• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.137-142
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• 2006

Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.2
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• pp.111-117
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• 2012

Purpose: In Korea, few studies have examined the acute toxicity of anti-obesity drugs. The purpose of this study is to analyze the general characteristics and clinical aspect of acute anti-obesity drug intoxication. Methods: We retrospectively investigated patients admitted to the emergency department after anti-obesity drug intoxication between March, 2004 and February, 2012. The medical records of these patients were reviewed for demographic data, toxicologic history, time elapsed to presentation, clinical symptoms and signs, treatment, and outcome. Results: There were a total of 18 anti-obesity intoxication cases during the study period; of 16 which were included in our study. The purchasing route of the anti-obesity drug was mainly through a doctor's prescription (68.8%), however, some were obtained through the internet and the pharmacies. The mean time to The most commonly ingested antiobesity drug was sibutramine (31.3%) and many of the cases (62.5%) were multi-drug ingestions. The most common clinical manifestations were gastrointestinal symptoms (94%), but, CNS symptoms (75%) and cardiovascular symptoms (75%) were almost equally present. 13 patients (81%) were discharged after clearance of toxic symptoms and signs with a mean observational period of 7.0 hours. 3 patients were admitted for observation and treatment; of which 1 patient died due to fatal complications. Conclusion: Most anti-obesity intoxications show mild toxicity and a nonfatal clinical course. However, the recent trend toward prescribing psychostimulant anti-obesity medication, which can be fatal after an acute overdose, calls physicians' attention to treating of anti-obesity intoxications.

• Journal of Korean Public Health Nursing
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• v.10 no.1
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• pp.106-117
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• 1996

This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.113-120
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• 2009

Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.3
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• pp.137-145
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• 2024

Stunting, a condition characterized by impaired growth and development in children, remains a major public health concern worldwide. Over the past decade, emerging evidence has shed light on the potential role of gut microbiota modulation in stunting. Gut microbiota dysbiosis has been linked to impaired nutrient absorption, chronic inflammation, altered short-chain fatty acid production, and perturbed hormonal and signaling pathways, all of which may hinder optimal growth in children. This review aims to provide a comprehensive analysis of existing research exploring the bidirectional relationship between stunting and the gut microbiota. Although stunting can alter the gut microbial community, microbiota dysbiosis may exacerbate it, forming a vicious cycle that sustains the condition. The need for effective preventive and therapeutic strategies targeting the gut microbiota to combat stunting is also discussed. Nutritional interventions, probiotics, and prebiotics are among the most promising approaches to modulate the gut microbiota and potentially ameliorate stunting outcomes. Ultimately, a better understanding of the gut microbiota-stunting nexus is vital for guiding evidence-based interventions that can improve the growth and development trajectory of children worldwide, making substantial strides toward reducing the burden of stunting in vulnerable populations.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.90-94
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• 2014

This study was performed to investigate on the frequent chief complaints and the causes of dogs and cats visiting to an emergency department, and to suggest the minimum requirements for veterinary emergency clinics in South Korea. The medical records were reviewed for 2,368 dogs and 347 cats visiting the emergency department of Haemaru Referral Animal Hospital from March 2012 to August 2013. Among them, 255 dogs and 35 cats visited more than one time and each visit was considered as an individual case. Therefore, 2,784 cases of dogs and 396 cases of cats were reviewed. The medical records were analyzed according to the criteria such as signalment, chief complaints, diagnoses, hospital admission, and outcome. In dogs, vomiting, diarrhea, or both were the most common chief complaints, followed by dyspnea, trauma, seizure, and lethargy. The most common causes of emergency visits were gastrointestinal disorders, followed by neurologic, cardiovascular, respiratory, urologic, and hematologic disorders. In cats, dyspnea was the most common chief complaint, followed by vomiting, diarrhea, or both, trauma, dysuria, and lethargy. The most common causes of emergency visits were urologic disorders followed by gastrointestinal, respiratory, infectious, and cardiovascular disorders. According to the results, vomiting, diarrhea, dyspnea, and trauma were the most frequently encountered chief complaints, which accounted for approximately 48.6% of all cases in both dogs and cats. However common causes were differed between the dogs and the cats. In order to provide proper emergency service, it is required to prepare the clinicians and facilities to diagnose and stabilize these emergency patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.71-77
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• 2016

Purpose: No studies have been conducted to investigate the acute toxicity of aryloxyphenoxypropionate herbicides in humans following ingestion. Therefore, this study was conducted to investigate the clinical characteristics of aryloxyphenoxypropionate herbicide poisoning and provide guidance for physicians treating patients who have ingested these types of herbicides. Methods: A retrospective observational case series was conducted using ten patients with history of aryloxyphenoxy propionate herbicide. Data were collected for clinical manifestation, management and final outcome. Results: The most common symptoms were gastrointestinal irritation and an altered mental state (Glasgow Coma Scale<15). An elevated lactate level was a common laboratory abnormality, and prolonged QTc interval was commonly observed. These clinical features normalized within one day of supportive treatment. Conclusion: The acute toxicity of aryloxyphenoxypropionate herbicides in humans is manageable with supportive treatment. However, physicians should take into account depressed consciousness, the possibility of arrhythmia, and an elevated lactate level when planning their treatment strategy.

• Child Health Nursing Research
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• v.14 no.2
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• pp.146-154
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• 2008

Purposes: The purposes of this study are to describe the health problems experienced by VLBW premature infants and their health care services utilization during the first year of life Method: Eighteen mothers of VLBW premature infants completed a survey questionnaire, asking socioeconomic/demographic information, health/developmental problems experienced by their infants, and their use of health care services. Results: Of the 18 infants, 78% experienced respiratory problems such as cold/running nose and wheezing during the first year and 33% experienced gastrointestinal problems such as vomiting, diarrhea and constipation. Twelve (67%) infants visited the emergency department at least one time and 10 infants (56%) were hospitalized at least once during their first year of age. Interestingly, infants without chronic lung disease visited the emergency department more than infants without chronic lung disease (p=.213). Infants living in non-disadvantaged neighborhoods were hospitalized more than infants living in disadvantaged neighborhoods (p=.000). Conclusions: Health care providers should initiate educating mothers, particularly those living in disadvantaged neighborhoods, about post-NICU discharge health care needs of their VLBW premature infants while their infants were still in the NICU so that unnecessary visits to the emergency department and rehospitalizations can be possibly prevented.

• The Journal of the Korean dental association
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• v.50 no.12
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• pp.755-762
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• 2012

Objective : The aim of this study was to investigate risk factor, precaution and treatment of aspirated foreign body during dental procedure. Material and Methods : Twenty cases of accidental aspiration of the foreign body, which removed by bronchoscopy at the Asan Medical Center between 2008 and 2012, were analyzed retrospectively. Results : Ten cases of accidental aspiration were occurred during dental procedure. Symtoms include cough(65%), dyspnea(50%), sputum(25%) and wheezing(25%). The most common location of foreign body was right bronchial tree(50%), left bronchial tree(45%) and carina(5%). Patients risk factors were chronic obstructive pulmonary disease, lung cancer, pulmonary tuberculosis, esophageal cancer and vegetative state. Conclusion : Accidental aspiration or swallowing of dental instrument or material is not uncommon accidents in dental practice. Most foreign bodies enter into gastrointestinal tract spontaneously. But aspiration into broncho-trachea can be more serious events and must be treated as an emergency situation. Prompt emergency treatment and removal of the foreign body is necessary to avoid complication. Dentists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental procedures.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.88-96
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• 2010

Purpose: Doxylamine is antihistamine drug that is used as a hypnotic. It is also used for suicidal attempts because it can be easily purchased at the pharmacy without a prescription. There were many articles about the complications after doxylamine intoxication such as a rhabdomyolysis, but only a few articles have reported on seizure. We reviewed the cases of doxylamine intoxication with seizure that were treated in the emergency department. Methods: We reviewed the medical records of the patients who were over 15 years old and who were intoxicated by doxylamine at 3 emergency medical centers from January 2006 to June 2010. We reviewed the patients' age, gender, the dose of doxylamine ingested, if gastrointestinal decontamination was done, the time from intoxication to hospital arrival, the seizure history, treatment of seizure, the electroencephalography (EEG) results, the brain computed tomography (CT) results and the blood test results. Results: There were 168 patients who were intoxicated by doxylamine during the study period. Twelve patients had a seizure episode. The differences between the patients who developed seizure and the patients who did not were the dose and the serum levels of sodium and creatinine. The only clinically meaningful difference was the amount of doxylamine. The amount of doxylamine ingested (>29 mg/kg) predicted the development of seizure with a sensitivity of 75% and a specificity of 92% on the ROC curve. One patient among the seizure patients expired in the emergency department. Conclusion: In case of doxylamine intoxicated patients, there is close relationship between seizure and ingested amount, so close observation needs to be done for the patients who ingest too much because doxylamine can cause death. Further prospective studies are needed for doxylamine intoxicated patients with a seizure episode.