We observed the change of serum cholinesterase and clinical symptoms of acute parathion intoxication in I.C.U. of N.M.C. from 1975 Sep. to 1976 Oct. The results were as follows; 1. Serum choinesterase level of control group (55 cases) was l00. 53+/-13. 8 and range was 74~125 unit. 2. Serum cholinesterase level were reduced markedly below 10 units in 10 cases of severe parathion intoxication. 3. With adequate treatment PAM & atropine, serum cholinesteraee level rose steadly from 3 rd hospital day to 7 th hospital day and thereafter marked rising was noted remarkable improvement of respiratory symptoms. 4. In cases of low serum cholinestrsse level, sudden aggravation of general symptoms even death occurred and the symptoms & signs were correlated serum cholinesterase level.
Atropine ; Cholinesterases* ; Clinical Study* ; Parathion*

The effects of multiple exposures to pesticides on plasma cholinesterase(ChE) activities and urinary p-nitrophenol excretion were evaluated in rats. Rats were received single dose i.p. with LD50/100(mg/kg) of organophosphorous(OP), organophosphorous-organochroline(OP-OC), organophosphorous-carbamate(OP-CAB), organophosphorous-organoarsenate(OP-OA) pesticides for 4 consecutive days. In repeated administration of pesticides, plasma ChE activities were decreased, but urinary p-nitrophenol were increased after the first injection and then decreased gradually. The recovery rates of ChE activities and p-nitrophenol excretion at 48 hours after the fourth infection were delayed in comparison with the baseline value of 24 hours before the first injection. Statistical significances were found between OP and other groups except OP-OA group after the second injection in plasma ChE activities, but in urinary p-nitrophenol excretion there was statistical significance only between OP and OP-CAB.
Animals ; Cholinesterases* ; Pesticides* ; Plasma* ; Rats*

Discontinuation syndrome is a cluster of symptoms that appear when a patient terminates long-term medication. We report 2 patients with Alzheimer's disease who developed significant behavioral disturbances after the cessation of cholinesterase inhibitors. Although the clinical profile of discontinuation syndrome in cholinesterase inhibitors are yet poorly defined, it may be of importance to consider this syndrome when patients develop significant behavioral disturbances after these agents are stopped, and if more severe reactions are expected, retrial of these agents may be prudent.
Alzheimer Disease ; Cholinesterase Inhibitors* ; Cholinesterases* ; Humans

In order to evaluate the health hazard due to organ orphosphorus insecticides, we measured the blood cholinesterase activity and urinary para-nitrophenol among 56 exposed subjects. They are orchard workers, rice plant workers and smithion factory workers. The clinical symptoms were also checked by physicians. We also measured the blood cholinesterase activity and urinary para-nitrophenol excretion of 20 urban people and 15 rural people who had never been exposed to organophosphorus insecticides in order to compare them according to age, sex and geographical differences. And these results were also compared with those of exposed groups. The results obtained were as follows. 1. The normal plasma cholinesterase activity and cell cholinesterase activity were 0.861+/-0.148 delta pH/hr and 0.822+/-0.154 delta pH/hr. And normal para-nitrophenol in urine was 1.21+/-0.52 mg/liter. 2. No significant difference was existed in blood cholinesterase activities and urinary para-nitrophenol excretion according to sex, age and geographical difference. 3. The plasma cholinesterase activity and cell cholinesterase activity of orchard workers, rice plant workers and smithion factory workers were 0.682+/-0.189 delta pH/hr, 0.775+/-0.160 delta pH/hr, 0.754+/-0.123 delta pH/hr and 0.691+/-0.082 delta pH/hr, 0.756+/-0.117delta pH/hr. And significant decreases in blood cholinesterase activities were existed among orchard workers and smithion factory workers compared with control group. 4. The urinary para-nitrophenol excretions of orchard workers, rice plant workers and smithion factory workers were 1.33+/-0.66 mg/liter, 1.19+/-0.88mg/liter and 1.37+/-0.67mg/liter and there were no significant difference between exposed groups and control group. 5. The clinical symptoms complained during and after organophosphorus insecticides exposure were frequently ranked by headache (67.7%) and vertigo (64.5%) and muscular ataxia and weakness (51.6%).
Ataxia ; Cholinesterases* ; Headache ; Insecticides* ; Plants ; Plasma ; Vertigo

BACKGROUND: Definite criteria for determining severity of organophosphate poisoning have not been made. Discovery of the third neuromuscular syndrome, the intermediate syndrome, have made it more complicating then ever. Objectives of this study is to determine early prognostic factors of outcome and development of a new treatment algorithm. METHOD: 74 patients admitted to Severance hospital with acute organophosphate poisoning during 5 years were included. We made a protocol concerning the initial consciousness level, QTc interval, PVC, serum cholinesterase, the intermediate syndrome, total hospital, ICU day, length of ventilator support, disposition and have done a study retrospectively. Multiple regression and Chi-square was used as statistical analysis. Significant statistical P-value was 0.05. RESULTS: The total hospital days were prolonged as serum cholinesterase levels were lower, the age was older and mental status graver.(p<.05) The length of ventilatory support was prolonged when patient's serum cholinesterase level was very low, they were unconscious and serum cholinesterase level not recovered to 500 IU/ml within initial 3 days. The intermediate syndrome was significantly related to the prolonged cholinesterase inhibition. CONCLUSION: As an early prognostic factor for the length of ventilatory support in organophosphate poisoning, 1) level of concsiousness and 2) serum cholinesterase level at admission, 3) recovery to more than 500 IU/ml within initial 3 days are useful. Especially when the serum cholinesterase level is not recovered to more than 500 IU/ml within initial 3 days, it is essential to observe closely for the possibility of an intermediate syndrome.
Cholinesterases ; Consciousness ; Humans ; Organophosphate Poisoning* ; Retrospective Studies ; Ventilators, Mechanical

BACKGROUND: The criteria established by Light et al in 1972 have been used widely for the differential diagnosis of the pleural effusions in transudates and exsudates. However, in recent years, several reports have agreed that these criteria misclassified an important number of effusions. For this reason, different parameters have been proposed for differentiation the transudates from exudates. Nevertheless, all these alternative parameters have not been better than the past criteria of Light et al. In response the usefulness of two parameters for differentiation pleural transudate from exudates were evaluated : pleural fluid cholinesterase level and pleural fluid to serum cholinesterase ratio. METHODS: A total of forty-three patient with know causes of the pleura effusion by diagnostic thoracentesis were studied. The following criteria for differentiating the pleural effusions in transudates and exsudates were analyzed : Light's criteria, the pleural fluid cholesterol level, the pleural fluid to serum cholesterol ratio. the pleural fluid cholinesterase level, and the pleural fluid to serum cholinesterase ratio. RESULTS: The conditions of forty-three patients were diagnosed. Ten were classified as having transudates and thirty-three as exudates. The percentage of effusions misclassified by each parameter was as follows : Light's criteria, 9.3% ; pleural fluid cholesterol, 2.3% ; pleural fluid to serum cholesterol ratio, 2.3% ; pleural fluid cholinesterase, 4.7% ; and pleural fluid to serum cholinesterase ratio, 2.3%. CONCLUSIONS: The pleural fluid to serum cholinesterase ratio is one of the accurate criteria for differentiating pleural transudates from exudates. If further studies confirm these results, the cholinesterase ratio could be used as the first step in the evaluation of pleural effusion and if evaluated together with the other criteria, the differentiation of pleural transudate from exsudates will become more accurate.
Cholesterol ; Cholinesterases* ; Diagnosis, Differential* ; Exudates and Transudates* ; Humans ; Pleura ; Pleural Effusion

The Pisa syndrome is a rare extrapyramidal side effect with twisting and bending characteristics of the upper trunk, neck, and head, usually caused by neuroleptic treatment. However, there have been no reports of Pisa syndrome in cholinesterase inhibitor therapy. We report 2 female patients of Alzheimer's disease with Pisa syndrome after cholinesterase inhibitor ther-apy. The postural disturbance in these patients was completely resolved after the cessation of the cholinesterase inhibitor. Although the pathophysiology of Pisa syndrome appears to be extremely complicated and poorly understood, it may be of importance to consider the relationship between acetylcholine and Pisa syndrome. Therefore, the present cases provide a novel viewpoint on the underlying mechanism of the Pisa syndrome and the role of acetylcholine in the movement disorder.
Acetylcholine ; Alzheimer Disease ; Cholinesterases ; Female ; Head ; Humans ; Movement Disorders ; Neck

BACKGROUND: Succinylcholine is metabolized by plasma cholinesterase (PChE). When it was pretreated by small doses of nondepolarizing muscle relaxants in order to minimize the side effects, there are evidences to be associated with alteration in the duration of action. This study is investigated whether the responses would be related to the enzymatic activities. METHODS: In 21 adult patients, ASA class I or II, PChE levels were measured by the modified Garry method after induction of anesthesia (control value) and at 3, 10, 20 and 30 min following administration of pancuronium 0.1 mg/kg, vecuronium 0.1 mg/kg and atracurium 0.5 mg/kg. Data were expressed as mean (SEM). RESULTS: The levels of PChE were significantly lower (p<0.05) than the control values at 3, 10, 20 and 30 min after given pancuronium as 4764 (270), 4777 (261), 4796 (306) and 4740 (332) IU/L respectively and after given vecuronium as 5004 (341), 5051 (329), 4969 (340) and 4960 (340) IU/L respectively whereas enzyme levels after given atracurium were not significant differences to compare the control values as 5153 (336), 5136 (320) 5124 (312) and 5151 (275) respectively. CONCLUSIONS: The results of present study show that both pancuronium and vecuronium may possibly inhibit PChE activity but this was not affected by atracurium.
Adult ; Anesthesia ; Atracurium* ; Cholinesterases* ; Humans ; Pancuronium* ; Plasma* ; Succinylcholine ; Vecuronium Bromide*

Plasma cholinesterase was assayed during the period immediately following IV bolus injection of succinylcholine 1mg/kg to test the effect of succinylcholine on pseudocholinesterase activity. Twenty healthy adult patients scheduled for elective surgery were studied. The resutls were as follows: The mean value of pre-injection pseudocholinesterase activity was 1124.15 IU/L, and the activity following succinylcholin injection was 1159.55IU/L during fasciculation, 982.70 at 1 min, 936.60 at 3 min, 891.25 at 5 min, 926.80 at 7 min, 1015.45 at 10 min, and 1007.70 at 15 min. It was concluded that the tendency to increase pseuducholinesterase activity during fasciculation seems to be due to choline, the metabolite of succinylcholine, however the cause of the significant decrease in pseudocholinesterase activity after fasciculation is uncertain. The only suggested mechanism is due to the inhibition of pseudocholinesterase by succinylcholine and its metabolites.
Adult ; Choline ; Cholinesterases ; Fasciculation ; Humans ; Plasma ; Pseudocholinesterase ; Succinylcholine*

The effects of insecticides padan, bassa (carbamate) and acephate (OP) on P.ChE activity, MetHb rate and acid-base balance were determined in rabbits. The rabbits were treated by oral administration. Results: In the first group plasma cholinesterase (P.ChE) activity was significantly decreased while methemoglobin (MetHb) rate was significantly increased at 2h and 4h and returned to the before treatment at 24h. The rabbits were mixed alkalosis at 2h, respiratory alkalosis at 4h. In the second group P.ChE activity significantly decreased, MetHb rate significantly increased at 2h and 4h of treatment and then returned to the normal levels at 24h. The rabbits were mixed alkalosis at 2h, respiratory alkalosis at 4h. In the third group P.ChE activity significantly decreased, MetHb rate significantly increased at 3h and 6h and not returned to the before treatment at 24h. The rabbits have respiratory alkalosis at 3h, metabolic acidosis at 6h
Cholinesterases ; Acid-Base Equilibrium ; Therapeutics ; Thiocarbamates ; Organothiophosphorus Compounds