• Proceedings of the Korean Society of Veterinary Pathology Conference
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• 2002.11a
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• pp.141-141
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• 2002

A patient (Painter+Viszula mixed breed, 4 months old, male), with chief historic sign of acute vomiting, hemorrhagic diarrhea, anorexia and dyspnea during 4 days was admitted ta College of Veterinary Medicine, Kyungpook National University. Necropsy findings were revealed ulcer and hemorrhage contained hemorrhagic diarrhea in gastrointestinal tract, severe emphysema and hemorrhage in the lung and kidney and cardiac hypertropy. Histopathological changes showed emphysema, hyperemia and hemorrhage in the lung, severe hyperemia, hemorrhage, hepatic vacuolation and cellular necrosis in the liver, hyperemia, hemorrhage, necrosis of tubular epithelium in the kidney, hemorrhage in cardiac muscle and hyperemia, necrosis and sloughing of epithelium in the intestine. In this case, we diagnosed as a paraquat poisoning.

• Environmental Analysis Health and Toxicology
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• v.25 no.4
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• pp.263-271
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• 2010

Objectives : The records of 447 pesticide poisoning deaths from the National Forensic Service (NFS) headquarters located in Seoul of Korea from 2005 to 2009 were retrospectively reviewed. Methods : The data of each case were analyzed by using the SPSS program. Results : The mean age was $57.8{\pm}14.8$ years and the range was 16-92 years. The numbers of deaths of males and females were 301 and 134, respectively. The largest number of cases occurred in people aged 50-59 years (n=92, 20.6%) followed by the age groups 40-49 years (n=91, 20.4%), 60-69 years (n=88, 19.7%), and 70-79 years (n=75, 16.8%). The total number of deaths among other age groups (10-19, 20-29, 30-39, 80-89, and 90-99 years) was 73, representing only 16.3%. Of all pesticide poisoning deaths, 96.2% were due to suicide, and 28.4% of the total number who died received medical treatment. The mostfrequent site of ingestion was the person's own residence (n=279, 62.4%). The most common classes of pesticide were bipyridylium herbicide (paraquat, 31.1%), organophosphate insecticide (21.7%), and carbamate insecticide (15.4%). The major pesticides having a high proportion of fatalities were paraquat (31.1%), methomyl (11.4%), glyphosate (9.1%), dichlorvos (5.6%), phosphamidon (4.6%), and methidathion (4.0%). Conclusions : This study showed that poisoning deaths due to pesticides are one of the major public health problems in Korea. Enforcement of regulations and safety education to prevent pesticide poisoning should be carried out by the government.

• Applied Microscopy
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• v.33 no.4
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• pp.275-282
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• 2003

This study was undertaken to investigate paraquat-induced pulmonary injuries and effects of colchicine on pulmonary fibrosis by paraquat. Fifteen Sprague-Dawley rats were intraperitoneally injected 10 mg/kg of paraquat and repeatedly with 2 days interval. Another 15 rats were injected paraquat as same manner and simultaneously injected 10 mg/kg of colchicine in a week. Five rats in each group were sacrificed 1, 2, and 4 weeks after initial injections, and lungs extracted were observed by light and electron microscopes. On light microscopy, there was mild infiltration of neutrophils, macrophages, and lymphocytes in alveolar spaces and walls at 1 week after paraquat injection. The cellularity of alveolar wall was increased with time. However, the cellularity was not so prominent in paraquat and colchicine simultaneously injected group. On electron microscopy, there was marked swelling or excoriation of type I epithelial cells and alveolar capillary endothelium with infiltration of neutrophils, macrophages and monocytes, and lymphocytes in alveolar walls. Such findings were persisted with time. In addition, fibroblastic proliferation and deposition of collagen fibers were prominent at 4 weeks after paraquat injection. Fibrosis also occurred at 4 weeks after paraquat and colchicine simultaneous injection. It was not proninent than that of paraquat injected group. According to the above result, it would be concluded that the type I pneumocytes and alveolar capillary endothelial cells are most vulnerable on paraquat poisoning, and that the colchicine is effective on inhibition of paraquat-induced pulmonary fibrosis.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.116-122
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• 2020

Acute respiratory failure is an important risk factor for mortality in patients with acute pesticide poisoning. Therefore, it is necessary to investigate the risk factors to predict respiratory failure in these patients. This study retrospectively investigated the clinical features of respiratory failure among patients with acute pesticide poisoning requiring mechanical ventilation. This study included patients who were admitted with intentional poisoning by pesticide ingestion from January 2017 to December 2019. Paraquat intoxication was excluded. Among 469 patients with acute pesticide poisoning, 398 patients were enrolled in this study. The respiratory failure rate was 30.4%. The rate of respiratory failure according to the type of pesticide was carbamate (75.0%), organophosphate (52.6%), glufosinate (52.1%), glyphosate (23%), pyrethroid (8.9%), and others (17%). The mortality was 25.6% in the respiratory failure group. The risk factors for respiratory failure were old age, low body mass index, and ingestion of more than 300 mL. In conclusion, respiratory failure is a risk factor for mortality in pesticide poisoning. Old age, low body mass index, and ingestion of more than 300 mL are the risk factors for predicting respiratory failure.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.86-93
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• 2017

Purpose: Some advanced countries have reported annual statistics for poisoning based on data from poison control centers. This study was conducted to propose a baseline format and statistics of poisoning in Korea from a national representative database. Methods: This study was a retrospective analysis of poisoning patients based on data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2016. Bite or sting injuries were not included. Variables related to poisoning were summarized using a similar format as the National Poison Data System in the United States. Results: A total of 7,820 poisoning patients presented to 23 EDs. Adults ${\geq}20$ years accounted for 84% of the population, while the proportion of intentional poisoning was 59.4%. The most common poisoning substances were therapeutic drugs (45%), gas (21%), pesticides (15%), and artificial toxic substances (13%). Overall, 34.5% of patients were admitted for further treatment. The mortality was 3.2% (248 cases), and the most common causative substances were carbon monoxide, glyphosate, and paraquat, in order. Conclusion: This study showed the recent status of poisoning in Korea. However, a comprehensive poisoning registry based on poison control centers may be required to provide more accurate national statistics in the future.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.150-155
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• 2009

Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.541-549
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• 2019

Objectives: This study aims to examine patients who developed acute pesticide poisoning while spraying or using pesticide and presented to the emergency department in hospitals in Chungcheongnam-do Province. Based on the findings, this study will provide implications for safety and health management pertaining to the use of pesticides. Methods: Pesticide poisoning data collected by the Chungnam Center for Farmers' Safety and Health from 2014 to 2018 was cross-sectionally analyzed. A total of 331 patients with pesticide poisoning presented to one of hospitals and four of medical centers in the region(Dankuk University Hospital, Gongju and Hongsung, Cheongyang, Cheonan Medical Center). Seventeen of these patients (15 men and two women) developed poisoning while spraying pesticide. The patients' charts were reviewed to collect data on pesticide poisoning, namely currently working in farming-related occupation, means of transportation to the hospital, place of poisoning, symptoms of acute pesticide poisoning, treatment, pesticide used when poisoning occurred, and classification by technical ingredients. Results: Fifteen out of 17 patients who developed poisoning while spraying pesticide were men. Insecticide was used in 35.3% of the cases, and herbicide was used in 29.4% of the cases, which was different from cases of poisoning from ingestion poisoning. The major symptoms were vomiting (35.3%), nausea (29.4%), dizziness (29.4%), and headache (23.5%). A total 11 ingredients were identified in 12 patients, and the most common ingredient was glyphosate, which is an herbicide. Most patients showed a state of mild toxicity, but two patients showed a state of severe toxicity. These patients respectively used glyphosate and paraquat. Conclusions: Our findings can be useful for suggesting the need for a national healthcare system to manage occupational pesticide poisoning among farmers. Further, these findings can be used to increase the awareness of the risk of acute poisoning during pesticide spraying and suggest the need for a safety health education to increase farmers' awareness of pesticide poisoning.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.130-133
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• 2008

In South Korea, attempted suicide by paraquat (PQ) intoxication is fairly common, and is lethal by pulmonary fibrosis and hypoxemia. However, the treatment of PQ poisoning is primarily supportive management. To increase the survival rate associated with PQ intoxication, many treatments have been developed. Here, we treated a case of PQ intoxication with steroid pulse therapy. A 23-year-old man was admitted to the hospital because of PQ intoxication. He drank two mouthfuls of Gramoxon (24% commercial paraquat). His vital signs were stable, but he had a throat infection, and navy blue urine in the sodium dithionite test. Standard treatment, including gastric lavage with activated charcoal was performed, and emergent hemoperfusion with a charcoal filter was initiated 11 h after PQ ingestion. Pharmacotherapy was initiated 18 h after PQ ingestion with the administration of 5 mg dexamethasone. On day 10, chest PA showed pulmonary fibrosis. Therefore, we initiated steroid pulse therapy, with 1g methylprednisolone in 100 mL of D5W administered over 1 h repeated daily for 3 days, and 1 g cyclophosphamide in 100 mL of D5W administered over 1 h daily for 2 days. On day 15, dexamethasone therapy was initiated. On day 30, pulmonary fibrosis was improved. Thus, if pulmonary fibrosis becomes exacerbated after dexamethasone therapy during the subacute stage, pulse therapy with methylprednisolone and cyclophosphamide could be helpful.

• Journal of Environmental Health Sciences
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• v.37 no.2
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• pp.81-93
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• 2011

Although pesticides have increased crop production and controlled disease, they have produced a number of adverse health effects. Pesticides have potential human toxicity and a variety of groups, such as farmers or industrial workers, as well as the general population, are exposed to pesticides. The purpose of this article, therefore, is to provide an overview of pesticide exposure and health through a literature review, focusing on exposure assessment, acute poisoning, chronic health effects, and future research needs. The exposure types and levels of pesticides vary by study subjects and need to be assessed by integrating several methods focused on the epidemiological purpose. Acute pesticide poisoning is a major public health problem in the world. Paraquat is the main causative pesticide for acute poisoning in Korea and should be banned in order to save several thousands of lives every year. Occupational pesticide exposure also causes numerous chronic diseases among farmers and industrial workers, including cancers, respiratory diseases, depression, retinal degeneration, diabetes, and abnormal menstrual cycle. However, controversy exists regarding the long-term effects of low-dose environmental pesticide exposure. The area of pesticide study is relatively new with broad study populations and it has received little academic and policy attention, particularly in Korea. More detailed studies investigating the risk of pesticide-related health effects and intervention efforts to reduce the problems are needed in Korea.

• The Korean Journal of Pesticide Science
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• v.12 no.2
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• pp.134-140
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• 2008

The data on pesticide poisoning death toll during 2000-2005 was obtained from Korean National Statistical Office and analysed to find out any precautionary measures against pesticide poisonings. Pesticide poisoning death toll showed slightly increasing trend with year up to about 3500 in 2005. Most of the pesticide poisoning death cases were intentional self-poisoning accounting for more than 80% of total pesticide poisoning death. The pesticide most often implicated in poisoning death were paraquat dichloride, a non-selective herbicide and organophosphate/carbamate insecticides. The regional distribution of pesticide poisoning death showed urban 21.6% and rural area 78.4%. As for the occupation of the dead, agricultural, forestry and fishery workers accounted for 27.4% and non-agricultural workers was 72.6% of pesticide poisoning death. Therefore, government need to take some precautionary measures to reduce the number of pesticide poisoning cases. It is strongly recommended that pesticide regulatory authorities encourage and train the agricultural workers to use safe storage boxes and enforce strict regulation for the prevention for the prevention of highly toxic pesticides sales to non-agricultural workers.