Encefalopatía tóxica por isopropanol: sobre-exposición accidental a gas propano / Toxic encephalopathy caused by liquefied gas exposure: report of one case

Liquefied hydrocarbon gas, such as propane is considered safe. However there are reports that voluntary exposure to liquefied gas at least could originate hallucinatory states. We report a 20 years old woman who was found in a coma with extensor muscle hypertonia, brisk tendon reflexes and extensor plantar (Babinski) responses after being exposed to propane gas. The brain magnetic resonance imaging (MRI) showed lesions in both hippocampi and white matter in the oval center. The patient had a normal oxygen saturation of 98%, a carboxyhemoglobin of 1.6% and a metabolic acidosis with a pH of 7.01 with an anion gap of 16 mEq/l. This pattern suggested that it was a consequence of the intermediary metabolism of isopropanol. The recovery of the patient was slow and four months later she still had lesions on MRI and limitations in her cognitive sphere, memory and executive functions. Thus, liquefied gas exposure can cause a toxic encephalopathy with a persistent damage of the central nervous system.

Recent Epidemiologic Features of Carbon Monoxide Poisoning in Korea: A Single Center Retrospective Cohort Study

PURPOSE: The aim of this study was to describe the epidemiologic characteristics of adult patients with carbon monoxide poisoning who presented to the emergency department in recent years. METHODS: This was a retrospective cohort study on adult consecutive patients with carbon monoxide (CO) poisoning who presented to the emergency department of a tertiary care university-affiliated hospital from January 1, 2008 to December 31, 2011. RESULTS: A total of 91 patients were included in this study; there were 56(61.5%) unintentional and 35(38.5%) intentional poisonings. For the unintentional CO poisonings, the principal sources of exposure to CO were fire (39.3%), charcoal (17.9%), briquette charcoal (7.1%), wood burning boiler (7.1%), gas boiler (5.4%), automobile heater (3.6%), briquette boiler (3.6%), firewood (3.6%), and other items (12.5%). For the intentional CO poisonings, the sources were ignition charcoal (60.0%), briquette (31.4%), charcoal (5.7%) and butane gas (2.9%). For the unintentional CO poisonings, the places of poisoning were the home (58.9%), workplace (10.7%), public accommodation (8.9%), tent (8.9%), automobile (3.6%) and parking place (1.8%). For the intentional CO poisonings, the places of poisoning were the home (77.1%), public accommodation (11.4%) and automobile (11.4%). The proportion of intentional CO poisonings among total poisonings has increased significantly in recent years; 0.0% in 2008, 3.3% in 2009, 5.5% in 2010, and 29.7% in 2011. CONCLUSION: This study showed that in recent years in Korea, the source of CO has diversified broadly and intentional CO poisonings from burning ignition charcoal or briquettes has increased. Prevention efforts should consider these factors.

Bronchospasm and Anaphylactic Shock Following Lidocaine Aerosol Inhalation in a Patient with Butane Inhalation Lung Injury

Allergic reactions to local anesthetics are very rare and represent <1% of all adverse local anesthetics reactions. A 54-year-old man was admitted to the hospital in the winter because of shortness of breath. The patient reportedly had an inhalation lung injury due to butane gas fuel. On the fifth day, he developed an asthmatic attack and anaphylactic shock immediately after lidocaine aerosol administration to prepare for bronchoscopy to confirm an acute inhalational lung injury diagnosis. Cardiopulmonary resuscitation was performed immediately after respiratory arrest, and the patient was admitted to the intensive care unit intubated and on a ventilator. He was extubated safely on the third post-cardiopulmonary resuscitation day. These observations suggest that aerosol lidocaine anesthesia may cause airway narrowing and anaphylactic shock. Practitioners should be aware of this potential complication. We report on this case with a brief review of the literature.

Isobutane driven salbutamol sulfate metered dose inhaler: formulation selection and respiratory tract absorption in guinea pigs / 药学学报

This paper is to study the iso-butane (A-31)-driven salbutamol sulfate (SS) metered dose inhaler (MDI) formulations and inhaling status in guinea pigs. Solubility determination and orthogonal design were used to screen non-chlorofluorocarbon (CFC) SS MDI formulations. Intubation inhalation of MDI in guinea pigs was used as a main administration method. Fluorescence HPLC detection method was testified as a potential method in assaying the concentration of SS in plasma of guinea pigs after inhaling various SS MDI formulations. Analysis of the data was executed with statistical moment calculation from which pharmacokinetic parameters were obtained. The results show that A-31 based on SS MDI formulations were screened and the guinea pigs in vivo determination method after inhaling SS MDI was established. The zero-moment rations of SS/A-31 MDI formulation to contrast sample and CFC SS MDI was 143.26% and 147.01%, respectively. The first moment value of SS/A-31 MDI formulation was the highest. It is a preliminary conclusion that the absorption result of SS/A-31 MDI formulation inhaled by guinea pigs is equivalent to HFA-134a formulation in sale and better than CFC formulation. A-31 could be used as a potential substitute candidate for CFC MDI propellant.

A Retrospective Epidemiologic Analysis of Burn Patients at Hanil Hospital

PURPOSE: Burn injuries still produce a significant morbidity and mortality. The collection and analysis of burn epidemiology data would provide insights into new prevention management strategies in terms of nationwide profile. We reviewed and compared the data from other countries. METHODS: This study was carried out to analyze the epidemiology, current etiological factors (circumstances), treatment methods and mortality of 4,321 acute burn patients, excluding electrical burn, who were admitted to Hanil Hospital Burn Center during 12 years (1996~2007). RESULTS: 1) The male to female ratio was 1.3:1. The mean age of admission was 30.0 years. The children below 18 years made up 38.9%, and adult over 60 years 10.2%. 2) The scald was the most common cause making up 53.8% followed by flame (30.8%), contact (9.3%), steam (3.6%) and chemical (2.1%) burn. The mean extent was 9.8%, 19.1%, 3.8%, 7.2%, 8.7% respectively. 3) The etiologies of scald burn were boiled water (32.9%), hot food soup (28.1%), boiling water (13.8%), instant food (10.3%) at home (87.4%). The 13.7% of victims underwent surgery of STSG (12.9%), FTSG (0.6%), local flap (1.2%) and advanced flap (0.1%). 4) The majority of flame burn occurred at home (43.7%) and work place factory (23.5%). Leading causes were inflammables (29.3%), fire (14.0%), explosion of butane can (12.8%), gas range (10.1%) and LPG (8.7%). The 31.4% of victims underwent STSG (26.2%), FTSG (0.8%), local flap (0.2%) and major amputation (0.1%). 5) The major victims (50.6%) of steam were children below 2years by exposing to steam of rice cooker (70.0%) at home. The 28.9% of victims underwent STSG (14.7%), FTSG (16.0%) and local flap (5.1%). 6) The contact burns occurred at various places (home; 56.5%, work place; 16.9%, vehicles; 9.0%, sauna; 4.5%) by various causes (Ondol; 11.9%, hot pack; 11.2%, oriental herb medicine; 6.7%). The 45.8% of victims underwent STSG (36.3%), FTSG (6.7%), local flap (5.2%), advanced flap (2.0%) and minor amputation (1.2%). 7) The chemical burn occurred at various place (home; 39.3%, work place; 49.4%) by acids (43.8%), alkalies (11.2%), vinegar (15.7%) and herb moxa (16.9%). The 28.1% of victims underwent STSG (22.5%), FTSG (9.0%), local flap (7.9%) and minor amputation (6.7%). 8) Children<18 years old were burnt mainly by scald (79.0%) while for adults below 50 years old was flame, over 50 years was scald. Children below 2 years old had higher frequency of steam (9.2%) and contact (7.9%) burn. The contact burn had relatively higher frequency among 7th (17.6%) and over 8th (20.4%), while chemical among 6th (3.9%) decade. 9) Inhalation injury was accompanied in 13.8% of flame burn (4.3% of total). The inhalation injury only was 4.9% of flame (1.5% of total). 10) The overall mortality rate was 1.8%. The mean age of death was 47.3 years old and burn extent was 74.5%TBSA. There was a strong correlation between flame burn (96.2% of total death), TBSA (50~60%; 9.3% vs 70~80%; 65.2%, 80~90%; 71.4%, over 90%; 87.9%) and mortality. The prognosis was poor for those over 70 year old (7.7% vs 30~50 yo; 2.8%, 7 th decade; 3.7%), flame burn (5.6% vs scald; 0.04%) and combined inhalation injury (22.3%). The patients died at mean 17.3 PBD by ARDS (51.3%), sepsis (44.9%), burn shock (20.5%) and ARF (5.1%) 11) The severity and sequelae of scald by prepackaged instant food, steams of rice cooker, flame by used butane can, contact by Ondol, sauna and chemical by vinegar should be added to preventive programs. CONCLUSION: Further study for implications of changes in management protocols and policies on treatment outcomes would improve the provision of appropriate care for the patients.

A case of pneumonitis induced by gasoline intoxication / 대한내과학회지

Hydrocarbons are a broad group of organic bodies consisting of hydrogen and carbon. They are commonly found in the environment in the form of gasoline (e.g., butane and propane) and are also used in stain removers, adhesives, lubricants, and a variety of paints. Ingestion of the compound accounts for approximately 3% of all poisoning cases in the United States, but such reports of poisoning are rare in Korea. Hydrocarbon poisoning has many adverse effects. In addition to potentially causing major damage to the respiratory and central nervous systems, direct exposure to hydrocarbons can also cause cardiac arrhythmia, hepatic dysfunction, renal failure, neuropathy, and other injuries. We present the case of a 20-year-old soldier who accidentally ingested a small amount of gasoline. He developed chemical pneumonitis, but recovered with no serious complications.

Comparative study of the toxic and histopathological effects of domestic butane and town gases mice

This work aimed to study pathological changes in different parenchymatous organs of mice acutely exposed to different concentrations of butagas and town gas. It was conducted on 35 mice divided into seven groups of five mice each, one group acted as a control. The animals were decapitated and blood samples were taken to detect level of COHb. Brain, heart, lungs, liver and kidneys were studied histopathologically to detect different pathological changes. No significant morphological difference between both gases of the same concentration was detected. The changes were in the form of edema, hemorrhage and mild inflammatory infiltrate with sublethal doses; while with lethal doses, necrotic foci were detected in some organs

Verrugas vulgares: crioterapia con butano líquido en 48 casos colegio Carlos W. Sutton La Joya 1997

OBJETIVOS: Determinar el efecto curativo de la crioterapia butano líquido en las verrugas vulgares. DISEÑO: Experimental, controlado por placebo. POBLACION Y MUESTRA: 96 pacientes con diagnóstico clínico de verrugas vulgares, dividido en dos grupos: A experimental (recibe butano) y B control (placebo). RESULTADOS: La frecuencia de verrugas fue 12.99 por ciento. Se consiguió curación en 46 casos (95.83 por ciento) en el grupo experimental, en tanto que en el grupo control la curación fue en 6 casos (12.5 por ciento). Las secuelas observadas fueron: cicatriz queloide (2.08 por ciento), hiperpigmentación (4.17 por ciento), hipopigmentación (33.33 por ciento). CONCLUSIONES: El butano líquido aplicado localmente es efectivo en el tratamiento de las verrugas vulgares y se presenta como una alternativa terapéutica.