• 대한임상독성학회지
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• 제20권2호
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• pp.82-85
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• 2022

Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or "e-liquid" leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.

• 대한임상독성학회지
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• 제18권2호
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• pp.78-84
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• 2020

Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

• Tuberculosis and Respiratory Diseases
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• 제62권2호
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• pp.113-118
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• 2007

연구배경: 파라쿼트 중독은 다발성 장기부전과 폐섬유화를 유발하여 높은 사망률을 초래한다. 폐섬유화의 약화를 위해 여러 종류의 면역억제제가 사용되었으나 그 치료효과는 다양하다. 철은 파라쿼트로 유발된 산화 스트레스에 의한 폐손상에 중요한 역할은 한다. 본 연구는 파라쿼트 중독의 치료시 철 킬레이트 제제인 deferoxamine의 효과를 보고자 시행되었다. 방 법: 2001년 10월부터 2005년 4월까지 파라쿼트 중독으로 내과계중환자실에 입원한 37명 중 28명이 본 연구에 포함되었다. 환자들은 서울아산병원의 파라쿼트 치료 프로토콜에 따라서 치료되었다. 이 중 12명이 추가로 deferoxamine 투여군으로 무작위 분류되었다. 결 과: 두 군간의 성별, 나이, 파라쿼트 중독의 정도, 섭취 후 병원까지의 도착 시간 등은 유의한 차이를 보이지 않았다. 파라쿼트 섭취 후 간기능과 신기능의 변화도 유의한 차이를 보이지 않았다. 전체 사망률은 두 군 간의 차이는 없었으나 deferoxamine 투여군에서 대조군과 비교시 호흡부전의 빈도가 높았다(4/7 versus 0/9, p=0.019). 결 론: 파라쿼트 중독 시 본 연구에서 적용된 용량과 기간의 deferoxamine (100mg/kg during 24 h)은 치료효과가 없을 것으로 사료된다.

• 농촌의학ㆍ지역보건
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• 제26권2호
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• pp.7-14
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• 2001

증례들은 40대 남자 1명과 여자 1명, 50대 여자 2명이었다. 담배 농사는 모두 10년 이상 종사하였다. 모두 어지러움과 구역을 호소하였으며, 구토, 두통, 설사, 쇠약감 등의 증상이 있었다. 이런 증상은 담배를 집중적으로 수확하는 시기에 발생하였으며, 날씨가 덥거나 땀을 많이 흘리는 경우에 증상이 심했다. 이슬에 젖은 담배잎을 수학하면서 증상이 발현되는 경우도 있었다. 최근 2-3년 동안에 상기 증상들이 1년에 2-3차례 발생하였다. 남자 1명이 고혈압으로 치료하고 있는 것을 제외하면 병력상 특이점은 없었으며, 모두 비흡연자였다. 증례들은 약국과 병원에서 수액요법 등으로 1일 이내에 호전되었다. 우리 나라에서 담배잎농부병의 유병률, 발생률 및 위험요인을 파악하기 위한 역학조사와 병 의원 감시체계를 가동하여야 한다. 담배잎을 수확하다가 어지러움과 구토를 주소로 내원하는 많은 사람들이 실제 담배잎농부병으로 진단되지 못하고 단순한 농약중독과 고온손상에 준하여 치료받는 경우가 많을 것으로 생각한다. 담배를 재배하는 농부는 물론 의료인에 대해서도 담배잎농부병의 예방과 치료에 대한 교육을 실시하여야 한다.

• BMB Reports
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• 제31권2호
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• pp.189-195
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• 1998

Methylmercury (MeHg), which is widely distributed in the environment, is well known for both its acute and chronic poisoning effects on the human health; however, the precise biochemical mechanisms by which this compound elicits its toxicity in a cellular level are still poorly understood. To examine whether MeHg-induced liver injury involves activation of Phospholipase $A_2$ ($PLA_2$), the $PLA_2$ activity of control and MeHg-administrated livers was measured. MeHg stably enhanced a liver form of cytosolic $PLA_2$ activity, which exhibited several biochemical properties similar to those of the 100 kDa $cPLA_2$, except in its elution profile of a DEAE-5PW HPLC, and it migrated as a molecular weight of 80 kDa in Western blot analysis. This blotting analysis also indicated that the MeHg-induced enhancement of the activity could be due to the increase in the amount of the enzyme protein rather than a stable modification of the enzyme such as phosphorylation. Our data also showed the higher myeloperoxidase activity in MeHg-administrated liver than in the control, suggesting that this increase in the amounts of the 80 kDa $PLA_2$ and its activity may be resulted from infiltration of neutrophils into the liver during a hepatic injury process such as MeHg-induced inflammation. Taken together, these data suggest that MeHg-induced liver injury may be mediated by activation of the 80 kDa form of liver cytosolic $PLA_2$.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권1호
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• pp.81-84
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• 2012

Gunshot wounds are unpredictable and require early, precise diagnosis and treatment. A penetrating gunshot wound can be fatal due to compromised airway, hypovolemic shock, lead poisoning and infection. This case report describes a 48-year-old male patient who had a suicidal gunshot wound on the right temporomandibular joint area using an air rifle. We successfully managed the patient by preoperative embolization, surgical removal of the foreign body and primary closure.

• 한국응급구조학회지
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• 제6권1호
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• pp.129-140
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• 2002

Purpose : To evaluate the emergency medical protocols and assessments through the case reports. Method : We studied retrospectively investigates the emergency calls through the 1339 emergency patients information center in 1997. Results : The emergency calls show an order : abdominal pain(13.5%), unconsciousness(12.0%), traffic accidents(7.4%), bleeding(6.6%), respiration difficulty(5.9%) by emergency medical protocols, and injury and poisoning(22.3%), symptom (51.6%), others (26.1%). Conclusion : The results suggest that a specific training program for emergency medical dispatchers should be established, and emergency medical dispatcher managers must review emergency medical dispatching cases on the basis of emergency medical protocols every year. Emergency medical services, furthermore, will continue to raise the standard for emergency medical dispatching.

• 대한간호학회지
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• 제31권4호
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• pp.538-547
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• 2001

Purpose: To evaluate the emergency medical protocols and need assessment through the case report Method: The study investigated the emergency call system through the 1339 emergency patients information center in 1997. Results: The emergency calls tend to follow general trends of the type of cases : abdominal pain (13.5%), unconsciousness(12.0%), traffic accidents (7.4%), bleeding (6.6%), respiration difficulty (5.9%). This was all collected through emergency medical protocols injury and poisoning (22.3%), symptom (51.6%), others (26.1%). Conclusion: The results suggest that a specific training program for emergency medical dispatchers should be established, and emergency medical dispatcher managers must review the cases on the basis of emergency medical protocols every year. Emergency medical services, furthermore, will continue to raise the standard for emergency medical dispatching.

• Clinical and Experimental Pediatrics
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• 제59권12호
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• pp.490-493
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• 2016

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents.

• Journal of Ginseng Research
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• 제34권2호
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• pp.132-137
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• 2010

Lead (Pb) is a metal that is generally considered to be toxic to the cardiovascular system. Pb-exposed animals display the evidence of increased oxidative stress and hypertension. The current study was designed to examine whether Korean red ginseng (KRG) has protective effects against Pb-induced hypertension and oxidative stress in Pb-exposed rats. Male Sprague-Dawley rats were randomly assigned to Pb exposure or control groups. KRG was administered in drinking water at a concentration of 100 mg/kg/day; the control group received plain drinking water. Animals in the Pb-exposed groups were provided with drinking water containing 100 ppm Pb acetate for 12 weeks. Blood pressure, plasma glutathione, blood Pb concentration, and hematologic data, such as red blood cell quantity, were determined. Pb poisoning was assessed by measuring the blood Pb concentration. Pb exposure (100 ppm) for 12 weeks resulted in a marked rise in systolic blood pressure and blood Pb concentration, as well as a significant reduction in plasma glutathione levels and red blood cell quantity. Other measurements, such as heart rate, body weight, and white blood cell quantity, were unchanged. Treatment with KRG significantly lowered blood pressure, raised plasma glutathione and increased red blood cell numbers in Pb-exposed animals; it also had no effect on heart rate, body weight, or white blood cell quantity. However, the elevated blood Pb concentration was not reduced by treatment with KRG (100 mg/kg). Taken together, these data indicate that treatment with KRG in Pb-exposed animals can reduce oxidative stress and lower blood pressure, suggesting that KRG might be protective against Pb-exposed hypertension and oxidative stress.