• 에너지공학
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• 제23권3호
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• pp.88-95
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• 2014

일반적으로 황분계 부취제는 연료가스에 인한 가스중독, 발화, 폭발 등의 사고를 방지하고, 배출가스에 의해 연료 가스 누출의 즉각적으로 손쉽게 검출할 수 있도록 LPG, LNG 그리고 도시가스와 같은 연료가스에 첨가 사용하고 있다. 본 연구에서는 새로운 비황분계 부취제(K-Petro S-Free)를 사용한 LPG 혼합연료의 엔진 성능과 배출가스(CO, THC, $CO_2$, $NO_x$, $SO_2$ ) 특성을 살펴보았다. 새로운 비황분계 부취제를 40mg/kg를 혼합한 LPG 연료(여름용, 겨울용)와 현재 사용 중인 황분계 부취제 (EM, ethyl mercaptan)를 혼합한 LPG 연료의 엔진 성능과 배출가스 특성을 실험하였다. 비황분계 부취제를 혼합한 LPG 연료의 엔진 성능은 황분계 부취제를 혼합한 LPG 연료와 비교할 때 비슷한 결과를 보여 주었다. 한편, 비황분계 부취제를 혼합한 LPG 연료의 엔진 배출가스 중 CO, THC, $CO_2$, $NO_x$은 황분계 부취제를 혼합한 LPG 연료와 비교할 때 비슷한 특성을 보였다. 그러나 2,000rpm에서 배출가스 중 $SO_2$은 비황분계 부취제를 혼합한 LPG 연료가 황분계 부취제를 혼합한 LPG 연료보다 83% 감소하는 우수한 결과를 보였다.

• 대한임상독성학회지
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• 제17권2호
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• pp.102-107
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• 2019

Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t_1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt_1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

• 대한임상독성학회지
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• 제21권2호
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• pp.117-127
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• 2023

Purpose: No consensus currently exists regarding the maximal pressure of hyperbaric oxygen (HBO₂) therapy performed within 24 hours of acute carbon monoxide (CO) poisoning. This study aimed to evaluate the difference in therapeutic effects according to the first HBO₂ pressure (3.0 atmospheres absolute [ATA] vs. 2.8 ATA). Methods: We used prospectively collected registry data on CO poisoning at a tertiary academic hospital in the Republic of Korea. Adult patients with acute CO poisoning treated with HBO₂ within 24 hours after arrival at the emergency department and without the use of additional HBO₂ after 24 hours between January 2007 and February 2022 were included. Data from 595 patients were analyzed using propensity score matching (PSM). Patients with mild (non-intubated) and severe (intubated) poisoning were also compared. Neurocognitive outcomes at 1 month after CO poisoning were evaluated using the Global Deterioration Scale combined with neurological impairment. Results: After PSM, the neurocognitive outcomes at 1-month post-CO exposure were not significantly different between the 2.8 ATA (110 patients) and 3.0 ATA (55 patients) groups (p=1.000). Similarly, there was also no significant difference in outcomes in a subgroup analysis according to poisoning severity in matched patients (165 patients) (mild [non-intubated]: p=0.053; severe [intubated]: p=1.000). Conclusion: Neurocognitive sequelae at 1 month were not significantly different between HBO₂ therapy pressures of 2.8 ATA and 3.0 ATA in patients with acute CO poisoning. In addition, the 1-month neurocognitive sequelae did not differ significantly between intubated and non-intubated patients.

• Journal of Hospice and Palliative Care
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• 제10권4호
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• pp.184-189
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• 2007

목적: 효과적인 통증관리의 장애요인은 크게 제도적 측면, 의료진 측면, 그리고 환자 측면으로 구분되며, 이는 모두 사회적 통념에 영향을 받는다. 따라서 본 연구는 일반인의 통증관리 장애요인을 규명하여 궁극적으로 우리 사회의 통증관리에 대한 이해를 향상시키기 위한 기초 자료를 마련하고자 시도되었다. 방법: 2007년 5월 15일부터 6월 15일까지 자원봉사자, 교사 및 지역사회 주민 163명을 대상으로 Gunnarsdottir, Donovan, Serlin, Voge와 Ward (2002)가 개발한 Barriers Questionnaire II (BQ-II)를 유양숙, 이원희, 조옥희와 이소우(2005)가 번한 보완한 통증관리 장애척도를 사용하여 자료를 수집하였다. 통증관리 장애척도의 Cronbach's $\alpha$는 .88이었다. 결과: 대상자의 평균연령은 53.36세이며, 92.6%가 통증교육을 받은 경험이 없었다. 대상자의 통증장애 정도는 평균 2.51점이었으며, 중독을 포함하는 해로운 영향 영역이 3.03점, 부작용을 포함하는 신체적 효과 영역 2.73점, 숙명론적 태도 영역 2.15점, 그리고 의사소통 영역 1.71점 순이었다. 문항별로는 '진통제를 사용하면 중독의 위험이 있다'의 장애정도가 가장 높았고, 다음은 '진통제를 사용하면 새로운 통증이 생겼을 때 알기가 어렵다', '진통제를 사용하면 몸이 익숙해져 곧 진통효과가 없을 것이다', '진통제로 인한 졸림은 조절하기 어렵다', '진통제는 면역력을 떨어뜨린다' 순이었다. 통증교육을 받은 경우의 통증관리 장애정도는 교육을 받지 않은 경우보다 유의하게 낮았다. 결론: 일반인들의 통증관리 장애요인은 환자나 가족과 유사하게 진통제 중독 및 내성에 대한 염려가 가장 높았으므로 사회적으로 확산되어 있는 통증관리 및 진통제 사용에 대한 올바른 이해를 높이기 위한 교육 및 홍보가 필요하다.

• 대한임상독성학회지
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• 제14권2호
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• pp.71-77
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• 2016

Purpose: No studies have been conducted to investigate the acute toxicity of aryloxyphenoxypropionate herbicides in humans following ingestion. Therefore, this study was conducted to investigate the clinical characteristics of aryloxyphenoxypropionate herbicide poisoning and provide guidance for physicians treating patients who have ingested these types of herbicides. Methods: A retrospective observational case series was conducted using ten patients with history of aryloxyphenoxy propionate herbicide. Data were collected for clinical manifestation, management and final outcome. Results: The most common symptoms were gastrointestinal irritation and an altered mental state (Glasgow Coma Scale<15). An elevated lactate level was a common laboratory abnormality, and prolonged QTc interval was commonly observed. These clinical features normalized within one day of supportive treatment. Conclusion: The acute toxicity of aryloxyphenoxypropionate herbicides in humans is manageable with supportive treatment. However, physicians should take into account depressed consciousness, the possibility of arrhythmia, and an elevated lactate level when planning their treatment strategy.

• Journal of Preventive Medicine and Public Health
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• 제7권2호
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• pp.359-366
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• 1974

The authors collected epidemiological and clinical informations on 1,307 CO patients from the questionairefilled by attendants of patients and from the clinical records kept in the hospital. All patients were treated by hyperbaric oxygenation at the Hyperbaric Chamber Unit of Seoul National University Hospital during 5 years, from January, 1969 to December, 1973. The following findings were obtained. 1. Female showed higher incidence rate than male. The highest incidence rate was observed in the age group of 15-29 years in both sex. 2. The most important variable influencing the recovery of the patients was the starting time of treatment. It was evident that earlier the starting time, shorter the recovery time. 3. Duration of admission was within 5 days in 57.1 percent of the admitted cases and 76.1 percent of them was discharged within 8 days. 4. As the complications, pulmonary edema, bronchopneumonia and trophic changes were observed. Also the neurological disorders were found. 5. The fatality rate followed by the hyperbaric oxygenation was 1.07 percent.

• 대한임상독성학회지
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• 제18권1호
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• pp.42-46
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• 2020

Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5℃, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO₂ 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO₃^- 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.

• 한국환경보건학회지
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• 제38권6호
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• pp.451-459
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• 2012

Background: In Korea, a healthy 36-year-old man developed acute interstitial pneumonitis soon after inhaling a waterproofing spray which he had applied at home to his outdoor jacket. Objectives: The objectives of this study were to review cases of varying degrees of respiratory toxicity and poisoning in connection with the use of waterproofing spray and summarize major reasons for cases of poisoning. Methods: We searched articles reporting on a combination of a waterproofing agent and/or respiratory symptoms, including acute respiratory syndrome, lung injury, pneumonia, pulmonary toxicity, and respiratory disease. Results: We reviewed a number of cases of varying degrees of respiratory toxicity and poisoning resulting from inhalation of waterproofing spray containing fluorocarbon co-polymer, solvents and propellants reported in a variety of countries. The literature searches concluded that among the ingredients of waterproofing agents, fluorinated polymer may cause acute respiratory health effects. Conclusion: Environmental policy should be implemented in order to prevent consumers from using household and industrial products including waterproofing agents. In addition, a national surveillance system should be created to collect cases of poisoning caused by the use of consumer products.

• 한국임상약학회지
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• 제31권3호
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• pp.216-230
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• 2021

Objective: Taking action on health inequalities starts with the production of information laying out the problems of inequalities, but Korean society has no national database to view related data at a glance. This study aimed to compare Korean national database with the Public Health Profile (PHP), a health inequality database of the UK. Methods: Data were collected from the websites of government and relevant organizations in the both countries between March and August 2020, which was updated in August 2021. Two themes including Co-occurring substance misuse and mental health issues in mental health and INteractive Health Atlas of Lung conditions in England were selected for comparison in terms of data accessibility, data usability and data visualization. Results: The British PHP is being served on a web-based platform, Fingertips. The data collected at the regional level were presented on 31 health inequality themes. The data are displayed at a level that can be compared between comparable communities, and visualized into various tables and figures. Comparable Korean data were scattered in several themes and websites, and mostly provided as a 17 administrative region base, which was too vast to make a meaningful comparisons. Conclusion: The findings proposed several considerations which could be useful for establishing a database of health inequality in the Korean society.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.5-24
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• 1984

There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.