Animals ; Chromatography, Thin Layer ; Dichlorvos ; blood ; Dimethoate ; blood ; Insecticides ; blood ; Methyl Parathion ; blood ; Mice ; Organothiophosphorus Compounds ; blood

Poisoning may result from self-injection. Previous reports have described acute cholinergic crisis, intermediate syndrome, and delayed toxicity resulting from parenteral organophosphate administration. These complications have been managed with antidotal and conservative treatment. Acute kidney injury was not listed among the complications. We report a case of acute kidney injury after intravenous injection with an unknown liquid. After chemical composition analysis, organophosphate dichlorvos has been identified as the injected liquid substance. A 50-year-old man injected this into his left arm. He visited the emergency department with a mental change accompanied by seizure. During admission, there were no typical cholinergic symptoms or intermediate syndrome; however, there was a development of acute oliguric kidney injury. The patient was treated successfully with a combination of hemodialysis, hemoperfusion, and conservative management. The manifested seizure, altered mental state, and acute kidney injury could have been caused by several types of poisoning. Based on patient history, which was obtained during the early treatment period, there was no information of what the injected material may have been, and there were no signs of a typical organophosphate toxidrome. However, the patient was successfully treated with rapid initiation of renal replacement treatment, without the use of antidotes. Poisoning by unknown causative substances poses a diagnostic challenge to emergency physicians. In many cases, treatment may be delayed while the physician tries to identify the toxin. However, the basic toxicology principle of focusing on the patient treatment rather than the poisonous substance should not be forgotten.
Acute Kidney Injury* ; Antidotes ; Arm ; Dichlorvos ; Emergencies ; Emergency Service, Hospital ; Hemoperfusion ; Humans ; Injections, Intravenous* ; Kidney ; Middle Aged ; Organophosphates ; Poisoning ; Renal Dialysis ; Seizures ; Toxicology

In organophosphate intoxication, the neurotransmitter acetylcholine accumulates in synapses, causing excessive stimulation of nicotinic and muscarinic receptors, producing various signs and symptoms. Organophosphates are highly toxic compounds that are readily absorbed through the skin, mucous membranes, and gastrointestinal and respiratory tracts. Organophosphate intoxication leads to many well defined complications, including cholinergic crisis, intermediate syndrome, and acute pancreatitis. However, parotitis caused by organophosphate intoxication is very rare. We experienced such a case of a 55 year old woman who visited the emergency center because of organophosphate intoxication. The next day, she complained of left facial redness, swelling, and pain. We checked serum lipase, amylase, and amylase-isoenzymes, and found elevation of salivary type amylase only. The mechanism of parotitis due to organophosphate intoxication is assumed to be similar to that of pancreatitis caused by organophosphate. In patients with elevated amylase caused by organophosphate intoxication, the possibility of parotitis must be considered.
Acetylcholine ; Amylases ; Dichlorvos ; Emergencies ; Female ; Humans ; Lipase ; Mucous Membrane ; Neurotransmitter Agents ; Organophosphates ; Pancreatitis ; Parotitis ; Poisoning* ; Receptors, Muscarinic ; Respiratory System ; Skin ; Synapses

OBJECTIVETo evaluate the reproduction toxicity of the mixture composed of dichlorvos, dimethoate and malathion synergistic effect on male mice, and further explore its possible mechanisms.

METHODSThe 105 male mice were divided into 7 groups, including control (0 mg/kg), mix low (10.8 mg/kg), mix medium (21.5 mg/kg), mix high dose (43.0 mg/kg), dichlorvos (5.1 mg/kg), dimethoate (12.6 mg/kg) and malathion (25.3 mg/kg) group. The oral gavage for successive 35 days, and the mice were sacrificed on the 36(th) day. The body weight, and the quantity, activity and morphology of sperms were examined. The levels of sexual hormone were measured, including testosterone (T), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E(2)). Pathological changes of testicle and epididymis were observed by morphology, pathology and electron microscope.

RESULTSAfter 14 days exposure, the body weights of the mice were lower in the mix-high dose group ((22.40 ± 3.07) g) than those in control group ((26.73 ± 2.82) g) (P < 0.05). After 28 days exposure, the body weights of the mice were also lower in the mix-medium dose group ((30.00 ± 4.93) g) than those in control group ((33.13 ± 3.29) g) (P < 0.05). The sperm counts and sperm motility decreased significantly as the toxic concentration arised. Comparing to control group ((373.33 ± 14.65)×10(6)/g weight of epididymis and (75.17 ± 7.68)%), the spermatozoa count and sperm motility had decreased in mix-medium and mix-high dose groups ((321.17 ± 18.19)×10(6)/g weight of epididymis, (225.00 ± 19.67)×10(6)/g weight of epididymis, and (64.67 ± 9.91)%, (57.83 ± 9.66)%), and the sperm abnormality rates were higher in mix-medium and mix-high groups ((43.33 ± 8.66)‰ and (55.00 ± 13.80)‰) comparing to those in control group ((32.67 ± 8.17)‰). Compared to those in control group (FSH (1.41 ± 0.20), E(2)(17.32 ± 2.72), LH (8.75 ± 1.32) and T (3.45 ± 0.80) nmol/L), the serum level of FSH (3.14 ± 0.62) and (3.85 ± 0.37) nmol/L, E(2) (36.81 ± 6.68) and (43.76 ± 9.82) nmol/L in mix-medium and mix-high dose group increased (P < 0.01), while the level of LH (5.21 ± 1.23) and (4.27 ± 1.09) nmol/L and T (1.37 ± 0.38) and (0.73 ± 0.18) nmol/L decreased (P < 0.01). The morphological and ultramicrostructure results of testicle and epididymis indicated that the mature sperm numbers were decreased, and the cacoplastic sperm head and the tail of spermatozoon were observed in mix-high dose groups.

CONCLUSIONThe dichlorvos, dimethoate and malathion mixture had synergistic reproductive toxicity to the testicle and epididymis structure and function, and thus leading to the process of generation cell cytopoiesis abnormalities, simultaneously the hypothalamus-pituitary-gonad axis were also affected and thus resulted in parasecretion.

Animals ; Body Weight ; Dichlorvos ; toxicity ; Dimethoate ; toxicity ; Malathion ; toxicity ; Male ; Mice ; Mice, Inbred ICR ; Organ Size ; Sperm Count ; Sperm Motility ; Spermatozoa ; drug effects ; Toxicity Tests

BACKGROUND: Organophosphate and carbamate insecticides have been used extensively in agriculture resulting in serious increases in poisoning. Levels of poisoning by carbamates and organic phosphorus compounds and the severity of associated symptoms are dependent not only on the degree of reduction of acetylcholinesterase activity in the nervous system but also on the rate of inhibition and the type of inhibitive action. The most striking differences between the clinical effects of the two groups of compounds are the much more rapid and spontaneous recovery from poisoning by carbamates and the relatively large difference between the smallest dosage of any carbamate that will cause mild illness and the lethal dosage of the same compound. The purpose of this study is to compare the clinical characteristics of acute intoxication by organophosphate and carbamate insecticides. METHOD: We retrospectively analyzed the clinical characteristics of 41 patients poisoned with organophsphates and 12 patients poisoned with carbamates, who were admitted to the department of internal medicine, Soonchunhyang Chunan hospital from January 1995 to December 1996. RESULTS: 1) The most common organophosphate was EPN (9 cases) followed by Dichlorvos (7 cases). In the carbamates group, Carbofuran (5 cases) was the most common followed by Methomyl (3 cases).2) The main cause of poisoning was ingestion for the purpose of suicide in both groups.3) The severity of poisoning was more acute in the organophosphate group than in the carbamate group.4) Altered consciousness and respiratory depression occurred more frequently in the organophosphate group than in the carbamate group. Six cases out of the organophosphate group suffered from respiratory depression 24 hours to 96 hours after poisoning.5) The activity of serum cholinesterase showed no significant difference between poisoning with organophosphates and with carbamates.6) The mortality rate was 22% in organophosphate intoxication and 16.7% in carbamate intoxication. The most common complication of organophosphate and carbamate intoxication was aspiration pneumonia. CONCLUSION: Carbamate insecticides exhibited less toxicity than organophosphates.
Acetylcholinesterase ; Agriculture ; Carbamates ; Carbofuran ; Cholinesterases ; Chungcheongnam-do ; Consciousness ; Dichlorvos ; Eating ; Humans ; Insecticides* ; Internal Medicine ; Methomyl ; Mortality ; Nervous System ; Organophosphates ; Phosphorus Compounds ; Pneumonia, Aspiration ; Poisoning* ; Respiratory Insufficiency ; Retrospective Studies ; Strikes, Employee ; Suicide

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving the motor neuron of the cerebrum, brain stem, and spinal cord. It has been suggested that various occupational or environmental agents could be a cause of ALS. We report upon a case of a person contracting ALS who experienced a long-time exposure to pesticides, implying that pesticides are probable causal agents of ALS. CASE REPORTS: The patient has been experiencing shoulder pain and limitation of movement that started abruptly about three years ago. Over time, these symptoms have become aggravated despite ongoing therapies including medication. After two years, he was diagnosed with ALS through electromyography, nerve conduction velocity and many laboratory tests at a university hospital in Seoul. His social and medical history was non-specific. The patient had worked for about 15 years at a waste disposal site and mainly destroyed glass bottles containing pesticides. During this period, his respiratory tract and skin were exposed to various raw pesticides without appropriate personal protective equipment. He did this job one or two times a week and worked for two or more hours without a break. Through an investigation into the patient's working environment, significant levels of dichlorvos, one of the organophosphates, were detected. CONCLUSIONS: The study results revealed that the patient was exposed to considerable doses of pesticides as opposed to men spraying pesticides. Although controversial, pesticide exposures have been associated with ALS. However, we suggest that in this case the possibility that these pesticide exposures acted as a causal agent for the diagnosed ALS based on plausible biological mechanisms and epidemiologic data.
Amyotrophic Lateral Sclerosis ; Brain Stem ; Cerebrum ; Contracts ; Dichlorvos ; Electromyography ; Glass ; Humans ; Male ; Motor Neurons ; Neural Conduction ; Neurodegenerative Diseases ; Occupational Exposure ; Organophosphates ; Pesticides ; Respiratory System ; Shoulder Pain ; Skin ; Spinal Cord

OBJECTIVETo observe the treatments on the patients with acute methamidophos dichlorvos (DDV) and omethoate poisoning and provide the reliable basis for the rational treatments on these three organophosphorus pesticides poisoning.

METHODS101 patients with AOPP in 7 hospitals were divided into three groups: Group A, 59 patients with acute methamidophos poisoning, Group B, 32 patients with acute DDV/dipterex (DEP) poisoning, Group C, 10 patients with acute omethoate/dimethoate poisoning. The levels of erythrocyte AChE and the therapeutic efficacies of pralidoxime chloride (PAM-Cl) were compared among the three groups.

RESULTSThe AChE activities of all the three groups were inhibited on level of (9.12 +/- 7.99) U/g Hb (group A), 7.32 +/- 4.62 U/g Hb (group B) and (12.01 +/- 9.53) U/g Hb (group C), among which no significant difference was found (P > 0.05). All the patients recovered from acute cholinergic excitation or crisis after the treatment of PAM-Cl. The erythrocyte AChE activities were obviously reactivated in group A three hours later after admission to hospital, each on level of (11.37 +/- 8.67) U/g Hb, (12.51 +/- 6.98) U/g Hb, (15.90 +/- 7.31) U/g Hb, (18.33 +/- 4.78) U/g Hb and (18.91 +/- 7.00) U/g Hb at the 12th, 24th, 48th, 72nd hour and discharge (P < 0.05), and the upgrade tendency was continuous. AChE activities in group B were also reactivated after treatment, each on level of (8.91 +/- 5.89) U/g Hb, (1.31 +/- 6.61) U/g Hb, (13.00 +/- 7.55) U/g Hb, (14.22 +/- 7.80) U/g Hb, (12.78 +/- 7.07) U/g Hb and (16.87 +/- 7.06) U/g Hb at the 3rd, 12th, 24th, 48th, 72nd hour and discharge, but the upgrade tendency turned slowly after 12 hours, the inhibited AChE activities were not reactivated in group C from the beginning to the end.

CONCLUSIONAfter the treatment of PAM-Cl, the AChE activities of the patients with acute methamidophos poisoning could be continuously reactivated, the AChE activities of the patients with acute DDV/DEP poisoning could also be reactivated in 12 hours, and then keep stable, but the AChE activities of the patients with acute omethoate/dimethoate poisoning could not be reactivated. However, PAM-Cl has therapeutic efficacy against acute toxicity of all the three organophosphorus pesticides. Oximes should be vigorously used in the treatment of AOPP, including acute omethoate/dimethoate poisoning.

Acetylcholinesterase ; metabolism ; Acute Disease ; Adult ; Cholinesterase Reactivators ; therapeutic use ; Dichlorvos ; poisoning ; Dimethoate ; analogs & derivatives ; poisoning ; Female ; Humans ; Male ; Middle Aged ; Organophosphate Poisoning ; Organothiophosphorus Compounds ; poisoning ; Pralidoxime Compounds ; therapeutic use ; Retrospective Studies

OBJECTIVETo investigate the characteristics of pesticide poisoning in Jiangsu Province, China, and to provide a scientific basis for developing effective intervention measures and prevention strategies.

METHODSThe data from report cards of pesticide poisoning in Jiangsu Province from 2006 to 2013 were arranged using EXCEL tables, and assessed. Statistical analysis was applied to the epidemiological data using SPSS.

RESULTSFrom 2006 to 2013, a total of 32672 cases of pesticide poisoning were reported in Jiangsu Province. Most of the cases were caused by non-occupational poisoning (life poisoning) (72.78%). A majority of patients with pesticide poisoning were 35-54 years old (40.85%) or older than 65 years (15.69%). There were more female patients (58.22%) than male patients (41.78%). Among patients with occupational poisoning, male patients (50.90%) were more than female patients. Among patients with non-occupational poisoning, female patients were more than male patients (38.37%). Pesticide poisoning mainly occurred from July to September. The case-fatality rate of occupational poisoning (0.47%) was lower than that of non-occupational poisoning (7.10%). All 13 cities in Jiangsu Province reported cases of pesticide poisoning. There were more cases in the northern regions than in the southern regions. Pesticide poisoning was mainly caused by organophosphorus insecticides including methamidophos, dichlorvos, dimethoate, omethoate, and parathion, which accounted for 65.58%of all cases. Paraquat had the highest case-fatality rate (10.06%) among all pesticides, followed by tetramine (10.00%), dimethoate or omethoate (7.85%), methamidophos (7.79%), and dimehypo (7.68%).

CONCLUSIONPesticide poisoning cannot be ignored. The management and control should be improved in production and usage of highly toxic pesticides including organophosphorus insecticides, rodenticides, and herbicides. More attention should be paid to the protection of vulnerable groups including women, children, and the elderly.

Adult ; Age Distribution ; Aged ; China ; epidemiology ; Cities ; Dichlorvos ; Dimethoate ; analogs & derivatives ; Environmental Exposure ; prevention & control ; statistics & numerical data ; Female ; Herbicides ; poisoning ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organothiophosphorus Compounds ; Paraquat ; Pesticides ; poisoning ; Poisoning ; epidemiology ; prevention & control ; Rodenticides

A modified electrometric method was described and validated for measurement of plasma and erythrocyte cholinesterase activities in 6~18 months old goats. The enzymatic reaction mixture contained 3 ml distilled water, 3 ml barbital-phosphate buffer (pH 8.1), 0.2 ml plasma or erythrocytes and 0.1 ml acetylthiocholine iodide (7.5%) as a substrate. The mixture was incubated at 37 degrees C for 40 minutes. The pH of the reaction mixture was determined by a pH meter before and after the incubation. The initial pH was measured before the substrate addition. The enzyme activity was expressed as deltapH/40 min. The coefficients of variation of the described method in measuring plasma and erythrocyte cholinesterase activities were 4 and 2%, respectively. Preliminary reference values (n = 14) of the mean cholinesterase activity (deltapH/40 min) and 95% confidence interval in the plasma were 0.194 and 0.184~ 0.204, respectively, and those of the erythrocytes were 0.416 and 0.396~0.436, respectively. The pseudocholinesterase activity of the plasma cholinesterase was 63.5% as determined by quinidine sulfate inhibition. The organophosphorus insecticides dichlorvos and diazinon at 0.5~4 micrometer and the carbamate insecticide carbaryl at 5~20 micrometer in the reaction mixture significantly inhibited plasma (13.7~85.5%) and erythrocyte (16.4~71.9%) cholinesterases in vitro in a concentration-dependent manner. The results suggest that the described electrometric method is simple, precise and efficient in measuring blood cholinesterase activity in goats.
Acid-Base Equilibrium/physiology ; Animals ; Carbaryl/pharmacology ; Cholinesterase Inhibitors/pharmacology ; Cholinesterases/*blood/drug effects ; Diazinon/pharmacology ; Dichlorvos/pharmacology ; Enzyme Activation/drug effects/physiology ; Erythrocytes/metabolism ; Goats/*blood ; Plasma/metabolism

This study was carried out to obtain the basic data for the preverition of chronic poisoning by organic phosphate pesticides. 6 sprayers who participated in the summer pest control programs of Jeonju city were chosen as the subjects in this study. Pesticides which were spread in the period of study are DDVP (1.09%), dursban (1.8%) and dibrom (1.9%). And from May 16, 1983 to Aug. 22, 1983, plasma cholinesterase activity, hematological and biochemical parameters were measured with several physical examinations for each sprayers and controls. Majors findings are as following; 1. Before pesticides were sprayed, plasma cholinesterase were 7.32+/-6 microM/20microliter/hr. in sprayers and 7.13+/-1.39 microM/20 microliter/hr. in the control group(p>0.05). 2. At 60th day of spraying, plasma cholinesterase activity of sprayers was 6.78+/-2.01 microM/20 microliter/hr. Which is significantly decreased from the pre-exposed value(p<0.01), but plasma cholinesterase activity in the control group was not changed. 3. The specific findings which suggested to organophosphorous poisoning were not found through the period of study. 4. Hematological and bichemical parameters were not significantly changed in the both groups.
Chlorpyrifos ; Cholinesterases* ; Dichlorvos ; Jeollabuk-do ; Naled ; Occupations* ; Pest Control ; Pesticides* ; Physical Examination ; Plasma* ; Poisoning