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전경홍,강명수,Jun, Kyung-Hong,Kang, Myung-Soo 대한임상독성학회 2009 대한임상독성학회지 Vol.7 No.1
Purpose: Paraquat, a globally used herbicide, is highly toxic to human beings. Hence, we reviewed some cases of paraquat poisoning in Korea. Methods: We analyzed the clinical and laboratory findings of 50 patients poisoned with paraquat retrospectively. The patients were admitted to the department of internal medicine in the Eumseong KeumWang hospital from January 2008 to December 2008. Results: Among 50 cases of paraquat poisoning, 28 cases were male. Twenty-four cases (48%) were over 60 years old. Fourty-nine patients ingested paraquat on purpose as suicidal attempts, while 1 patient underwent accidental ingestion. Seven patients swallowed less than one mouthful of paraquat, of which 4 patients survived. Eleven patients swallowed two mouthfuls of paraquat, of which 8 patients survived. Thirty-two patients swallowed over three mouthfuls of paraquat and they all died. Thirty-one patients with leukocytosis died. Twenty-one patients with metabolic acidosis died. Increased levels of blood amylase and glucose were related to high mortality, and increased level of blood creatinine was related to severe mortality. Hemoperfusions were accomplished in 27 patients of paraquat poisoning, of which 12 patients survived. Conclusion: Paraquat is a highly toxic herbicide. When patients arrive at the hospital, laboratory findings, urine paraquat concentrations, arrival time, and the amount of paraquat consumed must be considered for treatment plan.
증례 : 신장 ; 항산화제 및 혈액관류 병합요법으로 생존한 Paraquat 중독 치험 3예
전경홍 ( Kyung Hong Jun ),강명수 ( Myung Soo Kang ),최원석 ( Won Seok Choi ),김향 ( Hyang Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S
Paraquat 치료에서 가장 중요한 것은 급성 신부전이 일어나기 전에 위장 정화 및 항산화제와 혈액관류치료를 적극적으로 하여 혈중 paraquat의 농도를 낮추는 것이다. 적극적인 항산화제의 주입으로 산소라디칼에 의한 신장의 손상을 막고, 또한 신장은 paraquat의 최대의 배설구이므로 수액과 이뇨제 등을 통하여 paraquat의 배설을 촉진시키는 것이 paraquat 치료에 중심이 될 것으로 사료된다. 본 저자들은 내원 당시 비교적 높은 paraquat 혈중농도를 보인 환자들에 대하여 치료 프로토콜을 통한 혈액관류를 통한 빠른 체외 배설과 다양한 항산화제를 적극 투여하여 폐손상을 동반하지 않고 성공적으로 치료된 임상 3예를 보고 하는 바이다. 향후 paraquat 중독 환자의 치료에 도움을 줄 수 있는 치료 프로토콜이 더욱 연구 개발되어야 할 것으로 사료된다. Paraquat is a very potent herbicide and has produced many fatalities through indiscriminate use and suicide. Death is usually caused by pulmonary fibrosis with the ingestion of more than one mouthful of 20% paraquat. We experienced three cases of paraquat poisoning treated without pulmonary injury. Patients swallowed one to two mouthfuls of 20% commercial paraquat. Hemoperfusion was performed within a few hours after ingestion, and then combination therapy with several antioxidants, steroid, and diuretics was performed. The patients recovered completely without pulmonary injury. (Korean J Med 77:S1268-S1273, 2009)
임현술,배근량,김두희,전경홍,Lim, Hyun-Sul,Bae, Geun-Ryang,Kim, Doo-Hie,Jun, Kyung-Hong 한국농촌의학지역보건학회 1998 농촌의학·지역보건 Vol.23 No.2
It has been reported that among mushroom farmers, respiratory diseases such as hypersensitivity pneumonitis can be developed by inhalation of mushroom (Pleurotus ostreatus) spores. For the evaluation of respiratory symptoms among mushroom farmers, a questionnaire was made. The Questionnaire included general characteristics, past occupational histories, durations of the mushroom cultivation and characteristics of the symptoms. Following the questionnaire we interviewed the 72 mushroom farmers (12 males, 10 females) from Kyungbuk Province. We also examined white blood counts, erythrocyte sedimentation rates, eosinophil counts and total IgE counts for the 5 farmers. The results obtained are as follows. 1. The mean age among the 22 mushroom farmers was 46.9 years, and the mean duration of cultivation was 7.5 years. 2. Among the 22 mushroom farmers. 18 farmers (81.8 %) suffered from respiratory symptoms at work. The main symptom was coughing (100.0%), followed by chilling sensation (50.0 %), sputum (38.9 %) and sore throat (27.8 %). 3. Coughing and other associated symptoms occurred during work and disappeared after work or several days later when the exposure had been stopped. 4. Total IgE counts were elevated in all farmers examined the test. With above results, the respiratory symptoms that developed among mushroom farmers were typical patterns of hypersensitivity pneumonitis. Epidemiological studies and preventive measures for mushroom farmers should be established.
박성민,김범수,이만호,전우규,이상종,국신호,전경홍,권중혁,임시영 대한내과학회 1996 대한내과학회지 Vol.50 No.6
Chronic eosinophilic pneumonia has been defined as pulmonary infiltration of the lung by eosinophils that may be accompanied by an excess of these cells in the peripheral blood. We have experienced two females; a mother and a daughter who simultaneoulsy developed chronic eosinophilic pneumonia after consumption of rare cows liver. Although difference in the degree of severity of symptoms all both had fever cough dyspnea and shared opacification of peripheral lung parenchyme in the radiologic findings. The numbers of eosinophils were foung to have increased in the peripheral blood smears. During the period of steroid treatment clinical symptoms and chest roentograms had improved markekly, although symptoms have relapsed following the cessation of treatment.