• Journal of The Korean Society of Clinical Toxicology
• /
• v.14 no.2
• /
• pp.107-114
• /
• 2016

Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic x2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.19 no.1
• /
• pp.1-7
• /
• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• Journal of Korean Society of Occupational and Environmental Hygiene
• /
• v.32 no.1
• /
• pp.78-88
• /
• 2022

Objectives: To develop the smart sensor to protect worker's health from chemical exposure by adopting ICT (Information and Communications Technology) technologies. Methods: To develope real-time chemical exposure monitoring system, IoT (Internet of Things) sensor technology and regulations were reviewed. We developed and produced smart sensor. A smart sensor is a system consisting of a sensor unit, a communication unit, and a platform. To verify the performance of smart sensors, each sensor has been certified by the Korea Laboratory Accreditation Scheme (KOLAS). Results: Chemicals (TVOC; Total Volatile Organic Compounds, Cl₂: Chlorine, HF: Hydrogen fluoride and HCN: Hydrogen cyanide) were selected according to a priority logic (KOSHA Alert, acute poisoning statistics, literature review). Notifications were set according to OEL (occupational exposure limit). Sensors were selected based on OEL and the capabilities of the sensors. Communication is designed to use LTE (Long Term Evolution) and Wi-Fi at the same time for convenience. Electronic platform were applied to build this monitoring system. Conclusions: Real-time monitoring system for OEL of hazardous chemicals in workplace was developed. Smart sensor can detect chemicals to complement monitoring of traditional workplace environmental monitoring such as short term and peak exposure. Further research is needed to expand the scope of application, improve reliability, and systematically application.

• Journal of Environmental Health Sciences
• /
• v.20 no.2
• /
• pp.64-72
• /
• 1994

Tolerance to toxic effects of cadmium (Cd), including lethality has been shown following pretreatment with cadmium and zinc. This study was designed to determine if tolerance also develops to Cd-induced hepatotoxicity and renal toxicity. Three groups of rats (A, B, C), each consisting of 108 rats, were studied and each group was divided into three subgroups (1, 2, 3), 12 rats for each subgroup. Rats were subcutaneously pretreated with saline (A), CdCl$_2$ (0.5 mg/kg, B), and ZnCl$_2$ (13.0 mg/kg, C) during time periods of 5 days. At the end of the period, rats were challenged with CdCIa (3.0 and 6.0 mg/kg) by intraperitoneal injection. As for the cadmium levels in rat tissues after pretreatments, it was highest in the liver. Then kidney, heart, blood and muscle followed it in that order. After 24, 48 and 96 hours of intraperitoneal injection by challenge doses the concentration of cadmium in liver and kidney increased proportionally to the increase of challenge dosage. However metallothioneins in liver and kidney were increased by the pretreatment of cadmium and zinc. These data indicate the liver is a major target organ of acute Cd poisoning, and suggest that cadmium induced hepatic injury, via release of Cd-MT, may play and important role in the nephrotoxicity observed in response to short-term exposure to cadmium. This result suggests that increasing cadmium concentrations, gradually accumulating in liver and kidney as the result of the pretteatmerit, served to induced the synthesis of metallothionein, thus making them resistant to the challenge from cadmium.

• Journal of the Korean Society of School Health
• /
• v.2 no.1
• /
• pp.131-146
• /
• 1989

This study was conducted for the development of recording system of students' health problems, and for the application of International Classification of Health Problem in Primary Care(ICHPPC) as a tool of morbidity classification in school health care. The data were collected from 12th of September to 24th of September in 1988. The objects were composed of health problems written by 10 school nurses who take service in the elementary school. The results were as follows: 1. The features of students' health problmes. The health problems of students were 68 problems from the total numbers of 361 codes of ICHPPC. The 93.4% of health problems was contained in 20 descriptive diagnoses and 97.0% was contained in 30 descriptive diagnoses. According to frequency of main health problems, There were abrasion, scratch and blister(26.7%); disorder of stomach function, other disease of stomach and duodenum (20.4%); headache(10.6%); bruise and contusion (5.3%); acute URI (5.0%); laceration and open wound(4.6%); Insect bite and sting(4.0%); epistaxis(3.4%): abdominal pain(2.6%): superficial tissue(1.7%). Out of all health problems, Category 17(accident, injury and poisoning was 44.7%. and Category 9(digestive system Disease) was 22.2%. 2. Applicability of ICHPPC by the school nurses. School nurses used 68 codes, among the total number of 361 codes from ICHPPC. According to ICHPPC method, school nurses can classified more diverse health problems systematically and objectively than that in other studies on school nurses activities. ICHPPC was found as a useful and applicable tool of morbidity classification in the practice of school nurses.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.15 no.1
• /
• pp.31-39
• /
• 2017

Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.

• The Journal of Internal Korean Medicine
• /
• v.16 no.1
• /
• pp.1-16
• /
• 1995

This study was done in order to investigate the etiology and pathology of dementia in the variety literature. Dementia in elderly persons(above the age of 60) mainly classfied Alzheimer disease and Cerebral vascular dementia. The results were as follows: 1. Dementia patients have abnormal mental function, who have no mental weakness but defects of memory, verbal disturbance, behavior disturbance and loss of intellectual function. 2. Dementia regard as 'me-beng(?病)', 'jeon-gwang(癲狂)', and 'heo-ro(虛勞)' in oriental medicine and the symptom is a silence with no response, mixing, a crying or a laugh, a stranger behavior and a amnesia; disturbances of speech, emotion, behavior. 3. Dementia caused by Alzheimer disease, Multi infarct dementia, Parkinson's disease, sequelae of acute CO poisoning, head injury and alcoholism(occidental medically) and the 'Dam(痰) and Damhwa(痰火), weakness of heart and spleen(心脾虛) caused by pent up anger of seven emotions(七情鬱結), the weakness of liver and kidney(肝腎不足)(oriental medically). 4. The causes of Alzheimer disease are various; a heredity factor, a morphological factor of brain tissues, a psychological factor and a biochemical factor (occidental medically) ; the 'Dam(痰) and Damhwa(痰火) caused by weakness of the internal organs and disturbance of the emotions(oriental medically). 5. Cerebral vascular dementia caused by loss of the certain cerebral neurons and oriental medically caused by obstruction of 'dam(痰)' or 'eo heul(瘀血)'. It is recommended that further study of many sided investigations, specially against a weakness of spiritual functions and a certain neurotoxin in the future.

• Journal of Preventive Medicine and Public Health
• /
• v.47 no.3
• /
• pp.144-149
• /
• 2014

Objectives: Nicotine is a natural alkaloid and insecticide in tobacco leaves. Green tobacco sickness (GTS) is known as a disease of acute nicotine intoxication among tobacco farmers. Until now, GTS has been recognized globally as a disease that results from nicotine absorption through the skin. However, we assumed that GTS might also result from nicotine inhalation as well as absorption. We aimed to measure the airborne nicotine concentrations in various work environments of Korean tobacco farmers. Methods: We measured the nicotine concentrations in the tobacco fields, private curing barns, and joint curing barns of farmers from July to October 2010. All sampling and analyses of airborne nicotine were conducted according to the National Institute for Occupational Safety and Health manual of analytic methods. Results: The airborne nicotine concentrations (geometric mean [geometric standard deviation]) in the tobacco field were $83.4mg/m^3$ (1.2) in the upper region and $93.3mg/m^3$(1.2) in the lower region. In addition, the nicotine concentration by personal sampling was $150.1mg/m^3$. Similarly, the nicotine concentrations in the private curing barn, workers in curing barns, the front yard of the curing barn, and in the joint curing barn were $323.7mg/m^3$(2.0), $121.0mg/m^3$(1.5), $73.7mg/m^3$(1.7), and $610.3mg/m^3$(1.0), respectively. Conclusions: The nicotine concentration in the workplaces of tobacco farmers was very high. Future studies should measure the environmental concentration of nicotine that is inhaled by tobacco farmers.

• BMB Reports
• /
• v.31 no.2
• /
• pp.189-195
• /
• 1998

Methylmercury (MeHg), which is widely distributed in the environment, is well known for both its acute and chronic poisoning effects on the human health; however, the precise biochemical mechanisms by which this compound elicits its toxicity in a cellular level are still poorly understood. To examine whether MeHg-induced liver injury involves activation of Phospholipase $A_2$ ($PLA_2$), the $PLA_2$ activity of control and MeHg-administrated livers was measured. MeHg stably enhanced a liver form of cytosolic $PLA_2$ activity, which exhibited several biochemical properties similar to those of the 100 kDa $cPLA_2$, except in its elution profile of a DEAE-5PW HPLC, and it migrated as a molecular weight of 80 kDa in Western blot analysis. This blotting analysis also indicated that the MeHg-induced enhancement of the activity could be due to the increase in the amount of the enzyme protein rather than a stable modification of the enzyme such as phosphorylation. Our data also showed the higher myeloperoxidase activity in MeHg-administrated liver than in the control, suggesting that this increase in the amounts of the 80 kDa $PLA_2$ and its activity may be resulted from infiltration of neutrophils into the liver during a hepatic injury process such as MeHg-induced inflammation. Taken together, these data suggest that MeHg-induced liver injury may be mediated by activation of the 80 kDa form of liver cytosolic $PLA_2$.

• Applied Microscopy
• /
• v.36 no.4
• /
• pp.235-250
• /
• 2006

A protective effect of activated charcoal against the acute lead poisoning of kidney was studied in mile. Mice approximately 30 gm in weight were grouped into the control, lead acetate-treated, and activated charcoal-treated after lead acetate groups. Lead acetate (60 mg/kg) and activated charcoal (40mg/kg) were delivered orally. Serum AST, ALT and glucose were measured and the ultrastructural alteration of liver was examined by electron microscopy. Activated charcoal decreased the increase of serum AST, ALT and glucose levels induced by lead. Lead acetate-treated hepatic cells characterized by irregular nuclei, enlarged and reduced number of mitochodria, enlarged rough endoplasmic reticulum, loss of riboscomes. Cells treated with activated charcoal were similar to those of the control group. In conclusion, activated charcoal may protect the lead-induced toxicity on liver.