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      KCI등재후보

      급성 약물중독에 합병된 일과성 혹은 지속성 고암모니아혈증의 특성 = General Characteristics for Poisoning-Induced Transient or Sustained Hyperammonemia

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      다국어 초록 (Multilingual Abstract)

      Purpose: In patients with altered mentality caused by drugs or unknown causes, ammonia is checked to facilitate differential diagnosis or diagnose hepatic coma. This helps early prevention and treatment of brain damage due to hyperammonemia. This study was conducted to evaluate clinical characteristics of intoxicated adult patients with hyperammonemia. Methods: We evaluated 95 patients with hyperammonemia among intoxicated patients above the age of 15 who visited our ED from January 2013 to December 2015. We analyzed the demographic characteristics and type of poisoning substance, reason for ingestion, toxicological characteristics such as elapsed time from ingestion to hospital visit, lab, clinical progression and complications. Data were evaluated using the student`s t test or Mann-Whitney U test for continuous variables, and Chi-square test and Fisher`s exact test for frequency analysis of categorical variables. Results: When compared to healthy individuals, patients with hyperammonemia showed statistical significance on their SOFA score (p=0.016) and poison severity score (p<0.001). Additionally, patients with hyperammonemia showed significantly different initial serum AST level (p=0.012) and maximum serum AST level during the hospital stay (p=0.026) when compared to healthy individuals. Moreover, individuals with sustained hyperammonemia compared to transient hyperammonemia showed clinically significant SOFA scores (p<0.001), poison severity scores (p=0.007), mortality rates in the ICU (p=0.021), as well as different duration of hospital stay (p=0.037), serum creatinine level (p=0.002), erythrocyte sedimentation rate (p=0.025), and serum myoglobin (p=0.015). Conclusion: Most poisoning-induced hyperammonemia cases were transient and recovered without special treatment. Therefore, hyperammonemia is almost non-specific among poisoning patients.
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      Purpose: In patients with altered mentality caused by drugs or unknown causes, ammonia is checked to facilitate differential diagnosis or diagnose hepatic coma. This helps early prevention and treatment of brain damage due to hyperammonemia. This stud...

      Purpose: In patients with altered mentality caused by drugs or unknown causes, ammonia is checked to facilitate differential diagnosis or diagnose hepatic coma. This helps early prevention and treatment of brain damage due to hyperammonemia. This study was conducted to evaluate clinical characteristics of intoxicated adult patients with hyperammonemia. Methods: We evaluated 95 patients with hyperammonemia among intoxicated patients above the age of 15 who visited our ED from January 2013 to December 2015. We analyzed the demographic characteristics and type of poisoning substance, reason for ingestion, toxicological characteristics such as elapsed time from ingestion to hospital visit, lab, clinical progression and complications. Data were evaluated using the student`s t test or Mann-Whitney U test for continuous variables, and Chi-square test and Fisher`s exact test for frequency analysis of categorical variables. Results: When compared to healthy individuals, patients with hyperammonemia showed statistical significance on their SOFA score (p=0.016) and poison severity score (p<0.001). Additionally, patients with hyperammonemia showed significantly different initial serum AST level (p=0.012) and maximum serum AST level during the hospital stay (p=0.026) when compared to healthy individuals. Moreover, individuals with sustained hyperammonemia compared to transient hyperammonemia showed clinically significant SOFA scores (p<0.001), poison severity scores (p=0.007), mortality rates in the ICU (p=0.021), as well as different duration of hospital stay (p=0.037), serum creatinine level (p=0.002), erythrocyte sedimentation rate (p=0.025), and serum myoglobin (p=0.015). Conclusion: Most poisoning-induced hyperammonemia cases were transient and recovered without special treatment. Therefore, hyperammonemia is almost non-specific among poisoning patients.

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      참고문헌 (Reference)

      1 최윤호, "발작과 실신에서 일시적 혈중 암모니아 상승의 차이" 대한신경과학회 30 (30): 279-283, 2012

      2 김동규, "글리포세이트 중독환자에서 저혈압 발생의 의의와 관련 인자" 대한응급의학회 26 (26): 248-255, 2015

      3 김재환, "글루포시네이트암모늄(glufosinate ammonium, BASTA ® ) 중독 후 발생한 뇌병증" 대한신경과학회 32 (32): 113-116, 2014

      4 Verrotti A, "Valproateinduced hyperammonemic encephalopathy" 17 : 367-373, 2002

      5 Weng TI, "Unusual causes of hyperammonemia in the ED" 22 : 105-107, 2004

      6 Chen YJ, "The epidemiology of glyphosate-surfactant herbicide poisoning in Taiwan, 1986-2007: a poison center study" 47 : 670-677, 2009

      7 Lluis M, "Severe acute poisoning due to a glufosinate containing preparation without mitochondrial involvement" 27 : 519-524, 2008

      8 Persson HE, "Poisoning severity score. Grading of acute poisoning" 36 : 205-213, 1998

      9 Watanabe T, "Neurological effects of glufosinate poisoning with a brief review" 17 : 35-39, 1998

      10 Bosoi CR, "Identifying the direct effects of ammonia on the brain" 24 : 95-102, 2009

      1 최윤호, "발작과 실신에서 일시적 혈중 암모니아 상승의 차이" 대한신경과학회 30 (30): 279-283, 2012

      2 김동규, "글리포세이트 중독환자에서 저혈압 발생의 의의와 관련 인자" 대한응급의학회 26 (26): 248-255, 2015

      3 김재환, "글루포시네이트암모늄(glufosinate ammonium, BASTA ® ) 중독 후 발생한 뇌병증" 대한신경과학회 32 (32): 113-116, 2014

      4 Verrotti A, "Valproateinduced hyperammonemic encephalopathy" 17 : 367-373, 2002

      5 Weng TI, "Unusual causes of hyperammonemia in the ED" 22 : 105-107, 2004

      6 Chen YJ, "The epidemiology of glyphosate-surfactant herbicide poisoning in Taiwan, 1986-2007: a poison center study" 47 : 670-677, 2009

      7 Lluis M, "Severe acute poisoning due to a glufosinate containing preparation without mitochondrial involvement" 27 : 519-524, 2008

      8 Persson HE, "Poisoning severity score. Grading of acute poisoning" 36 : 205-213, 1998

      9 Watanabe T, "Neurological effects of glufosinate poisoning with a brief review" 17 : 35-39, 1998

      10 Bosoi CR, "Identifying the direct effects of ammonia on the brain" 24 : 95-102, 2009

      11 Clay AS, "Hyperammonemia in the ICU" 132 : 1368-1378, 2007

      12 Mao YC, "Hyperammonemia following glufosinate-containing herbicide poisoning: a potential marker of severe neurotoxicity" 49 : 48-52, 2011

      13 Gomceli YB, "Different clinical manifestations of hyperammonemic encephalopathy" 10 : 583-587, 2007

      14 Lee HL, "Comparative effects of the formulation of glyphosate-surfactant herbicides on hemodynamics in swine" 47 : 651-658, 2009

      15 Chalasani N, "Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States" 135 : 1924-1934, 2008

      16 Park HY, "Anterograde amnesia with hippocampal lesions following glufosinate intoxication" 67 : 914-915, 2006

      17 Roberts DM, "A prospective observational study of the clinical toxicology of glyphosatecontaining herbicides in adults with acute self-poisoning" 48 : 129-136, 2010

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      학술지 이력

      학술지 이력
      연월일 이력구분 이력상세 등재구분
      2027 평가예정 재인증평가 신청대상 (재인증)
      2021-01-01 평가 등재학술지 유지 (재인증) KCI등재
      2018-01-01 평가 등재학술지 선정 (계속평가) KCI등재
      2016-11-17 학회명변경 영문명 : Journal of The Korean Society of Clinical Toxicology -> Korean Society of Clinical Toxicology KCI등재후보
      2016-01-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0 0 0
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