Journal of The Korean Society of Clinical Toxicology

Original Articles

Prediction of Hematotoxicity in Patients with Acute Valproic Acid Intoxication: Jiwon Lee, Kyungman Cha, Won Jung Jeong, Hwan Song, Byung Hak So; J Korean Soc Clin Toxicol. 2025;23(2):29-37. Published online December 31, 2025; DOI: https://doi.org/10.22537/jksct.2025.00002

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Abstract PDF: Purpose: Valproic acid is a drug used for the treatment of convulsive disorders and for mood stabilization. Acute intoxication can result in gastrointestinal disturbances, neurologic symptoms, and hematologic toxicity. This study aims to identify factors that may predict patient prognosis.
Methods
In this single-center retrospective observational study, medical records from January 1, 2013, to December 31, 2022, were reviewed. The initial clinical features, laboratory results, and serum valproic acid levels of patients with acute valproic acid intoxication who presented to the emergency department were analyzed. Patients were divided into two groups: those who developed hematologic toxicity (hematotoxicity group) and those who did not (non-hematotoxicity group).
Results
A total of 115 patients were included in the analysis, of whom 23 (20%) developed hematotoxicity. The median age of patients with hematotoxicity was 39 years (interquartile range [IQR], 32.0–50.5), which was significantly higher than in the non-hematotoxicity group (p=0.001). The Glasgow Coma Scale score was lower in the hematotoxicity group, with a median of 12 points (IQR, 9.0–14.5) (p=0.013). Intensive care unit admission was more frequent in the hematotoxicity group (p=0.003). Compared with the non-hematotoxicity group, patients with hematotoxicity had a higher incidence of pneumonia, acute kidney injury, rhabdomyolysis, metabolic acidosis, and hyperlactatemia (all p<0.001, except p=0.009 for hyperlactatemia). The initial serum valproic acid concentration was also higher in the hematotoxicity group, with a median of 121.6 μg/mL (IQR, 59.8–154.3) (p<0.001). Multivariate analysis showed that the odds ratio for hematotoxicity was 6.20 (p=0.018) in the presence of metabolic acidosis and 8.32 (p<0.001) when the initial valproic acid concentration exceeded 115.0 μg/mL.
Conclusion
In patients with suspected acute valproic acid poisoning, early evaluation of arterial pH and serum valproic acid concentration is essential for predicting the prognosis.

Characteristics of Acute Toxic Alcohol Poisoning Patients in the Emergency Department: A Toxicological Laboratory Analysis of Ethylene Glycol and Methanol: Min Kyung Park, Emergency Vulnerable Area Regional Cooperation Team, Arum Lee, Misuk Kim, Yun Hee Kim, Jung-in Ko, Bum Jin Oh; J Korean Soc Clin Toxicol. 2025;23(1):19-27. Published online June 30, 2025; DOI: https://doi.org/10.22537/jksct.2024.00006

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Abstract PDF: Purpose: Toxic alcohol exposures are rare yet remain an ongoing and potentially lethal poisoning problem in Korea. Few studies have characterized the epidemiological features and blood substance levels in acutely intoxicated patients presenting to emergency departments (EDs). The objective of this study was to describe the characteristics of intoxicated patients for whom toxicological analyses were requested.
Methods
We reviewed demographic and analytical data from a toxicological laboratory operated by the National Medical Center between 2018 and 2022. In total, 1,244 cases from 35 EDs were analyzed.
Results
Of the analyzed cases, 108 cases (63 patients) tested positive for toxic alcohols, including methanol (MeOH), ethylene glycol (EG), and isopropyl alcohol. Sixty patients had a single toxic alcohol detected: 17 with MeOH and 43 with EG. Clinical features included a median age of 42 years, 63.3% male, 100% acute exposure events, 66.7% suicide attempts, and 50.0% ethanol co-ingestion. Median ingestion amounts were 255 mL (MeOH) and 365 mL (EG). Significant differences between MeOH and EG groups included ingestion of an unknown substance (41.2% vs. 69.8%, p=0.04), initial blood pH (7.33 vs. 7.20, p<0.01), and multiple substance ingestion (52.9% vs. 81.4%, p=0.03). Median blood concentrations were 255 mg/dL (MeOH) and 12 mg/dL (EG). Follow-up analyses occurred in 9 MeOH patients (52.9%, 15 tests) and 15 EG patients (34.9%, 30 tests).
Conclusion
This study presents the first confirmatory analytical data on toxic alcohol poisoning among ED patients in Korea, emphasizing ongoing cases around Seoul.

Predicting serum acetaminophen concentrations in acute poisoning for safe termination of N-acetylcysteine in a resource-limited environment: Dahae Kim, Kyungman Cha, Byung Hak So; J Korean Soc Clin Toxicol. 2023;21(2):128-134. Published online December 29, 2023; DOI: https://doi.org/10.22537/jksct.2023.00013

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Abstract PDF: Purpose: The Prescott nomogram has been utilized to forecast hepatotoxicity from acute acetaminophen poisoning. In developing countries, emergency medical centers lack the resources to report acetaminophen concentrations; thus, the commencement and cessation of treatment are based on the reported dose. This study investigated risk factors that can predict acetaminophen detection after 15 hours for safe treatment termination.
Methods
Data were collected from an urban emergency medical center from 2010 to 2020. The study included patients ≥14 years of age with acute acetaminophen poisoning within 15 hours. The correlation between risk factors and detection of acetaminophen 15 hours after ingestion was evaluated using logistic regression, and the area under the curve (AUC) was calculated.
Results
In total, 181 patients were included in the primary analysis; the median dose was 150.9 mg/kg and 35 patients (19.3%) had acetaminophen detected 15 hours after ingestion. The dose per weight and the time to visit were significant predictors for acetaminophen detection after 15 hours (odds ratio, 1.020 and 1.030, respectively). The AUCs were 0.628 for a 135 mg/kg cut-off value and 0.658 for a cut-off 450 minutes, and that of the combined model was 0.714 (sensitivity: 45.7%, specificity: 91.8%).
Conclusion
Where acetaminophen concentrations are not reported during treatment following the UK guidelines, it is safe to start N-acetylcysteine immediately for patients who are ≥14 years old, visit within 15 hours after acute poisoning, and report having ingested ≥135 mg/kg. Additional N-acetylcysteine doses should be considered for patients visiting after 8 hours.

Up-to-date treatment of acetaminophen poisoning: Phil Chung Sung, Moon Jeongmi, Chun Byeongjo; J Korean Soc Clin Toxicol. 2022;20(2):39-44. Published online December 31, 2022; DOI: https://doi.org/10.22537/jksct.2022.20.2.39

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Abstract PDF: N-Acetylcysteine (NAC) is the standard antidote treatment for preventing hepatotoxicity caused by acetaminophen (AAP) poisoning. This review summarizes the recent evidence for the treatment of AAP poisoning. Several alternative intravenous regimens of NAC have been suggested to improve patient safety by reducing adverse drug reactions and medication errors. A two-bag NAC infusion regimen (200 mg/kg over 4 h, followed by 100 mg/kg over 16 h) is reported to have similar efficacy with significantly reduced adverse reactions compared to the traditional 3-bag regimen. Massive AAP poisoning due to high concentrations (more than 300-lines in the nomogram) needs to be managed with an increased maintenance dose of NAC. In addition to NAC, the combination therapy of hemodialysis and fomepizole is advocated for severe AAP poisoning cases. In the case of a patient presenting with an altered mental status, metabolic acidosis, elevated lactate, and an AAP concentration greater than 900 mg/L, hemodialysis is recommended even if NAC is used. Fomepizole decreases the generation of toxic metabolites by inhibiting CYP2E1 and may be considered an off-label use by experienced clinicians. Since the nomogram cannot be applied to sustained-release AAP formulations, all potentially toxic sustained-release AAP overdoses should receive a full course of NAC regimen. In case of ingesting less than the toxic dose, the AAP concentration is tested twice at an interval of 4 h or more; NAC should be administered if either value is above the 150-line of the nomogram.

Effect on blood heavy metal concentration in gas poisoning by combustion of ignition coal: Pilot study: Sang Hwan Lee, Juncheol Lee, Yongil Cho, Byuk Sung Ko, Jaehoon Oh, Hyunggoo Kang; J Korean Soc Clin Toxicol. 2021;19(2):127-132. Published online December 31, 2021; DOI: https://doi.org/10.22537/jksct.2021.19.2.127

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Abstract PDF: Purpose: It is known that the most common cause of gas poisoning in Korea is suicide attempts by burning ignition coals. Ignition coals are made from waste wood, and studies have been reported that heavy metals are emitted when this coal is burned. However, there was no study on how much heavy metal poisoning occurs in the human body through this, so this study was planned to find out whether the concentration of heavy metals in the blood increased in patients exposed to ignition coal combustion. Methods: From April 2020 to April 2021, blood lead, mercury, and cadmium concentrations were investigated in carbon monoxide poisoning patients who visited one regional emergency medical center in Seoul, and their association with exposure time, source of poisoning, and rhabdomyolysis were investigated. Results: During the study period, a total of 136 carbon monoxide poisoning patients were tested for heavy metals, and 81 cases of poisoning by ignition coal were reported. When comparing poisoning caused by combustion of ignition coal and other substances, there was no difference in the concentrations of lead, mercury, and cadmium in the blood, and there was no difference in the number of patients above the reference range. However, the patients exposed to more than 5 hours of ignition coal gas exposure are more frequent than those in the group less than 5 hours in lead (51.4% vs. 23.9%, p=0.012). Conclusion: Compared to poisoning with other combustible substances, the blood concentration of lead, mercury, and cadmium does not increase further in patients with gas poisoning by ignition coal. However, prolonged exposure may result in elevated levels of lead.

Factors of Determining N-acetylcysteine Administration in Patients with Acute Acetaminophen Poisoning: Jeong Hwa Lee, Sangchun Choi, Sang Kyu Yoon, Kyu Cheol Shin; J Korean Soc Clin Toxicol. 2020;18(2):78-84. Published online December 31, 2020; DOI: https://doi.org/10.22537/jksct.2020.18.2.78

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Abstract PDF: Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

Acute Nicotine Poisoning due to Electronic Cigarette Liquid: Systematic Review of Case Reports: Si Yong Yang, Min Hong Choa, Je Sung You, Hyun Soo Chung, Sung Phil Chung; J Korean Soc Clin Toxicol. 2020;18(2):51-56. Published online December 31, 2020; DOI: https://doi.org/10.22537/jksct.2020.18.2.51

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Abstract PDF

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.

Citations

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Electronic Nicotine, Non-Nicotine Delivery Systems, and Liquid Use by Flavoring and Nicotine Concentrations
Yeun Soo Yang, Hyeon Jeong Lim, Unchong Kim, Kyoungin Na, Heejin Kimm
Journal of the Korean Society for Research on Nicotine and Tobacco.2023; 14(3): 101. CrossRef

Discrepancies and Validation of Ethanol Level Determination with Osmolar Gap Formula in Patients with Suspected Acute Poisoning: Haewon Jung, Mi Jin Lee, Jae Wan Cho, Jae Yun Ahn, Changho Kim; J Korean Soc Clin Toxicol. 2019;17(2):47-57. Published online December 31, 2019; DOI: https://doi.org/10.22537/jksct.2019.17.2.47

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Abstract PDF: Purpose: Osmolar gap (OG) has been used for decades to screen for toxic alcohol levels. However, its reliability may vary due to several reasons. We validated the estimated ethanol concentration formula for patients with suspected poisoning and who visited the emergency department. We examined discrepancies in the ethanol level and patient characteristics by applying this formula when it was used to screen for intoxication due to toxic levels of alcohol. Methods: We retrospectively reviewed 153 emergency department cases to determine the measured levels of toxic ethanol ingestion and we calculated alcohol ingestion using a formula based on serum osmolality. Those patients who were subjected to simultaneous measurements of osmolality, sodium, urea, glucose, and ethanol were included in this study. Patients with exposure to other toxic alcohols (methanol, ethylene glycol, or isopropanol) or poisons that affect osmolality were excluded. OG (the measured-calculated serum osmolality) was used to determine the calculated ethanol concentration. Results: Among the 153 included cases, 114 had normal OGs (OG≤14 mOsm/kg), and 39 cases had elevated OGs (OG>14). The mean difference between the measured and estimated (calculated ethanol using OG) ethanol concentration was -9.8 mg/dL. The 95% limits of agreement were -121.1 and 101.5 mg/dL, and the correlation coefficient R was 0.7037. For the four subgroups stratified by comorbidities and poisoning, the correlation coefficients R were 0.692, 0.588, 0.835, and 0.412, respectively, and the mean differences in measurement between the measured and calculated ethanol levels were -2.4 mg/dL, -48.8 mg/dL, 9.4 mg/dL, and -4.7 mg/dL, respectively. The equation plots had wide limits of agreement. Conclusion: We found that there were some discrepancies between OGs and the calculated ethanol concentrations. Addition of a correction factor for unmeasured osmoles to the equation of the calculated serum osmolality would help mitigate these discrepancies.

Evaluation of Cut-off Values in Acute Acetaminophen Intoxication Following the Revised Guideline of the United Kingdom: Sung Jin Park, Kyungman Cha, Byung Hak So, Hyung Min Kim, Won Jung Jeoung; J Korean Soc Clin Toxicol. 2018;16(2):68-74. Published online December 31, 2018; DOI: https://doi.org/10.22537/jksct.2018.16.2.68

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Abstract PDF: Purpose: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. Methods: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cut-off values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over '100-treatment line'. Results: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (${chi}^2$ test for trend, ${chi}^2=22.66$, p-value<0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. Conclusion: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.

Survival after Cardiac Arrest due to Acute Methamphetamine Poisoning: A Case Report: You Ho Mun, Jung Ho Kim; J Korean Soc Clin Toxicol. 2018;16(2):176-180. Published online December 31, 2018; DOI: https://doi.org/10.22537/jksct.2018.16.2.176

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Abstract PDF: Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

A Case Report of Cardiac Arrest Following Intentional Ingestion of Liquid Nicotine for Electronic Cigarette: Jung Ho Kim; J Korean Soc Clin Toxicol. 2018;16(2):172-175. Published online December 31, 2018; DOI: https://doi.org/10.22537/jksct.2018.16.2.172

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Abstract PDF: Acute nicotine poisoning by liquid nicotine for electronic cigarettes is becoming an increasing problem worldwide. On the other hand, there are no regulations regarding its concentration, container or labelling in Korea. This is the first case of a cardiac arrest after liquid nicotine ingestion that was confirmed by plasma nicotine detection in Korea. A 34-year-old male was found with a cardiac arrest at home by the emergency medical services crew, and had a return of spontaneous circulation after 27 minutes of cardio-pulmonary resuscitation. The cause of his cardiac arrest was suspected to be acute nicotine poisoning by the ingestion of liquid nicotine. Toxicology analysis of the National Forensic Service confirmed plasma nicotine, and the pharmacokinetic estimated average concentration of plasma nicotine at the time of the cardiac arrest was 29.7 mg/L, a lethal dose. He was hospitalized for further treatment, but was discharged after 20 days without any improvement. Considering the strong toxicity of nicotine, appropriate policy decisions are required for sales and distribution.

Is it Adequate to Determine Acetaminophen Toxicity Solely on Patients' History? An Analysis on Clinical Manifestation of Intoxication Patients with Positive Serum Acetaminophen Concentrations: Jee Hyun Kim, Won-joon Jeong, Seung Ryu, Yong Chul Cho, Jang Hyuck Moon, Hyun Soo Choi, Song Hee Yang, Hee Sun Chung; J Korean Soc Clin Toxicol. 2017;15(2):94-100. Published online December 31, 2017; DOI: https://doi.org/10.22537/jksct.2017.15.2.94

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Abstract PDF: Purpose: Acute acetaminophen intoxication is a common occurrence that can cause lethal complications. In most domestic emergency departments, clinicians tend to treat acetaminophen intoxication based on patients' history alone, simply due to the lack of a rapid acetaminophen laboratory test. We performed a 20-month study of intoxication patients to determine the correlation between the history of patients and serum laboratory tests for acetaminophen. Methods: We took blood samples from 280 intoxication patients to evaluate whether laboratory findings detected traces of acetaminophen in the sample. Patients were then treated according to their history. Laboratory results came out after patients' discharge. Agreement between patients' history and laboratory results were analyzed. Results: Among the 280 intoxicated patients enrolled, 38 patients had positive serum acetaminophen concentrations; 18 out of 38 patients did not represent a history suggesting acetaminophen intoxication. One patient without the history showed toxic serum acetaminophen concentration. Among the patients with the history, two patients with toxic serum acetaminophen concentration did not receive N-acetylcysteine (NAC) treatment due to their low reported doses, while other 2 patients without significant serum acetaminophen concentration did receive NAC treatment due to their high reported doses. Conclusion: This study showed a good overall agreement between history and laboratory test results. However, some cases showed inconsistencies between their history and laboratory test results. Therefore, in treating intoxication patients, a laboratory test of acetaminophen with rapid results should be available in most domestic emergency departments.

A Case of a Herbicide Poisoning Induced Methemoglobinemia Patient Treated with High-dose Vitamin C: Kyung Hoon Sun, Jun Kew Kim, Chang Yeon Ryu, Seo Jin Kim, Hyeon Kyu Jo, Tae Ho Yoo, Yong Jin Park, Sun pyo Kim; J Korean Soc Clin Toxicol. 2017;15(2):148-151. Published online December 31, 2017; DOI: https://doi.org/10.22537/jksct.2017.15.2.148

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Abstract PDF: Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.

The Usefulness of Serum Lipid Concentration as a Predictor of Convulsion in Patients with Glufosinate Ammonium Poisoning: Hyun Do Lee, Kyung Hoon Sun, Seong Jung Kim; J Korean Soc Clin Toxicol. 2017;15(1):40-46. Published online June 30, 2017; DOI: https://doi.org/10.22537/jksct.2017.15.1.40

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Abstract PDF: Purpose: Glufosinate ammonium (GA; phosphinothricin) can induce neurological complications such as altered mental status, amnesia, and convulsions. This study was conducted to evaluate whether blood lipid profiles can help predict convulsions in patients with GA poisoning. Methods: This study was a retrospective review of data acquired at a tertiary academic university hospital from March 2014 to July 2016. Independent t-test, Mann-Whitney test and Analysis of covariance (ANCOVA) of demographic and laboratory findings of 50 patients with GA poisoning were performed to identify correlations of general characteristics and laboratory findings, including blood lipid profiles of GA-poisoned patients between with and without convulsions. Results: Convulsion as a GA complication showed a significant association with poison volume, age, white blood cell count, and creatine phosphokinase (CK), albumin, lactate dehydrogenase (LDH), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) content in blood according to an independent t-test and Mann-Whitney test. However, ANCOVA demonstrated significant association with LDL and triglyceride. Conclusion: Blood lipid profiles, especially serum LDL and triglyceride, were useful in predicting convulsions in patients with GA poisoning.

In vitro Effects of Epigallocatechin Gallate on Sister Chromatid Exchange in the Lymphocytes Exposed to Glyphosate: Jung-Min Park, Woo-Ik Choi, Sang-Chan Jin, Jae-Ho Lee, In-Jang Choi; J Korean Soc Clin Toxicol. 2016;14(2):78-82. Published online December 31, 2016; DOI: https://doi.org/10.22537/jksct.2016.14.2.78

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Abstract PDF: Purpose: Green tea is known as a potent anti-oxidant, anti-carcinogen, and genetic protector. Glyphosate (N-phosphonomethyl glycine) is a widely used non-selective herbicide that causes DNA damage. The present study was conducted to investigate the protective effects of green tea in human blood lymphocytes exposed to glyphosate using the Sister Chromatid Exchange (SCE) frequency method. Methods: Peripheral blood was obtained from 10 volunteers and cultured through four different conditions. Four groups were divided into control, glyphosate only (300 ng/mL), glyphosate and low ($20{mu}m$) concentrations of epigallocatechin gallate (EGCG) and glyphosate and high ($100{mu}m$) concentrations of EGCG. Results: The glyphosate exposed groups had a higher mean SCE frequency ($10.33{pm}2.50$) than the control group ($6.38{pm}2.28$, p<0.001). The low concentrations of EGCG groups had a lower mean SCE frequency ($9.91{pm}1.93$) than the glyphosate-only group, although this difference was not significant (p=0.219). However, the high concentration group ($9.49{pm}1.85$) had a significantly lower SCE frequency than the glyphosate-only group (p=0.001). Conclusion: EGCG has a gene protective effect in human lymphocytes exposed to the genotoxicity of glyphosate in the case of high concentrations.

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