• 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 The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.33-36
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• 2012

Opioids are the one of the most commonly used drugs to control cancer pain all over the world. But, we should not overlook the potential risk of opioid intoxication because they have well-known detrimental side effects. The opioid intoxication can be diagnosed thorough various clinical manifestations. The altered mental status, respiratory depression, and miosis is very representative clinical features although these symptoms don't always appear together. Unfortunately the opioid-toxidrome can be varied. A 42 years old man came to our emergency room after taking about 900 mg morphine sulfate per oral. He was nearly alert and his respiration was normal. Even though his symptoms didn't deteriorated clinically, serial arterial blood gas analysis showed increase in PaCO2. So we decided to use intravenous naloxone. Soon, he was fully awaked and his pupils size was increased. After a continuous infusion of intravenous naloxone for 2 hours, PaCO2 decreased to normal range and his pupil size also returned to normal after 12 hours. Though the levels of serum amylase and lipase increased slightly, his pancreas was normal according to the abdominal computed tomography. He had nausea, vomit, and whole body itching after naloxone continuous infusion, but conservatively treated. We stopped the continuos infusion after 1 day because his laboratory results and physical examinations showed normal. As this case shows, it is very important to prescribe naloxone initially. If you suspect opioid intoxication, we recommend the initial use of naloxone even though a patient has atypical clinical features. In addition, we suggest intranasal administration of naloxone as safe and effective alternative and it's necessary to consider nalmefene that has a longer duration for opioid intoxication.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.47-53
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• 2016

Purpose: Intentional poisoning is a major public health issue in many parts of the world. This study was conducted to provide details regarding the epidemiology of intentional poisoning in a metropolitan emergency department and to identify the changing patterns and epidemiology of poisoning. Methods: A retrospective study was conducted to evaluate intentional poisoning of patients who visited the emergency department in a tertiary teaching hospital between 2001 and 2015. All intentional poisoning-related emergency department visits over three five year periods (2001-2005 (P1), 2006-2010 (P2) and 2011-2015 (P3)) were reviewed to investigate trends in intentional poisoning patients. Information regarding patient sex, age, time from episode to admission, psychiatric history, type of intoxicants, alcohol co-ingestion, gastric lavage, charcoal administration, any previous suicide attempts, need for hospitalization and death before discharge was reviewed. Results: A total of 1269 patients were enrolled in this study. The number of patients admitted during each period was P1=515, P2=439 and P3=315. Comparison of the three groups revealed significant differences according to age (p<0.001), psychiatric history (p<0.001), alcohol co-ingestion (p=0.013), gastric lavage (p<0.001), charcoal administration (p<0.001), need for hospitalization (p=0.044), repeated attempt (p<0.001) and type of intoxicants (p<0.001). Conclusion: The average age of intentional poisoning patients has increased. While the use of sedatives and multiple drugs increased, the use of pesticides and the antihistamine decreased.

• Human Ecology Research
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• v.58 no.1
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• pp.13-29
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• 2020

This study investigated the relationship between preschoolers' smart media usage in regards to cognitive and language development, especially the mediating effect of preschoolers' smart media addiction tendency and the moderated mediating effect of maternal guidance on smart media usage. The study surveyed 273 preschoolers' mothers who lived in Daegu City and Kyungpook Province. The findings of this study were as follows. First, preschoolers' smart media addiction tendency mediated the relationship between smart media usage time in regards to cognitive and language development. Second, maternal active mediation and monitoring moderated the relationship between preschoolers' smart media usage time and smart media addiction tendency. Third, there was a maternal co-use moderated the mediating effect of preschoolers' smart media addiction tendency on language development. In conclusion, preschoolers' smart media addition tendency mediated the effect of smart media usage time on cognitive and language development. Among the mediation pathways, the influence of preschoolers' smart media addiction tendency on language development was moderated by maternal co-use. The findings of this study suggest that maternal guidance should be applied differently depending on preschoolers' smart media addiction tendency. This study examined preschoolers' and maternal smart media-related variables on preschoolers' cognitive and language development in order to provide preliminary data that can be used to explore the maternal guidance on how to use smart media for their preschool children.

• Proceedings of the Korea Society for Industrial Systems Conference
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• 2002.06a
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• pp.356-360
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• 2002

Polluting the air with such pollutants as CO, H₂S and SO₂, industrial development huts increased the danger of gas toxication. Futhermore, as the: living standard goes higher, the consumption of explosive hydrocarbonic gases such as butane(C₄H/sub 10/) or propane(C₃H/sub 8/) has been soaring, which results in the danger of a gas explosion. As measures to cope with such dangers, the development of highly sensitive gas sensors, gas detectors adopting gas-sensing technologies, and gas recognition systems are urgently required. The objective of the present research is to develop a gas recognition system that is capable of identifying specific types of selected gases by formulating a semiconductor-typed gas sensor array, which not only improves the selectivity of semiconductor-typed gas sensors but also minimizes the erect of drifts on a single sensor signal, and applying the input pattern data of gases detected by the array to a neural network.

• Food Science and Preservation
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• v.15 no.1
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• pp.161-168
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• 2008

The effects tea beverages (TBs) prepared from powdered green tea (Gt), oolong tea (Ot), black tea (Bt), or pure tea (Pt) with lemon, orange, grenadine etc on cadmium toxicity in rats were investigated Sensory evaluations of the TBs are better than those of each water extracted teas. Cadmium (50 ppm) was administered to experimental rats fed a basic diet, or a diet with various TBs (15% w/v), for 5 weeks. Although body weight gains, feed intakes, and fecal weights in all Cd-treated groups were lower than those in the normal control group (NC), feed efficiency ratio, urine volumes, liver weights, and kidney weights did not differ significantly between groups. The serum ALT and AST levels in the Cd-treated control group (Cd-Co) were higher than those in the NC animals. Serum ALT and AST levels in all Cd-treated rats fed TB-supplemented diets were lower than in animals of the Cd-Co group. Tibia and femur weights in Cd-Co animals were lower than those in NC rats. Tibia and femur weights in Cd-treated rats fed TB-supplemented diets were higher than those in Cd-Co animals. There were no between-group differences in tibia lengths; animals in the NC and TB-supplemented diet groups showed femur lengths longer than those of Cd-Co rats. Although the contents of crude ash and cadmium in the femurs of Cd-Co mts was markedly higher than in the femurs of NC animals, the cadmium content in femurs of Cd-Co rats was significantly lower than that in the femurs of NC animals. The changes in mineral levels caused by Cd administration were alleviated by every TB-supplemented diet tested Whereas fecal calcium excretion by Cd-Co animals was significantly higher than that of NC rats, calcium excretion by Cd-treated rats fed TB-supplemented diets was significantly lower than that of Cd-Co animals. Fecal cadmium excretion by all Cd-treated rats fed TB-supplemented diets was significantly higher than that of Cd-Co animals. In conclusion, this study provides experimental evidence that various TBs may regulate cadmium-induced organ toxicity by reducing cadmium accumulation in tissues through the mechanism of increasing the fecal excretion of cadmium.

• Journal of the Korean Wood Science and Technology
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• v.46 no.5
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• pp.597-609
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• 2018

Korea Forest Service has supplied 76 industrial wood pellet boilers from 2011 to 2015 through subsidy programs. Since carbon monoxide (CO) and nitrogen oxides ($NO_x$) generated during boiler combustion are substances that lead to death in the case of acute poisoning, it is very important to reduce emissions. Therefore, the CO and $NO_x$ emission values of 63 boilers excluding the hot air blower and some boilers initially supplied were analyzed. The emission factor was also calculated from the measured exhaust gas concentration (based on exhaust gas $O_2$ concentration of 12%). The average value of CO emitted from industrial wood pellet boilers was 49 ppm and it was confirmed that the CO concentration was decreasing as the years passed. The emission factor of CO was 0.73 g/kg. The average value of $NO_x$ emitted from industrial wood pellet boilers was 67 ppm and the emission factor of $NO_x$ was 1.63 g/kg. Unlike CO, there was no tendency to decrease according to the installation year. Both CO and $NO_x$ measurements met the limits of the Ministry of Environment. These $NO_x$ emission factors were compared with the $NO_x$ emission factors produced by certified low $NO_x$ burners. The $NO_x$ emission factor of industrial wood pellet boilers was about 1.9 times that of certified low $NO_x$ LNG combustors and about 0.92 times that of coal combustion.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.115-121
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• 2016

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.46-53
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• 2014

Purpose: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. Methods: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. Results: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), $PaCO_2$<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and $PaCO_2$<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). Conclusion: Overall, dizziness, time interval between onset of symptoms and ingestion, ${\Delta}DBP$ and $PaCO_2$<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and $PaCO_2$<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.

• Journal of Food Hygiene and Safety
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• v.38 no.6
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• pp.409-419
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• 2023

Okadaic acid (OA) group toxins, including OA and its analogs, such as dinophysis toxins (DTXs), have been reported to cause diarrheal shellfish poisoning (DSP). These toxins are primarily produced by dinoflagellates and are accumulated in bivalves. Recently, the presence of Dinophysis sp., a causative alga of DSP, has been reported along the coasts of Korea, posing a potential risk of contamination to domestic seafood and exerting an impact on both the production and consumption of marine products. Accordingly, the European Food Safety Authority (EFSA) and the World Health Organization (WHO) have established standards for the permissible levels of OA group toxins in marine products for safety management. Additionally, in line with international initiatives, the domestic inclusion and regulation of DTX2 among the substances falling under the purview of management outlined by the 2022 diarrheal shellfish toxin standard have been implemented. In this study, we reviewed the physicochemical properties of OA group toxins, their various exposure routes (such as acute toxicity, genotoxicity, reproductive and developmental toxicity), and the relative toxicity factors associated with these toxins. We also performed a comparative assessment of the methods employed for toxin analysis across different countries. Furthermore, we aimed to conduct a broad review of human exposure cases and assess the international guideline for risk management of OA group toxins.