• 대한임상독성학회지
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• 제11권2호
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• pp.89-95
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• 2013

Purpose: Glyphosate is widely used and its toxic exposures are not rare. Occasionally, glyphosate intoxication can lead to death. The aim of this study is to analyze clinical findings and fatality in glyphosate intoxication. Methods: Clinical data on acute glyphosate intoxication were prospectively collected at 28 hospitals nationwide between August 2005 and July 2006. The patients' clinical symptoms and characteristics of fatalities were investigated and statistical analysis was performed. Results: Among 105 patients who were finally included, gastrointestinal symptoms(59%) were the most common. A significant difference in the amount ingested was observed between patients with higher systolic blood pressure and those with systolic blood pressure less than or equal to 80 mmHg (p<0.001). The more the patients ingested, the more aggravated their mental status became (p=0.004). Seven patients(6.7%) died, and all of them had ingested greater than or equal to 200 ml. Patients who died had ingested greater amounts than the survivors (p<0.001), and their mental status was worse (p<0.001), and systolic blood pressure was lower (p<0.001). According to the result of logistic regression analysis, relative risk was 24.1-fold higher in the 'poor' mental status group compared with 'good'. Conclusion: Patients who ingested large amounts of glyphosate showed poor mental status and lower blood pressure. Statistical difference in amount ingested, mental status, and systolic blood pressure was observed between survivors and patients who died. Ingested amounts and mental status were the most important factor of the prognosis of glyphosate intoxication.

• 대한임상독성학회지
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• 제11권2호
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• pp.81-88
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• 2013

Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time$^*$ frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.

• 대한임상독성학회지
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• 제11권1호
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• pp.1-8
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• 2013

Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

• 한국동물위생학회지
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• 제15권1호
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• pp.58-66
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• 1992

The insecticide p-nitropheny diethyl thiophospate is alse known by the symbol E.605 and a legion of trade names including “parathion”. The insecticide is widely used in agriculture, but it is highly toxic and now clear that parathion behaves like a cholinergic drug by inhibiting the enzyme cholinesterase. In order to know acute toxicity and the changes of glucose concentrations and activity according to time lapsed in female mice given orally single with the half dose to $LD_{50}$ of parathion, glucose contents and cholinesterase activities in serum as well as cholinesterase activities in whole brain and spinal cord were investigated, otherwise median lethal dose ($LD_{50}$) of parathion given orally against female mice was determined. The results obtained were summerized as follows ; 1. $LD_{50}$ value of parathion given orally to female mice was 7.1mg/kg(95% confidence limits, 3.8-13.1mg/kg) 2. The inhibition rate of cholinesterase activities in serum of parathion-administrated mice according to time lapsed were peakly decreased to 61% after 30 minutes in comparison to control group, but activities were completely recovered after 48 hours. 3. The inhibition rate of cholinesterase activities in whole brain of parathion-administrated mice according to time lapsed were peakly decreased to 49% after 2 hours in completely recovered after 24 hours. 4. The inhibition rate of cholinesterase activities in spinal cord of parathion-administrated mice according to time lapsed were peakly decreased to 57% after 2 hours in comparison to control group, but activities were completely recovered after 48 hours. 5. The changes of glucose contents in serum of parathion-administrated mice according to time lapsed and in directly after death due to parathion poisoning were no significantly difference.

• Advances in nano research
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• 제15권5호
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• pp.441-449
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• 2023

Heavy metals, widely present in the environment, have become significant pollutants due to their excessive use in industries and technology. Their non-degradable nature poses a persistent environmental problem, leading to potential acute or chronic poisoning from prolonged exposure. Recent research has focused on separating heavy metals, particularly from industrial and mining sources. Industries such as metal plating, mining operations, tanning, wood and chipboard production, industrial paint and textile manufacturing, as well as oil refining, are major contributors of heavy metals in water sources. Therefore, removing heavy metals from water is crucial, especially for safe water supply in swimming and water sports. Iron oxide nanoparticles have proven to be highly effective adsorbents for water contaminants, and efforts have been made to enhance their efficiency and absorption capabilities through surface modifications. Nanoparticles synthesized using plant extracts can effectively bind with heavy metal ions by modifying the nanoparticle surface with plant components, thereby increasing the efficiency of heavy metal removal. This study focuses on removing lead from industrial wastewater using environmentally friendly, cost-effective iron nanoparticles synthesized with Genovese basil extract. The synthesis of nanoparticles is confirmed through analysis using Transmission Electron Microscope (TEM) and X-ray diffraction, validating their spherical shape and nanometer-scale dimensions. The method used in this study has a low detection limit of 0.031 ppm for measuring lead concentration, making it suitable for ensuring water safety in swimming and water sports.

• 한국산업융합학회 논문집
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• 제26권5호
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• pp.845-853
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• 2023

The Ministry of Employment and Labor announced a roadmap for reducing serious accidents to create a "safe and healthy workplace, happy Korea" and ordered a risk assessment for all work processes in all workplaces on November 30, 2022. Accordingly, even workplaces that handle new chemicals must conduct risk assessment when introducing new chemicals, but the risk assessment techniques currently proposed by the government focus on preventing conventional accidents such as falls, getting caught, and bumping. Currently, there is a Chemical Hazard Risk Management (CHARM) technique that is most commonly used for chemical risk assessment, but in small and medium-sized businesses that lack professional manpower related to chemical substances, there are many technical terms in the technique and it is difficult to interpret, so its utilization is very low. Therefore, the purpose of this study is to present a method that can make risk assessment easier and simpler before handling new chemicals so that it can be used well in small and medium-sized businesses that lack professional manpower related to chemical substances. Through actual cases, the method of using CHARM was confirmed step by step, and based on this, risk reduction establishment and execution methods were derived. Based on the results of this study, it is expected that it will be used as the best tool for preventing accidents such as acute poisoning when handling chemicals in small and medium-sized workplaces that lack professional manpower related to chemical substances and make every effort to protect workers' health.

• 대한임상독성학회지
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• 제17권1호
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• pp.38-41
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• 2019

Procalcitonin (PCT) is commonly employed in medical practice as a diagnostic biomarker of bacterial infection and also as a monitoring biomarker for antimicrobial therapy. There have been a few published reports concerning elevated PCT levels in people with acute liver injury caused by an overdose of acetaminophen. We report here on a case of PCT elevation in an adolescent with acute acetaminophen poisoning without any bacterial infection or liver injury. A 15-year-old girl had deliberately ingested 20 tablets of 650 mg acetaminophen (13 g) and she presented to our emergency department. The PCT level on admission was elevated to 65.64 ng/mL (reference range: 0-0.5 ng/mL). Her PCT level on the second day peaked up to 100 ng/mL and then it gradually decreased. There was no evidence of liver injury or infection on the computed tomography examination and other lab tests. The patient regained her good health and was discharged on the sixth day of hospitalization.

• 대한임상독성학회지
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• 제20권1호
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• pp.1-7
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• 2022

Purpose: In patients with acute drug overdose, identification of drugs ingested is crucial to make a precise diagnosis. In most cases, the diagnoses are made on the medical history and physical examination findings. This study was undertaken to determine the concordance of diagnosis made on the basis of patient history by comparing it with urine toxicology analysis. Methods: This was a retrospective study of drug intoxicated patients over 18 years old who presented to the emergency center from 2017 to 2019. Specimens from urine were tested using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-TMS). The test results were compared with information obtained from patients. Diagnostic concordances for drug detection in intoxicated patients were calculated. Logistic regression analysis was used to examine the association between clinical characteristics and diagnostic discrepancy. Results: Totally, 370 patients were included in the analysis. Overall, 66 types of drugs were detected by UPLC-TMS. The drugs detected most frequently were zolpidem (104, 27.8%), citalopram (70, 18.7%), and paracetamol (66, 17.6%). The mean diagnostic concordance of patients was 52.7%. There were statistically significant diagnostic discrepancies in patients with underlying depression and patients intoxicated with multiple types of drugs. Conclusion: In ED patients with acute drug overdose, the diagnoses made on history alone were often inaccurate. It is essential to perform urine toxicology tests such as UPLC-TMS as a confirmatory instrument to improve accuracy in evaluating patients with drug intoxication.

• 대한핵의학회지
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• 제37권4호
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• pp.254-259
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• 2003

광대버섯과 같은 독버섯 중독시 간세포에 독성을 나타내어 간 기능의 이상을 유발할수 있다. 저자들은 개나리광대버섯을 섭취한 3명의 환자에서 간 기능을 평가하기 위하여 간세포에 선택적으로 섭취되어 간기능을 평가하는데 사용되어지고 있는 $^{99m}Tc-galactosyl$ human serum albumin (Tc-GSA)을 이용한 간 스캔을 시행하였고 간 초음파 검사와 비교하여 보았다. Tc-GSA 185MBq (3mg of GSA)을 정맥주사후 30분동안 동적 영상과 간과 심장 부위의 시간 방사능 곡선을 얻었다. 간기능의 정도를 평가하기 위하여 Tc-GSA의 간섭취 정도와 혈중 정체정도를 시각적인 평가와 간과 심장 부위의 시간 방사능 곡선을 이용한 반정량적인 평가를 시행하여 간섭취지수와 혈중제거지수를 구하였다. 시각적인 평가에서 2명의 환자에서 Tc-GSA의 경미한 정도의 간섭취 감소와 혈중 정체를 보였고 1명에서는 중등도의 간섭취 감소와 혈중 정체를 보였다. 반정량적인 평가에서는 2명의 환자에서 경미한 정도의 간섭취지수의 감소와 혈중제거지수의 증가를 보였고 1명에서 중등도의 간섭취지수의 감소와 혈중제거지수의 증가가 관찰되었다. 간초음파상에서는 1명의 환자는 지방침윤이 관찰되었으며 1명의 환자에서는 미약한 정도의 지방간이 관찰되어 급성 간기능 장애를 적절히 반영하지 못하였다. 본 증례를 통해 저자들은 간초음파 검사가 특이한 소견을 나타내지 못하여 간세포에 영향을 주는 독소나 약물 중독시에 간 영상화에는 Tc-GSA 간스캔이 유용하게 사용될 수 있을 것으로 추측할 수 있었다.

• 한국식품위생안전성학회지
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• 제29권3호
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• pp.189-194
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• 2014

본 연구의 목적은 식중독으로 인한 지속적인 위해 발생을 예방하기 위하여 학교의 급식시설 및 집기류에서 미생물 오염수준을 분석하고자 하였다. 그 결과, 총 세균 측정용 배지에서 $12.3{\pm}2.6$건으로 가장 많은 미생물이 배양되었고, 황색포도상구균 측정용 배지에서 $10.3{\pm}3.9$건과 대장균 측정용 배지에서 $9.5{\pm}3.9$건으로 미생물이 배양되었다. 그러나 비브리오 측정용 배지에서는 $1.5{\pm}1.0$건으로 가장 적은 미생물이 배양되었다. 급식시설 및 집기류에서 미생물 오염이 심한 곳은 전처리실 바닥으로 $4.5{\pm}0.6$건으로 가장 높고, 조리실 바닥도 $4.3{\pm}1.0$건으로 나타났다. 다음으로 조리대가 $3.3{\pm}1.0$건으로 나타났으며, 급식식탁에서도 $3.0{\pm}0.0$건으로 상당히 높은 미생물 오염을 확인할 수 있었다. 반면에 집기류에서는 시설들에 비하여 낮은 미생물 오염도를 보였다. 칼과 도마를 사용용도에 따라 구분하여 미생물을 분석한 결과, 생선용 칼에서 $2.0{\pm}0.8$건과 생선용 도마에서 $1.3{\pm}1.5$건으로 다른 용도에 비하여 약간 높은 미생물 오염도를 보였다. 배양된 미생물들을 동정한 결과, 다양한 미생물들이 오염되어 있으며 일부는 2번 이상씩 반복하여 검출되었다. 특히, 주요 식중독균인 Staphylococcus aureus는 조리대, 트렌치, 칼에서 3번에 걸쳐서 확인되었다. 또한 주요 식중독균에 속하는 Bacillus cereus가 칼에서 확인되었으며, 자연에 널리 분포하면서 때로는 급성폐렴을 일으키기도 하는 Klebsiella pneumoniae는 4번 반복하여 검출되었다. 위의 결과를 종합하여 보면, 황색포도상구균을 비롯한 주요 식중독균뿐만 아니라 식품의 부패를 일으키는 미생물들이 학교급식의 시설 및 집기류에 오염되어 있다는 것을 확인 할 수 있었다. 그러므로 학교급식의 안전성을 확보하고 학생들의 건강을 증진시키기 위하여 더욱 철저한 개인위생 및 효율적이고 체계적인 시설 관리가 이루어져야 할 것으로 사료된다