• 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.

• Korean Journal of Occupational Health Nursing
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• v.3
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• pp.31-40
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• 1993

The objective of this study was examine sick leave rates of hospital employees. The sick leave data of 2,123 employees in three(3) general hospitals located in Seoul during the period from January 1, 1992 to December 31, 1992 was analyzed to achieve the study objective. The sick leave rates were computed in compliance with the standards recommended by the International Association on Occupational Health. Univariate analysis methods($X^2$-test and ANOVA) were used to assess the sourse of variance in the rates. The results were as follows : 1. The total annual rates of sick leave were 4.8% in frequency(persons), 0.23% in lost time, 0.68 days in duration and 14.0 days in severity. 2. The sick leave rates of frequency(person). duration and lost time were significantly higher in female than male, in groups of 40-49 years than in the other age group, the married than the unmarried and in the long employment of 8 years or above than the short employment. But there was no significant difference in the rate of severity. Only the sick leave rate of frequency(person) was significantly related to the educatial status, but there was no significant difference in other analytical factors of sick leave rate. 3. The main causes of sick leave were injury and poisoning(24.3%), and disease of the digestive system, disease of the nervous system and sense organs, and complications of pregnancy, childbirth and puerperium(respectively 11.6%). The severity rate was the highest in neoplasms(32.2 days), and followed by endocrine, nutritional and metabolic disease and immunity disorders, injury and poisoning, and infections and parasitic disease in descending order. 4. The sick leave rates of frequency(person), duration and lost time were the highest in nutritional workers followed by registered nurses. However, severity rate was the highest in doctors and pharmacists and followed by in nutritional works. 5. The main cause of sick leave was complication of pregnancy, childbirth and puerperium in registered nurses(26.3%), injury and poisoning in nutritional workers(78.6%) and disease of respiratory system and digestive system in other workers.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.71-77
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• 2015

Purpose: Acute endosulfan poisoning is rare but causes significant morbidity and mortality. The aim of our study is to describe complications and features of seizure and determine factors associated with mortality in acute endosulfan poisoning. Methods: Twenty-eight adult patients with acute endosulfan poisoning admitted to our emergency department during a 15-year period were studied retrospectively. The clinical features of seizure, use of antiepileptic drugs during seizure, and hospital courses were evaluated. Clinical factors between survived group and non-survived group were compared for identification of factors associated with mortality. Results: Of the 28 patients with endosulfan poisoning, 4 patients (14.3%) died and 15 (53.6%) patients developed generalized tonic-clonic seizure. Thirteen patients (46.4%) and 5 patients (17.9%) progressed to status epilepticus (SE) and refractory status epilepticus (RSE), respectively. SE and RSE were associated with mortality. Almost all significant complications including shock, acute renal failure, hepatic toxicity, rhabdomyolysis, and cardiac injury developed in SE and RSE patients. Conclusion: SE and RSE were important contributors to death in endosulfan poisoning. Emergency physicians treating endosulfan poisoning should make an effort not to progress seizure following endosulfan poisoning to SE and RSE using a rapid and aggressive antiepileptic drug.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.72-82
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• 2021

Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.62-70
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• 2015

Purpose: Cardiac complications may occur in cases of organophosphate (OP) poisoning. However, a few studies regarding patterns of cardiac toxicity as determined by transthoracic echocardiography (TTE) after exposure to OP have been reported. In the current study, the authors examined cardiac functions using TTE in patients with myocardial injury caused by exposure to OP. Methods: A retrospective review was conducted on 16 consecutive cases of OP poisoning with myocardial injury (defined as elevated troponin I within 48 hours of arrival at the regional emergency center in South Korea and diagnosed and treated at the center from January 2012 to November 2014. Results: TTE was performed in 11 (69%) of the 16 patients with an elevated troponin I (TnI) level within 48 hours. Of these 11 patients, 5 patients (45.5%) exhibited reduced ejection fraction (EF), and 3 exhibited regional wall motion abnormality (RWMA). Two patients (18.2%) had both reduced systolic function and RWMA. Two of the 5 patients with reduced EF returned to normal systolic function, however two patients did not regain normal systolic function after admission. One patient expired due to multiple organ failure, and 4 patients were transferred with a moribund status. Twelve of 15 patients who survived to discharge (at 4 to 35 months) were followed. Five of these patients died during follow-up and 7 survived without further complications. Conclusion: OP can cause reversible cardiac dysfunction including reduced systolic function and RWMA. Serum TnI may be useful for initial assessment of cardiac function during the workup of patients suffering from OP poisoning. After the initial assessment of cardiac enzyme, further evaluation with TTE in patients with abnormal cardiac enzyme will be necessary to understand the cardiac toxicity.

• The Journal of Pediatrics of Korean Medicine
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• v.20 no.3
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• pp.143-160
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• 2006

Objectives : As the side effect brought up by internet game addiction, many reports come out, but most of past articles are for middle or high school students. There is seldom a poisoning game treatise to a primary school student, if there is treatise, it is real condition that treatise for lead pipe with psychological reasons is seldom discussion about physical symptoms. This research searches high grade elementary students' game use actual conditions and when divide to general user group, latent danger use group, high dangerous use group, according to serious illness degree of game poisoning, three groups and game poisoning happens, recognized about body symptoms that happen much. Methods : Target population of these questionnaire are fifth and sixth grade elementary student of Seoul city 2 school. Chose 263 elementary students, 144 men, 119 women who understand purpose of research and admit participation is 25 October, 2006 since 1 September, 2006 Results : As poisoning serious illness degree is high, there are many number of game times, much more boys are addicted to internet game than girs, insomnia is apt to happen frequently in game poisoning danger group, and correlation is high by megrim, shoulder ache, digestive trouble. Insomnia, symptoms that show next even if some symptoms show first because there is high correlation between megrim, shoulder ache, digestive trouble is high possibility to happen among four symptoms. Insomnia, megrim, shoulder ache, digestive trouble that happen by internet game poisoning, is apt to increase by increasing addiction. Symptoms treatment can divide by internal treatment that treat insomnia, megrim, digestive trouble, external treatment that is typical symptoms of VDT syndrome shoulder ache, headache, fatigue persimmon. Root treatment is mind symptoms treatment. Game addiction treatment is relationship method 'seven emotions injury treatment' in oriental medicine. 'promote the normal flow of qi' and 'adjustment of suitable emotion' can talk as pivotal point of treatment.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.252-257
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• 2019

Hyperbaric oxygen therapy (HBOT) is used to treat carbon monoxide (CO) poisoning. However, untreated pneumothorax is an absolute contraindication for HBOT. More caution is needed with regard to monoplace hyperbaric chambers, as patient monitoring and life-saving procedures are impossible inside these chambers. Central catheterization is frequently used for various conditions, but unnecessary catheterization must be avoided because of the risk of infection and mechanical complications. Herein, we describe a case of CO poisoning in which iatrogenic pneumothorax developed after unnecessary subclavian central catheterization. The patient did not need to be catheterized, and HBOT could not be performed because of the pneumothorax. Hence, this case reminds us of basic-but nonetheless important-principles of catheterization.

• Journal of Environmental Health Sciences
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• v.38 no.6
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• pp.451-459
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• 2012

Background: In Korea, a healthy 36-year-old man developed acute interstitial pneumonitis soon after inhaling a waterproofing spray which he had applied at home to his outdoor jacket. Objectives: The objectives of this study were to review cases of varying degrees of respiratory toxicity and poisoning in connection with the use of waterproofing spray and summarize major reasons for cases of poisoning. Methods: We searched articles reporting on a combination of a waterproofing agent and/or respiratory symptoms, including acute respiratory syndrome, lung injury, pneumonia, pulmonary toxicity, and respiratory disease. Results: We reviewed a number of cases of varying degrees of respiratory toxicity and poisoning resulting from inhalation of waterproofing spray containing fluorocarbon co-polymer, solvents and propellants reported in a variety of countries. The literature searches concluded that among the ingredients of waterproofing agents, fluorinated polymer may cause acute respiratory health effects. Conclusion: Environmental policy should be implemented in order to prevent consumers from using household and industrial products including waterproofing agents. In addition, a national surveillance system should be created to collect cases of poisoning caused by the use of consumer products.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.82-89
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• 2008

Objective:　We compared the prevalence of injury and poisoning in the agricultural and fishery population with that of the general population.Methods: The national health insurance data and agricultufor this study. The age-adjusted standardized morbidity ratio was used to compare the prevalence of all injuries and poisonings of the agricultural and fishery population with that of the general population for the year 2002, as well as the prevalence of certain injuries and poisonings common to the agricultural and fishery population. The age-adjusted standardized morbidity ratio and 95% confidence intervals were attained by using the general population as the standard population group.Results: The age-adjusted standardized morbidity ratio of total injuries and poisonings was significantly high in the agriculture and fishery population. The standardized morbidity ratio was 137.6 in the male agriculture and fishery population and 123.3 in the female agriculture and fishery population. In terms of injuries and poisonings common to the agriculture and fishery population, the age-adjusted standardized morbidity ratio was significantly high regarding the dislocations and strains of lumbar spine/pelvis, shoulder and neck, the fracture of rib/thoracic spine/sternum and pesticide poisoning.Conclusions: The overall prevalence of injury/poisoning was significantly higher in the agriculture and fishery population than in the general population. Various forms of research should be conducted on the injuries of the agriculture and fishery population in the future. In order to compare the differences in the prevalence rates of injuries according to time and region, standard definitions of injuries and occupation related injuries are required.

• Journal of Environmental Health Sciences
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• v.49 no.3
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• pp.149-158
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• 2023

Background: Injury is one of the major health problems in South Korea. Few studies have evaluated both intentional and unintentional injury when investigating the association between exposure to air pollutants and injury. Objectives: We aimed to explore the association between short-term exposure to ambient air pollution and years of life lost (YLLs) due to injury. Methods: Data on daily YLLs for 2002~2019 were obtained from the the Death Statistics Database of the Korean National Statistical Office. This study estimated short-term exposure to particulate matter with an aerodynamic diameter of <10 ㎛ (PM₁₀), particulate matter with an aerodynamic diameter of <2.5 ㎛ (PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and ozone (O₃). This time series study was conducted using a generalized additive model (GAM) assuming a Gaussian distribution. We also evaluated a delayed effect of ambient air pollution by constructing a lag structure up to seven days. The best-fitting lag was selected based on smallest generalized cross validation (GCV) value. To explore effect modification by intentionality of injury (i.e., intentional injury [self-harm, assault] and unintentional injury), we conducted stratified subgroup analyses. Additionally, we stratified unintentional injury by mechanism (traffic accident, fall, etc.). Results: During the study period, the average daily YLLs due to injury was 307.5 years. In the intentional injury, YLLs due to self-harm and assault showed positive association with air pollutants. In the unintentional injury, YLLs due to fall, electric current, fire and poisoning showed positive association with air pollutants, whereas YLLs due to traffic accident, mechanical force and drowning/submersion showed negative associations with air pollutants. Conclusions: Injury is recognized as preventable, and effective strategies to create a safe society are important. Therefore, we need to establish strategies to prevent injury and consider air pollutants in this regard.