• 동의생리병리학회지
• /
• 제28권1호
• /
• pp.102-106
• /
• 2014

Wild ginseng pharmacopuncture is a partly used Traditional Korean Medicine's therapy with no previously well documented hepatotoxicity. We report the the first case of suspected drug-induced liver injury (DILI) after intravenous Wild ginseng Pharmacopuncture therapy. Our clinical observation based on patient's laboratory studies, medical history, detailed drug history and ruling out other possible causes. Our patient's suspected diagnosis was wild ginseng pharmacopuncture-induced liver injury with correlation between detailed drug history and laboratory studies. This diagnosis was supported by the Council for International Organizations of Medical Sciences-Roussel Uclaf Causality Assessment Method(RUCAM). This report represents the first documented cases of suspected DILI after intravenous wild ginseng pharmacopuncture therapy, highlighting the need for future research regarding potential hepatotoxicity of Wild ginseng Pharmacopuncture.

• 대한간호학회지
• /
• 제22권2호
• /
• pp.143-156
• /
• 1992

This descriptive study explored the health and illness concepts of preschoolers to provide understanding on which to build research. The subjects were convenience sample three to six year of age attending one art institute in Cheju city. Data were collected through semistructured interviews by author, Children were asked to draw two figures, one healthy and one ill persons. The drawings were not analysed to grasp the meaning as in a projective technique, but only to relate to their response. Data were coded and categorized by content analysis. The results of this study are summarized as follows : 1) Three year olds responded with some unrelated answers but well to questions related to their experiences of illness ; older participants answered questions related health and illness concepts more easily. Generally the levels of subjects' responses did not differ according to age and sex. 2) Preschoolers' answers about the cause, treatment and prevention of illness, and the meaning and promotion of health were coded and then classificated to 9 categories, (food, obedience to authoritys physical function, presence or absence of illness or symptoms, hygiene. treatment, traumatic injury, rest and germs). Food and obeidence to authority categories were most frequent responses the food category was associated with obeidence to authority because it seemed that the children follow the orders of their parents or other authority figures to eat or not to eat something This result was compatible with that of previous studies that preschoolers perceived illness as possible punishment for misbehavior. Participants except for one four year old boy did not suggest that germs cause illness. The children perceived themselves and their families as healthy even though they had symptoms of illness. 3) Preschoolers' health and illness concepts were. influenced by their experiences and related to their development that rules derived from authority and if not complied with, will bring punishment. These oonceptualizations may be the disparity that they perceived themselves and their families as healthy even though they were ill. A previous study by Perrin and Gerrity suggested that the level of children's illness concepts correlated with that of their physical causality and was lower than it. But the levels of health and illness concepts in this sample higher than those of the physical causality.

• 대한한의학회지
• /
• 제30권2호
• /
• pp.30-45
• /
• 2009

Background: The safety of herbal products is an important issue in Korea. It is more complicated because of the concomitant use of conventional western drugs and herbal medicine, including prescribed medicine, folk herbs and food supplements. Although both western and traditional Korean medical doctors have studied on the safety of HMP, their results did not show relevant or consistent conclusions because of the poor quality of studies, including bias. Objectives: The aim of this study was to review the studies in Korea related to drug induced liver injury (DILI) systematically. We tried to estimate the proportion of causative materials of DILI and evaluate the clinical difference of DILIs from different materials. Methods: Systematic searches were performed on MedRIC and MEDLIS in Korea. The extraction of data as well as selective screening of the studies was carried out independently by two of the authors. There were no restrictions on the types of publication, including grey literature. Results: Twenty-one articles were included. Of them only 7 adapted prospective design and only 6 were published in peer-reviewed journals. The proportion of conventional drugs associated with hepatotoxic injuries in all DILI ranged from 15.8% to 83.3% and that of herbal medicine was from 28.9% to 44.7%. However, the criteria for herbal medicine were not clearly defined and concomitant medications were not fully investigated in most studies. There were limited objective data in the clinical differences of liver injuries from different materials and their results were conflicting. Conclusions: The causality assessments regarding DILI of herbal medicine were not performed properly and causative materials were misclassified in most of the studies published in Korea. These make the safety issue still ambiguous because of the limitations and lack of objectivity of the studies. More rigorous studies are required for clearly addressing these conflicting issues with cooperative investigation between traditional Korean and western medicine.

• 한방재활의학과학회지
• /
• 제32권3호
• /
• pp.131-140
• /
• 2022

Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

• Journal of Korean Neurosurgical Society
• /
• 제59권1호
• /
• pp.1-5
• /
• 2016

Chronic subdural hematomas (CSHs) are generally regarded to be a traumatic lesion. It was regarded as a stroke in 17th century, an inflammatory disease in 19th century. From 20th century, it became a traumatic lesion. CSH frequently occur after a trauma, however, it cannot occur when there is no enough subdural space even after a severe head injury. CSH may occur without trauma, when there is sufficient subdural space. The author tried to investigate trends in the causation of CSH. By a review of literature, the author suggested a different view on the causation of CSH. CSH usually originated from either a subdural hygroma or an acute subdural hematoma. Development of CSH starts from the separation of the dural border cell (DBC) layer, which induces proliferation of DBCs with production of neomembrane. Capillaries will follow along the neomembrane. Hemorrhage would occur into the subdural fluid either by tearing of bridge veins or repeated microhemorrhage from the neomembrane. That is the mechanism of hematoma enlargement. Trauma or bleeding tendency may precipitate development of CSH, however, it cannot lead CSH, if there is no sufficient subdural space. The key determinant for development of CSH is a sufficient subdural space, in other words, brain atrophy. The most common and universal cause of brain atrophy is the aging. Modifying Virchow's description, CSH is sometimes traumatic, but most often caused by degeneration of the brain. Now, it is reasonable that degeneration of brain might play pivotal role in development of CSH in the aged persons.

• 대한화상학회지
• /
• 제22권1호
• /
• pp.10-14
• /
• 2019

Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

• Journal of Korean Neurosurgical Society
• /
• 제57권1호
• /
• pp.19-22
• /
• 2015

Objective : Posttraumatic cerebral infarction (CI) is a well-known complication of traumatic brain injury (TBI). However, the causation and apportionment of trauma in patients with CI after TBI is not easy. There is a scoring method, so-called trauma apportionment score (TAS) for CI, consisted with the age, the interval, and the severity of the TBI. We evaluated the reliability of this score. Methods : We selected two typical cases of traumatic CI. We also selected consecutive 50 patients due to spontaneous CI. We calculated TAS in both patients with traumatic and spontaneous CI. To enhance the reliability, we revised TAS (rTAS) adding three more items, such as systemic illness, bad health habits, and doctor's opinion. We also calculated rTAS in the same patients. Results : Even in 50 patients with spontaneous CI, the TAS was 4 in 44 patients, and 5 in 6 patients. TAS could not assess the apportionment of trauma efficiently. We recalculated the rTAS in the same patients. The rTAS was not more than 11 in more than 70% of the spontaneous CI. Compared to TAS, rTAS definitely enhanced the discriminating ability. However, there were still significant overlapping areas. Conclusion : TAS alone is insufficient to differentiate the cause or apportionment of trauma in some obscure cases of CI. Although the rTAS may enhance the reliability, it also should be used with cautions.

• Safety and Health at Work
• /
• 제13권3호
• /
• pp.343-349
• /
• 2022

Background: In the United States, the dairy product manufacturing industry has consistently had higher rates of work-related nonfatal injuries and illnesses compared to the national average for industries in all sectors. The selection and implementation of appropriate safety performance indicators are important aspect of reducing risk within safety management systems. This study examined the leading safety indicators implemented in the dairy product-manufacturing sector (NAICS 3115) and their perceived effectiveness in reducing work-related injuries. Methods: Perceptions were collected from individuals with safety responsibilities in the dairy product manufacturing facilities. OSHA Incident Rate (OIR) and Days away, restricted and transferred (DART) rates from 2013 to 2018 were analyzed. Results: The perceived most effective leading were safety observations, stop work authority, near miss reporting, safety audits, preventative maintenance, safety inspections, safety training attendance, and job hazard analysis/safety analysis, respectively. The 6-year trend analysis showed that those implementing all eight top indicators had a slightly lower rates than those that did not implement all eight. Production focused mentality, poor training, and lack of management commitment were perceived as the leading causes of injuries in this industry. Conclusion: Collecting leading indicators with the unique interest to meet the regulatory requirements and to document the management system without the actual goal of using them as input to improve the system most probably will not lead to an effective reduction of negative safety outcomes. For leading indicators to be effective, they should be properly selected, executed, periodically evaluated and actions are taken when necessary.

• 대한한방내과학회지
• /
• 제30권1호
• /
• pp.153-172
• /
• 2009

Background : The safety of Korean herbal Medicine (KHM: prescribed herbal medicine by doctors of traditional Korean medicine) is an important issue in Korea. Although both fields. western medicine and traditional Korean medicine. have been studied on the safety of herbs and KHM, their results were not concordance with each other. Objectives : This study aims to review the influence of KHM on liver function in Korean literature systematically. Additionally, we tried to estimate the change of data of liver function test (LFT) and the incidence of liver injury (LI) after the use of KHM. Methods : Systematic literature searches were performed on 4 major databases of Korea from their inception to May 2008. Screening and selection of the studies and the extraction of data were performed independently by two authors. There were no restrictions on the types of publication including grey literatures. Results : Forty studies were included. Only sixteen studies were performed prospectively and fifteen studies collected data from outpatients. Only 8 studies reported the occurrence of LI after the use of KHM. Nineteen cases of LI showed no or mild symptoms and the elevation of LFT was not high. All of LI patients used conventional western drug and KHM concomitantly. and causality of LI was not assessed properly. The incidence of LI related to the use of KHM was estimated as 0.59%-0.76% from all data of these studies. The conflicting results were shown on the change of alanine aminotransferase (ALT) and total bilirubin (TB) after the use of KHM. Conclusions : KHM might be a minor cause of LI in Korea. However the results are not strongly supported as enough to make the safety issue clear because of the limitations of original studies. More rigorous studies are required for answering the safety issue of KHM with the cooperative investigation of both fields of Korean traditional medicine and western medicine.

• 한국환경보건학회지
• /
• 제47권2호
• /
• pp.111-122
• /
• 2021

Objectives: There was a judgment of acquittal for the manufacturer SK Chemical and the vendor Aekyung regarding humidifier disinfectant (HD) containing 5-chloro-2-methylisothiazol-3(2H)-one/2-methylisothiazol-3(2H)-one (CMIT/MIT). The rationale used in this judgement is discussed here in the light of scientific consideration. Methods: The sentencing document for the judgements was obtained from the Korea Supreme Court Service. In particular, the judgements made by the court related to the risk of HD and external and internal exposure to CMIT/MIT are discussed based on scientific evidence. Results: Rendering a determination in a criminal trial of insufficient evidence of causation, the court dismissed the prosecution's motion that humidifier disinfectant-associated lung injuries (HDLI) and asthma were associated with the utilization of these products. However, CMIT/MIT, a strong sensitizing and corrosive substance, has been reported to be associated with brain toxicity, allergic contact dermatitis, and asthma. Furthermore, the judgment did not consider total consumption amounts or the cumulative dose of CMIT/MIT in the humidifier. Lastly, there are several cases supporting the fact that exposure to water-soluble substances including CMIT/MIT can cause lower respiratory tract diseases. In addition to cases of asthma among the workers exposed to CMIT/MIT, we identified lung injury victims who were exposed to HDs exclusively containing CMIT/MIT. Conclusions: We conclude that there is sufficient evidence supporting the assertion that HDs containing CMIT/MIT cause lung injuries, including asthma, contrary to the court's judgement.