• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.129-135
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• 2016

Purpose: This study was conducted to compare demographic and characteristic differences in self-poisoned patients by age groups using a comprehensive trauma database. Methods: This study included 1,823 patients who were admitted to the emergency room following self-poisoning. Three age groups were defined: young patients (less than 19 years), adult patients (19 to 64 years) and elderly patients (65 years and old). From January 2011 to December 2015, data were obtained from in a single emergency medical center. We investigated the materials of poisoning, ingestion time, GCS, systolic blood pressure, heart rate, and outcomes of patients. Results: A total of 1,823 self-poisoned patients visited the hospital during 5 years. Among these, 130 (7.1%) were categorized as young, 1,460 (80.1%) were adults and 233 (12.8%) were elderly. The most common drug of self-poisoning substances was antipyretics (50.0%) for those in the young group, sedative drugs (45.0%) for adults, and pesticides (41.2%) for the elderly. Mortality was 2.7% in the adult group and 14.6% in the elderly group. After adjusting for all factors related to mortality, the odds ratio (OR) of mortality was 2.63 in the elderly group (95% confidence interval [CI]: 1.44-4.81). Conclusion: There were definite differences in the characteristics of three groups. The younger patients used drugs that could be easily obtained while older patients used more lethal drugs.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.2
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• pp.116-122
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• 2004

Purpose: Several risk factors related with chronic complications and mortality related with liver injury of mushroom poisoning were reported. But, there were few reports about the long term outcomes. The aim was to evaluate the long term clinical outcomes in mushroom poisoning regarding the risk factors. Methods: Clinical data were reviewed and outcomes were evaluated with medical records and/or telephone interviews. The patients who had one or more risk factors such as markedly elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT), prolonged prothrombin time (PT) were classified into high risk group. Patients had no risk factor classified into low risk group. Results: From June 1989 to December 2003, nineteen mushroom poisoning patients admitted to Asan Medical Center, seven were male, and mean age was $58\pm9$ years old. All the patients accidentally ingested and the interval from ingestion to symptom onset was $9\pm4$ hours. There were four patients in high risk group, and fifteen in low risk group. In high risk group, peak AST was $2,263.3\pm1,303.0IU/L$most prolonged PT was $38.0\pm27.4\%$, and stuporous mental status was shown in one patient. In low risk group, laboratory values returned to the normal values but histological evaluation revealed specific features of toxic hepatitis on sixth hospital day. Chronic complications such as persistent or chronic hepatitis, mortality was not occurred during follow up period (from 10 months to 16 years) in both groups. Conclusion: Although the number of patients were small, there were no chronic complications or mortality related with liver injury after mushroom poisoning regardless risk factors of chronic complications and mortality.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.1
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• pp.17-24
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• 2006

Objectives: To analyze the general characteristics and clinical differences of poisoning in children and adolescents and to take precautions of occasions. Methods: We retrospectively evaluated poisoning children and adolescents (less than 19 years) visiting to the emergency medical center of tertiary hospital in urban area. We collected demographic data, substance exposure data (materials, causes of poisoning and amount), and clinical outcome of poisoning for the past 2 years and 9 months. Results: 189 cases were reported of concerning poisoning in children and adolescents. The age groups were divided into four categories. (1) Infants group:<2 year, (2) Preschool age group: $2{\sim}5year$, (3) Children group: $6{\sim}12year$ and (4) Adolescents group: $13{\sim}18year$. The most vulnerable age group was the infants group. There were two-peaks of age distribution in poisoned patients on the whole. Various types of materials belonged to classes of druqs (56.6%). household products (34.4%) and industrial solvents (9.0%). On adolescents group, the frequency of drug poisoning was significantly high, in comparison with infants, preschool age, and children group (p=0.001). Most of the patient groups had been poisoned accidentally(73.5%), while most cases of adolescents poisoning had been intentional. 63% of the adolescents group had a suicidal purpose. Conclusion: The incidence of poisoning was most highly due to drugs. The cause of poisoning is most commonly accidental. while in adolescent group, intentional poisoning is mostly common. Special cares, like keeping children away from drugs, will be needed to prevent children poisoning, and psychiatric consultation and supportive cares can reduce the adolescents poisoning cases.

• Journal of Information Display
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• v.6 no.4
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• pp.35-39
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• 2005

In this paper, we investigate the oxide cathodes for the development of reliable electron sources. Poisoning in oxide cathodes is one of the serious problems in achieving reliable electron emission. In particular, early poisoning induces poor life performance as will be demonstrated herein. The survivability of electron emission sources is significantly improved by high doping of high-speed activator. The robust oxide cathodes with 0.17 % Mg operating at about 1,050 K are expected to work for very long times (>100,000 hours). We suggest that this key idea will contribute to solving the basic problems in oxide cathodes such as poisoning or ion bombardment for high power or high frequency applications of electron sources.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.71-77
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• 2015

Purpose: Acute endosulfan poisoning is rare but causes significant morbidity and mortality. The aim of our study is to describe complications and features of seizure and determine factors associated with mortality in acute endosulfan poisoning. Methods: Twenty-eight adult patients with acute endosulfan poisoning admitted to our emergency department during a 15-year period were studied retrospectively. The clinical features of seizure, use of antiepileptic drugs during seizure, and hospital courses were evaluated. Clinical factors between survived group and non-survived group were compared for identification of factors associated with mortality. Results: Of the 28 patients with endosulfan poisoning, 4 patients (14.3%) died and 15 (53.6%) patients developed generalized tonic-clonic seizure. Thirteen patients (46.4%) and 5 patients (17.9%) progressed to status epilepticus (SE) and refractory status epilepticus (RSE), respectively. SE and RSE were associated with mortality. Almost all significant complications including shock, acute renal failure, hepatic toxicity, rhabdomyolysis, and cardiac injury developed in SE and RSE patients. Conclusion: SE and RSE were important contributors to death in endosulfan poisoning. Emergency physicians treating endosulfan poisoning should make an effort not to progress seizure following endosulfan poisoning to SE and RSE using a rapid and aggressive antiepileptic drug.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.131-140
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• 2018

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.9-15
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• 2008

Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.1
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• pp.10-18
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• 2009

Purpose: Carbon Monoxide Poisoning is an important medical emergency in Korea, but the factors leading to its serious manifestation are not well studied. Methods: We conducted a 5-year retrospective study of 98 carbon monoxide poisoned patients who visited the emergency departments of the Medical Center between December 2004 and March 2009. We categorized the patients into those exhibiting only local symptoms (group 1) and those showing systemic symptoms and complications (group 2). We compared the general characteristics as well as the clinical and laboratory findings between both groups. Results: The male to female ratio was 1.18. The most common systemic symptom was a mental change (43.9%), while the most common complication was rhabdomyolysis (31.6%). Poisoned area closed private room in group 2 were 23 (41.8%) cases and burning region in group 2 were 16(29.1%) cases (p=0.956). Individuals who were accidentally poisoned comprised of 43 (78.2%) cases while those that attempted suicidal poisoning comprised 12 (21.8%) cases (p=0.016). The most common symptom at arrival was mental change 33 (60.0%) cases in group 2. The mean time exposed to carbon monoxide was 43$\pm$3.97 hours in group 1 and 55$\pm$10.11 in group 2 (p=0.012). The patient's age, context of poisoning, symptom at arrival, and time exposed to the poison were found to be significant risk factors for complications by logistic regression analysis. Conclusion: Carbon monoxide poisoning is an emergency medical condition and the risk factors involved in the development of serious complications must be evaluated.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.61-66
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• 2007

Trichloroethylene (TCE) is an unsaturated chlorinated hydrocarbon in the form of a colorless, volatile liquid, which is used as an industrial organic solvent for spot removal and for metal degreasing. In general, the primary complications of TCE poisoning result from involvement of the central nervous and respiratory systems, including aspiration pneumonia. A case is reported of a 54-year-old man who presented in a comatose state after accidental ingestion of 100 ml of TCE, and who recovered after conservative treatment and mechanical ventilation. We discuss this case and present a literature review.

• Korean Chemical Engineering Research
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• v.51 no.3
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• pp.370-375
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• 2013

We analyze the effects of CO poisoning and air bleeding on the performance of a PEM (polymer electrolyte membrane) fuel cell stack fabricated using commercial MEA (membrane electrode assembly). Dynamic response data from the experiments on the performance of a stack are identified by obtaining steady-state gains and time-constants of the first-order system model expressed as a first-order differential equation. It is found that the cell voltage of the stack decreases by 1.3-1.6 mV as the CO concentration rises by 1 ppm. The time elapsed to reach a new steady state after a change in the CO concentration is shortened as the magnitude of the change in the CO concentration increases. In general, the steady-state gain becomes bigger and the time-constant gets smaller with increasing the air concentration (air-bleeding level) in the reformate gas to restore the cell voltage. However, it is possible to recover 87%-96% of the original cell voltages, which are measured with free of CO, within 1-30 min by introducing the bleed air as much as 1% of the reformate gas into the stack.