• 대한임상독성학회지
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• 제14권2호
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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.

• 대한임상독성학회지
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• 제10권1호
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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.

• 대한임상독성학회지
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• 제14권1호
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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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• 제58권1호
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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.

• 한국산업정보학회:학술대회논문집
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• 한국산업정보학회 2002년도 춘계학술대회 논문집
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• pp.356-360
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• 2002

산업의 발달과 더불어 CO, $H_2$S, S $O_2$등에 의한 대기오염이 심각해져 가스중독의 위험성이 고조되었을 뿐만 아니라, 생활수준의 향상으로 부탄(C$_4$ $H_{10}$)이나 프로판(C$_3$ $H_{8}$) 등의 폭발성 탄화수소계 가스들의 수요가 급증하는 가운데 가스폭발의 위험성이 대두되고 있다. 이에 대한 방비책으로 고감도 가스센서의 개발 뿐만 아니라 가스센서를 응용한 가스검출 및 가스식별 시스템의 개발이 시급한 실정이다. 본 연구에서는 반도체식 가스센서의 선택도에 대한 문제점을 개선하는 동시에 단일 센서신호의 드리프트에 대한 영향을 최소화하기 위해 반도체식 가스센서 어레이를 구성하고, 이로부터 검지된 가스별 입력 패턴데이터를 신경 회로망(neural network)에 적용함으로써 가스의 종류를 선택적으로 인식할 수 있는 가스인식 시스템을 개발하고자 한다.다.

• 한국식품저장유통학회지
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• 제15권1호
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• pp.161-168
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• 2008

말차, 오룡차, 홍차 및 보이차로 제조한 음료가 Cd에 중독된 SD계 흰쥐의 해독에 미치는 영향을 조사하였다. 관능검사 결과 일반 물 추출물에 비하여 색상, 향, 맛에 대한 기호도가 현저하게 향상되었으며, 종합적 기호도는 오룡차 음료가 4.18점, 홍차음료가 4.14점으로 말차음료나 보이차 음료의 $3.74{\sim}3.88$점에 비하여 높았다. SD계 흰쥐를 정상군 (NC), Cd 대조군(Cd-Co), Cd투여 말차음료 15% 급여군 (Cd-Gt), Cd투여 오룡차음료 15% 급여군(Cd-Ot), Cd투여 홍차음료 15% 급여군(Cd-Bt) 및 Cd투여 보이차음료 15% 급여군 식이군(Cd-R)의 6군으로 구분하여 5주간 사육하였다. 차 음료 식이군의 체중증가량은 NC군에 미치지는 못하였으나 Cd에 의하여 감소된 현상을 상당히 개선하였다. 식이효율, 뇨량 및 분변량은 각 실험군간의 유의적인 차이가 없었다. Cd의 투여는 간과 신장의 중량, 경골의 중량 및 대퇴골의 길이를 감소시켰으나 차 음료의 섭취로 다소 개선되었다. 혈청 AST 및 ALT 활성은 모두 Cd 투여군에서 현저하게 증가하는 경향을 보였으나 차 음료 급여군에서는 5%수준에서 유의적으로 감소되었다. 대퇴골의 조회분 함량은 Cd-Co군에서 40.72%, Cd 투여-차 음료 급여군에서는 $35.31{\sim}37.02%$로 차음료의 급여에 의하여 5%수준에서 유의적으로 감소하였다. 대퇴골의 조회분 함량은Cd-Co군에서 40.72%, Cd 투여-차 음료 급여군에서는 $35.3{\sim}37.02%$로 차음료의 급여에 의하여 유의적으로 감소하였다 대퇴골의 Cd함량은 NC군에서는 0.08 ppm이었으나 Cd-Co군은 123.28 ppm, 실험식이군에서는 $23.07{\sim}28.82 ppm$으로 차음료의 급여로 현저하게 감소하였으며, Ca 함량은 NC군에서 6700 ppm, Cd-Co군에서 3760 ppm, 실험식이군에서는 $4040{\sim}5420 ppm$이었다. 분변의 회분함량은 Cd-Bt군이 14.80%로 높았으나 기타 음료군은 Cd-Co군과의 유의적인 차이를 보이지 않았다. 분변의 Cd 함량은 NC군 0.02 ppm, Cd-Co군 2.06ppm, 실험식이군 $4.38{\sim}5.35ppm$로 차 음료 급여군에서 높았으며, 이와 대조적으로 Ca함량은 차음료 급여군에서 낮았다. 이상의 실험결과, 말차, 오룡차, 홍차 및 보이차로 제조한 음료는 상호간의 뚜렷한 차이는 없으나 모두 섭취한 Cd를 체외로 배설시킴으로서 Cd에 의한 장기 손상을 경감시켜 줄 수 있을 것으로 생각된다.

• Journal of the Korean Wood Science and Technology
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• 제46권5호
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• pp.597-609
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• 2018

산림청은 보조금 지원사업을 통해 2011년부터 2015년까지 76대의 산업용 목재펠릿보일러를 보급하였다. 보일러의 연소 시 발생하는 일산화탄소(CO) 및 질소산화물($NO_x$)는 각각 급성 중독 시 사망에까지 이르게 하는 물질이기 때문에 배출량을 줄이는 것이 매우 중요하다. 따라서 이들 보일러 중 열풍기와 초기에 보급된 일부 보일러를 제외한 63대의 보일러에서 배출된 CO 및 $NO_x$ 계측값을 분석하였다. 또한 측정된 배출가스 농도(배기가스 $O_2$ 농도 12% 기준)로부터 배출계수를 산출하였다. 산업용 목재펠릿보일러에서 배출된 CO의 평균값은 49 ppm이었으며, 해를 거듭함에 따라 CO의 농도가 줄어들고 있음이 확인되었다. 이때 CO의 배출계수는 0.73 g/kg였다. 산업용 목재펠릿보일러에서 배출된 $NO_x$의 평균값은 67 ppm였으며, $NO_x$의 배출계수는 1.63 g/kg이었다. CO와는 달리 설치년도에 따라 감소하는 경향은 나타나지 않았다. CO 및 $NO_x$ 계측값은 모두 환경부의 허용기준을 만족하였다. 이러한 $NO_x$ 배출계수를 저$NO_x$ 인증된 연소기에서 생성되는 $NO_x$ 배출계수와 비교하였다. 산업용 목재펠릿보일러의 $NO_x$ 배출계수는 저$NO_x$ 인증된 LNG 연소기의 $NO_x$ 배출계수에 비해 약 1.9배, 석탄 연소에 비해 약 0.92배였다.

• 대한임상독성학회지
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• 제14권2호
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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.

• 대한임상독성학회지
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• 제12권2호
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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.

• 한국식품위생안전성학회지
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• 제38권6호
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• pp.409-419
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• 2023

Okadaic acid (OA) 군 독소는 설사성 패류중독(diarrhetic shellfish poison, DSP)을 유발하는 해양생물독소이다. 설사성패독은 오카다익산(OA)과 그 유사체인 디노피시스톡신(DTX)으로 구성되어 있으며, 주로 와편모조류에서 생성되어 이매패류의 체내에 축적되어 독화된다. 이에 EFSA, WHO에서는 안전관리를 위하여 수산물 내 OA군 독소 함량 기준을 설정하였다. 최근 우리나라 연안에서도 원인조류인 Dinophysis sp.의 출현이 보고된 바 있으며, 국내 수산물 생산과 소비에도 영향을 미치고 있다. 또한 국제적인 움직임에 발맞추어 국내에서도 2022년 설사성 패독 기준 관리 대상 물질에 DTX2를 추가하여 관리하고 있다. 본 연구는 OA군 독소의 이화학적 특성, 분석법, 인체 노출 사례와 국내외 관리 현황 등의 자료를 검토하여 OA군 독소의 체계적인 모니터링과 안전관리의 기반을 마련하고자 수행되었다.