• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.7
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• pp.926-931
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• 2007

Diarrhetic shellfish poisons (DSP) such as okadaic acid (OA), dinophysistoxin-1 (DTX1), pectenotoxin-1(PTX1), PTX2, PTX6 and yessotoxin (YTX) were determined simultaneously by LC-MS/MS and mouse bioassay in the shellfishes (oyster, mussel, Washington purple clam, ark shell, scallop and short necked clam) collected at Tongyeong, from March to September, 2006. Oyster and mussel were found to contain DSP (0.05${\sim}$0.1 MU/g) in March by mouse bioassay; however, no DSP components were detected on the LC-MS/MS. Also, a small amount of DTX1 (0.05 ${\mu}g/g$) in mussel (June) and OA (0.01${\sim}$0.02 ${\mu}g/g$) in 5 species of shellfishes(August) were determined by LC-MS/MS.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.131-139
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• 2017

Purpose: The purpose of this study was to investigate the epidemiologic characteristics of patients who visited emergency departments (EDs) after intentional poisoning in Korea. Methods: This study retrospectively analyzed the data of of 23 hospitals during a five-year period, between 2011 and 2015. We included patients who inflicted injury to themselves - attempt of suicide - by means of poisoning. Results: A total of 18,121 patients visited an ED after intentional poisoning. Among them, 58.3% were females; however, there were more males among those aged 60 years or older. The mortality rate for males was 8.6%, which was 3.1 times higher than that for females with 2.8%. The most common poison was pesticides (35.4%) in males and sedative-hypnotics (44.0%) in females. The most common causative agent of death was pesticide in both sexes (75.2% and 65.3%, respectively). Since the production of paraquat was discontinued in 2011, the number of deaths from pesticide poisoning has decreased. The mortality rate declined in both males and females, from 12.6% and 4.5% in 2011 to 7.1% and 2.1% in 2015, respectively. Conclusion: In this study, we analyzed the epidemiologic characteristics of intentional poisoning, especially the frequency of suicide attempts by gender and age group, the cause of suicide, and the causative agent. This can be used as basic data for establishing policies to reduce and prevent suicide attempts by poisoning.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.25 no.3
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• pp.13-33
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• 2012

Objective : The aim of this study is to find the therapeutic meaning of Pericarpium Granati and Cortex Betulae Platyphyllae in herbal medication. Methods : About the origin, the component, the processing the drug, the properties and tastes of drugs, the meridian tropism, the effects, the treating disease, the contraindication and the method of adminictration, I have researched 23 literatures and 10 disquisitions to mention the Pericarpium Granati and Cortex Betulae Platyphyllae. Result : 1. Pericarpium Granati is pericarp of mature fruit of The Pomegranate belongs to Punicaceae and Cortex Betulae Platyphyllae is bark of Betula platyphylla var. japonica (Miquel) Hara belongs to Betulaceae. 2. Pericarpium Granati consists of tannin 10.4~21.3%, lead 0.8%, resin 4.5%, mannitol 1.8%, sugar 2.7%, gum 3.2%, inulin 1.0%, musilage 0.6%, gallic acid 4.0%. Cortex Betulae Platyphyllae consists of betulin about 35%, various higher fatty acid about 35%, tannin about 7%. 3. The properties and taste of Pericarpium Granati is acid, astringency, warm, nontoxic and the meridian tropism is mainly stomach and large intestine meridian. The properties and taste of Cortex Betulae Platyphyllae is bitter, cold, nontoxic and the meridian tropism is mainly stomach meridian. 4. Pericarpium Granati has come into general use to treat roundworm, tapeworm, old diarrhea, anal prolapse, melena, metrorrhagia, leukorrhea, stomachache from worms, scabies etc. because it is effective on insecticiding, stopping diarrhea, controling hemorrhage and leukorrhea. Cortex Betulae Platyphyllae has come into general use to treat shigellosis, diarrhea, jaundice, cough, sputum, tonsillitis, pneumonia, nephritis, furuncle, prurigo, acne etc. because it is effective on cooling down heat, circulating humidity, removing phlegm, stopping cough, neutralizing poison. 5. Pericarpium Granati and Cortex Betulae Platyphyllae is useful method to external care. To use the herba, pulverize amount of property and then apply to the affected part. Conclusion : This study showed that Pericarpium Granati and Cortex Betulae Platyphyllae is useful herb to treat of skin disease and useful method to external care.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.22 no.2
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• pp.100-106
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• 2012

Objectives: Diazinon is an insecticide which acts as a contact stomach and respiratory poison, and used throughout the world to control a wide range of sucking and chewing insects and mites on a range of crops. In this study, the airborne diazinon levels were measured for farmers, pest control operaters, landscapers, and agricultural chemicals sellers, and an assessment of the health risk to the workers was presented. The exposure scenario was based on the route of inhalation and skin absorption. The "OSHA Method No. 62" was used to sample and measure the airborne diazinon levels. The skin wipe method was applied to measure the level of the diazinone exposure through the skin. For the determination of exposure scenario, the exposure factors were surveyed for the daily average inhalation rate and the exposure period and frequency and time of diazinone as well as the body weight and lifetime of the workers. The median values of exposure frequency and exposure time were selected after evaluating the validity of those. Methods: The highest level of the diazinon exposure in the air was $107.21ug/m^3$ in farmers, followed by $93.53ug/m^3$ in landscapers, at $31.40ug/m^3$ in pest control operators, and $1.04ug/m^3$ in agricultural chemical seller. The amount of skin absorption was the highest in farmers at 63.39 ug/day, followed by landscapers at 10.47 ng/day, pest control operaters at 4.26 ng/day, and agricultural chemicals sellers at 0.34 ng/day. The hazardous indices calculated using toxicological reference value were 2.79 for pest control operaters, 0.41 for landscapers, 0.07 for agricultural chemicals sellers, and 0.06 for farmers. Conclusions: While the farmers were exposed to the high levels of diazinon through the air and skin, the pest control operaters, landscapers and agricultural chemicals sellers have more the diazinon hazards than the farmer based on the risk assessment in this study.

• Korean Journal of Social Welfare Studies
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• v.45 no.3
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• pp.35-69
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• 2014

This study was conducted to explore initial motherhood experience of non-married mothers who decided to raise their babies. We applied Rennie's hermeneutic grounded theory for this study in which 7 non-married mothers participated. 9 hermeneutic categories which are 'decision to give birth', 'feeling of hitting bottom', 'ambivalence toward a life in stomach', 'realization of motherhood', 'motherhood anxiety', 'the bridle of social tag', 'hope of motherhood', 'encounter with new self' and 'visage of weary life' were constructed based on 145 meaning units, 34 subordinate categories. The core category that integrates motherhood experiences of participants was postulated as living with two conflicting visages of motherhood which are a cure and a poison at the same time. Motherhood experience processes were emerged in five stages which are decision to give birth, psychological frustration, realization of motherhood, confusion, and hope and discouragement of motherhood. Three types of motherhood experience were analyzed in the study which are adaptative, conflictive, and resistant. Based on the result of the study, the motherhood experience of non-married mother who decided to raise their babies are the process of emergence of new identity called mother. The non-married mothers formed their motherhood identities as they internalize socioculturally granted motherhood ideology. Moreover, the gap between socially oriented motherhood and realistic role of motherhood led to confusion. Based on this study, we suggest intervention plans to the field of social welfare practice that will support initial motherhood of non-married mothers who decided to keep their babies.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.108-117
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• 2019

Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.

• 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.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.52 no.3
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• pp.241-246
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• 2019

To understand the characteristics of paralytic shellfish poisoning in a major production area of the bay scallop Argopecten irradians in Korea, the seasonal variation and anatomical distribution of paralytic shellfish toxin (PST) were determined in bay scallops collected from the Gyeongnam coast of Korea from March to May 2018. PST levels in bay scallops in the survey area showed remarkable seasonal variation. PST was first detected at a level of 0.42 mg/kg on April 2, 2018, and the highest toxin level (3.15 mg/kg) was recorded on April 12. Among the tissues of bay scallops, the highest proportion of PST was found in the viscera ($54.9%{\pm}17.8%$), followed by the adductor ($22.8%{\pm}10.9%$), gonads ($8.9%{\pm}4.6%$), gills ($7.1%{\pm}3.7%$), and mantle ($6.3%{\pm}.8%$). In addition, with higher PST levels in the whole tissues of bay scallops, the proportion of PST in the viscera increased, whereas those in the mantle, gill, and gonad tissues decreased. In a high-toxicity group with more than 2.0 mg/kg PST in the whole tissues, the proportion of PST in the viscera was $71.8%{\pm}6.7%$.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.68-74
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• 2018

Purpose: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. Methods: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cut-off values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over '100-treatment line'. Results: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (${\chi}^2$ test for trend, ${\chi}^2=22.66$, p-value<0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. Conclusion: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.86-92
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• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.