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10,150 J의 심장조율동과 치료적 저체온법으로 소생한 중증 초오 중독 환자 1례
문형준 ( Hyung Jun Moon ),이정원 ( Jung Won Lee ),김기환 ( Ki Hwan Kim ),정동길 ( Dong Kil Jeong ),김종호 ( Jong Ho Kim ),김영기 ( Young Ki Kim ),이현정 ( Hyun Jung Lee ) 대한임상독성학회 2014 대한임상독성학회지 Vol.12 No.2
Aconitine, found in the Aconitum species, is highly extremely toxic, and has been known to cause fatal cardiac arrhythmias and cardiovascular collapse. Although several reports have described treatment of aconitine intoxication, management strategy for the patient in a hemodynamically compromised state who experienced cardiopulmonary collapse is unknown. We report here on a case of a successful cardiopulmonary resuscitation and therapeutic hypothermia in an aconitine-induced cardiovascular collapsed patient. A 73-year-old male who presented with nausea, vomiting, chest discomfort, and drowsy mental state after eating an herbal decoction made from aconite roots was admitted to the emergency department. He showed hemodynamic compromise with monomorphic ventricular tachycardia resistant to amiodarone and lidocaine. After 3 minutes on admission, he collapsed, and cardiopulmonary resuscitation was initiated. We treated him with repeated cardioversion/defibrillation of 51 times, 10,150 joules and cardiopulmonary resuscitation of 12 times, 69 minutes for 14 hours and therapeutic hypothermia for 36 hours. He recovered fully in 7 days.
문형준 ( Hyung Jun Moon ),이정원 ( Jung Won Lee ),유병대 ( Byeong Dae Yoo ) 대한임상독성학회 2013 대한임상독성학회지 Vol.11 No.2
The imidazopyridine, zolpidem, a non-benzodiazepine hypnotic drug, is widely-prescribed for insomnia. It is regarded as a good alternative to benzodiazepine because of the reduced possibility for abuse and development of dependence. However, more recently, due to the reduced possibility for abuse and development of dependence, it is regarded as a good alternative to benzodiazepine. adverse effects of zolpidem have been recognized. The objective of this report is to provide information on the potential for occurrence of benzodiazepine-like withdrawal seizure in patients who chronically take zolpidem continually. We present and discuss a case of seizure after sudden interruption of the protracted use of an abusively high dose of zolpidem. Zolpidem may not be the ideal drug for longterm pharmacotherapeutic management of insomnia. Clinicians should administer zolpidem at a low-dose for a short period of time for prevention of drug abuse and dependence and the potential for occurrence of benzodiazepine- like withdrawal seizure.
Segmental Arterial Mediolysis으로 인한 신경색과 혈복강
최재형 ( Jae Hyung Choi ),조영순 ( Young Soon Cho ),김재우 ( Jae Woo Kim ),이정원 ( Jung Won Lee ),문형준 ( Hyung Jun Moon ) 대한응급의학회 2012 대한응급의학회지 Vol.23 No.6
This article reports a patient with both a renal infarction and acute intra-abdominal hemorrhage secondary to a rare vascular disease, segmental arterial mediolysis. The patient was a 37-year-old male who presented with acute right flank pain. Abdominal and pelvic computerized tomography (CT) showed a right renal infarction. After three days, the right flank pain had diminished but left flank pain began. Visceral angiography revealed a wedge shape perfusion defect at the mid pole of the left kidney, suggesting a left renal infarction but there were no definite perfusion defects at the right kidney. After ten days, the patient complained of abdominal pain and 2 episodes of syncope. Abdominal CT revealed active bleeding from the splenic artery and a large amount of hemoperitoneum. After emergency embolization, the patient`s were stabilized. After 28 days, his condition was improved and discharged without complications. The angiographic and laboratory findings were consistent with a diagnosis of segmental arterial mediolysis involving the renal and splenic artery. This is the first case report of clinical progression related to segmental arterial mediolysis requiring emergent coil embolization.
일개 대학병원에서 경험한 자리공 중독 환자의 임상적 특성
정동길 ( Dong Kil Jeong ),문형준 ( Hyung Jun Moon ),이정원 ( Jung Won Lee ),박세훈 ( Sae Hoon Park ),이현정 ( Hyung Jung Lee ),설승환 ( Seung Whan Seo ),김아름 ( Ah Reum Kim ),최재형 ( Jae Hyung Choi ),김재우 ( Jae Woo Kim ) 대한임상독성학회 2012 대한임상독성학회지 Vol.10 No.2
Purpose: Although Pokeweed intoxication is relatively less severe, thereis little data onthe clinical presentation ofPokeweed intoxication in Korea. This study examined the clinical aspectsto providebasic data for evaluating Pokeweed intoxication. Methods: A retrospective study by a chart review was performedon 19 patients who ingested Pokeweed and presented to anacademic emergency department with an annual census of 40,000 between March 2012 and May 2012. Results: Nineteen patients were identified. All patients wereintoxicated unintentionally. The most common symptoms were vomiting with diarrhea and abdominal pain. The onset time varied, but occurs 30 minutes to 5 hours post ingestion of Pokeweed. All patients were discharged without fatal complications. Conclusion: Compared to previous reports, mostpokeweed poisoning patients complain of gastrointestinalsymptoms. Supportive care is the mainstay of the management of pokeweed intoxication. All symptoms were resolved over a 24 to 48 hour period.