• Journal of Preventive Medicine and Public Health
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• 제5권1호
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• pp.9-15
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• 1972

Carbon monoxide poisoning is one of the most serious health problems in Korea, because we have been encountered with the highest incidence of CO poisoning in the world due to the unique heating system in home called 'ondal'. We opened Hyperbaric chamber unit in the Seoul National University Hospital last Jan, 1969. We have treated 848 patients as of Sept. 30., 1972, around 44 months period. We collected the informations on the environmental conditions of the place where CO intoxication actually occured by filling up the questionaire from 505 patients. The following findings were obtained. 1. Age distribution showed that the highest incidence was found in the younger age group between age of 10 to age of 29 in both sex. 2. Sex ratio of the patients was 1:1.14. 3. The socio-economic level of the patient was relatively low. 4. Housewife & housemaid were the major victims of the intoxication in the female patients & in the case of the male patient, occupational backgrounds were diverse. 5. Many patients from the middle class experienced the intoxication by sleeping at newly built room. 6. Many intoxication has been occured in the structure of houses where communicating doors are existing between living room & kitchen. 7. All findings obtained taught us again that CO poisoning is the serious by-product of the national fuel policy which put emphasis on the use of coal & socio-economic status is a very important parameter in this hazards.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.568-570
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• 2017

• 대한임상독성학회지
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• 제2권2호
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• pp.147-150
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• 2004

Hydrogen sulfide is a colorless, and malodorous 'rotten eggs' gas that results from the decay of organic material. It is a byproduct of industry and agriculture. The mechanism of its toxicity is primarily related to inhibition of oxidative phosphorylation, which causes a decrease in available cellular energy. Because there is no rapid method of detection that is of clinical diagnostic use, management decisions must be made based on history, clinical presentation, and diagnostic tests that imply hydrogen sulfide's presence. Although there is some anecdotal evidence to suggest that the early use of hyperbaric oxygen is beneficial, supportive care remains the mainstay of therapy. We describe an occupational exposure to hydrogen sulfide gas in 51-year-old man. While cleaning the sewage of pigs. he became unconscious. When he arrived in the emergency department, he had irritability and confused mentality. The typical smell of rotten eggs on clothing and exhaled air were enough to be considered to be exposed to hydrogen sulfide. Hyperbaric oxygen therapy was performed. He had a recovery to normal function.

• Journal of Preventive Medicine and Public Health
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• 제27권1호
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• pp.84-106
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• 1994

Hyperbaric oxygen (HBO) therapy for carbon monoxide (CO) poisoning eventually inducing the hypoxia-reoxygenation condition, may produce oxygen free radicals, which forms 8-hydroxydeoxyguanosine (8-OH-dG) by attacking C-8 position of deoxyguanosine (dG) in DNA. Effects of oxygen partial pressure or duration of HBO therapy with or without CO poisoning on the tissue 8-OH-dG formation were investigated. Male Sprague-Dawley rats were grouped and exposed to air (control group), 4000 ppm of CO for 10 to 30 minutes (CO only group), air for 30 minutes after 30 minute exposure to 4000 ppm of CO(CO-air exposure group), HBO after 30 minute exposure to 4000 ppm of CO(CO-HBO group), or HBO therapy fo. $10{\sim}120$ minutes(HBO only group). The 8-OH-4G concentrations in the brain and the lung tissues were measured with high performance liquid chromatography and electrochemical detector (ECD). Average concentrations of the 8-OH-dG of each group were statistically compared. In the brain tissues, 8-OH-dG concentrations of the CO only group, the CO-air exposure group, and the CO-HBO group did not significantly differ from those of the control group. Similar insignificance was also found between the CO-HBO group and the HBO only groups. No appreciable dose-response relationship was observed between the 8-OH-dG concentration and the oxygen partial pressure or the duration of HBO. However, the 8-OH-dG concentrations of the 30 minute CO only group were higher than those of the CO-air exposure group (p-value<0.05). In the lung tissues, there were no significant differences between the 8-OH-dG concentrations of the control group and those of the CO only group, the CO-air exposure group, and the CO-HBO group. However, mean 8-OH-dG concentration of the CO-air exposure group was significantly higher than that of the CO only group under the same CO exposure condition(p-value<0.05). With the duration of CO exposure, the 8-OH-dG concentrations of the lung tissues decreased significantly (p-value<0.05). The concentrations of 8-OH-dG in the lung tissues proportionally increased with the duration of HBO, but no such relation was observed with the oxygen partial pressure. These results suggest that the brain may be more resistant to oxygen free radicals as compared with the lungs, and that oxygen toxicity following HBO may be affected by factors other than oxygen free radicals.

• Journal of Periodontal and Implant Science
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• 제49권1호
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• pp.2-13
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• 2019

Purpose: The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy. Methods: Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses. Results: New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2. Conclusions: HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.

• 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.

• 한국재난정보학회:학술대회논문집
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• 한국재난정보학회 2023년 정기학술대회 논문집
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• pp.353-354
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• 2023

과거와 달리 유독가스가 생성되는 화재, 폭발, 화학사고 및 급격한 기압차를 경험하게 되는 선박 침몰 구조 등 다양한 재난 혹은 사고 상황에서 고압산소치료가 욕구되며, 이를 수행할 수 있는 고압산소치료챔버는 재난에 대응하는 핵심 자원으로 그 수량과 배치가 적절해야 한다. 따라서 다양한 종류의 재난에서 발생하는 유독가스 피해자에게 고압산소치료는 필수적이나 본 연구에 의하면 국내에는 고압산소치료챔버의 숫자와 동시에 고압산소치료로 수용할 수 있는 환자수에도 한계가 있고 그 분포의 불균형도 존재하고 있어 재난 시 인명 피해 감소의 기반 장비, 시설로서 고압산소챔버의 균형있는 확산, 적용이 시급한 실정이며, 이는 가칭 재난고압산소지수로 객관화할 수 있다. 국내에서는 인구밀집지역인 수도권이 고압산소치료가 필요한 재난에 대한 대응 기반이 부족하다가 향상되고 있으며 부산, 경남 권역에 고압산소치료 자원이 편중된 현상을 보이고 있다. 고압산소치료 필요한 대량의 중환자 발생 시는 국내 전체의 고압산소치료기 활용 여부에 대한 실시간 모니터링 시스템이 필요하고 필요 시 원거리 피해자 전원 시스템을 갖추어야 하므로 이는 향후 구축해야 할 사항으로 이를 위한 전국적 고압산소치료기 모니터링 시스템이 필요하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.448-453
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• 1996

This is case report of florid osseous dysplasia occurred in the entire maxilla and mandible of 47-year-old female. Florid osseous dysplasia is an expansile, exuberant asymptomatic form of benign fibro-osseous disease of the periodontal ligament, often associated with jaw cysts and to be though as an abnormal reaction of bone to irritation or stimulation. The treatment was performed with removal of the necrotic bone, bone curretage and hyperbaric oxygen therapy. The patient did not well postoperatively and has shown sign of persistant infection with pus discharge.

• Toxicological Research
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• 제6권2호
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• pp.143-157
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• 1990

Effective measure to prevent oxygen toxicity is greatly required as there increase chances to be exposed to high oxygen pressure, for example, space travel, deep sea diving and hyperbaric oxygen therapy. In the present study, in an attempt to evaluate glutathione and chlorpromazine as protective agents against oxygen toxicity, effects of the agents were tested on various toxicities (death rate, convulsion rate, time to convulsion, increase in weight of lung and brain and pathological changes in the organs) observed in rats exposed to 5 Absolute Atmosphere (ATA) of 100% oxygen for 120 minute. Glutathione reduced mortality rate and convulsion rate and also markedly suppressed the increase in lung and brain weight. The pathological changes observed in these organs were ameliorated by administration of glutathione. Chlorpromazine also reduced mortality rate but its effects appeared to be limited mainly to pulmonary toxicities. Thus glutathione seems to be more effective than chlorpromazine as a protective agent. The results obtained may support that oxygen toxicity is mediated by oxygen free radicals.

• 대한임상독성학회지
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• 제18권1호
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• pp.34-41
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• 2020

Purpose: This study evaluated aggressive hyperbaric oxygen therapy (HBOT) by understanding various exposure routes of acute carbon monoxide (CO) poisoning, the risk factors causing acute cardiovascular, and neurological toxicity caused by poisoning. Methods: A retrospective study was conducted based on the medical records of 417 acute CO poisoning patients who visited the emergency care unit from March 2017 to August 2019. The exposure routes, HBOT performance, age, sex, medical history (hypertension, diabetes mellitus, ischemic heart disease, heart failure), intentionality, loss of consciousness (LOC), intake with alcohol or sedatives, and initial test results (carboxyhemoglobin (COHb), troponin-I, electrocardiography, echocardiography, brain MRI) were examined. Comparative analysis of the clinical information was conducted between the groups that showed acute cardiovascular toxicity and neurological toxicity, and groups that did not. Results: Among 417 patients diagnosed with acute CO poisoning, 201 cases (48.2%) were intentional, and charcoal briquette was the most common route (169 patients (40.5%)). Two hundred sixteen cases (51.8%) were accidental, and fire was the most common route (135 patients (32.4%)). The exposure route was more diverse with accidental poisoning. Three hundred ninety-nine patients were studied for acute cardiovascular toxicity, and 62 patients (15.5%) were confirmed to be positive. The result was statistically significant in intentionality, LOC, combined sedatives, initial COHb, HTN, and IHD. One hundred two patients were studied for acute neurological toxicity, which was observed in 26 patients (25.5%). The result was statistically significant in age and LOC. Conclusion: Active HBOT should be performed to minimize damage to the major organs by identifying the various exposure routes of CO poisoning, risk factors for acute cardiovascular toxicity (intentionality, LOC, combined sedatives, initial COHb, HTN, IHD), and the risk factors for acute neurological toxicity (age, LOC).