Nitrous oxide is medically used as an anesthetic gas and as an additive in whipped cream production. Few cases of death from nitrous oxide intoxication have been reported in Korea. However, fatalities due to inhalation of pure nitrous oxide in an amount enough to cause death have been recently increasing. We report two cases of death related to nitrous oxide abuse with a review of literature focusing on the fact that nitrous oxide abuse can be considered as a possible cause of death if appliances with nitrous oxide contents were found during the investigation, and the autopsy and toxicological findings cannot be attributed to nitrous oxide intoxication.
Autopsy ; Cause of Death ; Inhalant Abuse ; Inhalation ; Korea ; Nitrous Oxide* ; Toxicology

PURPOSE: The suicide rate of adolescents in Korea is increasing annually. Therefore, this research was done to identify the suicide attempt rate of middle and high school students and to identify factors that influence suicidal attempts. METHODS: The Korea Youth Health Risk Behavior Web-based Survey (2007) was used as data. Discriminant analysis and logistic regression were performed to analyze the data depending on gender to consider the gender difference in assessing the influence of each independent variable on suicidal attempts. RESULTS: Discriminant analysis according on gender showed that 13 factors correlated with suicidal attempts for boys, and 20 factors for girls. The most highly correlated factors were smoking, depression and inhalation experience. For inhalation experience, boys had 2.7 times higher possibility of suicide attempts (95% CI 1.8-3.0) and girls, a 2.4 times higher possibility (95% CI 1.7-3.5). CONCLUSION: The results of the study indicate a need to classify adolescents for expectation of suicide risk and high danger for suicidal attempts through, and introduce suicide prevention programs for these adolescents. In particular, it is necessary to start intervention with students who smoke, have sexual and inhalation experiences and high levels of depression.
Adolescent ; Adolescent Behavior/*psychology ; Adolescent Psychology ; Depression ; Discriminant Analysis ; Female ; Humans ; Inhalant Abuse ; Logistic Models ; Male ; Questionnaires ; Risk Factors ; Sex Factors ; Smoking ; Stress, Psychological ; Suicide, Attempted/*prevention & control/statistics & numerical data

Organic solvents are hydrocarbon-based substances that dissolve another substance. Organic solvents are usually lipid soluble, volatile and commonly used for painting, printing, degreasing, cleaning, thinning and extraction. Due to their volatility and lipid solubility, organic solvents are easily absorbed across the alveolar-capillary membrane and through the skin. Because organic solvents are lipophilic, they tend to be distributed to lipid-rich tissue, such as adipose tissue, nervous system and liver. Almost all organic solvent can induce skin diseases such as acute irritant dermatitis and chronic eczema. Some organic solvents are associated with allergic contact dermatitis. General and nonspecific central nervous system depression is another common toxic effect induced by most organic solvents. It shows symptoms which are the same as those from alcohol drinking, and those symptoms are completely resolved by removal from exposure to solvents. Long term and repeated exposures to organic solvents can also lead to chronic adverse neurobehavioral effects. These effects are also called as chronic toxic encephalopathy, chronic solvent intoxication and psycho-organic syndrome, and commonly reported symptoms of them are headache, depression, anxiety, and impairment of recent memory. Organic brain lesions can be found in workers suffering from psycho-organic syndrome, and in this case, there is a possibility of persistent disabilities. Carbon disulfide, n-hexane, and methyl n-butyl ketone are specifically toxic to the peripheral nervous system, and cause a symmetric ascending sensory and motor polyneuropathy. Halogenated hydrocarbons including carbon tetrachloride show toxic effects on the heart, liver, kidney, and blood. Toluene can sensitize the heart to arrhythmogenic effects of epinephrine, so sudden death in young and healthy people can be ensued from glue sniffing. Benzene is able to induce any type of leukemia, especially in victims with benzene-associated aplastic anemia. Exposure to some solvents during pregnancy has potential to induce congenital malformation and spontaneous abortion. In the treatment of diseases by organic solvents, the first step should be removal from exposure to the causative solvent.
Abortion, Spontaneous ; Adipose Tissue ; Alcohol Drinking ; Anemia, Aplastic ; Anxiety ; Benzene ; Brain ; Carbon Disulfide ; Carbon Tetrachloride ; Central Nervous System ; Death, Sudden ; Depression ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Irritant ; Eczema ; Epinephrine ; Female ; Headache ; Heart ; Hexanes ; Humans ; Hydrocarbons, Halogenated ; Inhalant Abuse ; Kidney ; Leukemia ; Liver ; Membranes ; Memory ; Methyl n-Butyl Ketone ; Nervous System ; Neurotoxicity Syndromes ; Occupational Diseases ; Paint ; Paintings ; Peripheral Nervous System ; Polyneuropathies ; Pregnancy ; Resin Cements ; Skin ; Skin Diseases ; Solubility ; Solvents ; Stress, Psychological ; Toluene ; Volatilization

Industrial glues contain many kinds of organic solvents and glue sniffing by young people has become a social problem in Korea. Glue vapor may induce chronic toxicities different from those induced by exposures to the solvent of single component. We studied the effects of the inhalation of glue vapor on the primary target organ, the pulmonary epithelium of the respiratory system. Vapor samples of glue were collected for analysis; the components were acetone, n-hexane, methyl cyclopentane, c-hexane, and toluene. For the inhalation of glue vapor, experimental mice were exposed in a whole body chamber for 20 min/d for 3, 5, 7, and 14 d. Control groups were exposed to room air. Animals were euthanized and lung tissues were fixed in 10% neutral formalin for light microscopy, and in 2.5% glutaraldehyde plus 1.5% paraformaldehyde for electron microscopy. The results are as follows. 1. Alcianophilic bands were not detected in the normal alveolar epithelium, but weak alcianophilic bands were detected in bronchioles. Alcian blue-PAS and PAS positive cells were found in the mucosae of mice exposed to glue vapor for 5 and 7 d. 2. Types I and II pneumocytes and capillary endothelial cells were found in the normal alveolar epithelium. The blood-air barrier consists of Type I pneumocytes, a common basal lamina, and the capillary endothelium. 3. The alveolar epithelium of vapor-exposed mice showed more type II pneumocytes. In the longerexposed group, Type I pneumocytes and endothelial cells contained many pinocytotic vesicles. 4. The vapor-exposed lungs showed macrophages in the alveolar space, mild interstitial swelling, and increased numbers of collagenous fibers. Clearly, ultrastructural changes in pulmonary epithelia can occur following glue sniffing.
Acetone ; Adhesives ; Animals ; Basement Membrane ; Blood-Air Barrier ; Bronchioles ; Collagen ; Cyclopentanes ; Endothelial Cells ; Endothelium, Vascular ; Epithelium ; Formaldehyde ; Glutaral ; Inhalant Abuse ; Inhalation* ; Korea ; Lung* ; Macrophages ; Mice* ; Microscopy ; Microscopy, Electron ; Mucous Membrane ; Pneumocytes ; Respiratory System ; Social Problems ; Solvents ; Toluene

Toluene is an aromatic hydrocarbon found in glues, cements, and solvents. Chronic or acute exposure is known to cause acid-base and electrolyte disorders and to be toxic to both the nervous system and the hematopoietic system. The three major clinical presentations involve neuropsychiatric, gastrointestinal, and muscular disorders, whereas toluene intoxication is difficult to diagnose without a history of substance abuse, such as glue sniffing. We report the case of a 27-year-old women who presented with the three major clinical manifestations associated with profound hypokalemia (K+=1 mEq/L) and metabolic acidosis (pH=7.17) after prolonged glue sniffing. To make an early diagnosis, the emergency physician should consider toluene intoxication in patients presenting with altered mental status, hypokalemic muscular paralysis, and a history of glue sniffing.
Acidosis* ; Adhesives* ; Adult ; Early Diagnosis ; Emergencies ; Female ; Hematopoietic System ; Humans ; Hypokalemia* ; Inhalant Abuse* ; Nervous System ; Paralysis ; Solvents ; Substance-Related Disorders ; Toluene

BACKGROUND AND OBJECTIVES: Recently, accidents have been reported of young adults who inhale industrial bond vapor. Acquiring industrial bond is easy for young adults, and glue sniffing has thus become a serious social problem. However, there have been few reports concerning the changes in the olfactory epithelium after exposure of industrial bond vapor. The aim of this study is to describe the morphological changes of the olfactory mucosa after being exposed to industrial bond vapor, using HE, AB, AB-PAS stains, immunohistochemistry and the electron microscopy. MATERIALS AND METHOD: Healthy ICR mice were exposed to industrial bond vapor (acetone 5212+/-1268 ppm, c-hexane 3757+/-711 ppm, methylcyclopentane 1820+/-375 ppm, n-hexane 139+/-30 ppm and toluene 0.9+/-1.4 ppm). The vapor was given to each animal with duration of 20 min/day for 3 days, 5 days, 7 days or 14 days in a specially designed box for this study. After exposure to industrial bond vapor, mice olfactory mucosae were excised and prepared for HE, AB, AB-PAS stains, immunohistochemistry and electron microscopy. RESULTS: Loss of cells and disarrangements of olfactory epithelium were prominent on the third day of exposure and the epithelium recovered to the normal state after the day 7 in the HE stain. And there were also definite ultrastructural changes in the epithelium : loss of microvilli in supporting cells, exposure of olfactory vesicles to the luminal surface and apoptotic bodies in electron microscopic study. Study with the AB and AB-PAS stains demonstrated an evidence of decreased mucin secretion on the day 3 and the content of mucin was normalized after the day 7. In the PCNA study, cells were unable to proliferate until day 3. The proliferation potential were increased (4 fold) on day 5 and returned to normal on day 14. CONCLUSION: This result indicated that industrial bond vapor can damage the olfactory epithelium of mice which can recover rapidly. Apoptosis and active proliferation could be the factors that are involved in the recovery of the epithelium that is open to regular industrial bond vapor exposure on daily basis.
Animals ; Apoptosis ; Coloring Agents ; Epithelium ; Humans ; Immunohistochemistry ; Inhalant Abuse ; Mice* ; Mice, Inbred ICR ; Microscopy, Electron ; Microvilli ; Mucins ; Olfactory Mucosa* ; Phenobarbital ; Proliferating Cell Nuclear Antigen ; Social Problems ; Toluene ; Young Adult

The renal cortical necrosis occurs in approximately 2% of adult patients with acute renal failure. The causes of renal cortical necrosis were usually associated with obstetrical problems. However, the distinctive changes occurred over the past 15 years in the etiology with a high incidence of non-obstetric causes than obstetric ones. We experienced a rare case of diffuse bilateral renal cortical necrosis in 16-year-old man who had a history of glue sniffing. To our knowledge, this is the first report in our country. A 16-year-old man was admitted with vague flank pain and oliguria. There was history of frequent adhesive glue sniffing. Laboratory data were as follows : BUN 77mg/dL, creatinine, 9.3mg/dL, protein 3+, RBC many/HPF, WBC 1-4/HPF in urinalysis, HBsAg(-), Anti-HBs(+), C(3)10.5mg/dL, C(4)7.4mg/dL), IgG 1,865mg/mL, IgA 512mg/mL. The kindey size was normal in ultrasonography. Renal cortex was diffusely not enhanced in MIJ Tl weighted image. Diffuse bilateral renal cortical necrosis was diagnosed by renal biopsy. In this case, adhesive glue sniffing may be a cause of acute cortieal necrosis.
Acute Kidney Injury ; Adhesives* ; Adolescent ; Adult ; Biopsy ; Creatinine ; Flank Pain ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Incidence ; Inhalant Abuse* ; Kidney Cortex Necrosis ; Necrosis* ; Oliguria ; Ultrasonography ; Urinalysis

The inhalation of volatile substances has becoming a popular fad among adolescents in the world. Glue sniffing is associated with injury of nervous system, liver and kidney. And rarely abnormality of blood and bone marrow suppression can develop. The main components of volatile substances that cause hematologic abnormality is thought to be benzene, toluene, and xylene. A 24 year-old male was admitted to our hospital due to gum bleeding. He was a chronic glue and organic solvents sniffer for 6 years, and quit sniffing 1 year before admission. He had no specific drug history. On admission, CBC was as follows: WBC 2,500/mm3; hemoglobin 8.9g/dl; hematocrit 25.1%; platelet 2,000/mm3. Bone marrow biopsy showed severe hypocellular marrow compatible with aplastic anemia. We report a case of aplastic anemia after habitual sniffing of glue and volatile substances with brief review of the literature.
Adhesives* ; Adolescent ; Anemia, Aplastic* ; Benzene ; Biopsy ; Blood Platelets ; Bone Marrow ; Flavin-Adenine Dinucleotide ; Gingiva ; Hematocrit ; Hemorrhage ; Humans ; Inhalant Abuse ; Inhalation ; Kidney ; Liver ; Male ; Nervous System ; Solvents ; Toluene ; Xylenes ; Young Adult

We describe a case of distal renal tubular acidosis in a 20-year-old woman with a history of glue sniffing. On admission she complained of nausea and somnolence. Severe hypokalemia and hyperchloremic metabolic acidosis with normal anion gap were noted. Her urinary osmolar gap and anion gap results were consistent with presence of renal tubular acidosis. Bicarbonate loading test along with urine PCO2 confirmed that she had type 1 renal tubular acidosis due to hydrogen ion secretion defect. Immunohistochemical staining of renal biopsy specimen with anti H+-ATPase antibody showed absence of proton pump in the collecting duct. Thus a case of distal renal tubular acidosis in association with glue sniffing is reported with a review of literatures.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Renal Tubular* ; Adhesives* ; Biopsy ; Female ; Humans ; Hypokalemia ; Inhalant Abuse* ; Nausea ; Proton Pumps ; Protons ; Toluene ; Young Adult

BACKGROUND: The drug abuse has become one of social problems especially in the adolescents. It has been well known that the drug abuse is concerned with interaction of biopsychosocial factors and farnily relation factors. So I have studied the general characteristics and rearing attitude and family state of the adolesents who were in a jail because of drug abuse and have intended to give some help for establishing effective strategies for family education and therapy. METHODS: The study was done for adolescents who were in a jail because of violation the illegal drug control law. The group was total 55 men and the age distribution was frorn 15 to 20 years. The Questionnaire was used in Mar 1996 for study and I analyzed 53 cases excluding 2 cases because they were nearly illiterate. The FACES III(Family Adaptability and Cohesion Evaluation Scales), family APGAR score and PBI(Parental Bonding Instrument) were used for evaluating the characteristics of family function and the parental rearing attitude. Statistical management with SAS was executed for data analysis. RESULTS: The average age of the group was 6.9+/-1.4. 48.1% of them lived in the metropolitan area, 40.4% lived in the middle-sized cities and 11.5% lived in the small country towns. The education level of 91.8% was under middle-school graduate. They have use drugs since the age of 14.6+/-1.8, they began to use glue sniffing at the first time in 78.8% and butane gas inhalation in 17.3%. The state of family showed the death of father in 28.9% and the death of mother in 13.5 % and 76.9% of deaths occured before they have become 13 years. Their parents divorced in 25 %. The mean APGAR score was 4.56+/-2.6, which means moderately dysfunctional state of family. In FACES III adaptability score was 20.3+/-5.7 and cohesion score was 26.2+/-6.9. According to the family type by FACES III, there were 5 cases(9.4%) in balanced, 19 cases(35.9%) in midrange, and 29 cases(54.7%) in extreme. In PBI mother overprotection score was 16.24+/-4.59, mother care score was 22.5+6.8, father overprotection score was 16.71+/-5.1 father care was 21.94+/-6.24. CONCLUSIONS: The drug abused adolescents in a jail were in hadicapped family because of deaths and divorce of parents. Their family function score was low and more than half of them had the extreme type of family. Therefore it is wise for us to have a concern for the family problem when understanding and managing drug abused adolescents.
Adolescent* ; Age Distribution ; Apgar Score ; Divorce ; Drug and Narcotic Control ; Education ; Fathers ; Humans ; Inhalant Abuse ; Inhalation ; Jurisprudence ; Male ; Mothers ; Parents ; Social Problems ; Statistics as Topic ; Substance-Related Disorders ; Surveys and Questionnaires