etters

Abstracts / Toxicology L

versible lactic acidosis and subsequent hemodynamic instability.

doi:10.1016/j.toxlet.2008.06.793

C58Differences in clinical profiles of patients With Protobothropsmucrosquamatus and Viridovipera stejnegeri envenoming in Tai-wan

Yen-Wen Chen 2, Yen-Chia Chen 2, Dong-Zong Hung 3, Hung-TsangYen 1, Chun-I Huang 2, Chen-Chang Yang 1,∗

1 National Yang-Ming University, Taipei, Taiwan, 2 Taipei VeteransGeneral Hospital, Taipei, Taiwan, 3 China Medical UniversityHospital, Taichung, Taiwan

Purpose: Envenoming by Protobothrops mucrosquamatus (formerlyknown as Trimeresurus mucrosquamatus) and Viridovipera stejnegeri(formerly Trimeresurus stejnegeri) accounts for the majority ofvenomous snakebites in Taiwan. We conducted a study to sys-tematically examine the clinical manifestations and responses toantivenom therapy following P. mucrosquamatus and V. stejnegerienvenoming.

Methods: Information on demographic characteristics, treat-ments, and systemic/local complications were abstracted frommedical charts among inpatients in a medical centre between 1991and 2006.

Results: 149 patients with P. mucrosquamatus envenoming and51 with V. stejnegeri envenoming were eligible for final analysis.P. mucrosquamatus and V. stejnegeri envenoming differed in age(43.5 years vs. 52.7 years, p = 0.003), biting site (lower limb 63% vs.20%, p < 0.001), local bruising (75% vs. 51%, p = 0.003), proportionof patients needing ≥3 vials of antivenom (66% vs. 41%, p = 0.003),and mean hospital stay (7.5 days vs. 3.8 days, p < 0.001). Univari-ate analysis further revealed that P. mucrosquamatus envenominghad a higher risk of rhabdomyolysis (Peto odds ratio and 95%confidence interval: 3.2; 1.04–9.55), cellulitis (POR: 3.3; 1.5–7.3),necrosis (POR: 4.3; 1.4–13.4), and skin graft (POR: 4.2; 1.2–15.1).

Conclusions: P. mucrosquamatus envenoming caused moresevere manifestations than V. stejnegeri envenoming, reflecting thedifferences in the amount, potency, and constituents of the venomsbetween the two pit vipers. With the higher toxicity, special precau-tion in monitoring potential major complications seems warrantedamong patients with P. mucrosquamatus envenoming.

doi:10.1016/j.toxlet.2008.06.794

C59Acute vitamin A poisoning following fish liver ingestion

Chen-Chang Yang 1,∗, Jou-Fang Deng 2

1 National Yang-Ming University, Taipei, Taiwan, 2 Taipei VeteransGeneral Hospital, Taipei, Taiwan

Purpose: Toxic levels of vitamin A may accumulate in the livers ofcertain fish species, such as sharks, snappers, tuna and sea basses.Ingestion of large amounts of fish liver can rarely cause vitamin Apoisoning, an illness characterized by severe headache, fever anddesquamation.

Methods: We retrospectively reviewed the records of patientswith suspected fish liver poisoning reported to a National PoisonCentre from July 1986 through June 2007. Patient’s demographicand clinical characteristics were collected and analyzed.

Results: A total of six incidents involving 19 patients (13 malevs. 6 female patients) were identified. The culprit fish specieswere tuna in 8 patients (1 incident), sea bass in 1 patient, snap-

180S (2008) S32–S246 S143

per in 3 patients (1 incident), and unknown species in 7 patients(3 incidents). Following the consumption of fish liver, all patientsdeveloped gastrointestinal and neurological effects, such as nau-sea, headache, and weakness, within 4–12 h. Some patients alsomanifested fever, facial flush, and conjunctival congestion. Diffusedesquamation and/or hair loss, lasting up to 8 weeks, developedafter the resolution of the aforementioned manifestations within1–4 days. All patients recovered well with supportive therapy alone.

Conclusion: Ingestion of fish livers rich in vitamin A can resultin acute hypervitaminosis A, the clinical features of which resem-ble those of vitamin A supplement overdose. Prompt diagnosisof acute vitamin A poisoning can be difficult in the absence ofdiffuse desquamation because the clinical manifestations are indis-tinguishable from ciguatera poisoning and routine bioassay isgenerally unavailable.

doi:10.1016/j.toxlet.2008.06.795

P9 Industrial Toxicology

D01What Is The Role of The Anti-Inflammatory Cytokines on TheDevelopment of CWP

Ilker Ates ∗, Sinan H. Suzen, Asuman Karakaya

Ankara University, Faculty of Pharmacy, Department of Toxicology,Ankara, Turkey

Cytokines appear to play a key role in the process of some inflam-mation reactions depending on interactions between pro- andanti-inflammatory mechanisms ending with several diseases suchas coal workers’ pneumoconiosis (CWP). The anti-inflammatorycytokines such as interleukin-1 receptor antagonist (IL1RA) andtransforming growth factor beta (TGFB1) are the key regulatorsthat control the pro-inflammatory cytokine response. In this study,to point out the some cytokine gene profiles of Turkish coalminers, we investigated the polymorphisms of anti-inflammatorycytokines IL1RA and TGFB1 and also IL-6 (has both pro- and anti-inflammatory effects) by performing genotyping analysis. We alsointended to observe that whether these polymorphisms in thegenes of the cytokines influence the development of CWP or notand to reveal the low and high-risk groups. According to results,although there was an enhancement, neither the IL1RA nor TGFB1variants showed a significant association with development of

CWP. In contrast, IL-6 variant showed a protective effect on CWPdevelopment.

This study was supported by Research Fund of Ankara University(20030803036).

doi:10.1016/j.toxlet.2008.06.350

D02OGG1 genetic polymorphism in workers exposed to crystallinesilica containing dust is not associated with silicosis in exposedworkers

Gonca Cakmak Demircigil 1,∗, Ela Kadioglu 1, Erdem Coskun 1, NuriVidinli 2, Yildiray Erbas 2, Arif Cimrin 3, Roel P.F. Schins 4, Paul J.A.Borm 5, Sema Burgaz 1

1 Department of Toxicology, Faculty of Pharmacy, Gazi University,Ankara, Turkey, 2 National Institute of Occupational Safety andHealth, Ankara, Turkey, 3 Chest Diseases, Faculty of Medicine, DokuzEylül University, Izmir, Turkey, 4 IUF, Institut fur umweltmedizinischeForschung, Dusseldorf, Germany 5 Centre of Expertise in Life Sciences,Zuyd University, Heerlen, New Zealand