In summary, we are presented with a patient who ingested mussel that are suspected to contain toxins that cause paralytic shellfish poisoning or PSP. Upon reaching the stomach, the digestive process accelerates the release of PSP toxins. The toxins are rapidly absorbed in the stomachs acidic medium and starts to work on the cellular Na channels, blocking the movement of Naions thus preventing the progression of the action potential with the absence of the action potential, there is a continued state of depolarization. This explains the feeling of numbness of the lips and fingertips, as seen in our patient, since these are the areas where nerve endings abound, and thus, are the areas most sensitive to these chemical changes. Our patient experienced this whole gamut of neurologic manifestations. He also started experiencing gastrointestinal symptoms such as epigastric pain and vomiting which are initially erroneously diagnosed as a separate problem Hearing hearsay reports on coconut milk being used as antidote for cases like these, the patient tried it too. The coconut milk, being an alkaline substance, must have stabilized some of the toxins, thus explaining the mild relief experienced by the patient prior to hospitalization. Upon reaching the hospitals, NGT was inserted and NaHCO3 lavage was done which further stabilized the toxins that were not yet absorbed, while those that were absorbed were excreted through the kidneys with the help of mannitol. After all these measures, the patient experienced considerable relief of the neurologic symptoms, though still with the intermitent epigastric pain erroneously diagnosed as Acid Peptic Disease and treated with antacids. Improvement of the neurologic complaints eventually lead to the discharge of the patient Our patient is just one of the lucky ones who benefited from immediate medical intervention to save his life. Many others arent so lucky - - - most of them never even know what hit them and thus could only look heavenwards hoping for divine intervention. Others are left to languish in understaffed overcrowded hospitals in far-flung places. Worse, a lot of those who have died of PSP never even get to a hospital Grim scenarios such as these are bound to occur yearly as long as pollution, deforestation, ignorance, and poverty prevail. We physician may not be able to curb these ills of society but we can certainly help, first and foremost by initiating the more crucial preventive measures, then by administering immediate and knowledgeable modes of treatment, and finally, by never losing the family physicians most important therapeutic tool: genuine concern for the patient. Hopefully, in doing so, we family physicians can join the family of man down to the sunset of our lives, enjoying Manila Bay for its red beautiful scape, and not for its red deadly tide.

Shellfish ; Harmful Algal Bloom

mcetylcholinesterase (acetylcholine acethydrolase, E.C.3.1.1.7) was found in venoms from the Conus species C. geographus C. striatus, C.magus and C. marmoreus. Optimum activity was obtained at pH 7.3 at 40ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'…¡ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'â€Ã...¡ÃÆ'‚°C. Partial purification of the enzyme from C. geographus was achieved by sequential chromatography through Sepharose 4B and DEAE cellulose. The preparation obtained was at least 90% pure as judged by the appearance of only a single band after staining of electerophoresis gels with Coomassie blue. The purified enzyme has a specific activity of around 700 U/mg and K of 7.7 x 10-4 M. SDS-gel electrophoresis indicated a relative sub-unit weight of 75,000. (Auth)
Enzymes, Acetylcholinesterase, Shellfish, Mollusk Venoms

Vibrio vulnificus is an opportunistic human pathogen, transmitted from seawater, raw oyster, and shellfish and responsible for severe septicemia. We studied V. vulnificus from surface seawater around Jeju Island between 2010 and 2011. In 2010, V. vulnificus was isolated and V. vulnificus septicemia was reported. Surface seawater temperature is an important factor for growth of V. vulnificus, and here we showed that high surface seawater temperature may influence growth of V. vulnificus and occurrence of emerging V. vulnificus septicemia on Jeju Island. This is the first report of isolation of V. vulnificus and emerging V. vulnificus septicemia on Jeju Island.
Humans ; Ostreidae ; Seawater* ; Sepsis* ; Shellfish ; Vibrio vulnificus*

This study was conducted to investigate the vibrio flora in edible shellfish (Ruditapes philippinarum, Scapharca broughtonii, Batillus cornutus and Mytilus coruscus) which were purchased from seafood-market or collected from shellfish culture bed in Pusan and Masan Bay from May to October 1997. Sixty-three vibrio strains were identified among 438 collected strains. Five species of vibrios [V. alginolyticus (22 strains), V. parahaemolyticus (35 strains), V. costicola (2 strains), L. damsela (V. damsela 2 strains), and V. cholerae non-Ol (2 strains)] were identified by their phenotyfic and biochemical characteristics. Four groups (142 strains) were identified as genus Vibrio by their biological characteristics, but they could not be identified to the species level.
Bays ; Busan ; Cholera ; Mytilus ; Population Characteristics ; Scapharca ; Shellfish* ; Vibrio*

This study was undertaken to observe the difference of patch test and prick test positive reactions in three groups, 20 atopic dermatitis patients, 20 chronic urticaria patients, and 20 normal controls, Twenty commercial antigens (ToriiCo.) and twenty three frozen and boiled antigens of fishes and shellfishes were used as test materials. The results were as follows: 1. No positive reaction was observed in all sixty subjects in patch test. 2 In prick test, difference in reactivity was observed among atopic dermatitis (14. 7%), chronic urticaria (8.7%), and normal control(1. 5%) 3. There was significant difference in reactivity between Torii and frozen antigens in atopic dermatitis group, but no significance in chronic urticaria and control groups. 4. Boiling altered the reactivity in tested materials in all three groups of subjects singificantly. 5. Patients with past or family history of allergic diseases showed double fold higher reactivity tban patients without any history.
Dermatitis, Atopic* ; Fishes ; Humans ; Patch Tests ; Shellfish* ; Urticaria*

PURPOSE: The purpose of this study was to develop a mercury database for food commonly consumed by Koreans. METHODS: Target foods for a mercury database were selected from dietary survey data of the 2007-2009 Korean National Health and Nutrition Examination Survey (KNHANES). Data for mercury contents of foods were collected through literature review. Among 702 food items reported by 24 hr dietary recall method, the contents of mercury for 300 food items were selected with systematic evaluation from the literature, which provided analytical values, and those of 56 food items were imputed by using a conversion factor. RESULTS: The mercury database developed in this study covered 50.7% of all kinds of consumed foods and 95.1% of total amount of food intake reported by 2007-2009 KNHANES. In the database, the geometric mean of mercury contents in food items was the highest in the fishes and shellfishes group (41.13 microg/kg, n = 101) followed by mushrooms (18.93 microg/kg, n = 12) and seaweeds (5.92 microg/kg, n = 14), and the lowest in the meats group (0.15 microg/kg, n = 17). CONCLUSION: The developed mercury database can be used to estimate the dietary mercury exposure of Korean people, and the method for development of a mercury database would be helpful to researchers in development of a new database for other food borne hazardous substances.
Agaricales ; Eating ; Fishes ; Hazardous Substances ; Meat ; Nutrition Surveys ; Shellfish

Paralytic shellfish poisoning results from consumption of mollusks that have fed on dinoflagellates capable of producing neurotoxins such as saxitoxin. The saxitoxin is concentrated in the shellfish and acts by decreasing sodium-channel permeability, thereby blocking neuronal transmission in skeletal muscles. Symptoms including paresthesia, perioral numbness, perioral tingling, nausea, vomiting, extremity numbness, extremity tingling, dizziness, ataxia, dysphagia, and weakness have been reported. In serious cases, respiratory hold may occur up to 6~24 hours after ingestion. Generally, the treatment for paralytic shellfish poisoning is supportive care, but mechanical ventilation is needed in serious cases acompanied by respiratory hold. We experienced two cases of paralytic shellfish poisoning. Respiratory hold was presented in one case and only mild paresthesia in the other case. After supportive management, including mechanical ventilation in former case, both patients were discharged without sequalae.
Ataxia ; Deglutition Disorders ; Dinoflagellida ; Dizziness ; Eating ; Extremities ; Humans ; Hypesthesia ; Mollusca ; Muscle, Skeletal ; Nausea ; Neurons ; Neurotoxins ; Paresthesia ; Permeability ; Respiration, Artificial ; Saxitoxin* ; Shellfish ; Shellfish Poisoning* ; Vomiting

OBJECTIVETo develop an ICR (female) mouse bioassay (MBA) for toxicity confirmation and evaluation of neurotoxins (brevetoxins)-contaminated shellfish.

METHODSBrevetoxins (BTX-B) as a causative agent of neurotoxic shellfish poisoning (NSP) under different shellfish matrices were intraperitoneally injected at different doses into mice to study their toxic effects and to differentiate the range of lethal and sublethal dosages. Their sensitivity and specificity were analyzed with 2 competitive ELISA kits for quantitative determination of standard BTX-B and dihydroBTX-B under different shellfish matrix-diluent combinations. Detection rates of MBA and two antibody-based assays for BTX-B from field NSP-positive shellfish samples were compared.

RESULTSBTX-B could be detected in shellfish tissues at concentration of 50-400 μg/100 g under shellfish matrix-Tween-saline media, which were appropriate to identify toxic shellfish at or above the regulatory limit (80 μg/100 g shellfish tissues). The LD50 identified was 455 mg/kg for BTX-B under general shellfish matrices (excluding oyster matrices) dissolved in Tween-saline. The presence of shellfish matrices, of oyster matrices in particular, retarded the occurrence of death and toxicity presentation in mice. Two antibody-based assays, even in the presence of different shellfish matrix-diluent combinations, showed acceptable results in quantifying BTX-B and dihydroBTX-B well below the regulatory limit.

CONCLUSIONThe two ELISA analyses agree favorably (correlation coefficient, r³⋝0.96; Student's t-tests, P>0.05) with the developed bioassay.

Animals ; Biological Assay ; Calibration ; Female ; Marine Toxins ; toxicity ; Mice ; Mice, Inbred ICR ; Oxocins ; toxicity ; Shellfish ; analysis

PURPOSE: This study examined and compared the associations of the iron status and food intake with the blood lead, mercury, and cadmium concentrations among Korean adolescent girls, premenopausal women, and postmenopausal women. METHODS: The data from the 2010~2011 Korea National Health and Nutrition Examination Survey (KNHANES) was used. The subjects were classified into three groups: adolescent girls (n = 268), premenopausal women (n = 1,157), and postmenopausal women (n = 446). The iron status was assessed by hemoglobin, hematocrit, serum ferritin, and iron concentrations, as well as the total iron binding capacity (TIBC). The food intake was estimated by a food frequency questionnaire. RESULTS: The blood heavy metal concentrations and poisoning rate in postmenopausal women were higher than in the other groups. The iron status in the adolescent girls and postmenopausal women was higher than that in the premenopausal women. In the adolescent girls, the iron status was inversely associated with the blood cadmium concentration. The dairy food intake was inversely related to the blood lead and cadmium concentrations. In premenopausal women, the iron status was inversely associated with the cadmium concentrations. The fish and shellfish food intakes were positively associated with the mercury concentrations. In postmenopausal women, the iron status was positively associated with the mercury and cadmium concentrations. Fast foods and fried foods were inversely associated with the lead concentration. CONCLUSION: The premenopausal women showed a lower iron status than the adolescent girls and postmenopausal women. The associations of the iron status with the blood heavy metal concentrations were different among the adolescent girls, premenopausal women, and postmenopausal women. In addition, the relationships of the food intakes with the blood heavy metal concentrations differed among adolescent girls, premenopausal women, and postmenopausal women. Further studies will be needed to confirm these findings.
Adolescent* ; Cadmium ; Eating* ; Fast Foods ; Female* ; Ferritins ; Hematocrit ; Humans ; Iron* ; Korea* ; Nutrition Surveys* ; Poisoning ; Shellfish

We surveyed 26 employees of a shell-handling factory on whom skin tests with 12 common allergens and shell powder extract were done. Specific bronchial Provocation tests with shell powder extract were performed on the subjects who had respiratory symptoms. Positive skin responders to shell powder extract were 8 among the 26 subjects (30.8%), and subjects who were positive responders to any one of 12 common allergens showed a higher positive rate than negative responders. Among the 8 subjects who had a positive skin response, four had respiratory symptoms. Three subjects were positive bronchial responders to bronchial provocation tests.
Adult ; Asthma/epidemiology* ; Bronchial Provocation Tests ; Human ; Korea ; Male ; Occupational Diseases/epidemiology* ; Shellfish* ; Skin Tests