Journal of The Korean Society of Clinical Toxicology
/
v.9
no.2
/
pp.61-70
/
2011
Purpose: This study investigated the effect on survival rate for organophosphate intoxication patients who received trachostomy. This research was conducted to help identify appropriate treatment of patients who received a trachostomy. Methods: This research was retrospectively conducted using the medical records of 141 patients who arrived at the Chosun University Hospital emergency medical center between Jan 2007 and Dec 2010, suffering from organophosphate intoxication. They were placed in two groups including one which received trachostomy as part of their treatment and one that did not. The effect of each variable on mortality was evaluated by regressionanalysis. Results: Of 141 patients with organophosphate intoxication, 105 of them did not tracheostomy and 16 were dead cohorts (15.2%). Their size of pupil was 1mm. Factors such as amount of organophosphate ingested, PAM time after ingestion, average body temperature, arrival time, atropinization time after ingestion, AST/ALT, Bun/Cr all appeared to be significant factors in death cohorts (P<0.05). 36 patients among the total had tracheostomy and 11 ones of them were in dead cohort (30.6%) and their average age was 58 years. The facts affect the state of patients in dead cohort include the amount of intoxication which between $327.27{\pm}194.1ml$, performing intubation 686 mins after intubation, reaching to the hospital after 580mins, injecting PAM 744 mins after intoxication, injecting atropine 627 mins after intoxication. The largest cases of patient's state was found to be stupor with 14 patients (38.9%) the level of Cholinesterase in blood appeared to be significant in dead cohort as $391.00{\pm}353.9IU/L$ (P<0.05). Conclusion: Further planned studies are necessary on the use of tracheostomy for treatment of poisoning victims, especially those intoxicated by organophosphorus insecticides.
Humans are exposed by a range of pollutants in soil via exposure routes such as ingestion, inhalation, and dermal contact. Risk assessment is a process of evaluating the adverse health effects of chemicals as a result of exposure to stressors, and it is a very useful tool to establish the cleanup goals in contaminated lands. In the exposure assessment that is one of main process in risk assessment, exposure factor plays a significant role to quantify the intake of soil pollutants. However there is a very limited study about the exposure factor applicable to Korea. In this study, we compared the exposure factors applied by the developed countries including the United States and representative European countries, and suggested the exposure factor that might be suitable in our situation. The exposure factors considered in this study include average lifetime, body weight, (exposed) skin surface area, life time, skin absorption, soil-skin adherence factor, and soil ingestion rate. This information is needed to quantitatively estimate the intake of soil pollutants in contaminated lands.
Journal of agricultural medicine and community health
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v.33
no.2
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pp.193-203
/
2008
Objectives: The aim of this study was to investigate the characteristics of acute poisoning cases admitted to a local emergency department in an urban-rural area. Methods: This retrospective study included all patients with acute poisoning who admitted the emergency department between June 2004 and May 2005. We analyzed the medical records for etiological and demographical characteristics of the acutely poisoned patients. Results: There were 155(1.0%) poisoning cases among 15,457 admitted to the emergency department. Of the admitted cases, 51.0% were female and 49.0% male. The poisoning made a peak in the age range of 30-39 and over 60. The seasonal distribution in poisoning patients suggested a peak in spring(38.1%) and summer(24.5%). The majority of exposures(95.5%) occurred in patient's home, 81.8% were deliberate. The most common agents of acute poisoning in deliberate causes were drugs(p<0.01). All of deliberate cases were suicidal attempts. The most common poisoning cases were pesticides in male, but in female were medications(p<0.01). Overall mortality rate of total cases were 12.9%. The overall mortality rate was higher in male(p<0.05), increasing age(p<0.05) and intentional ingestion(p<0.05), pesticides poisoning(p<0.05). Conclusions: The study forms a foundation for future work on poisoning epidemiology which hopefully will facilitate the allocation of preventive services in order to reduce the incidence as well as morbidity and mortality of toxic exposures.
Purpose: This study aimed to examine the early postprandial changes in gastrointestinal (GI) hormones and hemodynamics in terms of early dumping syndrome after gastrectomy for gastric cancer. Materials and Methods: Forty patients who underwent gastrectomy for gastric cancer and 18 controls without previous abdominal surgery were enrolled. Before and 20 minutes after liquid meal ingestion, blood glucose, glucagon-like peptide-1 (GLP-1), and GLP-2 concentrations and superior mesenteric artery (SMA) and renal blood flow were measured. The patients' heart rates were recorded at 5-minute intervals. All subjects were examined for dumping syndrome using a questionnaire based on Sigstad's clinical diagnostic index. Results: The postprandial increases in blood glucose, GLP-1, and GLP-2 levels as well as SMA blood flow and heart rate were greater in patients who underwent gastrectomy than in controls (all P<0.010). Patients who underwent gastrectomy showed a significantly decreased renal blood flow (P<0.001). Among patients who underwent gastrectomy, distal gastrectomy was a significant clinical factor associated with a lower risk of early dumping syndrome than total gastrectomy (hazard ratio, 0.092; 95% confidence interval, 0.013-0.649; P=0.017). Patients who underwent total gastrectomy showed a greater postprandial increase in blood glucose (P<0.001), GLP-1 (P=0.030), and GLP-2 (P=0.002) levels as well as and heart rate (P=0.013) compared to those who underwent distal gastrectomy. Conclusions: Early postprandial changes in GI hormones and hemodynamics were greater in patients who underwent gastrectomy than in controls, especially after total gastrectomy, suggesting that these changes play a crucial role in the pathophysiology of early dumping syndrome.
Rath, Sudhansu Sekhar;Singh, Mrinal Kanti;Suryanarayana, N
International Journal of Industrial Entomology and Biomaterials
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v.19
no.2
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pp.221-228
/
2009
Nosema sp. infection in the Indian tasar silkworm, Antheraea mylitta exerts a complex of influences on its host. The instar duration was extended significantly (P<0.001) except in $1^{st}$ instar. The infected larvae took about 48 days to reach the spinning stage against 40 days in the uninfected ones. The final weight attained by the larva at the end of each instar of development declined significantly following infection, as did weight gain and relative growth rate (RGR). The growth recorded/ day declined in infected larvae compared to uninfected ones from 8.2% during $1^{st}$ instar to 43.3% during $5^{th}$ instar. Food ingestion and digestion increased with advancement of the instar significantly irrespective of the status of the larvae but the relative consumption rate (RCR) declined. These parameters significantly declined in infected larvae (except food digested during $2^{nd}$ instar). The decline was more during $3^{rd}$ instar. In contrast, the approximate digestibility (AD %) was significantly higher in infected larvae than uninfected ones leaving the $1^{st}$ instar larvae unaffected. The efficiency of conversion of ingested food (ECI) and efficiency of conversion of digested food (ECD) did not change in a patterned way following the microsporidia (Nosema sp.) infection. The values of ECI significantly changed during $2^{nd}$, $3^{rd}$ and $5^{th}$ instars; while the change in ECD during $2^{nd}$, $4^{th}$ and $5^{th}$ were significant. During the entire larval life all the parameters tends to decline significantly following microsporidia infection but AD registered a significant increase. Nosema sp. spore concentration has increased 270.7 times during larval development in the course of experimentation.
Since Jan. 1957, 142 cases of benign esophageal stricture, 55 males and 87 females, were managed in our hospital, and their ages ranged from 3 to 77 years. old[mean 31.2yrs]. The most common cause was caustic burns and they all complained dysphagia and some loss of weight, general malaise and substernal pain, which usually appeared in 1 month to 1 year after ingestion of corrosive agents. The mid 1/3 of the thoracic esophagus was the most prevalent portion[29%] but rather evenly distributed along the entire esophagus. Operations were done on 129 patients, of whom 50 patients had ECG[esophagocologastrostomy], 5 PCG[pharyn-gocologastrostomy], 34 EG[esophagogastrostomy], 4 EJG[esophagojejunogastrostomy], 3 PG[pharyngogastrostomy], 2 esophageal end to end anastomosis and 31 Gastrostomy. There were 6 deaths in the postoperative period, so its operative mortality was 4.7%, among them 3 were ECG cases, 2 EG and 1 EJG. And 34 complications occurred so it recorded 24% complication rate. and in details in ECG 46%, PCG 60%, EG 17.6%, EJG 25%, and PG 33%. When we reviewed periodic variations, the mortality rate of the first 20 yrs. period was 6.9%, next 10yrs. 2.6% and now for last 2yrs non.
Kim Hyun;Won Ho Kyong;Kim Ho Jung;Lee Seo Young;Lee Kang Hyun;Hwang Sung Oh
Journal of The Korean Society of Clinical Toxicology
/
v.2
no.2
/
pp.96-100
/
2004
Purpose: This study was to investigate the effects of ethanol in ingested patients by analyzing data from a single institution's registry, Methods: We conducted a prospective study of 50 patients who has ingested drugs with/without ethanol came to emergency department from January 2004 to May 2004. Only patients over 18 years of age were included. Clinical characteristics, general and specific treatment, laboratory finding, complication, and clinical outcomes were obtained from protocol. Patients were divided into two groups: drug ingested with alcohol (ethanol group, n=18), and ingested without alcohol (non-ethanol group, n=32). Results: The age, the amout of ingestion, the time to treatment, the systolic blood pressure, the diastolic blood pressure and the shock duration were not different between two groups. The AST level with the ethanol group was higher than with the non-ethanol group ($230.94\pm518.88$ U/L vs $43.22\pm63.39$ U/L, p=0.002). The ALT level with the ethanol group was higher than with the non-ethanol group ($97.06\pm152.98$ U/L vs $32.75\pm43.10$ U/L, p=0.001). The lactic acid level with the ethanol group was higher than with the non-ethanol group ($7.40\pm6.33$ mmol/L vs $3.77\pm3.10$ mmol/L, p=0.001). The hospital stay duration and the admission rate were not different between two groups. Conlusions: The ethanol increased the levels of serum AST, ALT and lactic acid in intoxicated patients. But the ethanol dose not increase admission rate and duration of admission stay in intoxicated patients.
Between September 1988 and December 1993, 32 cases of benign esophageal stricture, of which 12 males and 20 females, were managed in Seoul National University Hospital hospital. Their age ranged from 2 to 61 years, and the mean age was 33.9 years. The ingestion of caustic agent was the most common cause, and the caustic material was acid in 16 patients [58% and alkali in 11patients [39% . Nearly all of the patients complained of dysphagia, and some of chest pain, epigastric pain, weight loss, vomiting, general malaise, and dyspnea. The most frequent site of stricture was found in the upper thoracic esophagus with 34% incidence followed by the lower thoracic esophagus[28% , whole esophagus[19% , and the mid esophagus[16% . The operations performed were 17[53% ECG[esophagocologastrostomy , 5[16% PCG[pharyngocologastrostomy , 5[16% EG[esophagogastrostomy , 2 EJG [esophagojejunogastrostormy by free jejunal graft , and 1 case each of EJ [esophagojejunostomy , esophageal end to end anastomosis, jejunostomy only, and gastrostomy only. In 23 patients [72% , diseased esophaguses were resected, using transhiatal total esophagectomy in 15 [47% and transthoracic partial esophagectomy in 8 [25% . Of those 23 patients, 3 patients [9.4% were diagnosed as esophageal carsinoma on microscopic examination. The postoperative most common complications were unilateral vocal cord palsy in 6 patients [19% , followed by cervical anastomosis leakage in 4 patients [12.5% , wound infection in 2 patients [6% , and pneumothorax in 2 patients [6% . Late death occurred 8 months after the operation in one patient, which was associated with infection due to anastomotic leakage. Our experience shows that the rate of mortality and the morbidity were low in patients receiving surgical management for esophageal stricture and that the cancer transformation rate was high. We recommend esophageal reconstruction surgery with esophagectomy [transhiatal or transthoracic for the esophageal stricture because it can avoid a chance of prevent cancer transformation.
An iron-fortified whey protein concentrate (Fe-WPC) was prepared by addition of ferric chloride to concentrated whey. A large part of the iron in the Fe-WPC existed as complexes with proteins such as ${\beta}$-lactoglobulin. The bioavailability of iron from Fe-WPC was evaluated using iron-deficient rats, in comparison with heme iron. Rats were separated into a control group and an iron-deficiency group. Rats in the control group were given the standard diet containing ferrous sulfate as the source of iron throughout the experimental feeding period. Rats in the iron-deficiency group were made anemic by feeding on an Fe-deficient diet without any added iron for 3 wk. After the iron-deficiency period, the iron-deficiency group was separated into an Fe-WPC group and a heme iron group fed Fe-WPC and hemin as the sole source of iron, respectively. The hemoglobin content, iron content in liver, hemoglobin regeneration efficiency (HRE) and apparent iron absorption rate were examined when iron-deficient rats were fed either Fe-WPC or hemin as the sole source of iron for 20 d. Hemoglobin content was significantly higher in the rats fed the Fe-WPC diet than in rats fed the hemin diet. HRE in rats fed the Fe-WPC diet was significantly higher than in rats fed the hemin diet. The apparent iron absorption rate in rats fed the Fe-WPC diet tended to be higher than in rats fed the hemin diet (p = 0.054). The solubility of iron in the small intestine of rats at 2.5 h after ingestion of the Fe-WPC diet was approximately twice that of rats fed the hemin diet. These results indicated that the iron bioavailability of Fe-WPC was higher than that of hemin, which seemed due, in part, to the different iron solubility in the intestine.
Parkinson's disease is a degenerative disease of a cranial nerve and has a main symptoms of irregular movement of muscle, stiffening, trembling which occurred by about 1% of population in the age of over 65. Moreover, the and prevalence rate and attack rate are soaring according to increase of elderly population. However, allopathy and surgery were done through dopamine and anticholinergic medicine for treatment but it developed a lot of complications due to medicine and progress since it makes slow progress or can't stop the treatment. Hereupon, I report that there is a case on one of the patients Young Jin Oriental Medical Clinic. The patient who is in state of treatment termination who doesn't need any further remedy and no worsening of symptoms after conduction of therapies of dialectic and 5 upright life cure regulations. 5 upright life cure regulations means five practive way for improvement of nature healing power. Upon undertaking the 5 upright life cure regulations, there were found significant results in such tests as Unified Parkinson Disease Rating Scale (UPDRS), Hoehn & Yahr Staging Scale, and Activity of Daily Living (ADL), and the ingestion of Benztropine 1mg and Requip 0.25mg was decreased from 3 times to 0 times. The study offers objective clinical data on Oriental Medicine treatment for Parkinson's disease which is one of representative neuro-degenerative diseases and thus broadens the application range of Oriental Medical treatment and presents the fundamental data on the clinical research on Parkinson's disease by adopting evidence-based medicine (EBM).
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