• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.88-94
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• 2011

Purpose: Delayed neuropsychological sequelae (DNS) commonly occurs after recovery from acute carbon monoxide poisoning. The aim of this article is to identify the factors associated with DNS development. Methods: We retrospectively evaluated patients, admitted to the medical center emergency department from June 2005 to March 2011, who were suffering from acute carbon monoxide (CO) poisoning. We categorized the patients into two groups - those with DNS, and those without DNS. Multiple regression analysis was performed to identify the factors related to manifestation of DNS. Results: Of the total one hundred fifty seven patients (157) recruited for the study, twenty two (22) developed DNS. Longer CO exposure times and lower GCS scores were positively associated with development of DNS symptoms. Conclusion: Our study identified two potential factors which are predictive of DNS development in CO intoxication, however, more studies are needed. Adequate follow-up after hospital discharge to monitor for and accurately identify manifestation of DNS, is also important.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.58-65
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• 2022

Purpose: Alcohol is one of the most commonly co-ingested agents in deliberate self-poisoning (DSP) cases presenting at the emergency department (ED). The increased impulsivity, aggressiveness, and disinhibition caused by alcohol ingestion may have different clinical features and outcomes in cases of DSP. This study investigates whether alcohol co-ingestion affects the clinical features and outcomes of DSP patients in the ED. Methods: This was a single-center retrospective study. We investigated DSP cases who visited our ED from January 2010 to December 2016. Patients were classified into two groups: with (ALC+) or without (ALC-) alcohol co-ingestion. The clinical features of DSP were compared by considering the co-ingestion of alcohol, and the factors related to discharge against medical advice (AMA) of DSP were analyzed. Results: A total of 689 patients were included in the study, with 272 (39.5%) in the ALC+ group. Majority of the ALC+ group patients were middle-aged males (45-54 years old) and arrived at the ED at night. The rate of discharge AMA from ED was significantly higher in the ALC+ group (130; 47.8%) compared to the ALC- group (p=0.001). No significant differences were obtained in the poisoning severity scores between the two groups (p=0.223). Multivariate analysis revealed that alcohol co-ingestion (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.01-1.98), alert mental status (OR=1.65; 95% CI, 1.17-2.32), past psychiatric history (OR=0.04; 95% CI, 0.01-0.28), age >65 years (OR=0.42; 95% CI, 0.23-0.78), and time from event to ED arrival >6 hrs (OR=0.57; 95% CI, 0.37-0.88) were independent predictive factors of discharge AMA (p=0.043, p=0.004, p=0.001, p=0.006, and p=0.010, respectively). Conclusion: Our results determined a high association between alcohol co-ingestion and the outcome of discharge AMA in DSP patients. Emergency physicians should, therefore, be aware that DSP patients who have co-ingested alcohol may be uncooperative and at high risk of discharge AMA.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.3.2-3
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• 1977

Deafness has been considered in recent publications a transient feature in the neurological complications of carbon monoxide poisoning. The inner ear is a sensitive as central nervous system to anoxia. It is well known a similar vulnerability to the toxic action of carbon monoxide for the two neurosensory epithelia of the organ of Corti. There is geographical character in the carbon monoxide poisoning and more frequently experienced in Korea. 10 cases of hearing loss due to carbon monoxide intoxication were reported with the literature review.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.92-99
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• 2016

Purpose: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. Methods: A retrospective chart review study was conducted for patients whose final diagnoses were "poisoning" and "benzodiazepine" or "sedatives-hypnotics" from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. Results: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. Conclusion: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.9-15
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• 1972

Carbon monoxide poisoning is one of the most serious health problems in Korea, because we have been encountered with the highest incidence of CO poisoning in the world due to the unique heating system in home called 'ondal'. We opened Hyperbaric chamber unit in the Seoul National University Hospital last Jan, 1969. We have treated 848 patients as of Sept. 30., 1972, around 44 months period. We collected the informations on the environmental conditions of the place where CO intoxication actually occured by filling up the questionaire from 505 patients. The following findings were obtained. 1. Age distribution showed that the highest incidence was found in the younger age group between age of 10 to age of 29 in both sex. 2. Sex ratio of the patients was 1:1.14. 3. The socio-economic level of the patient was relatively low. 4. Housewife & housemaid were the major victims of the intoxication in the female patients & in the case of the male patient, occupational backgrounds were diverse. 5. Many patients from the middle class experienced the intoxication by sleeping at newly built room. 6. Many intoxication has been occured in the structure of houses where communicating doors are existing between living room & kitchen. 7. All findings obtained taught us again that CO poisoning is the serious by-product of the national fuel policy which put emphasis on the use of coal & socio-economic status is a very important parameter in this hazards.

• Journal of the Korean Electrochemical Society
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• v.25 no.2
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• pp.88-94
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• 2022

The anion exchange membrane used in alkaline membrane fuel cells transports hydroxide ions, and ion conductivity affects fuel cell performance. Thus, the measurement of absolute hydroxide ion conductivity is essential. However, it is challenging to accurately measure hydroxide ion conductivity since hydroxide ions are easily poisoned in the form of bicarbonate by carbon dioxide in the atmosphere. In this study, we applied electrochemical ion exchange treatment to measure the absolute hydroxide ion conductivity of the anion exchange membrane. In addition, we investigated the effect of carbon dioxide poisoning of hydroxide ions on electrochemical performance by measuring bicarbonate conductivity. Commercial anion exchange membranes (FAA-3-50 and Orion TM1) and polyphenylene-based block copolymer (QPP-6F) were used.

• Journal of Auto-vehicle Safety Association
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• v.13 no.2
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• pp.15-23
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• 2021

Even though the number of CO poisoning casualties caused by unintended idling for the vehicles equipped with keyless ignition systems is more than 70, the problem still remains unsolved and became social issue in the US, and Senates introduced the bill which urges NHSTA to make regulation for this accordingly. To meet market safety needs and the regulations, we decided to provide automatic shut-off system very soon. In this paper, we would like to describe how to validate vehicle shut-off timing including defining required tests and case selections considering vehicle condition, garage/room size and temperatures with several assumptions. We believe that safe implementation of the shut-off function is possible via this methodology and the results. As NHTSA must be interested in shut-off timing, the methodology can be enhanced and conclusions could be reflected highly in the future regulation in case we continue this study with NHTSA or any other 3-rd party institutes.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.1
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• pp.18-25
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• 2020

Purpose: We studied the impact of arterial oxygen tension (PaO₂) on the long term neurologic outcome in patients with acute carbon monoxide poisoning. Methods: The study population included 311 patients who presented to emergency department with acute CO poisoning from January 2015 to January 2018. These patients underwent arterial blood gas testing at the time of presentation. The baseline demographic, clinical, laboratory, and clinical outcome data were recorded. The primary outcome of interest was the long term neurologic status. Results: The normoxia group was significantly older and it had a higher incidence of diffusion weighted MRI abnormality, and this group needed multiple HBO sessions compared to the group with moderate or severe hyperoxia. Also, the incidence of altered mentality at discharge was higher in the normoxia group than that of the moderate hyperoxia group. The incidence of a poor long term neurologic outcome was 11.3%. The incidence of a poor long term neurologic outcome decreased as the PaO₂ increased. The PaO₂ was significantly lower in patients with a poor long term neurologic outcome than that of the patients with a good outcome 198 (165.2 to 231.1) mmHg in the good outcome group vs. 154 (119-162) mmHg in poor outcome, p<0.001). In multivariate logistic regression analysis, PaO₂ was selected as an independent factor of the poor long-term neurologic outcome (OR 0.981 (95% CI: 0.968 to 0.995)) Conclusion: Higher PaO₂ was independently associated with a lower incidence of a poor long-term neurologic outcome.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.2
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• pp.73-79
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• 2012

Purpose: The purpose of this study was to identify the changes in the characteristics of patients with carbon monoxide (CO) poisoning, as well as the distinctive differences in intentionally exposed patients. Methods: The medical records of CO poisoning patients, who visited nine emergency departments between January 2010 and December 2011, were reviewed retrospectively. The clinical information including age, gender, hospitalization, type of discharge, cause and location of exposure, site of onset, concentration of initial blood carboxyhemoglobin (COHb), methods of treatment and presence of neurological complications was examined. The subjects were divided into an intentional and non-intentional group and the differences between them was compared. Results: A total 209 subjects were recruited. The median age was 38 years (29~49.5 years). They frequently complained of nausea and vomiting, and the most common exposures occurred in winter, normally in the home. The cause of exposure was usually fire, followed by incomplete combustion of fuels. The median initial blood COHb was 13.15%. The proportion of intentionally exposed patients was 21%. They were significantly younger, more frequently discharged against medical advice, and showed a higher initial blood COHb level (22.85%) than the non-intentional group. Conclusion: This study suggests that those with intentional CO poisoning are normally discharged against medical advice even when they have a higher initial COHb level. An adequate explanation of the delayed neurologic sequelae and short term follow-up observation is recommended for those patients with intentional exposure.

• Bulletin of the Korean Chemical Society
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• v.7 no.1
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• pp.12-15
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• 1986

Lead tolerance of $Pt/Al_2O_3$ catalysts was evaluated for CO oxidation depending on the properties of the alumina supports and base metals added as promoter. Among the four different alumina supports, the support with a large macropore volume (0.45 cc/g) and 5% Ce has shown the best resistence to lead poisoning. Most of the base metals added to the Pt-catalysts were found to be ineffective for improving lead resistence, but boron has shown an excellent lead tolerence, although it decreases the initial catalytic activity.