• Title/Summary/Keyword: Risk Treatment Method

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Health Risk Assessment of Disinfection By-products by Chlorination in Tap Water Ingestion (수도수중 염소 소독부산물로 인한 건강위해성 평가에 관한 연구 - 서울시 수도수중 Trihalomethanes 및 Haloaceticnitriles을 중심으로 -)

  • Chung, Yong;Shin, Dong-Chun;Yang, Ji-Yeon;Park, Yeon-Shin;Kim, Jun-Sung
    • Environmental Analysis Health and Toxicology
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    • v.12 no.3_4
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    • pp.31-41
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    • 1997
  • Public concerns about hazardous health effect from the exposure to organic by-products of the chlorination have been increased. There are numerous studies reporting that chlorination of drinking water produces numerous chlorinated organic by-products including THMs, HAAs, HANs. Some of these products are known to be animal carcinogens. The purpose of this study was to estimate health risk of DBPs by chlorinated drinking water ingestion in Seoul based on methodologies that have been developed for conducting risk assessment of complex-chemical-mixture. The drinking water sample was collected seperately at six water treatment plant in Seoul at March, April, 1996. In tap water of households in Seoul, DBPs were measured wilfh the mean value of 36.6 $\mu$g/L. Risk assessment processes,. which include processes for the estimation of human cancer potency using animal bioassay data and calculation of human exposure, entail uncertainties. In the exposure assessment process, exposure scenarios with various assumptions could affect the exposure amount and excess cancer risk. The reference dose of haloacetonitriles was estimated to be 0.0023 mg/kg/day by applying dibromoacetonitrile NOAEL and uncertainty factor to the mean concentration. In the first case, human excess cancer risk was estimated by the US EPA method used to set the MCL (maximum contaminant level). In the second and third case, the risk was estimated for multi-route exposure with and without adopting Monte-Carlo simulation, respectively. In the second case, exposure input parameters and cancer potencies used probability distributions, and in the third case, those values used point estimates (mean, and maximum or 95% upper-bound value). As a result, while the excess cancer risk estimated by US EPA method considering only direct ingestion tended to be underestimated, the risk which was estimated by considering multi-route exposure without Monte-Carlo simulation and then using the maximum or 95% upper-bound value as input parameters tended to be overestimated. In risk assessment for Trihalomethanes, considering multi-route exposure with adopting Monte-Carlo analysis seems to provide the most reasonable estimations.

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A Systematic Review on the Causative Medicines for Stevens-Johnson Syndrome (스티븐스-존슨증후군을 유발하는 주요 의약품별 위험도에 대한 체계적 문헌고찰)

  • Kwon, Kyoung-Eun;Jung, Sun-Young;Jung, Hyun-Joo;Kim, Bong Gi;Park, Byung-Joo
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.344-364
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    • 2013
  • Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.

Quantitative Risk Assessment Method for Metals in Water Body using WASP (WASP 모의를 이용한 하천 수계 중금속 위해성평가 방법)

  • Shin, Yu-Ri;Yoon, Chun-Gyeong;Jeon, Na-Jeong;Rhee, Han-Pil
    • Journal of Korean Society on Water Environment
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    • v.26 no.4
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    • pp.629-636
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    • 2010
  • According to the spatial movements of the Nak-dong river watershed, the changes in heavy metal concentrations were simulated by WASP7.3. The risk assessment was performed using the predicted data of WASP7.3. The target heavy metal was manganese (Mn). In the simulated manganese data of WASP7.3, the average concentration by regions was from 0.03 mg/L to 0.07 mg/L. It is lower than drinking water standard in korea. The risk assessment was presented that it was high at the junction of Nak-dong river and Kumho river. It was influenced by the discharge of industrial complexes and large cities which were located in the junction. In comparison of drinking water standard and predicted data of WASP7.3 risk assessment, whole watershed was also low level at predicted data. However, to keep the similar risk value ($10^{-7}$) in adults and children anywhere, it requires the additional treatment of the point source discharges. It was also reflected by regions. Through this study, it was possible to evaluate heavy metal influence in unattainable monitoring regions and to estimate heavy metal addition and reduction by locations. Therefore, the outcomes of WASP7.3 can connect with the risk assessment and it can evaluate the safety of human by regions.

Assessment of early nutritional state in critical patients with intoxication and the effect of nutritional status on prognosis (중독 중환자에서의 초기 영양상태평가와 예후와의 관계)

  • Ko, Dong-wan;Choi, Sangcheon;Min, Young-gi;Lee, Hyuk jin;Park, Eun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.2
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    • pp.93-99
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    • 2021
  • Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

Surgical Treatment of Thyroid Carcinoma - A Relation between Prognostic Factors and Survival Rate - (갑상선암의 외과적 치료 - 예후인자와 생존율의 관계)

  • Kim Jae-Hong;Oh Sang-Hoon;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.187-199
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    • 1997
  • Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

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Risk Factors Influencing High School Students to Runaway (고등학생의 가출에 영향을 미치는 위험요인)

  • Kim, Kyung-Hee;Kim, Ji-Su
    • Child Health Nursing Research
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    • v.13 no.3
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    • pp.338-348
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    • 2007
  • Purpose: This study was done to identify risk factors influencing high school students to runaway from home. A comprehensive analysis of individual, family and social environment-related factors was done. Method: The participants in this descriptive survey on causal relations were 974 students enrolled in high school who were selected by convenience sampling. The data collected in June and July, 2003 were put in to logistic regression analysis to build a prediction model. Results: 1) Individual-related factors for running away in high school students were experience with smoking and sexual intercourse. 2) Family-related factors for running away in high school students were economic status and physically ill-treatment of the types of ill-treatment. 3) social environment-related factors for running away in high school students were number of delinquent friends. Conclusions and Recommendations: Running away from home among Korean high school students was associated not only with individual factors, but also with family and social environmental factors. The findings of study suggest that board intervention programs should be provided to prevent running away form home by adolescent. It is also recommended that a program be developed that can help control the variables identified in this study along with follow up study to verify the model.

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The Weight Lifters' Shoulder (역도(力道)선수에서 견관절 질환)

  • Jeon, In-Ho;Kyung, Hee-Soo
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.73-80
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    • 2002
  • Purpose: Weight lifting is a good training to control body weight, to correct body shape and to relieve stress. How-ever if the training is continued by inadequate training method and technique, the risks of the shoulder injuries are relatively high. Main Subject: The rotator cuff injury is the most common disorder to wright lifters and often results from the train- ing program of upright row, military press and pectoral deck. The chances of subacromial impingement in these postures are high because the shoulder rotates under the acromion at 90 abduction state. Shoulder instability in weight lifters can develop due to various causes. aepeated microtrauma and excessive abduction and external rotation may result in laxity of the anterior capsular structure, ligament and muscles. Behind the neck and bench press are high risk training postures. Other than those injuries, idiopathic osteolysis of distal clavicle, acromioclavicular separation, pectoralis major muscle rupture, and triceps muscle rupture nay develop. Conclusion: The best treatment option of the shoulder injury to weight lifters is to eliminate the possible risk elements for the weight lifters in training program and to provide proper and prompt treatment as soon as possible.

Modified Extracorporeal Reduction of the Mandibular Condylar Neck Fracture

  • Kim, Min-Keun;Kwon, Kwang-Jun;Kim, Seong-Gon;Park, Young-Wook;Kim, Jwa-Young;Kweon, Hae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.1
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    • pp.30-36
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    • 2014
  • There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.

Impact of Planning Target Volume Margins in Stereotactic Radiosurgery for Brain Metastasis: A Review

  • Emmanuel Fiagbedzi;Francis Hasford;Samuel Nii Tagoe
    • Progress in Medical Physics
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    • v.35 no.1
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    • pp.1-9
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    • 2024
  • Margin inclusion or exclusion remains the most critical and controversial aspect of stereotactic radiosurgery (SRS) for metastatic brain tumors. This review aimed to examine the available literature on the impact of margins in SRS of brain metastasis and to assess the response of some medical physicists on the use of these margins. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used to review articles published in PubMed, Embase, and Science Direct databases from January 2012 to December 2022 using the following keywords: planning target volume, brain metastasis, margin, and stereotactic radiosurgery. A simple survey consisting of five questions was completed by ten medical physicists with experience in SRS treatment planning. The results were analyzed using IBM SPSS Statistics version 26.0. Of the 1,445 articles identified, only 38 articles were chosen. Of these, eight papers were deemed relevant to the focus of this review. These papers showed an increase in the risk of radionecrosis, whereas differences in local control were variable as the margin increased. In the survey, the response rate to whether or not to use margins in SRS, a critical question, was 50%. Margin addition increases the risk of radio necrosis. The local control rate varies among treatment modalities and cannot be generalized. From the survey, no consensus was reached regarding the use of these margins. This calls for further deliberations among professionals directly involved in SRS.

Cost Based Vulnerability Control Method Using Static Analysis Tool (정적 분석 툴을 이용한 비용 기반의 취약점 처리 방안)

  • Lee, Ki Hyun;Kim, Seok Mo;Park, Young B.;Park, Je Ho
    • KIPS Transactions on Software and Data Engineering
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    • v.5 no.3
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    • pp.139-144
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    • 2016
  • When, Software is developed, Applying development methods considering security, it is generated the problem of additional cost. These additional costs are caused not consider security in many developing organization. Even though, proceeding the developments, considering security, lack of ways to get the cost of handling the vulnerability throughput within the given cost. In this paper, propose a method for calculating the vulnerability throughput for using a security vulnerability processed cost-effectively. In the proposed method focuses on the implementation phase of the software development phase, leveraging static analysis tools to find security vulnerabilities in CWE TOP25. The found vulnerabilities are define risk, transaction costs, risk costs and defines the processing priority. utilizing the information in the CWE, Calculating a consumed cost in a detected vulnerability processed through a defined priority, and controls the vulnerability throughput in the input cost. When applying the method, it is expected to handle the maximum risk of vulnerability in the input cost.