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119와 1339에 접수되는 중독 상담 정보의 변화 비교: 응급의료정보센터(1339) 통합 이후의 소방구급상황센터(119)에서의 병원 전 독성 물질 노출자료 현황 분석
박광훈 ( Kwang Hoon Park ),박종수 ( Jong Su Park ),이성우 ( Sung-woo Lee ),김수진 ( Su-jin Kim ),한갑수 ( Kap Su Han ),이의중 ( Eui Jung Lee ) 대한임상독성학회 2017 대한임상독성학회지 Vol.15 No.2
Purpose: The aim of this study was to compare the toxicologic profiles and outcome of poisoned patients by comparing the data obtained through telephone counselling, each provided by emergency medical information center (1339) and emergency dispatch center (119). Methods: We analyzed the telephone-based poison exposure data before and after Seoul 1339 merged to 119. We compared the Seoul 1339 call response data in 2008 with Seoul and Busan 119 call response data between 2014 and 2016. We analyzed the changes in the trend and quality of data obtained, as well as the quality of service provided by each center before and after this reallocation, by comparing the data each obtained through telephone counselling. Results: The data was collected for a total of 2260 toxin exposure related calls made to Seoul 1339 in 2009, and 1657 calls to 119 in Seoul and Busan between 2014 and 2016. Significant difference was observed for age, sex, and reason for exposure to toxic substance between the two groups. Conclusion: After the integration of 1339 with 119, 119 focused on role of field dispatch and hospital transfer, lacking the consulting on drug poisoning. Moreover, data on exposure to toxic substances at the pre-hospital stage indicate that drug information and counseling are missing or unknown. In addition, first aid or follow-up instructions are not provided. Thus, systematic approach and management are required.
Metformin 과다 복용에 의한 대사성 젖산 산증 1례
박정숙,정성필,이한식,김의중,Park, Jung-Suk,Chung, Sung-Pil,Lee, Han-Shick,Kim, Eui-Chung 대한임상독성학회 2007 대한임상독성학회지 Vol.5 No.2
Metformin is antihyperglycemic, not hypoglycemic. It causes neither insulin release from the pancreas nor hypo glycemia, even when taken in large doses. But, there are several reports of metformin-associated lactic acidosis (MALT). We present a case report of severe lactic acidosis most probably resulting from high doses of metformin in a patient with no known contraindications for metformin. A 43-year-old female was admitted to the emergency department due to a metformin overdose. She had diabetes for 6 years, well-controlled with metformin and novolet. One hour before admission, she impulsively took 50g metformin (100 mg or 100 tablets). Physical examination for symptoms revealed only irritability, and laboratory evaluation revealed only mild leukocytosis. After one hour the patient was drowsy, and arterial blood gas analysis showed severe lactic acidemia Seven hours after ED arrival, she commenced hemofiltration treatment and was admitted to the intensive care unit. Continuous venovenous hemodiafiltration was initiated. Forty-eight hours later, full clinical recovery was observed, with return to a normal serum lactate level. The patient was discharged from the intensive care unit on the third day. A progressive recovery was observed and she was discharged from the general word on the thirteenth day.
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.
건강 보조 식품의 중독학적 관점에서의 고찰 글루코사민, 키토산
유지영 ( Ji Young You ) 대한임상독성학회 2011 대한임상독성학회지 Vol.9 No.1
Recently, westernized diet and lifestyles have led to obesity and various adult diseases resulting in a negative influence on the quality of life. There has been an increased interest in choosing proper diet and regular exercise in order to lead a healthy life. The number of people looking for dietary supplements has increased steadily. Dietary supplements are products intended to help maintain or improve the health of consumers. However, if customers take dietary supplements excessively, they may be harmful due to side effects, misuse, abuse and overdose. I performed a toxicologic review of the dietary supplements, glucosamine and chitosan, which are widely used in the country in order to provide the proper understanding of safety of these products.
소병학 ( Byung Hak So ),이미진 ( Mi Jin Lee ),김현 ( Hyun Kim ),문정미 ( Jeong Mi Moon ),박경혜 ( Kyung Hye Park ),성애진 ( Ae Jin Sung ),염석란 ( Seok Ran Yeom ),오성범 ( Seong Beom Oh ),유지영 ( Ji Young You ),이경우 ( Kyung Wo 대한임상독성학회 2010 대한임상독성학회지 Vol.8 No.2
Purpose: The aim of this study was to investigate toxic exposures in emergency centers with using a toxic exposure surveillance system-based report form as a preliminary study. Methods: We retrospectively reviewed the medical records of toxic exposure patients who visited emergency centers from January to December 2008. Results: 3,157 patients from 11 emergency centers were enrolled. Males were involved in 47.9% of the total cases of exposure and in 60.1% of the cases of fatal exposure. Suicidal intent was the most common (61.0%) reason and most (87.4%) fatal exposures were suicidal. Pesticides were involved in 30.7% of the cases and sedative/hypnotics/ antipsychotics were involved in 20.5%. The substances most frequently involved in fatalities were pesticides, and a 48.4% fatality rate was recorded for paraquat exposure. Conclusion: The toxic exposure data showed the preliminary poisoning events in emergency centers. It is recommended that toxicology professionals should develop a toxic surveillance system and serial reporting should be performed.
급성 아세트아미노펜 중독에서 N-acetylcysteine 투여 결정 관련 인자
이정화 ( Jeong Hwa Lee ),최상천 ( Sangchun Choi ),윤상규 ( Sang Kyu Yoon ),신규철 ( Kyu Cheol Shin ) 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.2
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.
이주환,박진욱,홍성준,전재천,진상찬 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.1
Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5。C, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO2 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO3 - 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.
서주현,노형근,어은경,전영진,정구영,Suh, Joo-Hyun,Roh, Hyung-Keun,Eo, Eun-Kyung,Cheon, Young-Jin,Jung, Koo-Young 대한임상독성학회 2008 대한임상독성학회지 Vol.6 No.2
Purpose: The hypnotic effect of zolpidem is comparable to benzodiazepines, but has less abuse and addiction potential than benzodiazepines, so is one of the most commonly prescribed hypnotics. The frequency of acute zolpidem overdose has increased, but clinical analysis and severity predictors are not known in Korea. Methods: A retrospective evaluation of histories, clinical courses, and laboratory findings of each patient treated from June, 2000, to May, 2006, in a university hospital for acute zolpidem intoxication. Results: We evaluated 30 patients, including 16 co-intoxication cases. Twenty-five patients presented mental alterations but became alert within 2 days. All patients recovered completely. The median zolpidem concentration was 0.9 mg/L (range: $0.2{\sim}7.4\;mg/L$). There was a weak correlation between the amount ingested and zolpidem concentration (r=0.25). None of them presented severe laboratory abnormalities, and these abnormalities did not relate to zolpidem concentration. Conclusion: The clinical progress of acute zolpidem intoxication is mild. We could not predict zolpidem concentration or clinical severity from the amount ingested and could not predict the clinical course from laboratory findings in the emergency department.