- Clinical Evaluation of Patients Intoxicated by a Gas Leak at an Underground Shopping Center - Carbon Monoxide Poisoning -
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Ji-Young Ahn, Young-Gil Ko
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J Korean Soc Clin Toxicol. 2006;4(2):122-127. Published online December 31, 2006
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 Abstract
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- Purpose: It is not easy to detect carbon monoxide (CO) leakage, and CO-intoxicated patients do not show a specific set of symptoms. The aims of this study are to clinically evaluate patients with CO gas intoxication from a CO leak at an underground shopping center, and to discuss the establishment of a disaster prevention plan. Methods: A total of 51 patients intoxicated by CO gas exposure in a gas disaster at a underground shopping center in Seoul on September 8, 2006 were enrolled in this study, and the patients' medical records were retrospectively reviewed. Results: The mean patient age was $29.4{pm}6.3$. The initial mean COHb level was $14.98{pm}6.97%$. The number of patients with COHb greater than 25% was three, and six patients experienced a syncopal attack. Only one patient-was treated with hyperbaric oxygen therapy. However, none of the patients complained of severe neurologic or cardiovascular symptoms. Conclusion: The symptoms of CO intoxication are non-specific and difficult to define, and the detection of CO leak-age is difficult. Thus, workplaces should be equipped with leakage sensors and automatic alarm systems and should have develop disaster prevention plans.
- Neurotoxic Shellfish Poisoning after Ingesting Whelk
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Young-Gil Ko, Ji-Young Ahn, Seok-Yong Ryu, Sang-Lae Lee, Suk-Jin Cho, Mi-Ran Kim
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J Korean Soc Clin Toxicol. 2006;4(2):147-150. Published online December 31, 2006
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- 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.
- Two Cases of Mad-Honey Poisoning with Cardiovascular Symptom
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Young-Gil Ko, Kyung-Hwan Kim, Ah-Jin Kim, Dong-Wun Shin, Jun-Soek Park, Jun-Young Roh, Ji-Young Ahn
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J Korean Soc Clin Toxicol. 2006;4(1):78-81. Published online June 30, 2006
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- Mad-honey poisoning is mainly brought about by the honey imported from Napal, Turkey, Brazil and other parts of Europe. This mad honey is extracted from Ericaceae plants of Rhododendron species and contains grayanotoxins that causes poisoning. These toxic compounds exert a specific stimulatory action on membrane permeability to Na+ions in various excitable tissues and cause depolarization of cell membranes. The toxic effects of grayanotoxins contained honey are mainly cardiovascular disturbances with bradycardia, cardiac arrhythmia, hypotension. There are Other symptoms like nausea, vomiting, salivation, dizziness, weakness and loss of consciousness. The precise amount for a toxic dose is not known. In general the severity of the honey poisoning depends on the amount ingested. Two cases of mad-honey poisoning are described here. Both patients showed bradycardia and arterial hypotension after ingestion of honey which was brought from Nepal. They were recovered fully within 24 hours after administration of fluids and atropine sulphate.
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KSCT
Korean Society of Clinical Toxicology