Twelve family members with tetramine poisoning after consumption of vegetables grown in polluted soils / 世界急诊医学杂志（英文）

@#The main toxic component of tetramine is tetramethylenedisulfotetramine (TETS). It is a sulfonamide derivative without special antidote, tasteless and tasteless, with high toxicity and high mortality.[1]It was first discovered by a German scientist Hagen in 1949. Although its use has been banned worldwide due to its high toxicity and mortality rate, it is still available in certain countries and has led to cases of intentional and unintentional poisoning. Tetramine blocks γ-neurons, leading to dizziness, fatigue, nausea, vomiting, convulsions, and other symptoms.[2-4]Due to the lack of recognized effective antidotes, many poisoned people suffocate and die as a result of continuous spasms of the respiratory muscles.[5-7] Tetramine poisoning sometimes occurs, but it is rare for vegetables grown in tetramine-contaminated soil to cause group poisoning after being eaten.

Simultaneous detection of 12 kinds of rodenticides in poisoned samples by ultra performance liquid chromatography-tandem mass spectrometry / 中国职业医学

OBJECTIVE: To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(HPLC-MS) method for simultaneous detection of 12 kinds of rodenticides such as tetramine, warfarin and rodenticide in suspected poisoning patients' residual food, vomit, gastric lavage, serum and urine. METHODS: The residual food, vomit, gastric lavage, serum and urine of patients with suspected rodenticide poisoning were collected. The food, vomit, gastric lavage and urine samples were added with ammonium acetate at a concentration of 2 mol/L, and than were repeatedly extracted twice by ethyl acetate. The serum sample was extracted by adding acetonitrile. After the sample was dried by nitrogen, it was dissolved in methanol ∶ammonium acetate(60 ∶40, V/V), and the supernatant was centrifuged and separated by a C18 column, and quantified by a standard curve method. Samples were detected by HPLC-MS. RESULTS: The linearity of the 12 kinds of rodenticides in the quantitative range of residual food, vomit, gastric lavage, serum and urine in patients with suspected rodenticide poisoning was good, and the correlation coefficient was 0.992 3-0.999 9. The detection limit of food, vomit or gastric lavage was 0.03-0.14 μg/kg, and that in serum and urine were 0.10-0.30 and 0.02-0.04 μg/L, respectively. The standard recovery rate was 84.4%-114.0%, and the within-run and between-run relative standard deviations were 2.7%-6.2% and 2.4%-9.5%, respectively.CONCLUSION: The method has advantages of simple operation, high efficiency and good accuracy. This method is suitable for emergency treatment of poisoning events caused by rodent drugs or poisoning.

An investigation on a family tetramine poisoning accident / 中华劳动卫生职业病杂志

Objective@#To investigate and analyze the clinical data of tetramine poisoning in a family and prevent similar incidents from happening again.@*Methods@#The study was conducted in July 2016 in a fami-ly with thiamine poisoning in shandong province, and the clinical data were analyzed.@*Results@#In this case, there are six cases of poisoning caused by the tetramine poisoning, and the convulsions are the main clinical manifestations, and the blood perfusion can have a good effect on the severe patients. After positive treatment, all 6 patients were cured.@*Conclusions@#The tetramine poisoning can cause severe convulsion, although the country has banned the production and use of it, the tetramine poisoning case still exist and cannot be ignored.

Two Cases of Tetramine Intoxication from Neptunea contricta

Even though Neptunea contricta appears similar to Batilus cornutus and Rapana venosa, they are different in tetramine content which inhibits the neuronal calcium channel. Therefore, mistaking Neptunea contricta for Batilus cornutus or Rapana venosa, can result in the occurrence of toxic symptoms. Three patients developed nausea, epigastric pain, chest pain, dizziness, blurred vision, dyspnea, hypertension and tachycardia after eating Neptunea contricta. Moreover, consumption of one only piece was sufficient to cause symptoms because each Neptunea contricta has 17.3 mg of tetramine. Accordingly, care should be taken when patients are consuming more than 5 pieces because toxic symptoms such as dyspnea can occur. Moreover, correct species identification is important because the quantity of tetramine varies among sea snail species. Finally, it is important to educate people to remove the salivary glands completely before consuming Neptunea contricta.

Two Cases of Neurotoxin Tetramine Poisoning Following Ingestion of Buccinum Striatissinum

Some carnivorous gastropods have heat stable tetramine toxins in their salivary glands. This toxin is an autonomic ganglionic blocking agent that enables them to catch the prey easily by paralyzing their targets. Acute tetramine toxin poisoning in humans from eating whelks has been well described based on numerous cases, but is rare in Korea. Symptoms of tetramine poisoning include eyeball pain, blurred vision, headache, dizziness, muscular twitching, tingling of hands and feet, weakness, paralysis and sometimes collapse. Gastrointestinal symptoms, such as abdominal pain, nausea, and vomiting can also occur. However, intoxication is self-limiting and patients will usually recover in about 24 hours. Herein, we report 2 cases of tetramine poisoning after ingestion of Buccinum striatissinum as meat and soup.

Two Cases of Neurotoxin Tetramine Poisoning Following Ingestion of Buccinum Striatissinum

Some carnivorous gastropods have heat stable tetramine toxins in their salivary glands. This toxin is an autonomic ganglionic blocking agent that enables them to catch the prey easily by paralyzing their targets. Acute tetramine toxin poisoning in humans from eating whelks has been well described based on numerous cases, but is rare in Korea. Symptoms of tetramine poisoning include eyeball pain, blurred vision, headache, dizziness, muscular twitching, tingling of hands and feet, weakness, paralysis and sometimes collapse. Gastrointestinal symptoms, such as abdominal pain, nausea, and vomiting can also occur. However, intoxication is self-limiting and patients will usually recover in about 24 hours. Herein, we report 2 cases of tetramine poisoning after ingestion of Buccinum striatissinum as meat and soup.

Effect of hemoperfusion therapy in children with acute tetramine poisoning / 中国小儿急救医学

ObjectiveTo analyze the therapeutic experience and value of hemoperfusion in children with acute tetramine poisoning.MethodsAccording to the choice of children's legal guardian,67 cases with acute tetramine poisoning were divided into two groups:the perfusion group (48 cases),and the control group (19 cases).The patients in perfusion group received blood perfusion based on conventional treatment,while the patients in control group received conventional treatment only.Survival outcomes of patients with different serum tetramine concentrations in two groups were compared.ResultsWhen the serum concentration of tetramine was ＞0.5 mg/dl,patients in both groups died in a short time.When the serum concentration of tetramine was 0.20～0.49 mg/dl,the drop value of serum concentration of tetramine significantly greater in perfusion group [(0.28±0.02) mg/dl] than that in control group [(0.13±0.03) mg/dl] (P＜0.05).When the serum concentration of tetramine was ＜0.2 mg/dl,the drop value of serum concentration of tetramine in two groups showed no significant difference [ (0.12±0.02) mg/dl vs (0.11±0.03) mg/dl] (P＞0.05).Conclusion The treatment method for tetramine poisoning should be selected based on the serum concentration of tetramine.

The therapeutic effects of combination of γ-aminobutyric acid, sodium dimercaptopropane sultanate and vitamin B6 in large doses on liver and heart in rats with acute tetramine intoxication / 中华急诊医学杂志

Objective To observe the therapeutic effects of the co-administration of γ-aminobutyric acid (CABA), sodium dimercaptopropane sulfonate (Na-DMPS) and vitamin B6 in large doses on liver and heart of rats with acute tetramine intoxication, and compare their separate effects of either GABA or Na-DMPS alone with those of the triad combination. Method Thirty rats were randomized into control group (n = 6), tetramine intoxication without treatment group (n = 6), tetramine intoxication treated with GABA group (n = 6), tetramine intoxication treated with Na-DMPS group (n = 6) and tetramine intoxication treated with triad combination (GABA + Na-DMPS + vitamin B6, GNDV n = 6) group. Samples of blood, liver tissue and heart tissue of rats with acute tetramine intoxication were collected immediately two hours after medication with different drugs. Serum alanine aminotrasferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were measured, and the pathological changes of liver tissue and heart tissue were observed under microscope. Results The symptoms of poisoning were apparently relieved and the latency for convulsion/muscular twitch were obviously delayed in poisoned rats treated with GABA, Na-DMPS and GNDV separately. Furthermore, combination group showed the latent period delayed longer than either GABA or Na-DMPS groups The GABA, Na-DMPS and GNDV significantly lowered the serum levels of ALT, AST, CK and CK-MB in rats with tetramine intoxication, and those serum levels of enzymes were lower in GNDV group than those in either GABA group or Na-DMPS group. However, there were no difference in those serum enzymes between GABA group and Na-DMPS group. Moreover, the intoxicated rats treated with combination treatment had the slightest pathological changes in liver and heart (GNDV < GABA or Na-DMPS). Conclusions The co-administration of γ-aminobutyric acid, sodium demercaptopropane sulfonate and vitamin B6 in large doses for the treatment of tetramine intoxication is a method of choice.

Clinical features and treatment of tetramine poisoning / 中国小儿急救医学

Tetramine poisoning still occurs and seriously impairs children' s health. Some children suffered from brain injury or death. Diagnosing accurately as soon as possible, eliminating poison rapidly,using antidotes timely and controlling convulsion quickly are the crucial treatment principles.

Study on the variation in blood concentration of tetramine in human body / 中国综合临床

Objective To study the variation of blood concentration of tetramine in human body with acute tetramine intoxication treated with three different protocols and the levels in human body after discharge from the hos-pital. Methods The blood concentration of tetramine was determined by gas chromatography-mass spectrometry (GC-MS). All 101 patients of acute tetramine intoxication were divided into 3 groups (routine comprehensive treat-ment group,hemoperfusion group,blood transfusion group) according to their blood concentration of tetramine and clinical symptoms. The patients were followed up to monitor the tetramine levels in a year. Results The level of tet-famine in blood was decreased from 33.0(1.7～115.0)μg/L to 18.0(0.3～47.6)μg/L in routine comprehensive treatment group. The total decrement was 45.5 %. The level was decreased from 108.0 (54.0～290.0)μg/L to 26.0 μg/L in hemoperfusion group. The total decrement was 75.9%. The decrement was 20.0%～45.0% after each he-moperfusion. The level was slightly high after 24 h of hemoperfusion. The total decrement in blood transfusion group was 33.5%～60.0%. The level was <0.3μg/L in all 25 out-patients 1 year after their intoxication. Conclusion Routine comprehensive treatment,hemoperfusion,blood transfusion are effective in the treatment of acute tetramine intoxication. The degradation of tetramine in human body is slow.

On Evidence-based Pharmacy and the Emergency Management of Pharmaceutical Affair Safety / 中国药房

OBJECTIVE:To provide reference for upgrading emergency management of pharmaceutical affairs and enhancing the safety and effectiveness of clinical medication.METHODS:The guiding effect of evidence-based parmacy(EBP)on emergency management of pharmaceutical affair security especially on the choice of drugs in clinical medication were discussed by elaborating the example of seeking sovereign remedy for tetramine acute poisoning.RESULTS & CONCLUSIONS:Emplying the principle of EBP to guide clinical medication can help to choose more effective and safe drugs and to find the best emergency treatment scheme.

The Antidotal Effects of High-dosage γ-Aminobutyric Acid on Acute Tetramine Poisoning as Compared with Sodium Dimercaptopropane Sulfonate / 华中科技大学学报（医学）（英德文版）

To investigate the therapeutic effect of high-dosage γ-aminobutyric acid (GABA) on acute tetramine (TET) poisoning, 50 Kunming mice were divided into 5 groups at random and the antidotal effects of GABA or sodium dimercaptopropane sulfonate (Na-DMPS) on poisoned mice in different groups were observed in order to compare the therapeutic effects of high-dosage GABA with those of Na-DMPS. Slices of brain tissue of the poisoned mice were made to examine pathological changes of cells. The survival analysis was employed. Our results showed that both high-dosage GABA and Na-DMPS could obviously prolong the survival time, delay onset of convulsion and muscular twitch, and ameliorate the symptoms after acute tetramine poisoning in the mice.Better effects could be achieved with earlier use of high dosage GABA or Na-DMPS. There was no significant difference in prolonging the survival time between high-dose GABA and Na-DMPS used immediately after poisioning. It is concluded that high-dosage GABA can effectively antagonize acute toxicity of teramine in mice. And it is suggested that high-dosage GABA may be used as an excellent antidote for acute TET poisoning in clinical practice. The indications and correct dosage for clinical use awaits to be further studied.

Effects of tetramine on cardiac/skeletal muscle in the rats and elucidate the relationship of the effects and the elevated sero-enzyme / 中华急诊医学杂志

Objective To investigate the effects of tetramine to cardiac/skeletal muscle in the rats and elucidate the relationship of the effects and the elevated sero-enzyme.Method The 30 homogeneous SD rats were invided into three groups:the control group,the half-lethal dose group and the lethal dose group.The number of female and male rats was equal.The tetramine powder is dissolved into 0.9% NS and puured into the stomach of the objects in medication groups;0.9%NS was poured into the rats of control group.Once the rat died or one hours later,the related sero-enzyme was determined and the rat was executed,Immediately cardiac muscle and skeletal musclewas respectively drawn the materials from the rat and was pathologically examined.Results After the rats are intragastric administrated they spasm in 10-60 min;the 6 rats of the medial lethal dose group die in 20-60 min.Serum TnI/CK/AST/LDH/a-HBDH in medication groups is higher than in control group (P

Correlation between Tetramine Poisoning and Hypocalcemia in Children / 实用儿科临床杂志

Objective To investigate the correlation between tetramine poisoning and hypocalcemia in children.Methods According to different severe cases grade,tetramine poisoning children were divided into critical group(70-90 score),extremely critical group(

A Case of Tetramine Intoxication from the Neptunea

Seafood is a vehicle for the transmission of intoxication. The Neptunea are sublittoral species of the marine prosobranch mollusk. Tetramine toxin is found in the salivary gland of Neuptunea. A woman developed blurred vision, dizziness, headache, diarrhea, numbness and gait disturbance one hour after ingesting conchs. Neurological examination showed dysesthesia, and motor weakness. Laboratory and electrophysiological studies were normal. The next day, she recovered from her symptoms. We report a patient with dysesthesia and motor weakness due to Neuptunea species' tetramine toxin.

Study on cell DNA damage induced by tetramine using comet assay / 中国法医学杂志

Objective To detect DNA damage in rat lymphocytes and brain cells induced by tetramine and study the toxicological mechanism of tetramine.Methods Lymphocytes and brain cells were separated and collected from healthy rats.DNA damages of cells which were exposed to various doses of tetramine for 60 min was detected using the single cell gel electrophoresis (SCGE) or comet assay.Results These are different degree DNA damages of lymphocytes and brain cells exposed from doses 1/20 LD 50 doses of tetramine to 1/2 LD 50 doses of tetramine.The test groups are very significantly statistical different to the control group(P

Clinical research on breath failure induced by acute tetramine poisoning / 解放军医学杂志

Objective To find the correlative factors which induce breath failure in acute tetramine poisoning cases, and to work out a right treatment scheme for these cases. Methods 47 cases were clinically diagnosed as slight, middling and severe poisoning, separately. The tetramine concentration in blood was compared between the three groups to reveal the relationship between blood concentration of tetramine and breath failure. Patients with breath failure were treated with muscle relaxant plus mechanical ventilation. Repeated hemoperfusions were given to the severe poisoning patients. Results No breath failure occured in both slight and middling groups, while in severe poisoning group, breath failure happened in 33.3% (4/12) patients aged below 15, and in 31.8% (7/22) adult patients aged above 15. Repeated hemoperfusion declined the tetramine concentration in blood, and gave a better effect than with CVVH or CVVHD treatment. muscle relaxant plus mechanical ventilation may control the symptom of twitching completely, and prevent from breath failure effectively. Conclusion Breath failure in acute tetramine poisoning cases was induced by systemic twitching and high blood tetramine concentration. It is very important to grade the poisoning cases according to poisoning degree. Repeated hemoperfusion is the best for blood purification. muscle relaxant plus mechanical ventilation may reduce the mortality effectively.

Effects of severe tetramine intoxication with hemoperfusion treatment / 实用儿科临床杂志

Objective To investigate the clinical significance of hemoperfusion(HP) in treating severe tetramine intoxication.Methods Fourty-eight children with severe tetramine intoxication from January 1999 to December 2002 were enrolled into two groups:HP treatment group and routine treatment group. Routine treatment group was treated with general therapy,such as gastrdavage,catharsis and so on. While hemoperfusion was added to HP treatment group besides general therapy.Results The number of cure in HP treatment group was higher than that in routine treatment group(? 2=8.17 P

Physical and Chemical Properties and Toxicity of Tetremthylene Disulfotertramine / 环境与健康杂志

Concerning the problem of understanding tetremthylene disulfotetramine Tetramine the present paper reviewed the physical and chemical properties and toxicity of Tetramine based on investigation and cases statistics and also presented an overall discussion on the importance of strictly prohibited Tetramine in China.

Effects and Safety of Hemoperfusion Therapy on Infants with Tetramine Poisoning / 实用儿科临床杂志

Objective To explore the effects and safety of hemoperfusion(HP) therapy on tetramine poisoning in infants.Methods Thirty-five infants with tetramine poisoning were divided into two groups: HP group(n=18) and non HP group(n=17).The changes of blood tetramine concentration and clinical symptom improving of both groups after the treatment were observed together with the adverse effects of HP group.Results The average blood tetramine concentration of HP group was higher than that of non HP group(342.2?333.4 vs 117.9?50.8 ?g/L,P