• Journal of Environmental Health Sciences
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• v.45 no.5
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• pp.541-555
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• 2019

Objectives: The aim of this study is to examine heavy metal exposure levels in the blood and urine of a nationally representative adult population in Korea, and to identify the major influence factors for exposure through linkage analysis using questionnaire data. Methods: Biological samples and questionnaire data were collected from adults aged 18 and over who had participated in the Korean National Environmental Health Survey from 2009 to 2017. Lead, mercury, and cadmium exposure levels were presented with geometric mean and 95th percentiles. Multiple regression analysis was performed to determine the factors affecting heavy metal concentrations. Results: Blood lead levels increased slightly in Cycle 2 compared to Cycle 1, but decreased in Cycle 3. Blood and urinary mercury and urinary cadmium levels decreased over time. The main influence factors included gender, age, and smoking status for blood lead levels; gender, age, and intake of fish at least once a week for blood mercury levels; and age for urinary cadmium levels. Conclusion: The Korean National Environmental Health Survey is an effective tool for confirming over-time changes in exposure to lead, mercury, and cadmium in Korean adults and to identify its influence factors. The results of this study are expected to present basic data for calculating reference values and baseline exposure levels for environmental chemicals in Korean adults.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.118-125
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• 2019

Purpose: Non-benzodiazepine hypnotic drugs (including zolpidem) are associated with an increased risk of suicide and suicidal ideation. Considering the wide usage of zolpidem, this drug should be considered a possible etiology for stupor or coma in any patient exposed to this drug. However, there are no reports on zolpidem blood levels in emergency department patients in Korea. We therefore reviewed the analyzed data of a toxicology laboratory at one university affiliated hospital. Methods: The sex, age, chief symptoms, suspiciousness of poisoning, and presumption of poison were analyzed from January 2018 to June 2019. The detection frequency and level of zolpidem in the patient blood were compared to the mental changes presented, which is the main consequence of zolpidem. Results: A total of 229 toxicological analyses, requested to a toxicological laboratory at one university affiliated hospital, were reviewed. Among 229 patients, the mean age was 54.3±20.7 years old with 113 women and 116 men. 8.7% of patients have psychiatric illness and 39.7% were poisoned intentionally. The chief symptoms detected were: mental change 55.0%, gastrointestinal 14.4%, cardiovascular 10.5%, focal neurological 7.4%, respiratory 3.5%, none 8.7%, and unknown 0.4%. A request for detailed reports revealed that causative poisons were specified only in 20.1% cases. Zolpidem was detected in 22.3% cases (51/229), with median blood level 1.26 mg/L (interquartile 0.1, 5.06 mg/L) and urine 0.90 mg/L (interquartile 0.11, 5.6 mg/L). Furthermore, zolpidem was more frequently detected in toxicology analysis of patients where mental change was the primary symptom, as compared to other symptoms (32.5% vs. 9.7%, p<0.01). Conclusion: This study reported the blood level of zolpidem in suspected poisoning patients admitted to the emergency department.

• Journal of the Korea Organic Resources Recycling Association
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• v.27 no.2
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• pp.57-66
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• 2019

This study carried out on-site investigation and precision monitoring to prepare proper design and operation technical guidelines for the use of bio gas in organic waste resources (fertilizing urine, food waste, food waste, food waste, etc.). According to the government's mid- and long-term policy on bio gasification, the expansion of waste resources is actively being pushed forward. However, facilities that use the biogas produced for urban gas and transportation are still under-efficient. Precision monitoring was carried out for biogasification facilities of organic waste resources in seven locations nationwide. When the results of precision monitoring were summarized with the four-season average, the efficiency analysis of each organic waste resource showed that the organic breakdown rate was 66.3% on average on VS basis. Analysis of biogas characteristics before and after pretreatment revealed that the $H_2S$ average of the entire facility was measured at 949.7 ppm using iron salts and desulfurization (dry, wet) and that the quality refining facility shearing and rear end was 29.0 ppm and 0.3 ppm. The methane content was found to be reduced by 65.6% at the rear of the fire tank, 63.5% at the back and 97.5% at the rear.

• Journal of Life Science
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• v.29 no.1
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• pp.37-44
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• 2019

Leaves of Sasa quelpaertensis Nakai are used in folk medicine for their anti-inflammatory, antipyretic, and diuretic properties. To ensure efficient utilization of S. quelpaertensis leaf, we previously reported a preparation method for phytochemical-rich extract (PRE) using the leaf residue, which was produced after hot water extraction. This study was undertaken to evaluate the hypouricemic potential of S. quelpaertensis leaf PRE in potassium oxonate (PO)-induced hyperuricemic mice. The administration of PRE significantly reduced serum uric acid (UA), blood urea nitrogen (BUN), and serum creatinine levels and increased urine UA and creatinine levels in the PO-induced hyperuricemic mice. It also reduced liver UA levels and xanthine oxidase (XA) activity. A histological analysis revealed that PRE administration protected against PO-induced liver damage, pointing to anti-inflammatory and cytoprotective effects in PO-induced hyperuricemic mice. We analyzed the transcriptome response to PRE administration in PO-induced hyperuricemic mice using RNA sequencing (RNA-Seq) in kidney tissues. The administration of PRE mainly enriched genes involved in mediating immune and inflammatory responses and the metabolic pathway. A Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the metabolic pathway, purine metabolism, and antibody biosynthesis were the major pathways altered in the PRE and PO groups. These results suggest a potential role for PRE in the prevention and treatment of hyperuricemia with inflammation.

• Journal of Environmental Health Sciences
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• v.46 no.6
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• pp.655-666
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• 2020

Objectives: The purpose of this study was to evaluate urinary arsenic concentrations by arsenic species and to identify related factors among local residents near abandoned metal mines in Korea. Methods: Among the subjects of the Health Survey of Residents Near Abandoned Metal Mines for 2013-2017, 664 people were enrolled in this study. Urinary arsenic species analysis was performed using ICP/MS. Result: The geometric means (95% Confidence Interval) by urinary arsenic species were 0.15 (0.13-0.17) ㎍/L for AsIII, 0.64 (0.55-0.75) ㎍/L for AsV, and 1.21 (1.05-1.40) ㎍/L for inorganic arsenic. The geometric means of urinary MMA and DMA were 1.58 (1.35-1.86) ㎍/L and 77.93 (72.61-83.63) ㎍/L, respectively, and that of organic arsenic was 83.15 (77.80-88.88) ㎍/L. The concentration of inorganic arsenic in the group using groundwater as drinking water was 1.36 (1.13-1.64) ㎍/L, which was statistically significantly higher than the 1.00 (0.80-1.25) ㎍/L in the other drinking water groups. Regarding rice consumption, the concentration of inorganic arsenic in urine in the group whose consumption was more than half rice produced in the residential area was 1.32 ㎍/L, which was statistically significantly higher than that of the 1.12 ㎍/L for the group whose consumption was less than half. Conclusion: In the analysis of the factors affecting the urinary inorganic arsenic concentration of the residents of the abandoned metal mine area, the use of groundwater as drinking water and consumption of rice produced in the residential area were considered related factors.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.21 no.1
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• pp.22-27
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• 2021

Propionic acidemia (PA) is an inherited autosomal recessive disorder, due to the deficiency of propionyl-CoA carboxylase (PCC). PCC is the enzyme which catalyzes the conversion of propionyl-CoA to D-methylmalonyl-CoA, and it is critical for the metabolism of amino acids, odd-chain fatty acids, and side chains of cholesterol. The clinical manifestations present mostly at the neonatal period with life-threatening metabolic acidosis and hyperammonemia. Here, we described a case of a 16-year-old Korean boy with late-onset PA who presented with embolic cerebral infarction due to dilated cardiomyopathy (DCMP) with left ventricular noncompaction. And he has family history of sudden cardiac death, so we performed metabolic screening and genetic tests. Elevated levels of 3-hydroxypropionic acid, methylcitric acid and propionylglycerine were detected in urine. Plasma acylcarnitine profile showed elevated propionylcarnitine (C3). Diagnosis of PA was confirmed by genetic analysis, which revealed compound heterozygous mutations, c.[1151T>G] (p.[Phe384Cys]) and c.[1228C>T] (p.[Arg410Trp]) in PCCB gene. His heart function is in improving state and the results of biochemical analysis are stable with heart failure medication and metabolic managements. We present a case of patient without episodes of metabolic decompensation who manifests DCMP as the first symptom of PA.

• Childhood Kidney Diseases
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• v.27 no.2
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• pp.97-104
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• 2023

Purpose: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria. Methods: This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks. Results: In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period. Conclusions: Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. ClinicalTrials.gov trial registration (NCT0223277)

• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.964-970
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• 2008

Purpose : Methylmalonic aciduria (MMA) and propionic aciduria (PA) are inborn errors in the catabolism of branched-chain amino acids. The study was undertaken to investigate the genotypes and clinical features of Korean patients with MMA and PA. Methods : This study examined 12 patients with MMA and eight with PA. We analyzed various clinical features, laboratory findings, treatments, and neuro-developmental outcomes. Diagnoses were based on the presence of characteristic compounds detected by amino acid analysis in serum and organic acid analysis in urine. Mutation analysis was performed in the genes of MUT, MMAA, MMAB, and MMACHC for MMA and PCCA and PCCB for PA. Results : Among the 20 patients, six patients were diagnosed before one month of age and nine patients were diagnosed after the newborn period. Five patients were diagnosed via a neonatal screening test. Patients with early-onset forms had more severe illness at presentation and generally poor outcomes. A favorable outcome was obtained in 55% patients; most of them were of a late-onset type or diagnosed by neonatal mass screening test without symptoms. Genotypes were confirmed in all patients with MMA. We detected 11 different mutations by MUT gene analysis in 10 patients, and three different mutations in MMACHC genes in two patients. PCCA and PCCB gene mutations were identified in 14 of the 16 alleles, in eight patients with PA. Conclusion : Organic aciduria is a fatal disease; however, better outcomes are expected whenever early diagnosis and prompt management are made possible. Mutation analysis is useful for confirming diagnoses and planning management strategies.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.11 no.2
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• pp.111-117
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• 2001

A cross-sectional study was performed to evaluate associations between lead biomarkers, lead-related symptoms, and ${\delta}$-aminolevulinic acid dehydratase (ALAD) genotype among 598 lead workers and 144 control office workers in storage battery industries, secondary smelting and litharge making industries. Lead inhibits the second enzymes, ALAD, in the heme synthesis pathway. ALAD gene, which codes for one of three isozymic proteins (termed ALAD1-1, ALAD1-2, and ALAD2-2), seems to modify the toxicokinetics of lead. The result as follows; The percents of total workers whose genotype of ALAD1-1 and ALAD1-2 were 88.4% and 11.6%, respectively. The zinc protoporphyrin in blood (ZPP) and ${\delta}$-aminolevulinic acid in urine (ALAU) of lead workers with ALAD1-2 were significantly lower than those of lead workers with ALAD1-1, but there were no significant difference between two genotype for blood lead, age, and work duration. The proportion of ALAD1-2 genotype in control office workers was 13.2%. The proportions of ALAD1-2 genotype of lead workers were 14.0%(their mean air lead level below $0.024mg/m^3$), 10.4%($0.025-0.049mg/m^3$), 11.8%($0.050-0.099mg/m^3$), and 9.4%(above $0.100mg/m^3$), respectively. In the logistic analysis of 15 lead related symptoms, 'arthralgia'(S7) symptom of ALAD1-2 was significantly lower (OR=0.481; 95% CI=0.248-0.932) than that of ALAD1-1, but 'feeling of irritation'(S11) of ALAD1-2 was significantly higher(OR=1.636; 95% CI=1.035-2.586) than that of ALAD1-1 after controlling possible confounder (blood lead, work duration, smoking and drinking habit).

• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.2
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• pp.57-61
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• 2016

Isovaleric acidemia (IVA) is an autosomal recessively inherited organic acid disorder due to a defect of the enzyme isovaleryl-CoA dehydrogenase in the leucine metabolic pathway. Deficiency of this enzyme results in the accumulation of derivatives of isovaleryl-CoA. In acute illness in IVA, isovaleric acid and its derivatives accumulate and profound metabolic acidosis with ketosis, characteristic pungent body odor, hypoglycemia, and hyperammonemia can be developed. Additionally, recurrent vomiting, failure to thrive, developmental delay, epilepsy and mental retardation are chronic presenting symptoms and signs for IVA. On the result of newborn screening for inherited metabolic disorders, increased levels of isovalerylcarnitine (C5) are shown. However, C5 elevation can be accompanied with short/branched-chain acyl-CoA dehydrogenase (SBCAD) and therapy with certain antibiotics containing pivalic acid. Quantitative measurement of organic acids in urine and acylcarnitine profiles in plasma are necessary to differential diagnosis. Molecular genetic analysis of the IVD gene for IVA and ACADSB is also helpful to confirm IVA and SBCAD deficiency, respectively. Considering that IVA can be associated with significant morbidity and mortality at acute presentation of metabolic crisis, early diagnosis prior to the onset of symptoms by newborn screening enable to introduction of early treatment and prevention of acute and chronic complications.