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      • KCI등재

        Different Clinical Courses for Poisoning with WHO Hazard Class Ia Organophosphates EPN, Phosphamidon, and Terbufos in Humans

        종구,문정미,이미진,전병조,Mun, Jong Gu,Moon, Jeong Mi,Lee, Mi Jin,Chun, Byeong Jo Korean society of Clincal Toxicology 2018 대한임상독성학회지 Vol.16 No.1

        Purpose: Extremely hazardous pesticides are classified as World Health Organization (WHO) hazard class Ia. However, data describing the clinical course of WHO class Ia OP (organophosphate) poisonings in humans are very scarce. Here, we compare the clinical features of patients who ingested hazard class Ia OPs. Methods: This retrospective observational case study included 75 patients with a history of ingesting ethyl p-nitrophenol thio-benzene phosphonate (EPN), phosphamidon, or terbufos. The patients were divided according to the chemical formulation of the ingested OP. Data regarding mortality and the development of complications were collected and compared among groups. Results: There were no differences in the baseline characteristics and severity scores at presentation between the three groups. No fatalities were observed in the terbufos group. The fatality rates in the EPN and phosphamidon groups were 11.8% and 28.6%, respectively. Patients poisoned with EPN developed respiratory failure later than those poisoned with phosphamidon and also tended to require longer mechanical ventilatory support than phosphamidon patients. The main cause of death was pneumonia in the EPN group and hypotensive shock in the phosphamidon group. Death occurred later in the EPN group than in the phosphamidon group. Conclusion: Even though all three drugs are classified as WHO class Ia OPs (extremely hazardous pesticides), their clinical courses and the related causes of death in humans varied. Their treatment protocols and predicted outcomes should therefore also be different based on the chemical formulation of the OP.

      • KCI등재후보

        자살시도 후 생존 퇴원한 환자에서 지역정신건강센터 등록 요인 분석 - 응급실 기반 자살시도자 관리시스템 자료 중심으로 -

        김동기 ( Dong-ki Kim ),전병조 ( Byeong Jo Chun ),문정미 ( Jong Mi Moon ),조용수 ( Yong Soo Cho ),배경열 ( Kyung-yeol Bae ),김현정 ( Hyun Jung Kim ),김미진 ( Mi Jin Kim ) 대한임상독성학회 2016 대한임상독성학회지 Vol.14 No.1

        Purpose: This study was conducted to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between January and September 2015 at the academic ED in the tertiary urban hospital. The variables examined included gender, age, address, type of insurance, history of previous psychiatric disease, suicide methods, number of previous attempts, CES-D (The Center for Epidemiologic Studies-Depression Scale), and disposition at ED. Univariate and multivariate logistic regression analysis were conducted to identify factors affecting the registration rate for the community-based post suicidal care program. Results: Overall, 331 suicides were investigated, 61 (18.4%) of which were registered in the post-suicide care program. Factors such as a intervention by psychiatric physician (OR: 3.287, 95%; CI: 1.207-9.624) and levels of depression by CES-D score of 16?24 (OR: 3.635; CI: 1.055-12.526) were significantly correlated with registration for the program. Conclusion: The registration rate for the community-based post suicidal care program was influenced by frequent intervention by a psychiatric physician and levels of depression by CES-D score of 16-24.

      • KCI등재

        Helicobacter pyloir 양성 소화성 궤양에서 lansoprazole 포함 삼제요법의 제균율 및 제균판정에 있어서 요소호기검사의 유용성

        정혜경,곽재진,유민아,배기선,정미,이종수,김도영,일환 대한감염학회 2003 감염과 화학요법 Vol.35 No.3

        목적 : 본 연구는 Helicobacter pylori (이하 H. polyri) 양성인 소화성 궤양 환자에서 lansoprazole 포함 삼제요법의 제균율을 알아보고, 제균 치료 후 제균 판정에 있어서 요소 호기 검사(Urea breath test, 이하 UBT) 및 신속요소분해(rapid urease test, 이하 RUT test)와의 일치율에 대하여 알아보고자 하였다. 방법 : 상부위장관내시경 검사에서 H. polyri 양성인 소화성 궤양환자에서 lansoprazole 60㎎+amoxicillin 2g+clarithromycin 1g의 약제를 2회 분복하여 1주간 복용하는 삼제요법을 실시하였다. 최소 4주후 추적 상부위장관내시경을 실시하였고, 전정부와 체부에서 각각 RUT를 실시하였으며 UBT(5분, 20분)를 시행하였다. 결과 : 대상환자는 총 46명으로 남자 34명(48±13세), 여자 12명(53±14세)이었다. LAC 삼제요법의 제균율은 40/46명(87.0%)이었고, 궤양의 치유율도 42/46명(91.3%)이었다. RUT와 20분 UBT 결과가 모두 음성이었던 경우는 41예, 모두 양성이었던 경우는 4예로 RUT와 UBT는 97.8% (45/46)의 일치율을 보였고, 1예는 UBT는 음성이었으나 체부에서 시행한 RUT가 양성이었다. 5분 UBT 검사가 양성이었던 예는 14/34 (41.2%) 이었고, 이 14예 중 12예(85.7%)는 20분 UBT 검사 음성, RUT 음성이었다. 결론 : Lansoprazole과 amoxicillin, clarithromycin 1주일 병합요법은 H. polyri 양성인 소화성 궤양 환자에서 87.0%의 제균율을 나타내어 우수한 효과를 보였고, 요소호기검사는 제균 치료 후 제균 판정에 유용한 비침습적인 방법임을 확인할 수 있었다. Background : There are only a few studies on Helicobacter pylori (H. pylori) for its eradication rates of lansoprazole-based triple therapy in Korea, and the results are controversial. Therefore, we undertook to investigate the eradication rate of lansoprazole-based triple therapy, and compare the concordance rate of urea breath test (UBT) and rapid urease test (RUT) in evaluating H. pylori eradication. Methods : Patients with acute peptic ulcer who were H. pylori-positive were recruited by prospective, consecutive manner. They received lansoprazole 30 ㎎ b.d., amoxicillin 1 g b.d. and clarithromycin 500 ㎎ b.d. for 1 week. Upper endoscopy was performed after 4 weeks to check for ulcer healing, and UBT and RUT were performed to evaluate H. pylori eradication status. Results : A total of 46 patients were recruited, and they were all compliant. H. pylori eradication rate was 87.0% (40/46) and ulcer healing rate was 91.3% (42/46). Forty one patients showed negative in both UBT and RUT, and 4 patients revealed positive in both tests, therefore, the concordance rate of UBT and RUT was 97.8% (45/46). Conclusion : Our study showed that 1-week lansoprazole-based triple therapy was effective in H. pylori eradication and ulcer healing. UBT can be an effective, noninvasive method for evaluating H. pylori status after H. pylori eradication.

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