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.33 no.3
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• pp.176-178
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• 2000

The toxicity of muscle in pufferfish, Tikifugu vermicularis radiatus is known to be weak. However, no food poisoning has reported in this species although market consumption has been relatively high in Korea, especially on western coastal area. It presumes that there could be different toxicity in fish muscle of fresh and frozen specimens. In this regard, the frequency of toxic fish, the toxicity level in fresh and frozen fish as well as highest toxicity ann average toxicity were investigated. From the results, weak toxicity was detected in frozen fish muscle whereas no toxicity was measured in fresh fish. According to this, it is suggested that the toxicity of frozen and fresh fish must be tested simultaneously when tonicity of pufferfish is investigated. The above results implicate that toxicity of pufferfish may be due to the phsyical treatment such as freezing or thawing process.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.71-80
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• 1989

The adverse effect of diving on the fetus may extend beyond n gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestatred $PO_2$ level, the following question about the effect of exposing a pregnant female to high partial pressure of inspired oxygen has been raised. 'What effect does an increased maternal $PIO_2$ have on fetal arterial $PO_2$ and therefore on possible fetal oxygen poisoning?' This study was carried out to observe the effects of maternal hyperoxia on gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestation. The treatment groups were subjected to either the high concentration of oxygen, or the high atmospheric pressure. On day 21 of gestation, laparotomy was performed to examine for number and distribution of implantations and live and resorbing embryos. Fetuses were weighed, and examined for gross malformations. Subsequently, they were fixed, measured in physical parameters, and examined for visceral anomalies. Minor visceral anomalies and anatomical variation was not found. Similarily, there were no significant differences when number of resorptions, mean fetal weights, pregnancy interruption rate were compared by analysis of variance. These results indicate that exposing rats to oxygen at increased atmospheric pressure doese not affect fetal health or survival.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.2
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• pp.119-126
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• 2013

Purpose: The aim of this study was to evaluate the clinical characteristics and outcome of patients who presented to the emergency department (ED) with cardiotoxicity caused by ingestion of Himalayan mad honey. Methods: Medical records of 12 patients who presented to the ED from January 1, 2005 to December 31, 2012 with cardiotoxicity caused by ingestion of Himalayan mad honey were retrospectively reviewed. Results: The mean age of patients was 54.5 years and 58.3% were men. The median amount of mad honey ingested was 30.0 cc, and the mean time from ingestion to onset of symptoms was 39.4 minutes. All patients had hypotension and bradycardia upon arrival in the ED. The initial electrocardiogram showed sinus bradycardia in seven patients, junctional bradycardia in four patients, and atrial fibrillation with slow ventricular response in one patient. Four patients were treated with intravenous normal saline solution only. Eight patients were treated with intravenous normal saline solution and atropine sulfate in a dose ranging from 0.5 to 2.0 mg. Blood pressure and pulse rate returned to normal limits within 24 hours in all patients. Conclusion: Our study showed that all patients with cardiotoxicity caused by ingestion of Himalayan mad honey had severe hypotension, bradycardia, and bradyarrythmias, including sinus bradycardia and junctional bradycardia and all patients responded well to conservative treatment, including intravenous normal saline solution and intravenous atropine sulfate.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.1-8
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• 2018

Purpose: Extremely hazardous pesticides are classified as World Health Organization (WHO) hazard class Ia. However, data describing the clinical course of WHO class Ia OP (organophosphate) poisonings in humans are very scarce. Here, we compare the clinical features of patients who ingested hazard class Ia OPs. Methods: This retrospective observational case study included 75 patients with a history of ingesting ethyl p-nitrophenol thio-benzene phosphonate (EPN), phosphamidon, or terbufos. The patients were divided according to the chemical formulation of the ingested OP. Data regarding mortality and the development of complications were collected and compared among groups. Results: There were no differences in the baseline characteristics and severity scores at presentation between the three groups. No fatalities were observed in the terbufos group. The fatality rates in the EPN and phosphamidon groups were 11.8% and 28.6%, respectively. Patients poisoned with EPN developed respiratory failure later than those poisoned with phosphamidon and also tended to require longer mechanical ventilatory support than phosphamidon patients. The main cause of death was pneumonia in the EPN group and hypotensive shock in the phosphamidon group. Death occurred later in the EPN group than in the phosphamidon group. Conclusion: Even though all three drugs are classified as WHO class Ia OPs (extremely hazardous pesticides), their clinical courses and the related causes of death in humans varied. Their treatment protocols and predicted outcomes should therefore also be different based on the chemical formulation of the OP.