PURPOSE: Although endosulfan is a highly toxic compound that is responsible for a number of severe intoxications and deaths, there are no specific antidotes for endosulfan poisoning. Most fatalities due to endosulfan ingestion have symptoms that develop within 4~6 hours after ingestion, and to improve survival chances it is important to recognize those patients with a poor prognosis as early as possible and to institute aggressive treatment. Therefore we sought to identify the factors that predict death in patients with endosulfan ingestion. METHODS: We enrolled 58 patients who were over 18 years and who presented to Chonnam National University Hospital with ingestion of endosulfan from January 2001 to June 2007. These patients were divided into two groups according to survival. The baseline characteristics, initial results of laboratory tests, the occurrence of complications, and the duration of hospitalization were collected. RESULTS: The fatality rate of endosulfan was 30.2%. The most common cause of death in the non-survival group was refractory status epilepticus. The patients in the non-survival group showed significantly lower blood pressure, arterial pH, base excess, and bicarbonate, and a significantly higher level of arterial carbon dioxide, sodium, and potassium than the survival group. In a multivariate analysis, the independent factors were arterial pH and the amount ingested. CONCLUSION: Endosulfan is a highly harmful pesticide with a fatality rate over 30%. The factors that predict death during hospitalization are arterial pH on admission and amount ingested. The physician must start an aggressive treatment, including early administration of the appropriate anticonvulsant, when a patient presents to the ER with these characteristics.
Antidotes ; Arterial Pressure ; Carbon Dioxide ; Cause of Death ; Eating ; Endosulfan ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Potassium ; Prognosis ; Sodium ; Status Epilepticus

PURPOSE: We sought to evaluate the distribution and characteristics of meibomian gland dysfunction (MGD) and the treatment patterns for symptomatic MGD patients in South Korea. METHODS: One hundred ninety-six right eyes of 196 MGD patients were enrolled. For each patient, meibum expressibility in the central eight glands in both the upper and lower eyelids was examined. Each upper and lower eyelid was separately classified into one of the following three subtypes: nonobvious obstructive (low-delivery without lid margin abnormality), obvious obstructive (low-delivery with lid margin abnormality), and hypersecretory (high-delivery with lid margin abnormality). All treatment plans were also recorded. RESULTS: The mean number of expressible glands of the central eight glands in the upper eyelids (3.9 ± 2.6) was significantly higher than that in the lower eyelids (2.2 ± 2.4, p < 0.001). Obvious obstructive MGD was the most common subtype, followed by the hypersecretory and nonobvious obstructive subtypes in both the upper and lower eyelids. Of the 196 subjects, 38 (19.4%) had upper and lower eyelids that were assigned to different categories. Eyelid hygiene was the most prescribed treatment (74.5%), followed by lubricant eye drop usage (71.5%). Physicians tended to determine treatment plans based on the subtype of the upper eyelid rather than that of the lower eyelid. CONCLUSIONS: The majority of subjects were classified as having the obvious obstructive subtype of MGD, and 19.4% had upper and lower eyelids that were different subtypes. Eyelid hygiene was the most prescribed treatment for MGD patients, and treatment patterns were mostly determined based on the subtype of the upper eyelids.
Classification ; Diagnosis ; Eyelids ; Humans ; Hygiene ; Korea ; Meibomian Glands