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대한임상독성학회지 = Journal of the Korean Society of Clini... 16건

  1. [국내논문]   비소 중독  

    김양호 (울산의대 산업 환경의학교실 ) , 이지호 (울산의대 산업 환경의학교실 ) , 심창선 (울산의대 산업 환경의학교실 ) , 정경숙 (울산의대 산업 환경의학교실)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 67 - 71 , 2004 , 1738-1320 ,

    초록

    Arsenic poisoning has three types of poisoning. First, acute arsenic poisoning is usually caused by oral intake of large amount of arsenic compound with purpose of homicide or suicide. Second, chronic arsenic poisoning is caused by inhalation of arsenic in the occupational setting or by long-term oral intake of arsenic-contaminated well water. Third, arsine poisoning occurs acutely when impurities of arsenic in non-ferrous metal react with acid. Clinical manifestation of acute arsenic poisoning is mainly gastrointestinal symptoms and cardiovascular collapse. Those of chronic poisoning are skin disorder and cancer. Arsine poisoning shows massive intravascular hemolysis and hemoglobinuria with acute renal failure. Exposure evaluation is done by analysis of arsenic in urine, blood, hair and nail. Species analysis of arsenic is very important to evaluate inorganic arsenic acid and mono methyl arsenic acid (MMA) separated from dimethyl arsenic acid (DMA) and trimethyl arsenic acid (TMA) which originate from sea weed and sea food. Treatment with dimercaprol (BAL) is effective in acute arsenic poisoning only.

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  2. [국내논문]   혈청 콜린에스테라제 활성도를 이용하여 유기인계 농약 음독 환자의 증증도를 예측할 수 있는가?  

    이상진 (이화여자대학교 의고대학 응급의학교실 ) , 정진희 (이화여자대학교 의고대학 응급의학교실 ) , 정구영 (이화여자대학교 의고대학 응급의학교실)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 72 - 76 , 2004 , 1738-1320 ,

    초록

    Purpose: Dealing patients with organophosphate poisoning, cholinesterase level has been used as a diagnostic and prognostic value. But there are some controversies that the cholinesterase level is significantly related to the severity or prognosis of acute organophosphate poisoning. We evaluated the correlation between initial serum level of cholinesterase and APACHE II score as an index for severity, and we assessed cholinesterase levels for predicting value of weaning from mechanical ventilation. Method: From August 1996 to March 2003, 23 patients with organophosphate poisoning who needed ventilatory care were enrolled. Retrospective review was done for the serum level of cholinesterase, APACHE II score, and the duration of ventilatory care. The percentage of measured serum cholinesterase to median normal value was used to standardize cholinesterase levels from different laboratories. Result: There were tendencies that the lower initial serum of cholinesterase, the higher the APACHE II score (r=0.297) and the longer the duration of mechanical ventilation (r=-0.204), but they were not significant (p=0.264 and p=0.351 respectively). In 9 patients whose serum cholinesterase level were checked at the time of weaning, mean of measured cholinesterase level was $10.3\pm7.60\%$ of normal value. Conclusion: There was no significant relationship between initial level of serum cholinesterase and severity or duration of mechanical ventilation. General health status of patient, amount of ingestion, toxicity of agent should be considered as important factors for severity of poisoning. And the decision of weaning should be based not solely on the cholinesterase level but on the consideration of general and respiratory state of individual patients.

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  3. [국내논문]   2002년 농약중독 사망자 통계청 자료 분석 및 제초제 중독으로 인한 사망사고 예방 대책  

    김욱진 (안동 응급의료센터 흉부외과 ) , 김효윤 (안동 응급의료센터 흉부외과 ) , 김승환 (연세대학교 의과대학 응급의학교실 ) , 김선욱 (연세대학교 의과대학 응급의학교실 ) , 조영순 (연세대학교 의과대학 응급의학교실 ) , 정성필 (충남대학교 의과대학 응급의학교실 ) , 이한식 (연세대학교 의과대학 응급의학교실)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 77 - 82 , 2004 , 1738-1320 ,

    초록

    Backgrounds: Deaths from pesticides poisoning has increased annually, but no studies have been reported. Especially paraquat is suspected to be a major material in pesticide poisoning deaths. In Korea, simple epidemiology of pesticides poisoning is not well known. So, there is no effective method to prevent pesticides poisoning. We tried to investigate the present status of pesticides poisoning with data from Korea National Statistical Office and suggest an effective counterplan. Methods: We analysed death cause data derived from Korean Statistical association, deaths causes being pesticides poisoning in the year 2002. Also, we investigated data from internet, mainly from Korea National Statistical Office home page. Results: Total 2,875 persons died after pesticides poisoning in 2002 year. Average age is 54.2 year, standard deviation being 17.7 year. Many victims (about $41\%$ ) died during the herbicides' non-necessary period (JanuaryMarch, October-December) Conclusion: Herbicides sale should be restricted only during herbicides' necessary period, and so called a pesticides safety supervisor system shall effectively prevent herbicides poisoning.

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  4. [국내논문]   강원 영서 북부 지역의 약물 중독 실태  

    옥택근 (강원대학교 의과대학 강원대학교병원 응급의학교실 ) , 조준휘 (강원대학교 의과대학 강원대학교병원 응급의학교실 ) , 박찬우 (강원대학교 의과대학 강원대학교병원 응급의학교실 ) , 김성은 (한림대학교 춘천성심병원 응급의학과 ) , 최기훈 (한림대학교 춘천성심병원 응급의학과 ) , 배지훈 (한림대학교 춘천성심병원 응급의학과 ) , 서정열 (한림대학교 춘천성심병원 응급의학과 ) , 정재봉 (한림대학교 춘천성심병원 응급의학과 ) , 안희철 (한림대학교 춘천성심병원 응급의학과 ) , 안무업 (한림대학교 춘천성심병원 응급의학과 ) , 유기철 (한림대학교 한강성심병원 응급의학과)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 83 - 89 , 2004 , 1738-1320 ,

    초록

    Acute poisoning is one of the diseases which need the most fastest emergency measures at the very beginning. However, at present, The Korea doesn't manage the toxication all over the country, and in particular, there is no guide to medical cure paying due regard to the traits of each area. This paper focused on the issue that the necessary data in preparing the facilities for the treatment of the poisoned patients and materials for medical treatment including antidote would have to be collected, after finding the special features of the symptoms by searching the present conditions of the poisoning in small towns next to farm villages in the North area of Youngseo, Kangwon province. This study was based on the questionnaires from 111 patients who were carried into the emergency room by the poisoning in two university hospitals of the North area of Youngseo, Kangwon, for one year, 2002. Upon investigation, the patients(111) visiting emergency room by the acute poisoning during the research period was found to be 0.37 percent of all patients(30,085) visiting emergency room. Among them, the most high percentage was given in their twenties and thirties at the rate of $39.6\%$ , and the ratio( $40.5\%$ ) of the poisoned patients after their fifties was much higher than a research( $10\%$ ) of other areas. Many poisoned patients came to their rescue in an emergency room generally in spring and in winter, from 7 a.m. to 3 p.m. Agricultural chemical of the toxic materials had a majority at a ratio of $57.7\%$ , and paraquat of the agricultural chemicals was found to have a lot of toxicity by $31.7\%$ . As the trace of the toxication, the oral poisoning was common by $89.2\%$ , and $55.9\%$ in the case of operating gastric lavage and nasogastric irrigation, but only $14.4\%$ for prescribing antidote. The mortality of the acute poisoned patients was $17.2\%$ , and the toxication by paraquat held a majority. As a result, the acute poisoning of the North area in Youngseo, Kangwon had both of the characteristics of the rural and the city, and the patients over their fifties by the population aging had more attack of the disease than other regions. Also, with the high ratio of the toxication by the agricultural chemicals, especially, the lethal agricultural chemical was used frequently. Therefore, these dangerous situations need to find the ways to cope with.

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  5. [국내논문]   일개 응급센터에 내원한 급성 중독 환자군의 특성 비교  

    정현욱 (전북대학교 의과대학 응급의학교실 ) , 김호권 (전북대학교 의과학연구소 ) , 정태오 (전북대학교 의과학연구소 ) , 진영호 (전북대학교 의과대학 응급의학교실, 의과학연구소 ) , 이재백 (전북대학교 의과대학 응급의학교실, 의과학연구소)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 90 - 95 , 2004 , 1738-1320 ,

    초록

    Purpose: The purpose of this study is to compare the toxicologic characteristics of two groups of patients with acute intoxication for two different time periods and to make recommendations based on the results of this study. Methods: We reviewed retrospectively the medical records of patients with acute intoxication in our emergency center from June 1997 to May 1998 (group A) and from June 2000 to May 2003 (group B), and we evaluated differences in the epidemiologic and the toxicologic characteristics between the two groups. Results: The ratios of the number of patients with acute intoxication to the total numbers of patients who visited our emergency department were $0.49\%$ and $0.52\%$ for groups A and B, respectively. In both groups many poisoned patients visited our emergency center from 4:00 pm to midnight. The interval between the time of intoxication and arrival at the hospital was significantly shorter in group B. The number of patients transferred to our emergency center was larger in group B. Attempted suicide was the major cause of acute intoxication in both groups. Major toxic substances in both groups were centrally active drugs and insecticides. The number of comatose and mechanically ventilated patients was larger in group B. However, there was no statistically significant difference in the mortality rates. Conclusion: Emergency physicians who manage intoxicated patients should recognize regional characteristics and differences in the toxicologic characteristics of poisoning. In addition, the establishment of a poisoning control center in the regional emergency center is necessary to integrate data control and to enhance specialized management of intoxicated patients.

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  6. [국내논문]   알코올이 약물 중독 환자에게 미치는 영향  

    김현 (연세대학교 원주의과대학 응급의학과 ) , 원호경 (연세대학교 원주의과대학 응급의학과 ) , 김호중 (연세대학교 원주의과대학 응급의학과 ) , 이서영 (연세대학교 원주의과대학 응급의학과 ) , 이강현 (연세대학교 원주의과대학 응급의학과 ) , 황성오 (연세대학교 원주의과대학 응급의학과)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 96 - 100 , 2004 , 1738-1320 ,

    초록

    Purpose: This study was to investigate the effects of ethanol in ingested patients by analyzing data from a single institution's registry, Methods: We conducted a prospective study of 50 patients who has ingested drugs with/without ethanol came to emergency department from January 2004 to May 2004. Only patients over 18 years of age were included. Clinical characteristics, general and specific treatment, laboratory finding, complication, and clinical outcomes were obtained from protocol. Patients were divided into two groups: drug ingested with alcohol (ethanol group, n=18), and ingested without alcohol (non-ethanol group, n=32). Results: The age, the amout of ingestion, the time to treatment, the systolic blood pressure, the diastolic blood pressure and the shock duration were not different between two groups. The AST level with the ethanol group was higher than with the non-ethanol group ( $230.94\pm518.88$ U/L vs $43.22\pm63.39$ U/L, p=0.002). The ALT level with the ethanol group was higher than with the non-ethanol group ( $97.06\pm152.98$ U/L vs $32.75\pm43.10$ U/L, p=0.001). The lactic acid level with the ethanol group was higher than with the non-ethanol group ( $7.40\pm6.33$ mmol/L vs $3.77\pm3.10$ mmol/L, p=0.001). The hospital stay duration and the admission rate were not different between two groups. Conlusions: The ethanol increased the levels of serum AST, ALT and lactic acid in intoxicated patients. But the ethanol dose not increase admission rate and duration of admission stay in intoxicated patients.

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  7. [국내논문]   파라콰트에 의한 피부 손상의 임상적 고찰  

    양종오 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 농약중독연구소 ) , 길효욱 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 농약중독연구소 ) , 이은영 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 농약중독연구소 ) , 홍세용 (순천향대학교 의과대학 내과학교실, 순천향대학교 천안병원 농약중독연구소)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 101 - 105 , 2004 , 1738-1320 ,

    초록

    Purpose: Paraquat is the most commonly used herbicide in Korea. Exposure to paraquat through the skin has resulted in local irritation or inflammation of varying degree, sometimes severe. The purpose of this study was to review the patients with paraquat poisoning by skin absorption. Methods: We analysed retrospectively the clinical and laboratory findings of 45 patients with paraquat poisoning after dermal exposure, who were admitted to Soonchunhyang University Cheonan Hospital from January 1999 to December 2003. Results: Among 870 cases of paraquat poisoning, 45 cases were exposed to paraquat through the skin. The peak incidence was the fifth decade( $40\%$ ). The clinical symptoms were pain, pruritus, nausea, and vomiting. The major skin lesions were generalized vesicobullae and necrotic erosion in face, scrotum, trunk, upper and lower extremities and etc. All patients were survived after skin contact or inhalation of paraquat. Conclusion: This study illustrates the extreme toxicity of paraquat and demonstrates that lethal quantities of paraquat may be absorbed if repeated exposure to it. Stricter precautions, including the mandatory use of protective clothing, should be recommended whenever this material is used.

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  8. [국내논문]   응급실을 경유하여 입원한 자살시도자들의 분석 -정신병력, 자살시도력 및 정신과적 진단을 중심으로-  

    허재민 (아주대학교 의과대학 응급의학교실 ) , 전우찬 (아주대학교 의과대학 응급의학교실 ) , 민영기 (아주대학교 의과대학 응급의학교실 ) , 정윤석 (아주대학교 의과대학 응급의학교실)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 106 - 115 , 2004 , 1738-1320 ,

    초록

    Purpose: This study analyzed the general features, psychiatric histories, past suicidal attempts and psychiatric diagnoses of suicide victims admitted via the emergency department (ED). Methods: Reviewing the charts of 138 inpatients of suicide attempts admitted via the ED from January 2002 to December 2003, we analyzed various data, including sex, age, season, stressful events, psychiatric histories, previous suicidal attempts, and psychiatric diagnoses during admission, and we used a chi-square test to chart the statistical data. Results: A significant difference was found between 1 st attempts and repeated attempts as to the mechanical methods used for the suicide attempts, There was a significant difference in the kinds of drugs between patients with and without psychiatric histories. In the psychiatric diagnosis, there was a significant difference in AXIS I between patients with and without psychiatric histories. In AXIS II, there was a significant difference between patients with and without psychiatric histories, 1st attempts and repeated attempts. Conclusion: We emphasize the importance of psychiatric consults, treatments, and follow-ups for suicide victims and the emergency physicians' function in helping them to contact psychiatric doctors.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

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  9. [국내논문]   급성 버섯중독으로 인한 간손상의 추적 조사  

    오범진 (울산대학교 의과대학 응급의학교실 ) , 김원 (울산대학교 의과대학 응급의학교실 ) , 임경수 (울산대학교 의과대학 응급의학교실)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 116 - 122 , 2004 , 1738-1320 ,

    초록

    Purpose: Several risk factors related with chronic complications and mortality related with liver injury of mushroom poisoning were reported. But, there were few reports about the long term outcomes. The aim was to evaluate the long term clinical outcomes in mushroom poisoning regarding the risk factors. Methods: Clinical data were reviewed and outcomes were evaluated with medical records and/or telephone interviews. The patients who had one or more risk factors such as markedly elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT), prolonged prothrombin time (PT) were classified into high risk group. Patients had no risk factor classified into low risk group. Results: From June 1989 to December 2003, nineteen mushroom poisoning patients admitted to Asan Medical Center, seven were male, and mean age was $58\pm9$ years old. All the patients accidentally ingested and the interval from ingestion to symptom onset was $9\pm4$ hours. There were four patients in high risk group, and fifteen in low risk group. In high risk group, peak AST was $2,263.3\pm1,303.0IU/L$ most prolonged PT was $38.0\pm27.4\%$ , and stuporous mental status was shown in one patient. In low risk group, laboratory values returned to the normal values but histological evaluation revealed specific features of toxic hepatitis on sixth hospital day. Chronic complications such as persistent or chronic hepatitis, mortality was not occurred during follow up period (from 10 months to 16 years) in both groups. Conclusion: Although the number of patients were small, there were no chronic complications or mortality related with liver injury after mushroom poisoning regardless risk factors of chronic complications and mortality.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  10. [국내논문]   의료 관련 종사자들의 약물음독에 대한 고찰 -2곳의 응급의료센터 경험을 토대로  

    이미진 (가톨릭대학교 의과대학 응급의학교실 ) , 박해관 (가톨릭대학교 의과대학 신경외과 ) , 박규남 (가톨릭대학교 의과대학 응급의학교실 ) , 최승필 (가톨릭대학교 의과대학 응급의학교실 ) , 이원재 (가톨릭대학교 의과대학 응급의학교실 ) , 김세경 (가톨릭대학교 의과대학 응급의학교실)
    대한임상독성학회지 = Journal of the Korean Society of Clinical Toxicology v.2 no.2 ,pp. 123 - 128 , 2004 , 1738-1320 ,

    초록

    Purpose: In recent review of physician suicides] the relative risk of physicians is higher than the general population. The majority of physician suicide were by poisoning. The purpose of this study was to analyse the medical personnels with suicide by poisoning compared with the general population. Methods: We reviewed medical records of 15 medical related personnels with suicide by poisoning who visited the emergency medical centers of St. Mary's and Kangnam St. Mary's hospitals from March 1998 to Aug 2004. For the comparison with general population in analysis] the collected data was acquired from medical records of 677 intoxicated patients in St. Mary's Hospital during the same period. Results: Fifteen suicides of physicians (n=7), nurses (n=4), medical students (n=2), pharmacist (n=1) and medical assistant technician (n=1) was evaluated with regard to the method of poisoning. Preferred methods were ingestion of medications orally ( $54\%$ ) and by infusion/injection ( $46\%$ ). The results were compared with the general population group (n=677: oral ingestion of medications $98\%$ , inhalation $1.6\%$ ). Intoxications by infusion/injection predominated more clearly in physicians than in the total collective. Conclusion: Comparing with the general population, the tendency to a method of suicidal poisoning being typical of the profession rises among physicians and related occupations with the degree of specialization, caused by increasing knowledge, easier access to appropriate drugs and methods.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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