The poisoning information database (PIDB) provides clinical toxicological information on commonly encountered toxic substances in Korea. The aim of this study was to estimate the coverage rate of the PIDB by comparing the database with the distribution of toxic substances that real poisoning patients presented to 20 emergency departments. Development of the PIDB started in 2007, and the number of toxic substances increased annually from 50 to 470 substances in 2014. We retrospectively reviewed the medical records of patients with toxic exposure who visited 20 emergency departments in Korea from January to December 2013. Identified toxic substances were classified as prescription drug, agricultural chemical, household product, animal or plant, herbal drug, or other. We calculated the coverage rate of the PIDB for both the number of poisoning cases and the kinds of toxic substances. A total of 10,887 cases of intoxication among 8,145 patients was collected. The 470 substances registered in the PIDB covered 89.3% of 8,891 identified cases related to poisoning, while the same substances only covered 45.3% of the 671 kinds of identified toxic substances. According to category, 211 prescription drugs, 58 agricultural chemicals, 28 household products, and 32 animals or plants were not covered by the PIDB. This study suggested that the PIDB covered a large proportion of real poisoning cases in Korea. However, the database should be continuously extended to provide information for even rare toxic substances.
Adolescent ; Adult ; Aged ; Animals ; Animals, Poisonous ; Child ; Child, Preschool ; Databases, Factual ; Drugs, Chinese Herbal/poisoning ; Emergency Service, Hospital ; Female ; Humans ; Infant ; Male ; Middle Aged ; Pesticides/poisoning ; Plants, Medicinal/poisoning ; Poisoning/*epidemiology ; Prescription Drugs/poisoning ; Republic of Korea ; Retrospective Studies ; Young Adult

A 61-year-old male patient was admitted because of unexplained abdominal pain and anemia. His past medical history was unremarkable except for having taken herbal medicine to treat facial palsy two months ago. The result of health examination performed about a month ago showed increased serum aspartate and alanine aminotransferase level, and he was diagnosed with toxic hepatitis by herbal medicine. When the patient presented to the outpatient department three weeks ago, follow-up liver function test results showed improvement but he complained of abdominal pain. Despite extensive blood chemistry tests and computed tomography, the cause of pain could not be found. After much deliberation, serum lead level and herbal medicines analysis was performed based on the fact that he took herbal medicine two months ago, and he could finally be diagnosed with lead poisoning. Since the serum lead level was high enough to be indicated for lead chelating therapy, conservative management was given. When a patient with toxic hepatitis due to herbal medication presents with abdominal pain, the possibility of lead poisoning should always be taken into consideration.
Acute Disease ; Alanine Transaminase/analysis ; Aspartate Aminotransferases/analysis ; Chemical and Drug Induced Liver Injury/*diagnosis ; Hemoglobins/analysis ; Humans ; Lead/analysis ; *Lead Poisoning ; Liver/enzymology/metabolism ; Liver Function Tests ; Male ; Middle Aged ; Plants, Medicinal/chemistry

Due to increasing participation in outdoor activities, many people visit the emergency room for various symptoms after mistaking poisonous plants for medicinal herbs. The toxicity of Arisaematis rhizome is due to its content of calcium oxalate, which causes painful oropharyngeal edema, hypersalivation, aphonia, oral ulceration, esophageal erosion, and hypocalcemia. We report a case of accidental poisoning after chewing and spitting of the root of A. rhizome, resulting in focal symptoms-such as oral pain, swelling and drooling-that required only conservative management. A 54-year-old male and his 58-year-old wife developed oral pain, swelling and drooling after accidentally chewing and spitting the root of the A. rhizome plant as a medicinal herb. Their symptoms started immediately after chewing on and spitting out the root of A. rhizome, and they were unable to speak due to oral pain, swelling, and hypersalivation on arrival at the emergency department. They were treated with antihistamines and corticosteroids and painkillers. A few hours after treatment, they had improved and were discharged from the hospital.
Adrenal Cortex Hormones ; Aphonia ; Calcium Oxalate ; Edema ; Emergency Service, Hospital ; Histamine Antagonists ; Humans ; Hypocalcemia ; Male ; Mastication ; Middle Aged ; Oral Ulcer ; Plants ; Plants, Medicinal ; Plants, Toxic ; Poisoning* ; Rhizome ; Sialorrhea ; Spouses

A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.
Animals ; Carbon Tetrachloride Poisoning ; Chemical and Drug Induced Liver Injury ; blood ; etiology ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Glycodeoxycholic Acid ; blood ; Lysophosphatidylcholines ; blood ; Male ; Metabolomics ; Phenylalanine ; blood ; Plants, Medicinal ; chemistry ; Principal Component Analysis ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; Tryptophan ; blood

It is valuable to establish a chemical-pharmacokinetic (PK)-pharmacodynamics (PD) fingerprint of traditional Chinese medicine (TCM) for comprehensively understanding the TCM integrated conception and revealing the material foundation. The chemical, metabolic in vitro, and PK/PD in vivo fingerprints of Schisandra chinensis (SC) alcoholic extract were established and comparatively analyzed using HPLC-UV-MS method, rat liver microsomes in vitro and CCl4 intoxicated rats in vivo. Four known effective lignans, schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin, were detected as the standard references in SC alcoholic extract with high concentration. SC alcoholic extract and four lignans when incubated with rat liver microsomes produced several metabolites in NAPDH-dependent manner. Chemical fingerprint of some components with bioactivities were also identified in PK and PD fingerprints in normal and ALI rats that explained the material foundation of SC alcoholic extract for multiple pharmacological effects. Schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin could be considered as the "PK marker" of SC alcoholic extract or its relevant preparations, while two metabolites of the four lignans, 7, 8-dihydroxy-schizandrin and another one (M(W) 432), could be recognized as drug-metabolism (DM) Marker. This work provides experimental data for the further studies of metabolism or material foundation of SC components.
Alanine Transaminase ; blood ; Animals ; Carbon Tetrachloride Poisoning ; Chemical and Drug Induced Liver Injury ; blood ; Chromatography, High Pressure Liquid ; Cyclooctanes ; isolation & purification ; pharmacokinetics ; pharmacology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacokinetics ; pharmacology ; Lignans ; isolation & purification ; pharmacokinetics ; pharmacology ; Male ; Microsomes, Liver ; metabolism ; Plants, Medicinal ; chemistry ; Polycyclic Compounds ; isolation & purification ; pharmacokinetics ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Schisandra ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Spectrophotometry, Ultraviolet

Mercury-containing preparations are widely used in surgery department of traditional Chinese medicine and have made remarkable achievements. But they are toxic to human kidney, nerve, immune, etc. Smilacis Glabrae Rhizoma is sweet, tasteless and neutral in nature and able to enter liver and stomach channels and detoxify mercury poisoning. This article summarizes the mercury poisoning and the detoxification effect of Smilacis Glabrae Rhizoma in ancient records, pharmaceutical studies and clinical application, in order to provide ideas and methods for the safe use of mercury-containing preparations in surgery department of traditional Chinese medicine.
Drugs, Chinese Herbal ; therapeutic use ; Humans ; Inactivation, Metabolic ; Liliaceae ; chemistry ; Liver ; drug effects ; metabolism ; Medicine, Chinese Traditional ; Mercury Compounds ; adverse effects ; pharmacokinetics ; therapeutic use ; Mercury Poisoning ; prevention & control ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Stomach ; drug effects ; metabolism

Drug-Related Side Effects and Adverse Reactions ; Humans ; Male ; Middle Aged ; Pinellia ; Plants, Medicinal ; poisoning

OBJECTIVETo study the therapeutic effects and mechanisms of SQDG on carbon tetrachloride-induced chemical liver injury in mice as well as its possible mechanisms. At the same time the pharmacodynamics of SQDG was compared with TGP or ASTs of effective dose.

METHODThe model of carbon tetrachloride-induced chemical liver injury in mice was prepared. The levels of ALT, AST, MDA content, SOD and GSH-Px activities in liver homogenate were assayed by spectrophotometry; Meanwhile, hepatic pathological examination was observed.

RESULTProtective effect of SQDG on carbon tetrachloride-induced chemical liver injury: SQDG was able to significantly decrease serum transaminase levels of chemical liver injury's mice induced by carbon tetrachloride, decreased MDA content and improved the reduced SOD and GSH-px levels in liver homogenate. Furthermore, SQDG also attenuate the area and extent of necrosis and reduce the infiltration of inflammatory cell. Compared with TGP or ASTs of effective dose, SQDG has a better effect on carbon tetrachloride-induced chemical liver injury in mice.

CONCLUSIONSQDG can protect mice injured by carbon tetrachloride-induced chemical.

Alanine Transaminase ; blood ; Animals ; Antioxidants ; isolation & purification ; pharmacology ; Aspartate Aminotransferases ; blood ; Astragalus membranaceus ; chemistry ; Carbon Tetrachloride Poisoning ; Chemical and Drug Induced Liver Injury ; etiology ; metabolism ; pathology ; Drug Combinations ; Glucosides ; isolation & purification ; pharmacology ; Glutathione Peroxidase ; metabolism ; Liver ; metabolism ; pathology ; Male ; Malondialdehyde ; metabolism ; Mice ; Paeonia ; chemistry ; Plants, Medicinal ; chemistry ; Protective Agents ; isolation & purification ; pharmacology ; Superoxide Dismutase ; metabolism

Plants in Acaceae family are often considered as ornamental and medicines. However many of them have irritation properties. As medicinal plants some of them are recorded in Chinese Pharmacopoeia and they are figured as poisonous. Through investigating the domestic and overseas studied paper, the needle-like calcium oxalate crystal exits in the plants of Acaceae family could be thought as irritation components of them. This conclusion is same with the studied conclusion of our study group in the medicines plant of Pinellia ternate belonging to the Acaceae family and our studies showed that the needle-like calcium oxalate crystal was the main irritation component of raw P. ternate. The irritated mechanism of raphides is relevant to its special shape, the protein enzyme adhering to it and idioblasts in plants.
Araceae ; chemistry ; Calcium Oxalate ; analysis ; poisoning ; Conjunctival Diseases ; chemically induced ; Crystallization ; Dermatitis, Contact ; etiology ; Humans ; Mucous Membrane ; drug effects ; Pinellia ; chemistry ; Plants, Medicinal ; chemistry

OBJECTIVETo investigate the effect of protecting liver of brevifolin and 8,9-single-epoxy brevifolin of Phyllanthus simplex.

METHODRats were administered with CCl4 (ip) or alcohol (ig) to establish acute or chronic liver injured model, respectively. ALT, AST and TBIL in serum were measured using colorimetric analysis to evaluate liver function. MDA content or SOD activity in serum and liver tissue was measured by thiobarbituric acid chromatometry and xanthine oxidase methods, respectively. The hemorheological parameters were observed.

RESULTBrevifolin and 8,9-single-epoxy brevifolin reduced the increase of ALT induced by CCl4, but they did not influence the increase of AST. And it could inhibit the pathologic increase of serum TBIL induced by alcohol. They could ameliorate the MDA increase or SOD decrease in serum and liver tissue in rats with liver injury, and decrease abnormal changed hemorheological parameters.

CONCLUSIONBrevifolin and 8,9-single-epoxy brevifolin show protective effective against acute and chronic liver injuries, and the mechanism is relevant to antagonizing the lipid peroxidation of free radical and improving the blood circulation.

Animals ; Carbon Tetrachloride Poisoning ; Chemical and Drug Induced Liver Injury ; physiopathology ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Hemorheology ; drug effects ; Hepatitis, Alcoholic ; physiopathology ; Liver ; physiopathology ; Male ; Phyllanthus ; chemistry ; Plants, Medicinal ; chemistry ; Protective Agents ; isolation & purification ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Taxoids ; isolation & purification ; pharmacology