• 제목/요약/키워드: Causality Assessment

검색결과 46건 처리시간 0.029초

Childhood Arsenic Exposure and Health Risk Assessment from Rice Cultivated Near the Mining Areas in Korea

  • Paik, Min-Kyoung;Kim, Won-Il;Im, Geon-Jae;Hong, Moo-Ki
    • 한국식품위생안전성학회지
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    • 제25권2호
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    • pp.148-152
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    • 2010
  • 우리나라 유아들이 비소에 노출된 경우의 인체위해성에 대한 상관관계 연구가 미비한 실정이다. 본 연구는 우리나라 광신인근 지역에서 생산된 백미의 섭취를 통한 비소의 노출을 유아기(1-6세)와 타 연령군으로 나누어 평가하고 해당 연령군의 인체위해성 평가를 확률적 접근법을 이용해 실시하였다. 우리나라 광산인근 지역에서 생산된 백미 섭취를 통한 D아기의 비소 노출량은 체중을 기준으로 했을 때 타 연령군에 비해 높게 나타났다. 피부암에 대한 초과발암위해의 경우 1-2세 군과 3-6세 군의 50% percentile값이 각각 만명 당 1.76명과 3.16명으로 나타났다. 어린이와 같은 아만성기간 동안의 비소 노출에 대한 비발암 기준 참고치(0.005 mg/lg/day)를 적용한 결과 비발암위해도의 평균값 뿐 아니라 고섭취군을 나타내는 95% percentile 값 또한 규제수치인 1.0 이하로 나타났다.

국내에서 보고된 한약 및 민간요법, 건강식품 관련 약인성간손상에 대한 체계적 고찰 (Hepatotoxic Events Associated with Herbal Medicinal Products, Folk Remedies and Food Supplements in Korea)

  • 박해모;장인수;이선동
    • 대한한의학회지
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    • 제26권2호
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    • pp.152-165
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    • 2005
  • Background: The use of herbal preparations as remedies for various medical conditions has continuously increased in Korea Large proportions of Korean patients use herbal medicinal products, folk remedies, and food supplements. However, studies on the safety of herbal products arc conducted on a less than sufficient basis even in the countries like Korea where herbal medicine is being used extensively. Some of the reports on the safety of herbs were done by the doctors of western medicine but lack of knowledge and misclassification led to misunderstandings. Objecitves: This study aims to review the recent evidences on hepatotoxic events associated with the use of herbal medicinal products, folk remedy, and food supplements. In the process, this review will grasp trends in this field of studies and will direct further researches into the right direction. Methods: Systematic literature searches were performed on MedRic and MEDLIS in Korea. Screening and selection of the articles and the extraction of data were performed independently by two of authors. There were no restrictions regarding the published date. In order to avoid bias, the articles written by medical doctors, not by oriental doctors were selected. 43 journals were chosen for the review. Results: Analyzing the number of journals, studies on the drug-induced liver injury were increased after the year 2000. The proportion of herbal and folk remedy associated hepatotoxic injuries in all drug-induced liver injury was $21.0\%-30.0\%$. But criterion for herbal medicine is rather vague and limited objective data hindered objectiveness. Few of single medicinal herbs and combination preparations were associated with hepatotoxic injuries. But because of lack of objectivity, further researches must be conducted to yield more concrete results. Conclusions: yield more concrete results. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risks.

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어린이 건강관련 유해물질 연구방향 (Chemical Risk Factors for Children's Health and Research Strategy)

  • 이효민;정기화
    • 한국식품위생안전성학회지
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    • 제23권3호
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    • pp.276-283
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    • 2008
  • 국내 외 선행연구결과에 의한 어린이 출생 전 후 건강에 영향을 미칠 수 있는 주요 유해물질은 inorganic arsenic, BPA, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalate, PFOA/PFOS, vinyl chloride 등으로서 국내에서도 이들을 포함한 확인 연구가 수행되어져야 할 것이다. 또한 어린이들의 행동발달과 연관된 생활환경에서의 다양한 인체노출이 확인됨에 따라 탁아소, 유치원과 같은 경우 어린이 활동공간을 대상으로 환경모니터링 및 위해관리활동도 병행되어야 할 것이다. 또한 어린이 건강에 영향을 미치는 유해물질을 중심으로 독성평가, 인체영향연구, 환경 및 인체모니터링과 위해평가를 수행하므로 유해물질의 원인-상관관계를 확인하고 사실자료에 근거한 관리정책을 반영하는 것이 바람직하다.

열다한소탕가대황(熱多寒少湯加大黃) 복용 후 간 손상 수치가 상승된 1례 (A Clinical Case of Liver Injury with Administration of Yeoldahanso-tang plus Rheum rhabarbarum)

  • 권은미;정의홍;김은희;서영광;이수경;김달래;김선형
    • 사상체질의학회지
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    • 제21권3호
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    • pp.209-215
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    • 2009
  • 1. Objects: This case study reports a liver injury in treatment of constipation with Yeoldahanso-tang plus Rheum rhabarbarum. 2. Methods: The patient's subjective symptoms and the laboratory data including aspartate transaminase(AST), alanine transaminase(ALT), alkaline phosphatase(ALP), and gamma($\gamma$)-glutamyl transpeptidase(GGT) were observed before and after liver injury. We used the Roussel Uclaf Causality Assessment Method(RUCAM) scale in order to find out whether if Yeoldahanso-tang plus Rheum rhabarbarum was related with the liver injury. 3. Results: The patient's AST and ALT were elevated more than twice after a 3week administration period of herbal medicine. After discontinuation of the herbal medicine and administration of hepatic protective medication, AST and ALT decreased. The patient's general condition improved during hospitalization. The RUCAM score was estimated at 8. 4. Conclusions: This case is presented to bring more attention to the toxicity of herbal medicine.

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청심연자탕 복용이 한방병원 입원환자의 간 기능에 미치는 영향 (Influence of Cheongsimyeonja-tang on the Liver Function of Inpatients at the Korean Medicine Hospital)

  • 한윤희;서희정;이인
    • 대한한방내과학회지
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    • 제40권6호
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    • pp.1035-1042
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    • 2019
  • Background: Herbal medication is widely used in the Korean Medicine Hospital, and drug-induced liver injury (DILI) in Korea has increased proportionally. Herb-induced liver injury now accounts for approximately 40% of cases of hepatotoxicity in Korea, according to research data. Currently, however, the component responsible for the toxicity is usually unknown or can only be suspected. Objective: To study the hepatotoxicity of Cheongsimyeonja-tang in DILI. Methods: A retrospective review was conducted of 82 inpatients between April 2010 and March 2017 with suspected drug-induced liver injury (n=5). The standard criteria (RUCAM scale) for drug-induced liver injury (DILI) were applied. The electronic medical records (EMRs) were retrospectively reviewed to identify the relevant database. Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (T. Bili) were analyzed in blood samples before and after the administration of Cheongsimyeonja-tang. Results: Five cases out of 82 patients had a criterion-referenced probable (RUCAM) score ranging from 6 to 8 points DILI. However, statistical analysis of the liver function parameters results of the 82 patients did not show a statistically meaningful elevation after taking Cheongsimyeonja-tang. Conclusions: These data suggest a relationship between Cheongsimyeonja-tang and DILI. More studies are needed to validate these observations and to explore their implications.

산삼약침 시술 후 발생한 것으로 의심되는 약인성 간손상 : 증례 보고 (Case of Suspected Drug-Induced Liver Injury after Intravenous Wild Ginseng Pharmacopuncture)

  • 조희근;정필선;김희영;배소연;조미진;신준혁;한세혁;나재일;설재욱;이상영
    • 동의생리병리학회지
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    • 제28권1호
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    • pp.102-106
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    • 2014
  • Wild ginseng pharmacopuncture is a partly used Traditional Korean Medicine's therapy with no previously well documented hepatotoxicity. We report the the first case of suspected drug-induced liver injury (DILI) after intravenous Wild ginseng Pharmacopuncture therapy. Our clinical observation based on patient's laboratory studies, medical history, detailed drug history and ruling out other possible causes. Our patient's suspected diagnosis was wild ginseng pharmacopuncture-induced liver injury with correlation between detailed drug history and laboratory studies. This diagnosis was supported by the Council for International Organizations of Medical Sciences-Roussel Uclaf Causality Assessment Method(RUCAM). This report represents the first documented cases of suspected DILI after intravenous wild ginseng pharmacopuncture therapy, highlighting the need for future research regarding potential hepatotoxicity of Wild ginseng Pharmacopuncture.

A survey on the impact of a pharmacovigilance practice training course for future doctors of Korean medicine on their knowledge, attitudes, and perception

  • Kim, Mikyung;Han, Chang-ho
    • 대한한의학회지
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    • 제42권4호
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    • pp.40-60
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    • 2021
  • Objectives: This study aimed to evaluate the impact of a training course on pharmacovigilance for future doctors of Korean medicine (DKM). Methods: In 2020, a pharmacovigilance training course was conducted for 57 senior students of a Korean medicine (KM) college, and its impact to the students were assessed in terms of the knowledge, attitudes, and perceptions of these students at three-time points: pre-training, post-training, and 4-6 months after the end of the training. Results: A total of 38 students completed the survey. The average score from the knowledge test increased significantly after training compared to prior to the training (5.47±2.140, 6.61±1.001, respectively, p<0.001) and was maintained until the final survey (6.61±1.220). The rate of correct answers to most of the knowledge test questions increased after the training but decreased in the final survey. In terms of attitudes, self-confidence in causality assessment (2.63±1.025, 4.58±0.826, p<0.001) and spontaneous reporting (2.08±1.050, 4.74±0.446, p<0.001) significantly increased after the training and then slightly decreased (3.92±1.171, 4.40±0.755). The perception level was high prior to the training, and this pattern was maintained throughout the study period. Students responded that pharmacovigilance education was necessary for DKM after training, and for the undergraduates of KM colleges. Conclusions: This study shows that this pharmacovigilance training course is effective for students majoring in KM but that retraining is required at least 6 months after the initial training. Further follow-up studies are needed to ensure that students actively participate in spontaneous reporting after graduation, and continuous education should be provided to graduates.

국민건강보험공단 청구자료를 활용한 파킨슨병과 관련된 코호트 연구 디자인 분석 및 향후 한의중재 관련 파킨슨 후향적 코호트 연구를 위한 제언 (Current Research Status of National Health Insurance Database Studies in Korea Related to Parkinson's Disease and Future Research Proposals for Integrative Therapies)

  • 황예채;임정태
    • 대한예방한의학회지
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    • 제28권1호
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    • pp.69-87
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    • 2024
  • Objectives : This study is to investigate the current National Health Insurance Database cohort studies related to complications of Parkinson's Disease (PD) and suggest the design of Korean medical epidemiological studies of PD. Methods : Nationwide longitudinal studies of PD patients in South Korea were collected through Pubmed and the Korea Citation Index (KCI). We selected cohort studies that used the National Health Insurance Database in Korea and targeted Parkinson's disease patients. Studies published before February 2024 were categorized according to study designs. We examined variables and covariates, enroll dates and matching methods. Results : Of a total of 536 studies, 18 studies met the inclusion criteria. All studies used the National Health Insurance (NHI) Research Database and among them, 5 used sample data and one senior database. Studies can be classified into two types. 11 cohort studies were comparing PD patients and non-PD patients. Another type was 4 PD patients cohort studies. Most studies used two diagnostic codes (G20 and V124) for inclusion criteria. Enroll periods were from 2002 to 2017, and follow-up periods were from 7 to 14 years. 16 studies considered age and sex as covariates. 15 studies used the propensity score matching method to increase the level of causality. There was only one study related to the Korean medical treatment. Conclusion : In future cohort studies on Korean medical treatment, more attempts should be made to reveal the effect of the treatments on PD patients by defining inclusion criteria for patient groups, covariates, exposure variables, and assessment indicators more operatively.

Identifying Characteristics of Incidents at Hazardous Material Facilities

  • Kim, Geun-Young;Kim, Sang-Won;Won, Jai-Mu
    • 한국방재학회 논문집
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    • 제9권6호
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    • pp.51-56
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    • 2009
  • 안전 및 품질 평가시스템은 유해물질 재난을 예방하기 위해 유해물질의 생산 저장 수송 취급에 매우 중요하다. 현재 유해물질은 플라스틱, 가정의 세척제, 비료 또는 석유관련제품으로 우리의 일상생활 어디에서든지 존재하고 있다. 그러나 유해물질은 인간이나 환경에 누출되었을 때 매우 위험한 물질이다. 유해물질은 석유기반 경제시대에 매우 폭넓게 사용되고 있다. 우리나라의 환경부는 전세계적으로 유해물질의 유형이 약 십만개가 넘을 것으로 추산하고 있다. 또한 매년 4백개 이상의 새로운 물질이 개발되고 있다. 따라서 유해물질 관리측면에서 우리는 유해물질 사고로부터 안전한가에 대해 의문이 제기될 수 있다. 1984년에 발생해 6,400명이 넘는 사망자와 3만명 이상의 부상자를 낸 인도 보팔사고는 이러한 우리의 유해물질 안전에 대한 불안을 증폭시키는 대표적인 사례이다. 우리나라는 최근 산업의 고도화로 각종 유해물질 사고가 빈번하게 발생하고 있다. 따라서 낙후된 유해물질 관리시스템을 자기관리가 가능한 안전시스템으로 전환하기 위한 위험평가시스템의 구축이 우리사회에 요구되고 있다. 본 연구는 유해물질 위험평가시스템 구축을 위한 기반을 제공하기 위해 지난 10년동안 유해물질 관련시설에서 발생한 사고사례들을 연구의 대상으로 하여 유해물질 시설사고의 특성을 빈도분석, 교차분석 등의 통계기법을 적용하여 분석하였다. 분석결과 사고시설 유형과 연도, 계절, 발생지역, 사망자 발생간 관계가 있는 것으로 나타났다.

지역사회 거주 노인 대상의 생활공간 이동성(Life-space mobility) 연구 동향 (Trends of Life-Space Mobility in Community-dwelling Elderly)

  • 정은화
    • 재활치료과학
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    • 제10권1호
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    • pp.19-35
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    • 2021
  • 목적 : 본 연구는 지역사회 거주 노인의 생활범위 이동성에 대한 연구를 체계적으로 고찰하여 연구 동향에 대해 분석하여 정리하고자 한다. 연구방법 : 2010년부터 1월부터 2020년 1월까지 PubMed, Embase의 데이터베이스를 이용하여 지역사회 거주 노인의 생활공간 이동성에 대한 논문을 검색하였으며, 1차 검색된 335편의 논문 중 선정기준 및 배제기준에 따라 27편의 논문을 최종 선택하여 분석하였다. 결과 : 총 27편의 선정된 연구 중 근거수준 II에 해당하는 코호트 연구가 11편(40.7%)으로 가장 많았다. 연구 대상자는 일반 노인이 가장 많았고(81.5%), 생활공간 이동성 평가도구는 University of Alabama Life-Space Assessment(UAB-LSA)의 사용이 가장 많았다(88.9%). 총 27편의 연구 중 신체적 영역의 연구는 8편(29.6%), 정신사회적 영역의 연구는 8편(29.6%), 인지적 영역의 연구는 6편(22.2%), 사회적 영역의 연구는 2편(7.4%), 기타 영역의 연구는 3편(11.1%)으로 나타났다. 노인의 생활공간 이동성은 신체적, 인지적, 정신사회적 또는 사회적 요인과 같은 단일 요인이 영향을 미치는 것이 아닌 다차원적인 관점에서 분석될 필요성이 있다. 결론 : 본 연구결과를 통해 향후 지역사회 거주하는 다양한 상태의 노인들의 생활공간 이동성의 연구를 통해 인과관계를 검증하고, 지역사회에서 작업치료적인 접근이 가능한 중재 프로그램의 개발을 통해 노인의 생활공간 이동성에 대한 연구가 확대될 것을 기대한다.