• YAKHAK HOEJI
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• v.54 no.5
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• pp.341-347
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• 2010

The majority of forensic autopsies in Korea are performed by the National Institute of Scientific Investigation (NISI), and the NISI has carried out about 4,000 cases annually. Total 4,578 autopsies were performed by NISI in 2009, among them 2,918 cases (64%) were carried out at main office of NISI in Seoul, which is in charge of Seoul, Incheon and Gyeonggi province. In this study we investigated pattern of drugs & poisons in autopsy cases for recent three years in Korea. Postmortem specimens (bloods, gastric contents, etc) from autopsy cases by main office of NISI during 2007~2009 were screened for drugs & poisons. Using laboratory information management system of NISI (iLIMS), the kinds of drugs & poisons and the frequency were investigated. As the results, 1,705 cases were negative to drugs & poisons, it occupied 58% of total 2,918 autopsy cases in 2009. During three years (2007~2009), the kinds of drugs & poisons detected in specimens were 206, 185 and 203, respectively, and top three drugs were atropine (anticholinergic), chlorpheniramine (antihistamine) and lidocaine (local anaesthetic/anti-arrythmic). These drugs were supposed to be used not so much for suicidal or homicidal purpose as for therapeutic purpose in hospital. Meanwhile cyanide showed the highest frequency of poisons during 2007~2009, and the frequency was 32 cases in 2009. In case of pesticides, poisoning by paraquat (herbicide, 17 cases) showed the highest frequency, and methomyl (insecticide, 9 cases) and glyphosate (herbicide, 7 cases) were followed. Finally we selected 62 drugs as target drugs for systematic toxicological analysis (STA) for Korea. Poisons such as pesticides, natural toxins, volatile compounds should be included for STA in further study.

• YAKHAK HOEJI
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• v.57 no.4
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• pp.289-292
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• 2013

A total of 2,080 forensic autopsies in Seoul, Incheon and Gyeonggi province were performed by the National Forensic Service (NFS) in 2010. After analysing blood samples collected at autopsies by GC-MS and LC-MS/MS, the types and prevalence of drugs and poisons in blood were investigated using our laboratory information management system. Among 2,080 cases, 1,061 cases (51%) were positive for drugs and poisons. Surprisingly, antidepressants were identified in 137 cases which comprised 13% of the positive cases. Twelve different kinds of antidepressants were determined: Amitriptyline, fluoxetine, nortriptyline, trazodone, imipramine, mirtazapine, citalopram, venlafaxin, clomipramine, paroxetine, sertraline and bupropion. Amitriptyline was the most frequently detected antidepressant and was identified in 39 cases. Moreover, amitriptyline, fluoxetine, and nortriptyline were included in the list of the 20 most commonly encountered drugs or poisons in the analysis of blood collected at autopsies from 2007 to 2009, indicating the prevalence of their use. In this study, the 137 antidepressant-related deaths were classified by the mode of death to predict the prevalence of these drugs. As a result, those deaths were divided into four groups based on the cause and mode of death: 56 cases of suicide with fatal concentrations of antidepressant drugs in blood, 6 homicidal cases directly or indirectly related to antidepressants, 59 natural deaths with antidepressants detected in blood and 16 deaths caused by fire or other accidents with antidepressants detected in blood. Because incidents involving antidepressants have been increasing, especially in suicides or homicides, it is necessary for the health authorities and law enforcement administrations to cooperate and share the statistical data for curbing the abuse of antidepressants. This report is expected to provide the reference data related with antidepressants for the investigation of the deaths.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.101-106
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• 2017

Purpose: This study examined the patterns of drugs, poisons, and chemicals detected in autopsy samples performed in the Seoul Institute and other regional forensic offices of the National Forensic Service (NFS) between 2014 and 2016. Methods: The investigation carried out using the laboratory information management system. Forensic toxicological identification and quantitation were performed in autopsy samples, including heart blood, peripheral blood, liver, kidney, vitreous humor and etc. Gas chromatography/mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were used to analyze the drugs and poisons. Results: Forensic autopsies were performed on 9,674 cases in this period. Based on the autopsy reports, 699 cases (7.2%) were considered as unnatural deaths caused by fatal intoxication. The number of male deaths was higher than that of female deaths, with the age of 50-59 being the most common age group. Conclusion: Drugs comprised the largest number of deaths due to poison, followed by alcohol, agrochemicals, drug with alcohol, carbon monoxide, and cyanide, in that order. Zolpidem was the most frequently used drug in all drug-related intoxication cases.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1996.04a
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• pp.36-41
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• 1996

Drugs mean not only medicines but also poisons, pesticides, food additives, cosmetics, cleaning agents, environmental pollutants and so on, which are normally considered foreign to the body, It is important to know what happens to these drugs when they get into the body. In the past the metabolic changes of drugs had been referred to as “detoxication mechanism”, but since there are many instances in which drugs are converted in the body to more active substances. Thus, metabolism of drugs is responsible for activation and inactivation of the drugs in the body. The major reactions in drug metabolism are oxidation, reduction, hydrolysis and conjugation. Of these four areas, most of the attention had been focused on the oxidation. Therefore, in contract of ample literatures on drug-oxidizing enzymes, there were relatively few reports on drug-reducing enzymes. In recent years, however, the reduction has received an increasing interest due to its pharmacological or toxicological significance. The present lecture is organized keeping with a focus on drug-reducing enzymes which have been explored by us and by other groups.

• Biomolecules & Therapeutics
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• v.29 no.5
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• pp.562-570
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• 2021

Topoisomerase IIα has been a representative anti-cancer target for decades thanks to its functional necessity in highly proliferative cancer cells. As type of topoisomerase IIα targeting drugs, topoisomerase II poisons are frequently in clinical usage. However, topoisomerase II poisons result in crucial consequences resulted from mechanistically induced DNA toxicity. For this reason, it is needed to develop catalytic inhibitors of topoisomerase IIα through the alternative mechanism of enzymatic regulation. As a catalytic inhibitor of topoisomerase IIα, AK-I-191 was previously reported for its enzyme inhibitory activity. In this study, we clarified the mechanism of AK-I-191 and conducted various types of spectroscopic and biological evaluations for deeper understanding of its mechanism of action. Conclusively, AK-I-191 represented potent topoisomerase IIα inhibitory activity through binding to minor groove of DNA double helix and showed synergistic effects with tamoxifen in antiproliferative activity.

• YAKHAK HOEJI
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• v.55 no.2
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• pp.106-115
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• 2011

Systematic toxicological analysis (STA) means the process for general unknown screening of drugs and toxic compounds in biological fluids. In order to establish STA, in previous study we investigated pattern of drugs & poisons in autopsy cases during 2007~2009 in Korea, and finally selected 62 drugs as target drugs for STA. In this study, rapid and simple drug identification and quantitative analytical program by gas chromatography-mass spectrometry(GC-MS) was developed. The in-house program, "DrugMan", consisted of modified chemstation data analysis menu and newly developed macro modules. Total 55 drugs among 62 target drugs were applied to this program, they were 14 antidepressants, 8 anti-histamines, 5 sedatives/hypnotics, 5 narcotic analgesics, 3 antipsychotic drugs, and etc. For calibration curves, fifty five drugs were divided into four groups of range considering their therapeutic or toxic concentrations in blood specimen, i.e. 0.05~1 mg/l, 0.1~1 mg/l, 0.1~5 mg/l or 0.5~10 mg/l. Standards spiked bloods were extracted by solid-phase extraction (SPE) with trimipramine-D3 as internal standard. Parameters such as retention times, 3 mass fragment ions, and calibration curves for each drug were registered to DrugMan. A series of identification, semi quantitation of target drugs and reporting the results were performed automatically. Calibration curves for most drugs were linear with correlation coefficients exceeding 0.98. Sensitivity rate of DrugMan was 0.90 (90%) for 55 drugs at the level of 0.5 mg/l. For standard spiked bloods at the level of 0.5 mg/l for 29 drugs, semi quantitative concentrations were ranged 0.36~0.64 mg/l by DrugMan. If more drugs are registered to database in DrugMan in further study, it will be useful tools for STA in forensic toxicology.

• Journal of Preventive Medicine and Public Health
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• v.10 no.1
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• pp.25-33
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• 1977

The epidemiological informations on 1,828 cases of acute drug intoxication admmitted to the emergency rooms of 5 general hospitals, 4 in Seoul City and 1 in Incheon City from Jan. 1974 to Dec. 1974, were reviewed for statistical analysis. More detailed information on 796 cases from 3 hospitals were available in terms of the causative agent. The general findings obtained are as follows; 1. The sex ratio of the patient is 1.26 females to 1 male and this figure is almost consistent with the reports of previous authors. 49.7% of total cases were found in the age group of 20-29, which indicate the highest in percent distribution of age. 2. The incidence of acute drug intoxication was different by the season as the highest in summer and the lowest in winter. 3. As the cause of the intoxication, the attempted suicide occupied the single highest one with 91.7%. 4. The kind of causative agents varies with seasons as more economic poisons in the summer time and more drugs in the winter time.

• Bulletin of the Korean Chemical Society
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• v.23 no.3
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• pp.391-394
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• 2002

Berberine and berberrubine, which display antitumor activity, have also demonstrated distinct enzyme-poisoning activities by stabilizing topoisomerase Ⅱ-DNA cleavable complexes. The protoberberine berberrubine differs in chemical structure with berberine at only one position, however, it shows a prominent activity difference from berberine. Solution structures of berberine and berberrubine determined by NMR spectroscopy are similar, however, the minor structural rearrangement has been observed near 19 methoxy or hydroxyl group. We suggest that the DNA cleavage activities of topoisomerase Ⅱ poisons could be correlated with both chemical environments and minor structural change together with hydrophobicity of interacting side chains of drugs with DNA molecule.

• Korean Journal of Pharmacognosy
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• v.18 no.1
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• pp.26-33
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• 1987

Aconites distribute widely in northern hemispere of the earth reaching to arctic zone from warm and temperate one. Hitherto, these tuberous roots, 'Cho O', have been known to be famous plant poisons and essential important drugs possessing many remedial effects in each region of the world, especially in Korea and China. In Korea, although these plants grow widely in whole districts, their classifications are quite obscure. Especially, Aconitum triphyllum $N_{AKAI}$ is distributed whole districts. To clarify the botanical origin of 'Cho O', we studied on the anatomical characteristics of Aconitum triphyllum $N_{AKAI}$ growing wild in Korea. As a result, the environmental varieties of A. triphyllum $N_{AKAI}$ were recognized.

• 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.