• Journal of the Korean Magnetic Resonance Society
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• v.15 no.1
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• pp.54-68
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• 2011

$^1H$ nuclear magnetic resonance (NMR) spectroscopy of biological samples has been proven to be an effective and nondestructive approach to probe drug toxicity within an organism. In this study, ketoprofen toxicity was investigated using $^1H$-NMR spectroscopy coupled with multivariate statistical analysis. Histopathologic test of ketoprofen-induced acute gastrointestinal damage in rats demonstrated a significant dose-dependent effect. Furthermore, principal component analysis (PCA) derived from $^1H$-NMR spectra of urinary samples showed clear separation between the vehicle-treated control and ketoprofen-treated groups. Moreover, PCA derived from endogenous metabolite concentrations through targeted profiling revealed a dose-dependent metabolic shift between the vehicle-treated control, low-dose ketoprofen-treated (10 mg/kg body weight), and high-dose ketoprofen-treated (50 mg/kg) groups coinciding with their gastric damage scores after ketoprofen administration. The resultant metabolic profiles demonstrated that the ketoprofen-induced gastric damage exhibited energy metabolism perturbations that increased urinary levels of citrate, cis-aconitate, succinate, and phosphocreatine. In addition, ketoprofen administration induced an enhancement of xenobiotic activity in fatty oxidation, which caused increase levels of N-isovalerylglycine, adipate, phenylacetylglycine, dimethylamine, betaine, hippurate, 3-indoxylsulfate, N,N-dimethylglycine, trimethyl-N-oxide, and glycine. These findings demonstrate that $^1H$-NMR-based urinary metabolic profiling can be used for noninvasive and rapid way to diagnose adverse drug effects and is suitable for explaining the possible biological pathways perturbed by nonsteroidal anti-inflammatory drug toxicity.

• Journal of Environmental Science International
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• v.19 no.6
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• pp.715-735
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• 2010

This study is designed to assess the priority order of the chemicals to cause to generate occupational diseases in order to understand the fundamental data required for the preparation of health protective measure for the workers dealing with chemicals. The 41 types of 51 ones of chemicals to cause to generate the national occupational diseases were selected as the study objects by understanding their domestic use or not, and their occupational diseases' occurrence or not among 110,608 types of domestic and overseas chemicals. To assess their priority order the sum of scores was acquired by understanding the actually classified condition based on a perfect score of physical riskiness(90points) and health toxicity(92points) as a classification standard by GHS, the priority order on GHS riskiness assessment, GHS toxicity assessment, GHS toxic xriskiness assessment(sum of riskiness plus toxicity) was assessed by multiplying each result by each weight of occupational disease's occurrence. The high ranking 5 items of chemicals for GHS riskiness assessment were turned out to be urethane, copper, chlorine, manganese, and thiomersal by order. Besides as a result of GHS toxicity assessment the top fives were assessed to be aluminum, iron oxide, manganese, copper, and cadium(Metal) by order. On the other hand, GHS toxicity riskiness assessment showed that the top fives were assessed to be copper, urethane, iron oxide, chlorine and phenanthrene by order. As there is no material or many uncertain details for physical riskiness or health toxicity by GHS classification though such materials caused to generate the national occupational diseases, it is very urgent to prepare its countermeasure based on the forementioned in order to protect the workers handling or being exposed to chemicals from health.

• Environmental Analysis Health and Toxicology
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• v.19 no.1
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• pp.81-91
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• 2004

Although it is suggested that risk -based management plan is needed to manage air pollution effectively, we have no resources enough to evaluate all aspects of substances and set priorities. So we need to develop a logical and easy risk-based priority setting method. However, it if impossible that only one generic system that is consistent with all the use is developed. In this study, we proposed a human health risk based priority-setting method for hazardous air pollutants, and ranked priorities for this method. First of all, after investigating previous chemical ranking and scoring systems, we chose appropriate indicators and logics to goal of this study and made a chemical priority ranking method using these. As results, final scores in priority ranking method were derived for 25 substances, and ethylene oxide, acrylonitrile and vinyl chloride were included in high ranks. In addition, same substances were highly ranked when using default values like when using no default, but the scores of hydrofluoric acid and ryan and compounds were sensitive to default values. This study could be important that priorities were set including toxicity type and quality and local inherent exposure conditions and we can set area-specific management guidelines and survey plans as a screening tool.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.2
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• pp.103-110
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• 2012

Purpose: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. Methods: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. Results: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echo cardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patients were discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were $2.53{\pm}2.29$ and $2.19{\pm}2.12$, respectively (p=0.860). Conclusion: Cardiovascular manifestations occur after acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant in itself in the clinical course, and the short-term prognosis of cardiac toxicity is unlikely to be unfavorable in acute CO poisoning.

• Journal of Preventive Medicine and Public Health
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• v.57 no.4
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• pp.407-419
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• 2024

Objectives: This study was conducted to measure financial toxicity (FT) among patients with cancer in Vietnam using the COmprehensive Score for financial Toxicity (COST) and to describe the cost management strategies employed by these patients. Methods: This comprehensive cross-sectional study enrolled 634 patients from 2 specialized oncology hospitals in Vietnam. Using COST cut-off scores, FT was classified as none/mild (≥26), moderate (14-25), or severe (≤13). Cost management strategies, or coping mechanisms, were classified into 4 groups: lifestyle changes, financial resource strategies, treatment modifications, and support seeking. Results: The prevalence of FT was 91.8%, with 51.7% of participants demonstrating severe and 40.1% exhibiting moderate FT. Severe FT was significantly associated with female, low education level, unstable employment, low household economic status, and advanced cancer stage. The most common coping strategies were as follows: among lifestyle changes, reducing spending on basic items and leisure activities (78.7%) and cutting back on essential household expenses (66.4%); among financial resource strategies, borrowing money from relatives or friends (49.1%) and withdrawing funds from retirement or savings accounts (34.1%); within treatment modifications, switching treatment facilities or doctors due to cost concerns (9.3%); and within support seeking, obtaining help from welfare or community organizations (18.8%). All strategies were significantly more likely to be used by patients with severe FT. Conclusions: FT was highly prevalent among patients with cancer. Most patients relied on lifestyle adjustments and coping strategies, underscoring the need for improved financial support systems to alleviate the economic burden associated with cancer care.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.1
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• pp.73-81
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• 2012

Object: The aim of this study is to suggest a list of priority chemicals for the Hazard & Risk Evaluation of Chemicals (HREC) controlled by the Industrial Safety and Health Act (ISHA). Method: Screening assessment was done for 642 chemicals whose exposure threshold limit values were set by the Ministry of Employment and Labor (MOEL). Hazard data were collected from Korea Occupational Safety & Health Agency (KOSHA) and/or other toxicity database. Exposure data were obtained from KOSHA internal database. The hazard and exposure scores of chemicals were listed by order of priority in accordance with GHS classification and exposure index data. Result: From the result of screening risk assessment for 642 chemicals, we extracted a list of 13 priority chemicals for HREC performed by the ISHA. A priority list of 27 chemicals which have carcinogen, mutagen and/or reproductive toxicity but not controlled by the ISHA was suggested for additional evaluation as "chemicals for special management".

• The Korean Journal of Pain
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• v.27 no.3
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• pp.297-300
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• 2014

This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

• Environmental Analysis Health and Toxicology
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• v.20 no.2 s.49
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• pp.109-121
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• 2005

A chemical ranking and scoring (CRS-Korea) system was developed and proposed to use as the first step to prioritize the toxic chemicals for the purpose of monitoring and detailed risk assessment that might follow as necessary. The CRS-Korea system takes a basic concept of risk assessment (both human health risk and ecological risk) in that risk score is determined by the product of toxicity score and exposure score. Included in the toxicity category are acute toxicity, chronic/sub -chronic toxicity, carcinogenicity, and other toxicity. The exposure category consists of quantity released to the environment, bioconcentration, and persistence. A consistent scheme and a comprehensive chemical data base are offered in the CRS-Korea system to calculate a score for the each component in the two categories by using specific physicochemical, fate, and toxic properties and the quantity of the chemical used. The toxicity score is obtained by adding up all the individual scores for the components in the toxicity category. The exposure score is determined by multiplication of the score of the quantity released with the sum of persistent score and bioconcentration score. Equal weight is given to the toxicity score and the exposure score. As the CRS-Korea system was applied to identify 50 national priority chemicals, it was found that significant data gap exists on toxicity and fate properties and that the uncertainty associated with estimating the quantify released to the environment is notably high. The proposed CRS system is only a screening tool in the first step toward the priority setting and should be used with expert judgement and other considerations necessary.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2505-2510
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• 2014

Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

• Journal of Pharmacopuncture
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• v.22 no.3
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• pp.147-153
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• 2019

Objectives: Many studies have been reported the efficacy of intravenous lipid emulsion (ILE) as an antidote on acute lipophilic drug toxicity. Clozapine, highly lipophilic dibenzodiazepine neuroleptics, is an important medication in the schizophrenia therapy regimen. Acute intoxication with antipsychotics is one of the main reasons for the referral of poisoned patients to the hospital. We expected that ILE could be used for the therapy of acute clozapine intoxicated patients. Methods: We used two groups of consisting of six male rats. Both groups received a toxic dose of clozapine (40 mg/kg) intravenously, via the tail vein. After 15 minutes, they were treated with intravenous infusion of 18.6 mg/kg normal saline (NS group), or 18.6 mg/kg ILE 20% (ILE group). We evaluated blood pressure (BP) and heart rate by power lab apparatus through the tail artery, ataxia by a rat rotary circle, seizure scores and death in multiple times after starting clozapine administration. For biochemical and pathological evaluations the samples of tissue and blood were taken. Results: Our results demonstrated that ILE 20% could return hypotension-induced clozapine better than normal saline. Furthermore, ataxia and seizure have rectified more rapidly and deaths reduced. Clozapine administration causes pancreatitis and lung injury but fat emulsion did not show an optimal effect on tissue damages caused by clozapine toxicity. Conclusion: In conclusion, ILE can remove toxic signs of clozapine same as other lipophilic medicines, however, clinical uses of ILE for this intention requires more appraisement to determine the precise implication and safety.