Journal of The Korean Society of Clinical Toxicology

Changwoo Kang

3 Articles

Initial Serum Ammonia as a Predictor of Mortality in Patients with Acute Glufosinate Ammonium Herbicide Poisoning: Eun Na Ko, Dong Hoon Kim, Soo Hoon Lee, Jin Hee Jeong, Sang Bong Lee, Aejin Sung, Ja Hyoen Suh, Changwoo Kang; J Korean Soc Clin Toxicol. 2020;18(2):136-140. Published online December 31, 2020; DOI: https://doi.org/10.22537/jksct.2020.18.2.136

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Purpose: The association of the initial serum ammonia level with in-hospital mortality in patients with acute glufosinate-ammonium herbicide poisoning was studied. Methods: This retrospective cohort study was conducted between March 2012 and August 2019 in the emergency department after glufosinate-ammonium herbicide poisoning. Survivors and non-survivors were analyzed using a Mann-Whitney U test and Fisher's exact test. Multivariate logistic regression analysis was performed to determine the independent risk factors for mortality. Results: One hundred and six patients were enrolled; 11 died, yielding a mortality of 10.4%. The serum bicarbonate level was significantly lower in the non-survival group than the survival group. Age, serum ammonia, blood urea nitrogen, creatinine levels, SOFA score, and APACHE II score were significantly higher in the non-survival group than the survival group. Age, serum ammonia, and creatinine level were independent risk factors for mortality in multivariate logistic regression analysis. Conclusion: The initial serum ammonia level is associated with mortality in patients with acute glufosinate herbicide poisoning.

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Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status
Rok Lee, Tae Yong Shin, Hyung Jun Moon, Hyun Jung Lee, Dongkil Jeong, Dongwook Lee, Sun In Hong, Hyun Joon Kim
Journal of The Korean Society of Clinical Toxicology.2023; 21(2): 135. CrossRef

The Effect of Intravenous Lipid Emulsion in a Rat Model of Verapamil Toxicity: Dae-Myung Ha, Dong Hoon Kim, Taeyun Kim, Soo Hoon Lee, Jin Hee Jeong, Sang Bong Lee, Daesung Lim, Changwoo Kang; J Korean Soc Clin Toxicol. 2018;16(1):9-14. Published online June 30, 2018; DOI: https://doi.org/10.22537/jksct.2018.16.1.9

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Abstract PDF: Purpose: Intravenous lipid emulsion (ILE) has been shown to have significant therapeutic effects on calcium channel blocker overdose in animal studies and clinical cases. In this preliminary experiment, we investigated the hemodynamic changes and survival in a rat model of verapamil intoxication. Methods: Fourteen male Sprague-Dawley rats were sedated and treated with ILE or normal saline (control), followed by continuous intravenous infusion of verapamil (20 mg/kg/h). Mean arterial pressure and heart rate of rats were monitored during the infusion. In addition, the total dose of infused verapamil and the duration of survival were measured. Results: Survival was prolonged in the ILE group ($32.43{pm}5.8min$) relative to the control group ($24.14{pm}4.3min$) (p=0.01). The cumulative mean lethal dose of verapamil was higher in the ILE group ($4.3{pm}0.7mg/kg$) than in the control group ($3.2{pm}0.5mg/kg$; p=0.017). Conclusion: ILE pretreatment prolonged survival and increased the lethal dose in a rat model of verapamil poisoning.

Hypoalbuminemia as a Predictor of 30-day Mortality in Patients with Acute Organophosphate Insecticide Poisoning: So Yeon Kim, Ryun Kyung Lee, Tae hu Kim, Dong Hoon Kim, Taeyun Kim, Soo Hoon Lee, Jin Hee Jeong, Sang Bong Lee, Changwoo Kang; J Korean Soc Clin Toxicol. 2017;15(1):11-16. Published online June 30, 2017; DOI: https://doi.org/10.22537/jksct.2017.15.1.11

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Abstract PDF: Purpose: The association of hypoalbuminemia with 30-day in-hospital mortality in patients with organophosphate insecticide poisoning (OPI) was studied. Methods: This retrospective cohort study was conducted between January 2006 and November 2013 in the emergency department (ED) after OPI poisoning. A Kaplan-Meier 30-day survival curve and the log-rank test were used to analyze patients stratified according to serum albumin levels on ED admission (hypoalbuminemia or normo-albuminemia). Independent risk factors including hypoalbuminemia for 30-day mortality were determined by multivariate Cox regression analysis. Results: A total of 135 patients were included. Eighty-eight (65%) patients were male and the mean age was $57.3{pm}17.0$ years. Serum albumin, mean arterial pressure, and Glasgow coma scale score were significantly higher in the survival group than the non-survival group. APACHE II score was significantly lower in the non-survival group than the survival group. The mortality of the hypoalbuminemia group (serum albumin <3.5 g/dl) was 68.8%, while that of the normo-albuminemia group (serum albumin ${geq}3.5g/dl$) was 15.1%. The area under the ROC curve of the serum albumin level was 0.786 (95% CI, 0.690-0.881) and the APACHE II score was 0.840 (95% CI, 0.770-0.910). Conclusion: Hypoalbuminemia is associated with 30-day mortality in patients with OPI poisoning.

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