- Initial Electrocardiographic Changes associated with Clinical Severity in Acute Organophosphate Poisoning
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Hwan-Jung Lee, Jae-Chol Yoon, Tae-O Jeong, Young-Ho Jin, Jae-Baek Lee
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J Korean Soc Clin Toxicol. 2009;7(2):69-76. Published online December 31, 2009
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Abstract
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- Purpose: Various electrocardiogram (ECG) changes can occur in patients with acute organophosphate poisoning (OPP) and may be associated with the clinical severity of poisoning. The present study aimed to evaluate the extent and frequency of ECG changes and cardiac manifestations, and their association with acute OPP clinical severity. Methods: Seventy-two adult patients admitted to our emergency department with a diagnosis of acute OPP were studied retrospectively. ECG changes and cardiac manifestations at admission were evaluated. ECG changes between respiratory failure (RF) group and no respiratory failure (no RF) groups were compared. Results: Prolongation of QTc interval (n=40, 55.6%) was the most common ECG change, followed by sinus tachycardia (n=36, 50.0%). ST-T wave changes such as ST segment elevation or depression and T wave change (inversion or non-specific change) were evident in 16 patients (22.2%). Prolongation of QTc interval was significantly higher in the RF group compared with the no RF group (p=0.03), but was not an independent predictor for RF in acute OPP (OR; 4.00, 95% CI; 0.70-23.12, p=0.12). Conclusion: While patients with acute OPP can display ECG changes that include prolongation of QTc interval, sinus tachycardia, and ST-T wave changes at admission, these changes are not predictors of respiratory failure.
- Prolonged Cardiopulmonary Resuscitation in a Cardiac Arrest Patient with Aconitine Intoxication
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In-Woo Hwang, Tae-O Jeong, Jae-Baek Lee, Youn-Ho Jin
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J Korean Soc Clin Toxicol. 2007;5(1):67-70. Published online June 30, 2007
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- Aconitum is an extremely dangerous plant that contains various toxic diterpenoid alkaloids, primarily concentrated in the roots. We report a case of acute intoxication of a 60-year-old man admitted to our emergency department after ingestion of a large amount of homemade aconitine decoction. At presentation about one hour after intake, the patient was unconscious and electrocardiographic analysis showed a ventricular tachycardia/fibrillation. Several times defibrillation was applied and antiarrhythmic agents were administered, but the patient still exhibited a refractory ventricular fibrillation and failed to return to spontaneous circulation. Sustained cardiopulmonary resuscitation finally produced a pulsatile cardiac rhythm at two hours after intake. The patient was discharged from our hospital on day 8. The authors stress that clinicians must be aware of the possible occurrence of life-threatening ventricular arrhythmia in cases of aconitine intoxication and be prepared to persist with prolonged CPR as necessary.
- Changes in Characteristics of Patients with Acute Intoxication in a Regional Emergency Medical Center
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Hyun-Wook Jeong, Ho-Kwon Kim, Tae-O Jeong, Young-Ho Jin, Jae-Baek Lee
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J Korean Soc Clin Toxicol. 2004;2(2):90-95. Published online December 31, 2004
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- Purpose: The purpose of this study is to compare the toxicologic characteristics of two groups of patients with acute intoxication for two different time periods and to make recommendations based on the results of this study. Methods: We reviewed retrospectively the medical records of patients with acute intoxication in our emergency center from June 1997 to May 1998 (group A) and from June 2000 to May 2003 (group B), and we evaluated differences in the epidemiologic and the toxicologic characteristics between the two groups. Results: The ratios of the number of patients with acute intoxication to the total numbers of patients who visited our emergency department were $0.49\%$ and $0.52\%$ for groups A and B, respectively. In both groups many poisoned patients visited our emergency center from 4:00 pm to midnight. The interval between the time of intoxication and arrival at the hospital was significantly shorter in group B. The number of patients transferred to our emergency center was larger in group B. Attempted suicide was the major cause of acute intoxication in both groups. Major toxic substances in both groups were centrally active drugs and insecticides. The number of comatose and mechanically ventilated patients was larger in group B. However, there was no statistically significant difference in the mortality rates. Conclusion: Emergency physicians who manage intoxicated patients should recognize regional characteristics and differences in the toxicologic characteristics of poisoning. In addition, the establishment of a poisoning control center in the regional emergency center is necessary to integrate data control and to enhance specialized management of intoxicated patients.
- Phytolacca Radix Poisoning due to Misidentification as an Arrowroot
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Woo-Je Jin, Youngho Jin, Tae-O Jeong, Jae- Baek Lee
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J Korean Soc Clin Toxicol. 2004;2(1):27-30. Published online June 30, 2004
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- Phytolaccaceae had been used as a pharmaceutical drugs or food in Korea. Nowadays, it is rarely used due to its toxicity, and then, case reports as to poisoning also are rare. Recently, Authors experienced a case of an occurrence in a group intoxication after ingestion of roots of phytolacca american a misidentifying as arrowroot. We report this case with review of phytolacca radix poisoning.
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