• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.4
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• pp.276-280
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• 2016

Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the stomach, which were treated with an epinephrine injection. The Dieulafoy lesion, although thought to be rare, should be considered when investigating an acute gastrointestinal bleed. These lesions have been successfully treated endoscopically. Appropriate anticipation and preparation for diagnosis and therapy can lead to optimal outcomes for the pediatric patient.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.147-150
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• 2006

Neurotoxic shellfish poisoning (NSP) can result from eating filter-feeding shellfish carrying brevetoxins produced by the marine dinoflagellate Krenia brevis (formally Gymnodinium breve). Brevetoxins enhance sodium entry into cells via voltage-sensitive sodium channels and have an excitatory effect. The incubation period is three hours (range 15 minutes-18 hours). NSP is characterized by gastroenteritis combined with neurologic symptoms. Gastrointestinal (GI) symptoms include abdominal pain, nausea, diarrhea and burning pain in the rectum. Neurologic symptoms are paresthesia, reversal of hot and cold temperature sensation, myalgia, headache, vertigo, and ataxia. Other symptoms may include malaise, tremor, dysphagia, bradycardia, decreased reflexes, dilated pupils, seizure, and coma. The health problem caused by K. breviscan be associated with a red tide bloom. We encountered 3 cases of neurotoxic shellfish poisoning. They all presented with GI and neurologic symptoms andrecovered after conservative treatment.

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.109-112
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• 2011

Aluminum phosphide is commonly used as a rodenticidal agent in agricultural workplaces. However, reported cases of aluminum phosphide poisoning in Korea are rare. Upon contact with moisture in the air, aluminum phosphide releases highly toxic phosphine gas ($PH_3$). $PH_3$ is readily absorbed through lung epithelium and into the bloodstream. Phosphine may cause denaturing of oxyhemoglobin and enzymes important to respiration and metabolism, and also may effect cellular membranes. There are numerous complications associated with acute aluminum phosphide poisoning including gastrointestinal, respiratory, and cardiac toxicities. We report the case of a 46-year-old man who suffered from respiratory and cardiac toxicities after unintentional aluminum phosphide exposure. More intensive education for prevention is recommended.

• 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.

• Nuclear Engineering and Technology
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• v.38 no.3
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• pp.231-238
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• 2006

Whole-body exposure to high-dose radiation causes injury involving multiple organs that depends on their sensitivity to radiation. This acute radiation syndrome (ARS) is caused by a brief exposure of a major part of the body to radiation at a relatively high dose rate. ARS is characterized by an initial prodromal stage, a latent symptom-free period, a critical or manifestation phase that usually takes one of four forms (three forms): hematologic, gastrointestinal, or cardiovascular and neurological (neurovascular), depending upon the exposure dose, and a recovery phase or death. One of the most important factors in treating victims exposed to radiation is the estimation of the exposure dose. When high-dose exposure is considered, initial dose estimation must be performed in order to make strategy decisions for treatment as soon as possible. Dose estimation can be based on onset and severity of prodromal symptoms, decline in absolute lymphocyte count post exposure, and chromosomal analysis of peripheral blood lymphocytes. Moreover, dose assessment on the basis of calculation from reconstruction of the radiation event may be required. Experience of a criticality accident occurring in 1999 at Tokai-mura, Japan, showed that ARS led to multiple organ failure (MOF). This article will review ARS and discuss the possible mechanisms of MOF developing from ARS.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.143-146
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• 2006

Historically, the common folk have made use of various wild herbs for both food and medicinal purposes. However, the misuse of these wild herbs can lead to adverse consequences, including severe poisoning in some cases. In cases of poisoning from wild herbs, patients can exhibit a variety of symptoms depending on the herbs involved, which in addition to gastrointestinal symptoms may include hemodynamic alteration and abnormal neurologic signs. In the present case, two patients were admitted to the emergency room with symptoms of toxicity after consuming Rhododendron brachycarpum liquor. Rhododendron brachycarpum and other wild herbs contain the toxic material grayanotoxin. Because of its serious toxic symptoms, great caution must be exercised in using rhododendrons for food and medicinal purposes.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.264-268
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• 2014

There are a lot of dental emergency situation. Especially on disabled or pediatric patient with negative behavior, accidental aspiration or ingestion of foreign body (ex: dental instrument) is one of the common accidents in dental procedure. Dentists and dental hygienists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental treatment, especially on the disabled. This is a case of an accident during the dental treatment of 14-year-old female patient with cerebral palsy. During scaling, prolonged retained primary tooth which had resorbed roots was fell into left bronchi. So we tried to remove the crown by endotracheal approach. Most ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them need endoscopic or surgical removal. Moreover aspiration into broncho-trachea can be more serious events and must be treated as emergency situation.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.123-129
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• 2008

A 36-year-old female was transferred to our emergency medical center with decreased mental status after a 6.0 g propafenone overdose because of domestic disturbance. She had no previous history of epilepsy, diabetes mellitus, hypertension or psychiatric illness. Before presenting to our center, gastrointestinal decontamination, charcoal administration, and endotracheal intubation due to bradycardia and generalized seizure had been performed. Soon after hospital arrival, at 5 h after ingestion, she collapsed into shock and fatal arrhythmia. We successfully resuscitated the patient with amiodarone, sodium bicarbonate, a large volume of normal saline, calcium, and ventilator care. At 23 h after ingestion, she was fully recovered and had no subjective signs or symptoms. To our knowledge, this is the first case report of intentional propafenone overdose in Korea, which we report with reviews of the previous literature.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.40-42
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• 2015

Benzoylureas are chemical compounds best known for their use as insecticides. Diflubenzuron is one of the more commonly used benzoylurea pesticides. Others include chlorfluazuron, flufenoxuron, hexaflumuron, and triflumuron. They act as insect growth regulators by inhibiting synthesis of chitin in the body of the insect. They have low toxicity in mammals because mammals have no chitin. Chlorfluazuron insecticides, which are mixed with solvent naphatha, are commonly used. Thus we assume that in the presented case mental change outcome of poisoning was connected with toxic effects of solvent naphtha rather than with chlorfluazuron action. Components of solvent naphtha, particularly trimethylbenzenes, exert strong irritant action on the gastric mucosa and are very well absorbed from the gastrointestinal tract. We report on a 67-year-old man with stuporous mentality after intentional ingestion of approximately 200 ml of liquid chlorfluazuron in a suicide attempt. He was discharged after conservative treatments including gastric irrigation, charcoal, mechanical ventilation, hydration, and antibiotics for aspiration pneumonia without complications.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.2
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• pp.130-134
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• 2005

Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circultion (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.