아마존 모토로 담수가오리(Potamotrygon motoro)의 척추 돌기 독 가시에 의한 손상 1례

좌민홍 ( Min Hong Choa ),전승호 ( Seung Ho Jun ),김덕환 ( Duk Hwan Kim ),박종수 ( Jong Su Park ),김수진 ( Su Jin Kim ),홍윤식 ( Yun Sik Hong ),이성우 ( Sung Woo Lee ) 대한임상독성학회 2013 대한임상독성학회지 Vol.11 No.1

Potamotrygon motoro, also known as the Marble motoro, is a potamodromous freshwater ray native to the basins of the Amazon River. Marble motoros were introduced to South Korea in the 2000s, and, because they are easy to raise, were sold as aquarium fish. The aim of this report is to illustrate a new case involving envenomation by a Marble motoro. A 35-year-old commercial aquarium assistant came to the hospital after being pricked by a Marble motoro. The clinical picture in this case showed acute local pain with minimal systemic manifestations. This patient recovered after receiving symptomatic treatment and wound care. This case of envenomation accentuates the potential for injury among people coming in contact with a venomous Marble motoro.

모션캡쳐 기술을 이용한 모바일기기용 기본소생술 교육용 컨텐츠의 제작

좌민홍(Min Hong Choa),정현수(Hyun Soo Chung),김승호(Seung Ho Kim) 한국의료시뮬레이션학회 2014 한국의료시뮬레이션학회지 Vol.3 No.1

Phenylpropanolamine 음독 후 발생한 심근허혈

박종우,좌민홍,박준석,조광현,Park Jong Woo,Choa Min Hong,Park Joon Seok,Cho Kwang Hyun 대한임상독성학회 2003 대한임상독성학회지 Vol.1 No.1

Phenypropanolamine (PPA) is a sympathetic amine used in over-the-counter cold remedies and weight-control preparations. The side effects are hypertension, dysrhythmias, stroke, etc. The Food and Drug Administration (FDA) is taking steps to remove PPA from all drug products and has requested that all drug companies discontinue marketing products containg PPA due to high risk of hemorrhage stroke. But, in Korea now, patinets take products containg PPA with over the counter. We report here the case of PPA induced myocardial injury in a young woman who takes overdose for suicide.

소아의 에틸렌글리콜 및 메탄올 중독에서 Fomepizole의 효과

민하나 ( Ha Na Min ),황윤정 ( Yoon Jung Hwang ),고동률 ( Dong Ryul Ko ),주영선 ( Young Seon Joo ),공태영 ( Tae Young Kong ),좌민홍 ( Min Hong Choa ),박인철 ( In Cheol Park ),정성필 ( Sung Phil Chung ) 대한임상독성학회 2017 대한임상독성학회지 Vol.15 No.2

Purpose: The purpose of this study is to evaluate the effectiveness and adverse effect of fomepizole in the management of acute ethylene glycol or methanol poisoning in children. Methods: Databases such as PubMed, Embase, Cochrane library, and KoreaMed were searched using terms related to fomepizole, ethylene glycol, methanol and pediatric. All studies, regardless of study design, reporting effectiveness or safety endpoints in children were included. Reference citations from identified publications were reviewed. Only reports written in English or Korean languages were included. The reference search was performed by two authors. Results: Twenty-two relevant literatures were finally included. They were one narrative review, 4 retrospective case series, and 17 case reports (19 cases). Case reports were classified as 5 fomepizole only, 8 fomepizole with other therapies, and 6 no fomepizole. All patients from the literatures were fully recovered without long term sequelae. Adverse effects of fomepizole were reported including anaphylaxis, thrombophlebitis and nystagmus. Conclusion: There are insufficient literatures regarding fomepizole treatment in children with ethylene glycol or methanol poisoning. The benefits or harms are not clearly established based on the clinical evidences. More prospective comparative studies are required in the future.

일부 지역의 전화상담을 통해 얻어진 독성물질 노출정보와 응급실 기반 중독 정보 분석

김수진 ( Su Jin Kim ),좌민홍 ( Min Hong Choa ),박종수 ( Jong Su Park ),이성우 ( Sung Woo Lee ),홍윤식 ( Yun Sik Hong ) 대한임상독성학회 2014 대한임상독성학회지 Vol.12 No.1

Purpose: The purpose of this study is to find differences in the demographics of toxic exposed patients and substance between call based poison information data and hospital based poison information data. Methods: Seoul 1339 call-response data were used as call based poison data and toxic related injury surveillance data of the Korean center for disease control and prevention (KCDC) were used as hospital based poison data. Age, sex, the kind of exposed substance, reasons for exposure, and exposure routes were compared between two data sets. We analyzed the presence or not of documentation on the name and amount of exposed substance, symptoms after exposure in call based poison data. Results: Seoul1339 poison data included a total of 2260 information related to toxic exposure and KCDC poison data included 5650 poison cases. There was no difference in sexual distribution. Pediatric exposure and accidental exposure were more common in call based poison data. The most common exposed substances were household products in call based poison data and medicines in hospital based poison data, respectively. Documents regarding amount and time of toxic exposure and symptoms after toxic exposure were not recorded exactly in call based poison data. Conclusion: There were significant differences in age, reasons for toxic exposure, and the kinds of exposed substances. Poison information data from both pre-hospital and hospital must be considered.

Amatoxin 중독 환자에서 Silymarin, Penicillin, N-acetylcysteine의 효과 비교: 체계적 고찰

최민우,고동률,공태영,좌민홍,유제성,정성필,Choi, Min Woo,Ko, Dong Ryul,Kong, Taeyoung,Choa, Min Hong,You, Je Sung,Chung, Sung Phil 대한임상독성학회 2018 대한임상독성학회지 Vol.16 No.1

Purpose: This study was conducted to evaluate the clinical efficacy of pharmacologic treatment of amatoxin poisoning patients. Methods: Literature was accessed through PubMed, EMBASE, Cochrane library, KoreaMed, KISS and KMBASE. Studies relevant to human use of pharmacologic therapy including silymarin, penicillin and N-acetylcysteine (NAC) for amanita poisoning were included. Case reports, letters, editorials and papers with insufficient information were excluded. Comparison of clinical outcomes (especially mortality and liver transplantation rate) in each study was analyzed. Results: The final analysis included 13 retrospective studies. None of these studies showed direct comparisons of individual agents. Among 12 studies comparing silymarin vs penicillin, eight showed clinical superiority of silymarin. Among eight studies comparing silymarin with NAC, six showed clinical superiority of silymarin. Among seven studies of NAC vs penicillin, five showed clinical superiority of NAC. Conclusion: This systematic review suggested that clinical superiority of various pharmacological agents used to treat amatoxin poisoning is debatable. Nevertheless, the available evidence suggests it is reasonable to consider combinations of multiple agents for patients with amanita poisoning. Further studies are required to establish a treatment regimen for amanita poisoning.

액상형 전자담배 용액에 의한 급성 니코틴 중독: 증례보고의 체계적 고찰

양시용 ( Si Yong Yang ),좌민홍 ( Min Hong Choa ),유제성 ( Je Sung You ),정현수 ( Hyun Soo Chung ),정성필 ( Sung Phil Chung ) 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.2

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.

출혈성 쇼크 환자에서 비교차시험 O+형 혈액 수혈의 유용성

이지환 ( Ji Hwan Lee ),좌민홍 ( Min Hong Choa ),조준호 ( Jun Ho Cho ),정성필 ( Sung Pil Chung ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.2

Purpose: It is important to begin a transfusion safely and appropriately as soon as possible in a hemorrhagic shock patient. A group O+ unmatched pack red blood cell (universal O+) transfusion may satisfy that requirement. We report our experiences with universal O+ to compare its usefulness for hemorrhagic shock patients with that of a matched pack red blood cell transfusion in the emergency department (ED). Methods: This is a retrospective study. Patients who had systolic blood pressure of less than 90 mmHg or a pulse rate of more than 120 beats per minute in the ED were included, and their medical records were reviewed. The collected data were demographic data, vital signs, blood test results, time to transfusion, the amount of transfusion, complications, and diagnoses. We calculated the emergency transfusion score (ETS) based on the patients` medical records. Results: Two hundred thirty-five patients were included. Forty-eight patients (36 trauma and 12 non-trauma patients) were transfused with a universal O+. These patients had less time to transfusion compared with the cross-matched transfusion groups (35±42 versus 170±187 minutes, p<0.001). There were no differences in complications between groups (p=0.076). Of the patients who were transfused with universal O+, 94.4% got more than 3 ETS. Conclusion: The universal O+ transfusion, compared with matched pack red blood cell transfusion, should be a useful treatment for ED hemorrhagic shock patient due to its having a shorter time to transfusion without an increase in complications. (J Korean Soc Traumatol 2009;22:167-71)

경추 손상 환자에서 전산화 단층 촬영 시행을 위한 임상적 기준: NEXUS 기준과 Canadian cervical spine rule

최양환 ( Yang Hwan Choi ),조준호 ( Jun Ho Cho ),좌민홍 ( Min Hong Choa ),박유석 ( Yoo Seok Park ),정현수 ( Hyun Soo Chung ),정성필 ( Sung Pil Chung ) 대한외상학회 2008 大韓外傷學會誌 Vol.21 No.1

Purpose: National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian Cervical Spine rule (CCR) are commonly used in cervical trauma patients to determine whether a plain cervical X-ray should be performed. However, plain cervical X-rays are so inaccurate that cervical spine computed tomography (CT) is often considered as a screening test. We studied the usefulness of the NEXUS criteria and the CCR for determining the need for a CT evaluation in the emergency department (ED). Methods: This prospective observational study was conducted from January 2007 to March 2008. Plain X-ray and CT scans of the cervical spine were performed on blunt trauma patients with neck pain. The relevancy of CT was examined using the NEXUS criteria and the CCR. Sensitivity, specificity, positive predicted value, and negative predicted value analyses were performed to diagnose the cervical spine injury. Results: During the study period, 284 patients were enrolled in this study. The sensitivity, specificity, positive predicted value, and negative predicted value of the NEXUS criteria were 87.5%, 1.1%, 5.0%, and 60.0% respectively, while those of the CCR were 87.5%, 8.2%, 5.3%, and 91.6%. There were two missed fracture cases when the NEXUS criteria and the CCR were applied independently, however, no cases were missed when both were applied. Conclusion: This study suggests the NEXUS and the CCR in combination can be used as a guide to CT evaluation for cervical spine injury in the ED.

한국 영화에 표현된 응급 처치의 적절성 평가

박인철,좌민홍,김승호 대한응급의학회 2002 대한응급의학회지 Vol.13 No.4

Purpose: As the lay public indirectly acquires medical knowledge through the mass media, it is desirable to show medically correct care in movies or TV dramas. We evaluated whether the emergency care depicted in Korean box-office movies is appropriate and medically sound. Methods: We selected Korean movies which more than 100,000 peoples had seen in Seoul from 1996 to 2001. We excluded fantasy or historical movies from the list. After searching the emergency situations in videos, including cardiopulmonary arrest, loss of consciousness, injuries, and medical emergencies, we evaluated whether the needed care was provided and properly done and whether the result was medically sound. Results: During the 6-year period, we found 46 emergency situations in 80 movies (0.6 per movie). Loss of consciousness was the most common emergency situation (34.8%), followed by cardiopulmonary arrest (15.7%). Emergency care was provided in 24 situations (52.2%), but was appropriate in only 8 among those 24 situations. Regardless of care, 50% improved and another 36.4% improved without any interventions. There was total of 106 necessary actions in the 46 situations: for instance, EMS system activation, airway maintenance, breathing and circulation support, spinal cord protection, and hemostasis. Only 21 among the 106 necessary actions (19.8%) were done. Hemostasis by external compression was the most common action done (44.4%), and airway maintenance was the least (3.6%). Conclusion: We found that emergency care and its result were not properly depicted in Korean box-office movies. Emergency physicians and the medical community should pay attention to this problem and serve as medical advisors to guarantee a medically sound portrayal.