Methyl Bromide 중독 2예 시간을 훈증하였고 송풍기로 약 10분간 환기시킨 후에 이 뇌염의 병력은 없었고 사회력 및 가족력에는 특이 사항이 송 작업을 진행하였다. 내원 2일 전에는 평소보다 작업양 없었다. 이 많고 일하는 인원이 적어 약 3~4분간만 환기시킨

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세연 오
8 years ago
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1 KISEP Case Report 대한간질학회지 2003;7(2):125 7(2): 발작과 의식저하를 동반한 급성 Methyl Bromide 중독 2예 3 조광덕 1 임수빈 1 이순금 1 최성훈 2 김태훈 2 한군희 3 송경일 Two Cases of Methyl Bromide Intoxication with Seizures and Altered Mental State Kwang Deog Jo, M.D. 1, Soo-Bin Yim, M.D. 1, Soon Keum Lee, M.D. 1, Seong Hoon Choi, M.D. 2, Tae Hoon Kim, M.D. 2, Koon Hee Han, M.D. 3 and Kyung Il Song, M.D. 3 Department of Neurology, 1 Internal Medicine, 3 Kangnung Asan Hospital, Department of Family Medicine, 2 Seoul Asan Hospital, Asan Medical Center, University of Ulsan College of Medicine Methyl bromide is presently used as a fumigant for insects in soil, grains or fruit in storage or transport. It is a neurotoxic agent and has been responsible a number of deaths or acute poisonings among occupationally exposed persons. We report 2 patients, who had worked fumigation warehouse, presented with seizures and altered mental state. The serum concentrations of bromide were elevated 32.9 and 42.5 mg/l, respectively. Brain MRI showed bilateral symmetric high signal intensities in the splenium of corpus callosum, the globus pallidus, the quadrigeminal plate, the periaqueductal gray matter, the red nucleus, the substantia nigra, the medial lemniscus, the pontine tegmentum, the dentate nucleus, and the medulla. There was no brain lesion in the other patient. Appropriate and supervised handling of the chemical and regular education to workers are important to avoid the risk of methyl bromide poisoning. J Korean Epilep Soc 2003; 72: KEY WORDSMethyl bromideneurotoxicityseizure. - 증 례 1: 증 례 대한간질학회지 2003;7(2):

2 Methyl Bromide 중독 2예 시간을 훈증하였고 송풍기로 약 10분간 환기시킨 후에 이 뇌염의 병력은 없었고 사회력 및 가족력에는 특이 사항이 송 작업을 진행하였다. 내원 2일 전에는 평소보다 작업양 없었다. 이 많고 일하는 인원이 적어 약 3~4분간만 환기시킨 후 이학적검사상 활력징후는 정상이었고 피부 발진은 없었 에 작업을 하였다. 과거력상 두부 외상이나 열성경련 및 다. 신경학적검사상 의식은 혼돈상태로 시간과 장소에 대 A B C D E 126 대한간질학회지 2003;7(2): F Fig. 1. T2 weighted axial MRI of case 1, obtained on the 5th hospital day, show bilateral symmetric high signal intensities in the splenium of corpus callosum (A), the globus pallidus (B), the quadrigeminal plate (C, closed arrow), the periaqueductal gray matter (C, closed arrow), the red nucleus (C, open arrow), the substantia nigra (C, open arrow), the medial lemniscus (C, open arrow), the pontine tegmentum (D), the dentate nucleus (E), and the medullar (F).

3 조광덕임수빈이순금 등 증 례 2: - - 대한간질학회지 2003;7(2):

4 Methyl Bromide 중독 2예 고 찰 128 대한간질학회지 2003;7(2):

5 조광덕임수빈이순금 등 REFERENCES 1. Choi SJ, Hwang SH, Chun S, et al. Serum cholinesterase activities and serum bromide concentrations in farmers. Korean J Rural Med 1998;23(2): Michalodimitrakis MN, Tsatsakis AM, Christakis-Hampsas MG, Trikilis N, Christodoulou P. Death following intentional methyl bromide poisoning: toxicological data and literature review. Vet Hum Toxicol 1997;39(1): Hustinx WNM, van de Laar RTH, van Huffelen AC, Verwey JC, Meulenbelt J, Savelkoul TJF. Systemic effects of inhalational methyl bromide poisoning: a study of nine cases occupationally exposed due to inadvertent spread during fumigation. Br J Ind Med 1993; 50: Choi KD, Shin JH, Kim DS, et al. A case of chronic methyl bromide poisoning associated with cerebellar ataxia, polyneuropathy and optic neuropathy. J Korean Neurol Assoc 2002;20(3): Lee JH, Chung WC, Choi SY, Park KH, Kim SW. A case of methyl bromide intoxication with continual residual neurologic symptoms. Korean J Intern Med 1984;27(5): Park TH, Kim JL, Son JE, et al. Two cases of neuropathy by methyl bromide intoxication during fumigation. Korean J Occup Environ Med 2000;12(4): Squier MV, Thompson J, Rajgopalan B. Case report: neuropathology of methyl bromide intoxication. Neuropathol Appl Neurobiol 1992; 18: Yamano Y, Kagawa J, Ishizu S, Harayama O. Three cases of acute methyl bromide poisoning in a seeding farm family. Ind Health 2001; 39: Shield LK, Coleman TL, Markesbery WR. Methyl bromide intoxication: neurologic features, including simulation of Reye syndrome. Neurology 1977;27: Behrens RH, Duke DCD. Fatal methyl bromide poisoning. Br J Ind Med 1986;43: Uncini A, Basciani M, Di Muzio A, Antonini D, Onofrj M. Methyl bromide myoclonus: an electrophysiological study. Acta Neurol Scand 1990;81: Hine CH. Methyl bromide poisoning. A review of ten cases. J Occup Med 1969;11(1): Moosa MR, Jansen J, Edelstein CL. Treatment of methyl bromide poisoning with haemodialysis. Postgrad Med J 1994;70: Roche L, Colin M, Tommasi M, Lejeune E. Intoxication mortelle par le bromure de methyle. Annales Medicales et Legales 1958;38: Franken L. Étude anatomique d un cas d intoxication par le bromure de méthyle. Acta Neurol Belg (Bruxelles) 1959;59: Hauw JJ, Escourolle R, Baulac M, Morel-Maroger A, Goulon M, Castaigne P. Postmortem studies on posthypoxic and post-methyl bromide intoxication: case reports. In: Fahn S, ed. Adv Neurol. Vol 43: Myoclonus. New York: Raven Press. 1986: 대한간질학회지 2003;7(2):

Lumbar spine

Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical