55 gardenal-poisoned patients were measured the drug’s blood levels to compare with their clinical manifestations and select appropriate treatment methods. The mean value was 36.87mg/l. The patients with the blood gardenal levels equal to or less than 60mg/l usually had first or second-stage coma, mild respiratory failure (if any), and fewer severe complications. This group of patients only required simple measures such as gastric lavage, the use of activated charcoal, enhanced diuresis and urine alkalization. Whereas the patients with the levels more than 60mg/l commonly suffered from third or fourth-degree coma, severe to life-threatening respiratory failure, hypotension and other severe complications. They not only needed simple curative methods but also mechanical ventilation and hemodialysis. the hemodialysis could reduce the blood gardenal concentration up to 665 for each intervention period. Owing to this extracorporeal technique for the removal of toxins, the duration of mechanical ventilation, enhanced diuresis, urine alkalization as well as the necessary amount of bicarbonate was decreased remarkably.
Phenobarbital ; Phenobarbital/poisoning ; Blood ; Diagnosis ; Therapeutics

BACKGROUND: Activated charcoal has been widely used as an adsorbent for the management of drug intoxicated patients in the emergency department(ED). Although there are several commercial ready-mixed charcoal suspension preparations in the market, we are using custom-made suspension from hospital grade bulk charcoal powder. We designed this study to compare the adsorptive capacity of the Actidose Aqua(R), which is a commercial charcoal product, Fuller's earth, and custom-made activated charcoal used in our ED. METHODS: First, we performed modified USP methylene blue adsorption test which is a standard adsorption test for activated charcoal. Then, the drug adsorption test for phenobarbital, acetaminophen, salicylate, and aminophylline was done. Graded amount of three adsorptives were added to the stock solutions of each drugs. The adsorption test were performed as follows: The vials containing drugs and adsorptives were shaken for 30 minutes to ensure adsorption equilibrium, then the suspension was filtered through in-line filter. The filtrates were analyzed by ultraviolet spectroscopy to determine the residual drug concentrations. Finally we examined and compared the surface area and the structure of activated charcoal and Fuller's earth using scanning electron microscopy. RESULTS: In methylene blue adsorption test, the adsorption rate was 60.1% in Actidose Aqua(R) and 59.0% in custom-made charcoal, and 70.2% in Fuller's earth. For the phenobarbital, acetaminophen, and sallcylate, the adsorption rate of Actidose Aqua(R) and custom-made charcoal was greater than 90% with the ratio o adsorptives to drugs over 10:1. For aminophylline, two charcoal products showed excellent adsorption in 5:1 ratio. But Fuller's earth showed poor adsorption in all rages. CONCLUSION: Custom-made activated charcoal showed a comparable adsorption capacity to Actidose Aqua(R). Fuller's earth showed a poor performance to be used as a substitute for activated charcoal in acute drug poisoning otherwise paraquat.
Acetaminophen ; Adsorption ; Aminophylline ; Charcoal* ; Emergencies ; Humans ; Methylene Blue ; Microscopy, Electron, Scanning ; Paraquat ; Phenobarbital ; Poisoning ; Rage ; Spectrum Analysis

One of the most obvious effects of cadmium poisoning in experimental animals is induction of testicular necrosis. Many studies have been conducted, but the mechanism of the disturbance, which is peculiar to the testicle, has not been elucidated. Testicular damage due to cadmium exposure greatly differs depending upon strains of mice and methods of administration. As a preventive measure against testicular necrosis due to cadmium, pretreatment of small doses of cadmium and several kinds of metals have been found to be effective. In order to examine testicular damage by cadmium doses and protective effects by small doses of metals (Cd, Cu, Se, Mn) and phenobarbital which were administered before single challenge dose of cadmium, mature male I. C. R. mice, 16 weeks of age, weighing approximately 40g were used in this study. The weights of the body and the testicle, cadmium concentration in the testicle and results of histopathological findings of the experimental groups were as follows. 1. With regard to the body weight of each group that was injected intraperitoneally with single cadmium doses of 0.5, 1.O, 2.O and 3.Omg/kg the last two groups showed a significant decrease in one week. 2. Relative testicular weight (testicular weight ,body weight) one week after cadmium administration decreased significantly in the group of more than 1.Omg/kg administration. However, in the pretreatment groups, it was found that the group pretreated with cadmium did not decrease. 3. Cadmium concentration in the testicle in each group increased with the amount of cadmium doses. However, in the pretreatment group, the groups pretreated with cadmium and manganese did not increase. 4. In histopathological findings of the testicle on the 7the day after cadmium administration, the minimum dose of cadmium that induced edema in the interstitial tissue and inactive spermatogenesis in a few germinal epithelia was O.5 mg/kg, but the changes seemed to be due to inhibitory effect for spermatogenesis rather than direct injury to the testicular tissue. Necrosis was observed in the spermatogenic epithelium in the 2.O mg/kg group and severe necroses were extended to the interstitial tissue in the 3.O mg/kg group. The critical concentrations of cadmium for the histopathological change in the testicular tissue was 0.32ug/g and that for necrotic change was 0.60ug/g. 5. Protective effect in the pretreatment groups was noticeable in the cadmium pretreated group and moderate effect in the manganese group; however, in the other metal groups and the phenobarbital group little effect was observed. 6. Comparison of the histopathological findings between the group of pretreatment showing effect.
Animals ; Body Weight ; Cadmium Poisoning ; Cadmium* ; Edema ; Epithelium ; Humans ; Male ; Manganese ; Metals* ; Mice* ; Necrosis ; Phenobarbital ; Spermatogenesis ; Testis* ; Weights and Measures