Journal of The Korean Society of Clinical Toxicology

Original Article

The 2022 Annual Report on Toxicology Surveillance and Severe Poisoning Cases at Emergency Departments in Korea: Eun Sun Lee, Su Jin Kim, Gyu Chong Cho, Mi Jin Lee, Byung Hak So, Kyung Su Kim, Juhyun Song, Sung Woo Lee; J Korean Soc Clin Toxicol. 2023;21(1):1-16. Published online June 30, 2023; DOI: https://doi.org/10.22537/jksct.2023.00007

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Purpose: This study investigated the actual incidence of acute poisoning in Korea on a nationwide scale, with the aim of laying the groundwork for future initiatives in prevention, strategic antidote distribution, and the development of effective emergency treatment for acute poisoning.
Methods
The study analyzed data from 3,038 patients who presented to emergency departments with poisoning-related conditions from June 1, 2022 to December 31, 2022 at 10 sites in nine cities across the country. We extracted data on general characteristics of the poisoning cases, including demographic characteristics (age and gender), place of exposure, reason for poisoning, route of exposure, and the substance involved in the poisoning incident. Age-related patterns in reasons for poisoning, medical outcomes, frequent and primary poisoning substances, and deaths were also analyzed.
Results
The population analyzed in our study was predominantly female, with women constituting 54.74% of all cases. Among infants and children, non-intentional poisoning due to general accidents was the most common cause, accounting for 71.43% of cases. Conversely, suicidal poisoning was more prevalent among teenagers and adults over 20. Fifty-two patients died during the study period, with males comprising approximately two-thirds (67.31%) of these fatalities. Pesticides were the most common poisoning substance among those who died, accounting for 55.77% of such cases. Notably, a significant majority of the victims were elderly individuals aged 60 and above.
Conclusion
This study holds substantial significance, since it represents the first comprehensive investigation and analysis of the symptoms, treatment, and causes of death due to poisoning in Korea on a national scale. By substantially expanding the range and types of poisonous substances examined, we were able to more precisely identify the characteristics and clinical patterns of poisoning cases nationwide.

Citations

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Development and Validation of a Virtual Patient Simulator for the Management of Acute Poisoning: An Assessment of Face and Content Validity
Ki Yong Kwon, Ji-Hoon Kim, Hyo Joon Kim
Journal of The Korean Society of Clinical Toxicology.2025; 23(1): 10. CrossRef
Clinical and Epidemiological Characteristics of Acute Poisoning Patients in South Korea in 2024: An In-Depth Sample Analysis Based on the National Emergency Department Information System
Hyein Park, Gyu Chong Cho, Yudong Sohn, Taejin Park, Youngsuk Cho
Journal of The Korean Society of Clinical Toxicology.2025; 23(2): 38. CrossRef
Prediction of Hematotoxicity in Patients with Acute Valproic Acid Intoxication
Jiwon Lee, Kyungman Cha, Won Jung Jeong, Hwan Song, Byung Hak So
Journal of The Korean Society of Clinical Toxicology.2025; 23(2): 29. CrossRef
Development of a Web Application for Simulating Plasma Drug Concentrations in Patients with Zolpidem Intoxication
Hwa Jun Cha, Sungpil Han, Kwan Cheol Pak, Hyungsub Kim
Pharmaceutics.2024; 16(5): 689. CrossRef

Causative Substance and Time of Mortality Presented to Emergency Department Following Acute Poisoning: 2014-2018 National Emergency Department Information System (NEDIS): Hyeonjae Lee, Minhong Choa, Eunah Han, Dong Ryul Ko, Jaiwoog Ko, Taeyoung Kong, Junho Cho, Sung Phil Chung; J Korean Soc Clin Toxicol. 2021;19(2):65-71. Published online December 31, 2021; DOI: https://doi.org/10.22537/jksct.2021.19.2.65

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Abstract PDF

Purpose: The purpose of this study was to investigate the cause of acute fatal poisoning and the time of death by analyzing the National Emergency Department Information System (NEDIS) of South Korea. Methods: The NEDIS data from 2014 to 2018 excluding non-medical visits were used for this study. The patients with acute poisoning were extracted using diagnostic codes. The toxic substances were classified into pharmaceuticals, pesticides, gases, artificial poisonous substances, and natural toxic substances. Patients were classified according to the time of death, place of death, and region. In each case, the most causative substances of poisoning were identified. Results: There were 380,531 patients including poisoning-related diagnoses, of which 4,148 (1.1%) died, and the WHO age-standardized mortality rate was 4.8 per 100,000. Analysis of 2,702 death patients whose primary diagnosis was acute poisoning, the most common cause of poisoning death was pesticides (62%), followed by therapeutic drugs, gas, and artificial toxic substances. Herbicides were the most common pesticides at 64.5%. The proportion of mortality by time, hyperacute (<6 h) 27.9%, acute (6-24 h) 32.6%, subacute (1-7 d) 29.7%, and delayed period (>7 d) were 9.8%. Conclusion: This study suggests that the most common cause of poisoning death was pesticides, and 60% of deaths occurred within 24 hours. The 71% of mortality from pesticides occurred within 6-24 hours, but mortality from gas was mostly within 6 hours. According to the geographic region, the primary cause of poisoning death was varied to pesticides or pharmaceuticals.

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Clinical and Epidemiological Characteristics of Acute Poisoning Patients in South Korea in 2024: An In-Depth Sample Analysis Based on the National Emergency Department Information System
Hyein Park, Gyu Chong Cho, Yudong Sohn, Taejin Park, Youngsuk Cho
Journal of The Korean Society of Clinical Toxicology.2025; 23(2): 38. CrossRef
A Novel Method for Medical Predictive Models in Small Data Using Out-of-Distribution Data and Transfer Learning
Inyong Jeong, Yeongmin Kim, Nam-Jun Cho, Hyo-Wook Gil, Hwamin Lee
Mathematics.2024; 12(2): 237. CrossRef
Factors Associated with Mortality in Elderly Patients Admitted to Intensive Care Unit due to Acute Drug Intoxication from Suicide Attempts
Kyung-Eun Kim, Sun-Hee Moon, Chieun Song, Minjeong An
Journal of Korean Critical Care Nursing.2024; 17(2): 1. CrossRef
Implementation of Regenerative Thermal Oxidation Device Based on High-Heating Device for Low-Emission Combustion
Hoon-Min Park, Dal-Hwan Yoon, Joon-Seong Lee, Hyun-Min Jung, Dae-Hee Lee, Dong-Hwan Jeon, Tae-Yeung Lim
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The 2022 Annual Report on Toxicology Surveillance and Severe Poisoning Cases at Emergency Departments in Korea
Eun Sun Lee, Su Jin Kim, Gyu Chong Cho, Mi Jin Lee, Byung Hak So, Kyung Su Kim, Juhyun Song, Sung Woo Lee
Journal of The Korean Society of Clinical Toxicology.2023; 21(1): 1. CrossRef
Demographic characteristics of patients admitted to the emergency department for intoxication and a time series analysis during the COVID-19 period
Bongmin Son, Nayoon Kang, Eunah Han, Gina Yu, Junho Cho, Jaiwoog Ko, Taeyoung Kong, Sung Phil Chung, Minhong Choa
Journal of The Korean Society of Clinical Toxicology.2023; 21(2): 92. CrossRef
Machine Learning-Based Prediction Models of Acute Respiratory Failure in Patients with Acute Pesticide Poisoning
Yeongmin Kim, Minsu Chae, Namjun Cho, Hyowook Gil, Hwamin Lee
Mathematics.2022; 10(24): 4633. CrossRef

Severity Predictors of Elderly Poisoning Patients Admitted to an Emergency Medical Center: Chang Yong Park, Kyung Man Cha, Byung Hak So, Won Jung Jeong; J Korean Soc Clin Toxicol. 2019;17(2):94-101. Published online December 31, 2019; DOI: https://doi.org/10.22537/jksct.2019.17.2.94

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Abstract PDF

Purpose: This study examined the clinical characteristics of severe elderly poisoning patients to determine the factors that can prevent them. Methods: Data were collected from patients over 65 years of age presenting to the emergency center with poisoning from 2013 to 2018. Their medical records were analyzed retrospectively, and patients with a poisoning severity score of three or more were defined as the severe poisoning group. The risk factors were evaluated by univariate and multivariate analysis. Results: This study analyzed 292 patients, of whom 37 (12.7%) belonged to the severe poisoning group. The severe poisoning group showed a significantly higher association with pesticide poisoning and intentional suicide attempts. Loneliness and somatization were the cause of the suicidal ideas. No significant differences in age, sex, drinking, ingestion time, poisonous materials other than pesticides, and neuropsychological consultation were observed between the two groups. Conclusion: The severe elderly poisoning patients were the result of intentional poisoning for suicide. Loneliness and somatization were the most influential causes of suicidal poisoning. Therefore, psychiatric screening and frequent medical treatment for elderly people are required to prevent severe poisoning in elderly patients.

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The 2022 Annual Report on Toxicology Surveillance and Severe Poisoning Cases at Emergency Departments in Korea
Eun Sun Lee, Su Jin Kim, Gyu Chong Cho, Mi Jin Lee, Byung Hak So, Kyung Su Kim, Juhyun Song, Sung Woo Lee
Journal of The Korean Society of Clinical Toxicology.2023; 21(1): 1. CrossRef

Trends in Korean Pediatric Poisoning Patients: Retrospective Analysis of National Emergency Department Information System: Kyeongjae Lee, Kyung Hwan Kim, Dong Wun Shin, Junseok Park, Hoon Kim, Woochan Jeon, Joon Min Park, Hyunjong Kim; J Korean Soc Clin Toxicol. 2017;15(2):69-78. Published online December 31, 2017; DOI: https://doi.org/10.22537/jksct.2017.15.2.69

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Abstract PDF: Purpose: This study reports the clinical features of infant, child, school aged and adolescent patients treated for acute poisoning in nationwide emergency departments (EDs). Methods: We retrospectively analyzed clinical data pertaining to patients under 19 years of age who were treated for acute poisoning in nationwide EDs from 2013 to 2015. The data were collected by the National Emergency Department Information System (NEDIS). All patients were divided into three groups: 'Infant and child group' (0 to 5 years), 'school age group' (6 to 12 years) and 'adolescent group' (13 to 18 years). General characteristics, Korea Standard Classification of Disease $7^{th}$ (KCD-7) codes and results of care were collected. Results: There were 14,500 pediatric poisoning cases during the study period. The distribution of patient age was bimodal with two peaks among infant, child and adolescent group. The proportion of alert mentality at the ED visit of the infant and child group was 99.3%, while that of the adolescent group was 86.4%. The proportion of intentional intoxication was higher in the adolescent group (40.7%) than other age groups. Among children less than 13 years of age, various poisonous substances and therapeutic drugs were common. Conclusion: There were some clinical differences in acute poisoning patients between age groups. It is necessary to establish a preventive plan considering characteristics by age. Since the KCD-7 code has limitations in analyzing the characteristics of poisoning patients, it is necessary to consider the registration system of poisoning patients.

In vitro Protective Effects of Glehnia Littoralis on Alpha-amanitin Induced Hepatotoxicity: Bo Hyun Kim, Kyung Hoon Sun, Sun Pyo Kim, Yongjin Park; J Korean Soc Clin Toxicol. 2017;15(2):107-115. Published online December 31, 2017; DOI: https://doi.org/10.22537/jksct.2017.15.2.107

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Abstract PDF: Purpose: Glehnia littoralis has been used to treat ischemic stroke, phlegm, cough, systemic paralysis, antipyretics and neuralgia. The pharmacological mechanisms of Glehnia littoralis include calcium channel block, coumarin derivatives, anticoagulation, anti-convulsive effect, as well as anti-oxidant and anti-inflammatory effects. Alpha-amanitin (${alpha}$-amanitin) is a major toxin from extremely poisonous Amanita fungi. Oxidative stress, which may contribute to severe hepatotoxicity was induced by ${alpha}$-amanitin. The aim of this study was to investigate whether Glehnia littoralis ethyl acetate extract (GLEA) has the protective antioxidant effects on ${alpha}$-amanitin -induced hepatotoxicity. Methods: Human hepatoma cell line HepG2 cells were pretreated in the presence or absence of GLEA (50, 100 and $200{mu}g/ml$) for 4 hours, then exposed to $60{mu}mol/L$ of${alpha}$-amanitin for an additional 4 hours. Cell viability was evaluated using the MTT method. AST, ALT, and LDH production in a culture medium and intracellular MDA, GSH, and SOD levels were determined. Results: GLEA (50, 100 and $200{mu}g/ml$) significantly increased the relative cell viability by 7.11, 9.87, and 14.39%, respectively, and reduced the level of ALT by 10.39%, 34.27%, and 52.14%, AST by 9.89%, 15.16%, and 32.84%, as well as LDH by 15.86%, 22.98%, and 24.32% in culture medium, respectively. GLEA could also remarkably decrease the level of MDA and increase the content of GSH and SOD in the HepG2 cells. Conclusion: In the in vitro model, Glehnia littoralis was effective in limiting hepatic injury after ${alpha}$-amanitin poisoning. Its antioxidant effect is attenuated by antidotal therapy.

A Case Report of Envenomation and Injury by a Poisonous Spine of A Marble Motoro (Potamotrygon Motoro): Min Hong Choa, Seung Ho Jun, Duk Hwan Kim, Jong Su Park, Su Jin Kim, Yun Sik Hong, Sung Woo Lee; J Korean Soc Clin Toxicol. 2013;11(1):46-48. Published online June 30, 2013

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Abstract PDF: Potamotrygon motoro, also known as the Marble motoro, is a potamodromous freshwater ray native to the basins of the Amazon River. Marble motoros were introduced to South Korea in the 2000s, and, because they are easy to raise, were sold as aquarium fish. The aim of this report is to illustrate a new case involving envenomation by a Marble motoro. A 35-year-old commercial aquarium assistant came to the hospital after being pricked by a Marble motoro. The clinical picture in this case showed acute local pain with minimal systemic manifestations. This patient recovered after receiving symptomatic treatment and wound care. This case of envenomation accentuates the potential for injury among people coming in contact with a venomous Marble motoro.

Comparison between Emergency Patient Poisoning Cases and the Tox-Info System Database: Hyun-Jong Kim, Yang-Weon Kim, Hyun Kim, Chang-Bae Park, Byung-Hak So, Kyeong-Ryong Lee, Kyung-Woo Lee, Kyung-Won Lee, Sung-Woo Lee, Jang-Young Lee, Gyu-Chong Cho, Jun-Ho Cho, Sung-Phil Chung; J Korean Soc Clin Toxicol. 2012;10(1):8-14. Published online June 30, 2012

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Abstract PDF: Purpose: The Tox-Info system is a poisonous substance information database developed by the Korean National Institute of Food and Drug Safety Evaluation. The aim of this study was to estimate the coverage effectiveness of the Tox-Info system by comparing the toxic substances included in the database with the distribution of the toxic substances implicated in the cases of intoxicated patients presenting to emergency departments. The secondary aim of the study was to propose any additional substances that should be added to the database. Methods: We retrospectively reviewed the medical records of patients suffering with toxic exposure who had visited any of 12 selected emergency departments in Korea from January 2010 to December 2011. The identified toxic substances were classified into groups including prescription drugs, agricultural chemicals, household products, animals or plants, herbal drugs, and others. We calculated the coverage rate of the Tox-Info database relative to the number of intoxication cases and the type of toxic substances involved. Results: A total of 5,840 intoxicated patient records were collected. Their mean age was $46.6{pm}20.5$ years and 56.2% were female. Of the total intoxication cases, 87.8% of the identified toxic substances were included in the Tox-Info database, while only 41.6% of all of the types of identified toxic substances were included. Broken down by category, 122 prescription drugs, 15 agricultural chemicals, 12 household products, 14 animals or plants and 2 herbal drugs involved in poisoning cases were not included in the Tox-info database. Conclusion: This study demonstrated the clinical usefulness of the Tox-Info system. While 87.8% of the substances involved in the cases were included in the Tox-Info database, the database should be continuously updated in order to include even the most uncommon toxic substances.

Clinical Analysis of Puffer Fish Poisoning Cases: Seung-Hwan Hyun, Chang-Hwan Sohn, Seung-Mok Ryoo, Bum-Jin Oh, Kyung-Soo Lim; J Korean Soc Clin Toxicol. 2011;9(2):95-100. Published online December 31, 2011

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Abstract PDF: Purpose: Ingestion of puffer fish can be poisonous due to the presence of potent neurotoxins such as tetrodotoxin (TTX) found in its tissues. There are few clinical reports related to TTX. We performed this study to evaluate the clinical characteristics of TTX poisoning. Methods: We conducted a retrospective study of the 41 patients diagnosed with TTX poisoning who visited the Seoul Asan medical center from July 2004 and December 2010. A review of patients' electronic medical records and patient telephone interviews were conducted. Diagnosis of TTX poisoning was confirmed by observing the casual link between puffer fish consumption and the development of typical TTX intoxication symptoms. Results: The mean age of the patients included in the study was 46.6 years. The highest incidence of intoxication was observed in patients in their 50s (10 patients). Seasonal distribution of intoxication events included 10 in spring, 7 in summer, 10 in fall, and 14 in winter. In most cases, symptoms occurred within 1 hour of ingestion. A wide range of symptoms were associated with puffer fish ingestion affecting multiple body systems including neuromuscular (27 patients), gastrointestinal (19 patients), and cardiopulmonary/vascular (19 patients). All patients were treated with symptomatic and supportive therapy and recovered completely, without sequelae, within 48 hours. In three cases, ventilator support was required. Conclusion: TTX poisoning is not seasonally related, and patients admitted to the emergency room were observed with a wide range of symptoms. Where TTX poisoning is diagnosed, supportive therapy should be performed. Early intubation and ventilation is important, especially is cases of respiratory failure.

Characteristics of elderly patients with acute poisoning: Bo-Kyeong Kim, Si-Young Jung, Koo-Young Jung; J Korean Soc Clin Toxicol. 2010;8(2):61-68. Published online December 31, 2010

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Abstract PDF: Purpose: Poisoning is a major health problem for the elderly, and poisoning can cause fatal side effects. However, the characteristics and clinical features of elderly patients with acute poisoning have not been well studied in the previous domestic research. So, we tried to analyze the clinical characteristics and toxic substances of the patients who were 65 years old or older and who were admitted to the regional emergency medical center due to acute poisoning. Methods: We retrospectively reviewed the medical records and poisoning protocols of the patients who were 65 years of age or older and who had with acute poisoning and who visited the ED in our emergency center from January 2005 to December 2009. We collected the demographic information, the gender, the underlying diseases, the causes and toxic substances, the initial presentation, the treatment and the outcomes. Results: A total of 2179 poisoned patients visited the hospital during 5 years, and among them 244 were 65 years of age or older (11.2%). The mean age was $75.6{pm}6.9$ years and the male:female ratio was 1:1.7. The most common cause of poisoning was suicide (73.4%) and the most common source of poisonous substances was their own drugs. Of the substances used for poisoning, benzodiazepine was the most common drug (25.8%), followed by sedatives other than benzodiazepine (25.4%), insecticide (12.7%), chemical agents (12.3%) and herbicides (8.2%). The most common initial presentation was mental change (64.8%). When comparing the factors between the three elderly groups, there was no difference in gender, the cause, the substances and the underlying disease. The outcomes of treatment included ICU admission (56.1%), a good condition at discharge (12.7%) and admission to a general ward (12.7%). The overall mortality rate was 10.2% for the elderly patients. Conclusion: In this Korean study, unlike the foreign studies, the most common cause of poisoning in elderly patients was intentional poisoning. The admission rate was 68.8% and mortality rate was 10.2%.

A Case of Colchicine Intoxication Presenting as Acute Gastroenteritis: Ji-Yun Ahn, You-Dong Sohn, Hyuk-Sool Kwon, Hee-Chol Ahn; J Korean Soc Clin Toxicol. 2008;6(2):138-141. Published online December 31, 2008

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Abstract PDF: A 47-year-old woman ingested about 12 mg of colchicine with suicidal intent. Colchicine, a highly poisonous alkaloid, is a commonly used treatment for gout, Bechet's disease, and familial Mediterranean fever. Despite the knowledge of its side effects, the risk of a significant overdose is under-appreciated. She suffered from acute multisystem toxicity, including gastrointestinal disorders, bone marrow suppression, alopecia, and probable pancreatitis, but she ultimately recovered with supportive therapy. We report a case of acute colchicine toxicity from a single overdose with a review of the literature.

A Familial Case of Tetramine Intoxication from Neptunea: Chang-Won Lee, Jung-Keun Kwak, Kyung-Choon Park, Ji-Yeong Ryu, Ji-Young You, Gyu-Chong Cho; J Korean Soc Clin Toxicol. 2007;5(1):50-52. Published online June 30, 2007

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Abstract PDF: Certain parts of shellfish contain poisonous substances and cause intoxication. Tetramine toxin is found in the salivary gland of Neptunea. Three family members were admitted to the hospital with chief complaints of dizziness and blurred vision, gait disturbance, and spasms of the lower extremities after ingesting Neptunea. Physical examination revealed sluggish pupil light reflexes, but laboratory studies were normal. Symptoms were completely resolved within 24 hours after injection of atropine. We report a case of three patients with dizziness and blurred vision, gait disturbance, and spasms of the lower extremities due to Neptunea tetramine toxin.

A Patient Presenting with Abnormal Behavior after Wild Plant Ingestion: Taek-Geun Ohk, Yoon-Seong Kim, Chan-Woo Park, Joong-Bum Moon, Ki-Hoon Choi, Jeong-Yeul Seo, Hee-Cheol Ahn, Moo-Wob Ahn, Jun-Hwi Cho; J Korean Soc Clin Toxicol. 2006;4(1):48-51. Published online June 30, 2006

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Abstract PDF: With well-being boom recently, the common people, but not experts, are increasingly taking in them directly by picking wild herbs. However, only experts can distinguish between edible vegetables and poisonous herbs from the wild herbs. Especially, it is not even easy for experts to distinguish them only by looking into buds in spring without flowers or fruit. So, sometimes many patients are being carried into the emergency room by the toxic symptom after taking by misunderstanding the poisonous herbs as edible vegetables. For herb intoxication as well as drug intoxication, what kinds of vegetables patients took in, and when and how much they took in them are important information for curing. Of course, in the case of intoxicating in the wild herbs, the patients can have a lot of symptoms and sings-hemodynamic alteration and abnormal neurologic sign as well as gastrointestinal symptoms-according to the kinds of herbs which they took in. Therefore, it is difficult to find the kinds of herbs which they took in through the specific symptoms. Recently we experienced a case with showing typical anticholinergic symptoms after ingestion of Scopolia japonica. As a result, the publicity activities about the wild plants needs because if the person without their previous knowledge take in the poisonous herbs, serious side effects can be produced..

The Clinical Aspects of Wild Plant Poisoning: Taek-Gun Ok, Chan-Woo Park, Jun-Hwi Cho, Seung-Whan Cheon, Seung-Young Lee, Sung-Eun Kim, Ki-Hoon Choi, Ji-Hoon Bae, Jeong-Yeul Seo, Hee-Cheol Ahn, Moo-Eob Ahn, Byung-Ryul Cho, Yong-Hoon Kim; J Korean Soc Clin Toxicol. 2005;3(2):79-85. Published online December 31, 2005

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Abstract PDF: Purpose: With the recent boom in 'eating healthy', many adults are interested in dieting to prevent future diseases. However only well trained experts can distinguish between what are edible vegetables and herbs from their poisonous look-alikes. In cases where a patient unknowingly ingests a poisonous herb, is caught off guard by the poisonous side effects that occur because of their lack of knowledge of what they have ingested. This paper will focus on the need to educate the public about the risks involved with ingesting wild vegetables and herbs and study the emergency diagnosis and treatment of poisoned patients that enter the emergency room. Method: This study was done in the spring of 2004 (from March to May) in the Kangwon Young-Seo districts of Korea. 15 subjects used in this study, entered the emergency room showing signs of toxic symptoms. Data was collected by examining subject's records. Additional data was collected by collaborating with physicians in the hospital that diagnosed and treated the subjects. Identifying the poisonous vegetable or herb is the first step to proper diagnosis and treatment. Subjects admitted to the emergency room, underwent a battery of tests: laboratory examination, ECG, radiological exam and etc. Results: The demographics of the study encompassed subjects with the average age of $50{pm}19$ years old. There were 10 men and 5 women. Common symptoms of this study included; gastrointestinal symptoms such as nausea, vomiting, epigastric pain and so on. In the case of Caltha palustris ingestion, additional symptoms were present; bradycardia and hypotension which lasted for a long time. While cases that ingested Scopolia parviflora had little effect on vital signs but manic episodes lasted for about three days. Veratrum patulum ingestion showed signs of bradycardia and hypotension but contrary to Caltha palustris recovery was shorten by treating with dopamine. However, dizziness, headache and paresthesia of the extremities continued for a long time. Finally Sium ninsi ingestion showed visual disturbance, paresthesia of the extremities, dizziness as their initial symptoms. Conclusion: The risks involved with ingesting wild plants without the proper knowledge can lead to serious side effects and steps need to be taken to educate the public. In addition, all emergency physicians need to have a working knowledge of the symptoms and signs associated with ingesting toxic wild plants and need to treat accordingly.

Phytolacca Radix Poisoning due to Misidentification as an Arrowroot: Woo-Je Jin, Youngho Jin, Tae-O Jeong, Jae- Baek Lee; J Korean Soc Clin Toxicol. 2004;2(1):27-30. Published online June 30, 2004

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Abstract PDF: 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.

The Shock with Bradycardia after Ingestion of Caltha palustris: Chan-Woo Park, Taek-Gun Ok, Jun-Hwi Cho, Dong-Wook Choi, Ae-Young Her, Hee-Young Lee, Yong-Hoon Kim, Byung-Ryul Cho, Sung-Eun Kim, Ki-Hoon Choi, Ji-Hoon Bae, Jeong-Yeul Seo, Jae-Bong Chung; J Korean Soc Clin Toxicol. 2004;2(1):41-44. Published online June 30, 2004

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Abstract PDF: With a recent well-being boom, our interest in chemical-free vegetables is also increasing. So, some people are trying to take in wild plants chosen by themselves. However, others often come to their rescue in an emergency department after eating them, caused by their misunderstanding poisonous herbs as edible vegetables. We have ever seen two persons carried into the emergency department with bradycardia and shock incurred by his intake by confusion between Caltha palustris and Ligularia fischeri lately. There were symptoms such as epigastric pain, nausea, vomiting and so on in their cases, and the symptoms of bradycardia and hypotension continued. Owing to sustained bradycardia and hypotension states, we applied a dopamine to a patient, and then the in-patient left the hospital two days later. We presumed the cause of the two symptoms appeared in two cases to be a saponin in Caltha palustris. For that reason, if someone has the bradycardia and hypotension symptoms from an unknown cause after taking in wild plants, they have to consider a toxication by the Caltha palustris. Therefore, this paper focused on the issue that unexpected poisoning would have to be prevented by studying about wild plants much more and informing the toxic risk from the plants.

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