배양림프구에서 Paraquat의 세포독성에 대한 Vitamin C와 Deferoxamine의 항산화 효과

어은경,김경희,Eo Eun-Kyung,Kim Kyung-Hee 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Purpose: As basic information of antioxidant treatments for the patient with paraquat intoxication, in human peripheral lymphocytes, the cytotoxicity of paraquat was measured, and to evaluate the antioxidant effect of vitamin C and deferoxamine against this cytotoxicity, malondialdehyde (MDA), superoxide dismutase (SOD) activity and total antioxidant status (TAS) were measured. Methods: From 10 healthy adults, after obtaining a consent, 20ml peripheral blood was collected. Experimental groups were divided to (1) control group, the group treated with an identical amount of saline, (2) P group: the group treated with paraquat only, (3) PV group: the group treated with paraquat followed by vitamin C 30 minutes later, (4) PD group: the group treated with paraquat followed by deferoxamine 30 minutes later, (5) PVD group: the group treated with paraquat followed by vitamin C 30 minutes later and subsequently deferoxamine one hour later, and (6) PDV group: the group treated with paraquat followed by deferoxamine 30 minutes later and subsequently vitamin C 1 hour later, and thus to total 6 groups. In each group, 10 samples of peripheral blood was assigned and $100{\mu}M\;paraquat,\;100{\mu}M$ vitamin C, and $100{\mu}M$ deferoxamine were used as reagent. Lymphocytes were isolated, cultured, and cytotoxicity was measured by the Microculture Tetrazolium method (MTT assay), MDA and SOD activity, and TAS concentration were measured. Results: In regard to the cytotoxicity measured in each group, their cytotoxicity was decreased in the group treated with antioxidants, in comparison with the group treated with paraquat only. In the cases that the order of the treatment of these two antioxidants was altered, viability in the PDV group $(1.077{\pm}0.121)$ was increased more that the PVD group $(0.888{\pm}0.152)$ statistically significantly (p=0.018). Concerning the amount of MDA, in comparison with the P group $(6.78{\pm}0.93{\mu}mol/L)$, after the treatment of each antioxidant, the concentration of MDA was decreased statistically significantly (p<0.05). In the group treated with two antioxidants together, in comparison with the group treated only with one antioxidant, the amount of MDA was increased statistically significantly $(PV:\;3.96{\pm}0.98{\mu}mol/L,\;PD:\;4.92{\pm}1.50{\mu}mol/L,\;PVD:\;3.22{\pm}0.83{\mu}mol/L,\;and\;PDV:\;3.42{\pm}0.95{\mu}mol/L,\;p=0.007)$. The concentration of SOD measured in the blood in each group after the administration of paraquat, in comparison with the control group, a pattern of the elevation of SOD activity and subsequent decrease was detected, however, it was not statistically significant. In the comparison of the groups treated with antioxidants, in comparison with the P group $(1419.9{\pm}265.9{\mu}mol/L)$, SOD activity was decreased statistically significantly in only the PDV group $(1176.4{\pm}238.9{\mu}mol/L)$ (p=0.017). In regard to TAS measured in each group, in comparison with the P group $(0.87{\pm}0.05{\mu}mol/L)$, in all groups treated with the antioxidants, the PV group was $1.00{\pm}0.03{\mu}mol/L$ (p=0.005), the PD group was $9.01{\pm}0.24{\mu}mol/L$ was $4.64{\pm}3.98{\mu}mol/L$ (P=0.005), and the PDV group was $9.41{\pm}0.27{\mu}mol/La$ (p=0.005), and thus total antioxidant activity was increased statistically significantly In a multiple comparison test, the PDV group showed the highest total antioxidant activity (p<0.0001). Conclusion: The result of the assessment of the antioxidant effect of vitamin C and deferoxamine on paraquat-induced cytotoxicity showed that in regard to cytotoxicity, SOD activity and TAS measurement, the best result was observed in the PDV group. Therefore, it was found that vitamin C and deferoxamine were effective antioxidants for the paraquat-induced cytotoxicity, and it suggests that the administration of deferoxamine fol

보행속도와 중족지관절(MTPJ) 경사각의 변화에 따른 Hip-knee-ankle Joint의 상호운동 특성

어은경(Eun-Kyung Eo),김철웅(Cheol-Woong Kim) 대한기계학회 2010 대한기계학회 춘추학술대회 Vol.2010 No.11

Human walking is defined as repeated performance of sequence of movement by lower limb, hip, knee and ankle, and consists of stance and swing phases that include different body alignments. The gait is composed of multiple cycles that show similar connectivity of movement of each articulation in functional pattern of lower limb and it is important to observe the movement of each articulation compared with other movements. Consequently, the relation between articulation angles and timing is very important. Based on the assumption, in this study, we observed the flexion-extension angles of hip-knee-ankle movement and any changes in gait cycle when metatarsophalangeal joint angle and walking speed varied in normal adults. Consequently, no change was found in knee flexion-extension angles but the value of flexion angle peak in stance phase rose as metatarsophalangeal joint tilt angle and walking speed increased. The ankle as a whole showed plantar-flexion in its flexion-extension angle and plantar-flexion was larger than dorsiflexion to move forward. Furthermore, the stance phase in gait cycle was shorter as the walking speed became faster.

표준화 환자를 이용한 시뮬레이션에서 응급의학과 전공의의 실수 말하기 대화 내용 분석

어은경 ( Eun Kyung Eo ),김찬웅 ( Chan Woong Kim ),박경혜 ( Kyung Hye Park ) 대한의료커뮤니케이션학회 2021 의료커뮤니케이션 Vol.16 No.1

Background : We analyze the contents of conversations of emergency medicine (EM) residents in a simulation using standardized patients in error disclosure education, and examine the characteristics of them. Methods : Error disclosure education program was conducted for 15 EM residents at a training hospital. One case of near miss and one case of adverse event were developed, and all 15 residents participated in each case. The contents of 30 error disclosure conversation were analyzed. Results : Residents talked more in ‘Acknowledge what happened’ and ‘Response/Plan for care’, and it was rare to have conversations of ‘Tell me about it’ or ‘Answer questions’ in both cases. The cause of the incident was explained frankly, but when the patient blamed there were some residents who told honestly or not. There was a tendency to vaguely reveal the subject who made the mistake or attribute it to another cause. Most of residents apologized to the patient. Most of residents explained systematic recurrence prevention measures and compensation plans, but there were cases where the contents were not specific or inaccurate. Throughout the entire phase, the expression “we” was often used. Conclusion : Residents had doctor-led conversations while error disclosure, so that they need more patient-centered conversations. When apology, empathy and regret should be conveyed in various expressions. Residents need to be properly trained and able to explain to patients about follow-up measures such as systematic recurrence prevention measures and compensation plans. These results can be a basic material for teaching error disclosure or guidelines.

다이설피람-에탄올 반응에 의한 저체온증 1례

배현아,어은경,Bae, Hyun-A,Eo, Eun-Kyung 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1

Disulfiram (tetraethylthiuram disulphid) is used in the treatment of chronic alcoholism since it causes an unpleasant aversive reaction to alcohol. It works by inactivating hepatic aldehyde dehydrogenase, leading to pronounced rise in the acetaldehyde concentration when ethanol is metabolized. Acetaldehyde causes alcohol sensitivity, which involve vasodilation associated with feeling of hotness and facial flushing, increased heart rate and respiration rates, lowered blood pressure, nausea, headache. One of its metabolites, diethyldithiocarbamate (DDC) can inhibit the enzyme dopamine $\beta$-hydroxylase (DBH), this may account for the profound refractory hypotension and hypothermia seen with the disulfiram-ethanol reaction (DER), resulting from norepinephrine depletion. This report is presents the case of a patient we met, who presented with hypothermia caused by the disulfiram-ethanol reaction, and along with a brief review of the subject.

시안화칼륨 중독으로 인해 발생한 파킨슨씨병 1례

서주현,어은경,Suh, Joo-Hyun,Eo, Eun-Kyung 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.2

Acute cyanide poisoning is usually the result of attempted suicide which is often lethal within minutes or leads to a very poor prognosis after delayed and inadequate treatment. It affects the cerebral structures with the highest oxygen requirement, such as the basal ganglia, the cerebral cortex. We experienced a-45-year-old man who ingested Potassium Cyanide. He was stuporous. In 25 minutes, respiratory arrest developed and cardiopulmonary resuscitation was done. After return of spontaneous circulation, he admitted to intensive care unit, and conservative treatment was started. The clinical status was improved by degrees, but he couldn't perform daily activity like before. Minimal limitation of movement and memory deficit were left. In magnetic resonance imaging, which taken at the 11th day after admission, there were both basal ganglia and folia of cerebellum abnormality.

중독손상으로 퇴원한 환자에서 중독 양상 비교 - 전국 입원손상환자 조사사업 자료를 이용 -

정시영,어은경,김찬웅,박혜숙,김영택,Jung, Si-Young,Eo, Eun-Kyung,Kim, Chan-Woong,Park, Hye-Sook,Kim, Young-Tak 대한임상독성학회 2008 대한임상독성학회지 Vol.6 No.1

Purpose: There has been no nationwide surveillance survey of poisoning cases in Korea. This study examined the clinical characteristics of poisoning admissions in order to obtain preliminary data for future planning. Methods: This study retrospectively reviewed the data on poisoning admissions of 150 hospitals based on the hospital discharge injury surveillance data of Center for Disease Control and Prevention in Korea from January to December in 2004. The demographic data, poisons used, causes of poisoning, reasons for attempted suicide and mortality rate was investigated according to the age group. The factors associated with mortality were also evaluated. Results: A total 836 patients admitted for poisoning were analyzed. Their mean age was $46.5{\pm}19.5$ years (male 415, female 421). The most frequent age group was the 4th and 5th decades. The most common poisons involved were pesticides (45%) and medications (23%). The majority (64%) involved intentional poisoning except for those in the 1st decade. The most common reason for the attempted suicide was family problems. However, individual disease was the most common reason in those over 60 years. The overall mortality rate was 8.7% (73/836). Pesticides and being elderly (over 65 years old) were strongly correlated with fatality. Conclusion: The incidence of intentional poisoning increases from the 2nd decade making it a preventable injury. "Overall, the incidence of intentional poisoning increases from the 2nd decade". Therefore, there is a need to frame a prevention policy corresponding to each factor related to fatality, such as an elderly population and pesticides.

염소 가스 중독에서 나트륨 중탄산염의 흡입치료 2례

이동훈,어은경,Lee, Dong-Hoon,Eo, Eun-Kyung 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1

A chlorine gas is a common irritant and when exposed, it result in mild occular, oropharyngeal, or respiratory symptoms. In severe case, however, it may result in pulmonary edema, interstitial pneumonia, or respiratory failure. We report the case of 29-year-old and 46-year-old men is accidentally exposed to chlorine gas during cleaning water. The patients complained dyspnea, chest tightness, cough and both eye pain. During hospitalization, they were treated with inhalation of humidified oxygen, beta-adrenergic agonist and $2\%$ sodium bicarbonate. After several days, patients were discharged without respiratory symptoms and complication. In treatment of chlorine gas toxicity the inhalation of sodium bicarbonate is a possible initial therapy can improve respiratory symptoms in spite of lack of evidence.

하지강성 가변 인공건 액추에이터(LeSATA^®)의 개발 Part I - Metatarsophalangeal Joint Tilt Angle의 보행분석 -

한기봉,어은경,오승현,이순혁,김철웅,Han, Gi-Bong,Eo, Eun-Kyung,Oh, Seung-Hyun,Lee, Soon-Hyuck,Kim, Cheol-Woong 대한기계학회 2013 대한기계학회 논문집. Transactions of the KSME. C, 산업기술과 혁신 Vol.1 No.2

기존의 보행분석 연구들은 하지를 하나의 스프링으로 간주하였다. 만약 슬관절 신전을 보조할 수 있는 슬관절 액추에이팅 메커니즘을 개발할 수 있다면 보행에 필요한 탄성-변형률에너지를 혁신적으로 저장-방출할 수 있고, 그 결과 보행 중 하지강성은 더욱 증가할 것이다. 게다가 족관절 액추에이팅 메커니즘까지 추가되어 있다면 슬관절 액추에이터에 의한 과도한 인공하지강성을 능동적이고 적절한 수준으로 보상해주는 기전으로 작동할 것이다. 만약 가속도에 의한 보행속도 증가를 방지하기 위해 인위적 감속통제를 작동시킨다면 불필요한 운동에너지의 방출이 발생되고 하지강성 액추에이터의 실효성은 의심을 받게 된다. 따라서 본 저자는 보행속도를 2개의 세그먼트에 의한 상대 각속도 조절기법을 이용하여 하지강성을 증가시킨다는 기본개념으로 슬-족관절 액추에이터 시스템을 개발하였다. 또한 족관절에 슬관절 액추에이팅에 대한 보상기전이 존재하는 경우, 족관절의 보상기전이 중족지절관절 경사각 및 보행속도 변화에 미치는 상호영향을 연구하였다. The established gait analysis studies have regarded leg as one single spring. If we can design a knee-ankle actuating mechanism as a primary actuator for supporting knee extension, it might be possible to revolutionary store or release elastic strain energy, which is consumed during the gait cycle, and as a result leg stiffness is expected to increase. An ankle joint actuating mechanism that stores and releases the energy in ankle joint is expected to support and solve excessive artificial leg stiffness caused by the knee actuator (primary actuator) to a reasonable extent. If unnecessary kinematic energy is released with the artificial speed reduction control designed to prevent increase in gait speed caused by increase in time passed, it naturally brings question to the effectiveness of the actuator. As opposed to the already established studies, the authors are currently developing knee-ankle two actuator system under the concept of increasing lower limb stiffness by controlling the speed of gait in relative angular velocity of the two segments. Therefore, the author is convinced that compensatory mechanism caused by knee actuating must exist only in ankle joint. Ankle joint compensatory mechanism can be solved by reverse-examining the change in metatarso-phalangeal joint (MTPJ) tilt angle (${\theta}_1=0^{\circ}$, ${\theta}_2=17^{\circ}$, ${\theta}_3=30^{\circ}$) and the effect of change in gait speed on knee activity.

소아 및 청소년 중독 환자에서 중독 양상의 차이

서주현,어은경,Suh Joo-Hyun,Eo Eun-Kyung 대한임상독성학회 2006 대한임상독성학회지 Vol.4 No.1

Objectives: To analyze the general characteristics and clinical differences of poisoning in children and adolescents and to take precautions of occasions. Methods: We retrospectively evaluated poisoning children and adolescents (less than 19 years) visiting to the emergency medical center of tertiary hospital in urban area. We collected demographic data, substance exposure data (materials, causes of poisoning and amount), and clinical outcome of poisoning for the past 2 years and 9 months. Results: 189 cases were reported of concerning poisoning in children and adolescents. The age groups were divided into four categories. (1) Infants group:<2 year, (2) Preschool age group: $2{\sim}5year$, (3) Children group: $6{\sim}12year$ and (4) Adolescents group: $13{\sim}18year$. The most vulnerable age group was the infants group. There were two-peaks of age distribution in poisoned patients on the whole. Various types of materials belonged to classes of druqs (56.6%). household products (34.4%) and industrial solvents (9.0%). On adolescents group, the frequency of drug poisoning was significantly high, in comparison with infants, preschool age, and children group (p=0.001). Most of the patient groups had been poisoned accidentally(73.5%), while most cases of adolescents poisoning had been intentional. 63% of the adolescents group had a suicidal purpose. Conclusion: The incidence of poisoning was most highly due to drugs. The cause of poisoning is most commonly accidental. while in adolescent group, intentional poisoning is mostly common. Special cares, like keeping children away from drugs, will be needed to prevent children poisoning, and psychiatric consultation and supportive cares can reduce the adolescents poisoning cases.

불화수소산 음독에 의한 심정지 1례

이재희,정진희,어은경,Lee, Jae-Hee,Jung, Jin-Hee,Eo, Eun-Kyung 대한임상독성학회 2007 대한임상독성학회지 Vol.5 No.2

Hydrofluoric acid is a weak inorganic acid used for etching and as rust removals. Systemic toxicity after oral ingestion induces rapid development of hypocalcemia and hyperkalemia, leading to ventricular fibrillation and finally asystole. We report a case of intentional ingestion of hydrofluoric acid producing an altered mental state at the time of the patient's arrival in the emergency department. The patient died approximately 80 minutes after the exposure with asystol.