• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.28-31
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• 2019

Glyphosate herbicides, which are widely used worldwide, are known to have low toxicity. However, excessive intake may cause serious life-threatening complications; therefore, caution is needed when using them. A 51-year-old man visited the hospital after ingesting glyphosate herbicide. At the time of admission, his vital signs were 80/60 mmHg-115/min-20/min-$37.3^{\circ}C$. Electrocardiogram (ECG) showed QRS widening and corrected QT (QTc) prolongation, and blood tests showed metabolic acidosis. Treatment with gastric lavage, activated charcoal, sodium bicarbonate and intravenous lipid emulsion therapy was performed. After 2 hours, his blood pressure increased to 130/90 mg, and no QRS widening was observed on ECG.

• Biomedical Science Letters
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• v.21 no.3
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• pp.135-143
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• 2015

Electrocardiogram measures the electric impulses generated by the heart during its cycle. Recently genome-wide association studies on electrocardiogram traits revealed many relevant genetic loci. Therefore, these findings need to be validated and investigated to determine the underlying mechanisms using mouse models. Invasive radiotelemetry has been widely used to record the electrocardiogram in mice because it has several advantages over non-invasive measurements. However, radiotelemetry is expensive and requires complicated surgery. On the other hand, a non-invasive method using 3 electrodes (one for earth) for lead II is easy to establish and allows for rapid measurement. In this study, eleven mice were measured with this non-invasive method and no statistical difference among them was found in any ECG measurements. In addition, repeat measurement in the same mouse was performed in 9 sets of experiment and the results indicated that non-invasive method was reliable for reproducibility. Further it was shown that measurements for 1, 5, 10, and 15 minutes were not different so that a short recording such as 5 minutes was enough to estimate the ECG values including heart rate. Further this method was validated by measuring the ECG of Balb/c and FVB that were previously shown to differ in ECG values by radiotelemetry. Significant differences were found in heart rate, PR interval and corrected QT interval between these mouse strains. This study partially proved that non-invasive method also could provide the accuracy and reproducibility. Based on these results, the non-invasive ECG recordings of lead II is recommended as a useful method for quick test in mouse model.

• Journal of the Korean Geosynthetics Society
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• v.16 no.1
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• pp.73-83
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• 2017

Laboratory and in-situ tests were conducted to evaluate the cone factors for the layers with low plasticity containing a lot of silty and sand soils from the west coast (Incheon, Hwaseong and Gunsan areas) and its applicability was evaluated based on these results. The cone factors were evaluated from 19 to 23 based on unconfined compression strengths (qu), from 13 to 13.8 based on simple CU strengths and from 11.6 to 13.1 based on field vane strengths, respectively. The unconfined compression strengths of undisturbed silty soil samples with low plasticity were considerably underestimated due to the change of in-situ residual effective stress during sampling. Half of unconfined compression strength (qu/2) based cone factors of silty soils with low plasticity fluctuated and were approximately 1.8 times higher than simple CU based values of these soils. When evaluating cone factors of these soils, it should be judged overall on the physical properties such as the grain size distribution and soil plasticity and on the fluctuation of the corrected cone resistance and the sleeve friction due to the distribution of sandseam in the ground including pore pressure parameter.

• The Korean Journal of Physiology and Pharmacology
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• v.23 no.3
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• pp.203-217
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• 2019

The present study was designed to examine the effect of heme oxygenase-1 (HO-1) induction by cobalt protoporphyrin (CoPP) on the cardiac functions and morphology, electrocardiogram (ECG) changes, myocardial antioxidants (superoxide dismutase [SOD] and glutathione [GSH]), and expression of heat shock protein (Hsp) 70 and connexin 43 (Cx-43) in myocardial muscles in isoproterenol (ISO) induced myocardial infarction (MI). Thirty two adult male Sprague Dawely rats were divided into 4 groups (each 8 rats): normal control (NC) group, ISO group: received ISO at dose of 150 mg/kg body weight intraperitoneally (i.p.) for 2 successive days; ISO + Trizma group: received (ISO) and Trizma (solvent of CoPP) at dose of 5 mg/kg i.p. injection 2 days before injection of ISO, with ISO at day 0 and at day 2 after ISO injections; and ISO + CoPP group: received ISO and CoPP at a dose of 5 mg/kg dissolved in Trizma i.p. injection as Trizma. We found that, administration of ISO caused significant increase in heart rate, corrected QT interval, ST segment, cardiac enzymes (lactate dehydrogenase, creatine kinase-muscle/brain), cardiac HO-1, Hsp70 with significant attenuation in myocardial GSH, SOD, and Cx-43. On the other hand, administration of CoPP caused significant improvement in ECG parameters, cardiac enzymes, cardiac morphology; antioxidants induced by ISO with significant increase in HO-1, Cx-43, and Hsp70 expression in myocardium. In conclusions, we concluded that induction of HO-1 by CoPP ameliorates ISO-induced myocardial injury, which might be due to up-regulation of Hsp70 and gap junction protein (Cx-43).

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.130-135
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• 2020

Purpose: Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. Methods: This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. Results: Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. Conclusion: The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.34.1-34.8
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• 2023

Background: Hydrogen sulfide is a toxic substance that humans can be exposed to occupationally, and cases of hydrogen sulfide poisoning of workers in industrial sites are commonly reported. However, there have been no cases of poisoning of the public due to an unauthorized discharge of wastewater, so it is important to describe this incident. Case presentation: In a small village in Jeollanam-do, Republic of Korea, accounts of a terrible stench had been reported. A 26-year-old man who lived and worked in a foul-smelling area was taken to the emergency room with a headache, dizziness, nausea, and repeated syncope. A subsequent police and Ministry of Environment investigation determined that the cause of the stench was the unauthorized discharge of 9 tons of wastewater containing hydrogen sulfide through a stormwater pipe while the villagers were sleeping. The patient had no previous medical history or experience of symptoms. Leukocytes and cardiac markers were elevated, an electrocardiogram indicated biatrial enlargement, left ventricular hypertrophy, and corrected QT interval prolongation. Myocardial hypertrophy was detected on a chest computed tomography scan, and hypertrophic cardiomyopathy was confirmed on echocardiography. After hospitalization, cardiac marker concentrations declined, symptoms improved, and the patient was discharged after 7 days of hospitalization. There was no recurrence of symptoms after discharge. Conclusions: We suspect that previously unrecognized heart disease manifested or was aggravated in this patient due to exposure to hydrogen sulfide. Attention should be paid to the possibility of unauthorized discharge of hydrogen sulfide, etc., in occasional local incidents and damage to public health. In the event of such an accident, it is necessary to have government guidelines in place to investigate health impact and follow-up clinical management of exposed residents.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.456-458
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• 2013

The aim of this study is to evaluate the reference value for electrocardiogram in healthy captive raccoon dogs. Forty-one free-ranging adult raccoon dogs rescued from Wildlife rescue centre, Kangwon National University were enrolled in this study. The 6-lead electrocardiogram was obtained in all raccoon dogs without any chemical restraints. The mean heart rate was $146.10{\pm}43.31$ beats/min (95% confidence interval 132.84~159.36 beats/min). The mean respiration rate was $35.73{\pm}11.56$ breaths/min (95% confidence interval 32.19~39.27 breaths/min). The mean systolic blood pressure was $136{\pm}29.26$ mmHg (95% confidence interval 127.99~145.91 mmHg). Electrocardiographical features were also evaluated in all raccoon dogs. The mean duration and amplitude of P-wave were $38.2{\pm}4.0$ ms (range 28-40 ms) and $0.128{\pm}0.039$ mV (range 0.09~0.20). The mean duration and amplitude of QRS complexes were $48.5{\pm}7.2ms$ (range 36-60 ms) and $1.330{\pm}0.650$ mV (range 0.15~2.30). The range of the mean electrical (QRS) axis was $-91^{\circ}{\sim}+96^{\circ}$ ($10^{\circ}{\sim}60^{\circ}$; 95% of confidence interval). The mean corrected QT (QTc) interval was $273.7{\pm}32.7ms$ (range 212-333 ms), while the mean PR interval was $76.1{\pm}10.0ms$ (range 50-82 ms). To the authors' knowledge, this is the first study to provide references in electrocardiogram (ECG) in healthy captive raccoon dogs.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1232-1235
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• 2008

Imipramine, a tricyclic antidepressant (TCA), is used for the treatment of non-polar depression and nocturnal enuresis in children in whom an organic pathology has been excluded, anxiety disorders, and neuropathic pain. Clinical toxicity following the treatment of TCAs, including imipramine, is well known. The anticholinergic effects initially present include a dry mouth, ileus, dilated pupils, urinary retention, and mild sinus tachycardia. The central nervous system toxicity includes delirium, agitation, restlessness, hallucinations, convulsions, and CNS depression or coma. However, the most life-threatening toxicity remains the development of cardiac dysrhythmias. Conduction delays such as QRS and corrected QT prolongation, wide QRS complex tachycardia, and the Brugada electrocardiographic pattern have been reported. Sodium bicarbonate decreases QRS widening and suppresses dysrhythmias by providing excess sodium to reverse the TCA-induced sodium-channel blockade and possibly by binding directly to the myocardium. There are no pediatric case reports on imipramine or other TCA associated toxicity in Korea. Here, we describe a patient who presented with convulsions, tachycardia with a wide QRS complex, a Brugada electrocardiographic pattern, and anuresis associated with an accidental overdose of imipramine and the outcome of treatment with sodium bicarbonate.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.83-92
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• 2021

Purpose: Glyphosate herbicide (GH) is a widely used herbicide and has been associated with significant mortality as poisoned cases increases. One of the reasons for high toxicity is thought to be toxic effect of its ingredient with glyphosate. This study was designed to determine differences in the clinical course with the salt-type contained in GH. Methods: This was a retrospective study conducted at a single hospital between January 2013 and December 2017. We enrolled GH-poisoned patients visited the emergency department. According to salt-type, patients were divided into 4 groups: isopropylamine (IPA), ammonium (Am), potassium (Po), and mixed salts (Mi) groups. The demographics, laboratory variables, complications, and their mortality were analyzed to determine clinical differences associated with each salt-type. Addtionally, we subdivided patients into survivor and non-survivor groups for investigating predictive factors for the mortality. Results: Total of 348 GH-poisoned patients were divided as follows: IPA 248, Am 41, Po 10, and Mi 49 patients. There was no difference in demographic or underlying disease history, but systolic blood pressure (SBP) was low in Po group. The ratio of intentional ingestion was higher in Po and Mi groups. Metabolic acidosis and relatively high lactate level were presented in Po group. As the primary outcome, the mortality rates were as follows: IPA, 26 (10.5%); Am, 2 (4.9%); Po, 1 (10%); and Mi, 1 (2%). There was no statistically significant difference in the mortality and the incidence of complications. Additionally, age, low SBP, low pH, corrected QT (QTc) prolongation, and respiratory failure requiring mechanical ventilation were analyzed as independent predictors for mortality in a regression analysis. Conclusion: There was no statistical difference in their complications and the mortality across the GH-salt groups in this study.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.404-415
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• 1998

Background: Sleep apnea syndrome, which occurs in 1~4 % of the adult population, frequently has different cardiovascular complications such as hypertension, ischemic heart disease, cardiac arrythmia as well as sleep-wake disorder such as excessive daytime hypersomnolence or insomnia. Mortality and vascular morbidity are reported to be significantly higher in sleep apnea syndrome patients than in normal population. According to the recent studies, autonomic dysfunction as well as hypoxemia, hypercapneic acidosis, and increased respiratory effort, may playa role in the high prevalence of cardiovascular complications in patients with sleep apnea syndrome. However the cause and mechanism of autonomic neuropathy in patients with sleep apnea syndrome are not well understood. We studied the existence of autonomic neuropathy in patients with sleep apnea syndrome and factors which influence the pathogenesis of autonomic neuropathy. Method: We used the cardiovascular autonomic neuropathy(CAN) test as a method for evaluation of autonomic neuropathy. The subjects of this study were 20 patients who diagnosed sleep apnea syndrome by polysomnography and 15 persons who were normal by polysomnography. Results: Body mass index and resting systolic blood pressure were higher in sleep apnea group than control group. Apnea index(Al), respiratory disturbance index(RDI) and snoring time percentage were significantly higher in sleep apnea group compared with control group. But there were no significant differences in saturation of oxygen and sleep efficiency in two groups. In the cardiac autonomic neuropathy test, the valsalva ratio was significantly low in sleep apnea group compared with control group but other tests had no differences between two groups. The CAN scores and corrected QT(QTc) interval were calculated significantly higher in sleep apnea group, but there were no significant correlations between CAN scores and QTc interval. There were no significant data of polysomnography to correlate to the CAN score. It meant that the autonomic neuropathy in patients with sleep apnea was affected by other multiple factors. Conclusion: The cardiovascular autonomic neuropathy test was a useful method for the evaluation of autonomic neuropathy in patients with sleep apnea syndrome and abnormalities of cardiovascular autonomic neuropathy were observed in patients with sleep apnea syndrome. However, we failed to define the factors that influence the pathogenesis of autonomic neuropathy of sleep apnea syndrome. This study warrants futher investigations in order to define the pathogenesis of autonomic neuropathy in patients with sleep apnea syndrome.