• 재활치료과학
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• 제9권4호
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• pp.33-43
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• 2020

목적 : 본 연구는 통합방법론을 이용하여 고엽제 환자의 우울 및 삶의 질을 심층적으로 알아보고자 하였다. 연구방법: D병원에 입원한 고엽제 환자 29명을 대상으로 일반적인 특성, 우울, 삶의 질과 29명의 대상자 중 17명을 대상으로 포커스그룹 면담을 실시하였다. 통합방법론은 모형 중 Teddlie와 Tashakkori(2003)가 제시한 순차적 통합설계를 사용하였다. 분석방법으로는 일반적인 특성은 빈도 및 백분율로 산출하고 우울 및 삶의 질은 기술통계 분석, 포커스그룹 면담은 내용분석방법을 사용하였다. 고엽제 환자의 우울 및 삶의 질은 순차적 통합설계 방법을 통해 심층적으로 분석하였다. 결과: 고엽제 환자의 연령은 75세~79세(58.6%)가 가장 많았고, 70~74세(34.3%), 85세 이상(3.4%), 65~69세(3.4%) 순이었다. 고엽제 환자의 우울은 19.24점, 삶의 질은 평균 57.66점으로 나타났다. 포커스그룹 면담 결과 3가지의 주제와 7개의 구성 요소, 14개의 하위구성 요소로 3가지의 주제는 "파병 경로", "고엽제 노출 경로", "고엽제 노출 이후의 삶"으로 나타났다. 결론: 본 연구는 통합방법론을 이용하여 선행연구들과는 차별되게 고엽제 환자의 우울 및 삶의 질을 심층적으로 분석할 수 있었다. 향후 고엽제 환자의 우울 및 삶의 질을 개선할 수 있는 신체활동이 포함된 집단작업치료 프로그램을 개발하고 적용하는 연구와 사회적 관심과 제도적 지원도 적극적으로 이루어져야 할 것이다.

• 대한임상독성학회지
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• 제18권1호
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• pp.26-33
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• 2020

Purpose: Agent Orange (AO) is a herbicide and defoliant used by the United States and its military allies during the Vietnam War. Pneumonia is a common cause of death among Vietnam veterans in our hospital. There have been no previous studies researching any association between AO exposure and the prognosis for pneumonia. The primary objective of this study was to investigate associations between AO exposure and 30-day mortality due to pneumonia. The secondary objective was to examine the clinical factors associated with therapeutic outcomes in veterans with pneumonia, and to assess the prevalence of combined diseases in AO-exposed veterans. Methods: This study retrospectively included veteran patients diagnosed with pneumonia in the emergency department and hospitalized between February 2014 and March 2018. The enrolled patients were grouped according to their defoliant exposure history, and the clinical information of defoliant-exposed and non-defoliant-exposed groups were compared. Patients were divided according to 30-day mortality, and significant factors influencing mortality were evaluated by using univariate analysis and multivariate analysis. The final multivariate model revealed the effect of AO exposure on therapeutic outcomes of pneumonia. Results: A total of 1006 patients were analyzed. Of these, 276 patients had a history of AO exposure, whereas 730 patients had not been exposed. Factors positively associated with 30-day mortality were malignancy, respiratory rate, blood urea nitrogen, and albumin which was negatively associated with mortality. Conclusion: Exposure to defoliant is not associated with 30-day mortality in patients with pneumonia. However, veterans with defoliant exposure are associated with a high prevalence of diabetes mellitus, hypertension, cerebrovascular accident, malignancy, and chronic kidney disease.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.228-236
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• 2001

Objectives : To propose a feasible, valid and appropriate study designs and epidemiologic methods for evaluating the adverse health effects of Agent Orange-chemical defoliants used in Vietnam- in Korea. Methods : A literature study was peformed on Agent Orange, herbicides, pesticides and dioxins. The study subjects, study design, exposure assessment and health outcomes assessment were examined in each study. The potential data sources for the study subjects, study design, exposure assessment and health outcomes assessment in Korea were investigated. Results and Conclusion : In earlier Korean studies, research subjects for studying the effects of Agent Orange were identified from the patients or persons who claimed to have Agent Orange-related diseases due to the difficulties in identifying the entire population of Vietnam veterans in Korea. In this study, an attempt was made to identify the total number of Vietnam veterans in Korea. As a result, the addresses of 20,000 Vietnam veterans were obtained. It is proposed that a retrospective cohort design on a sample of the total number of Vietnam veterans is a feasible and appropriate study design. Self report questionnaires and military records were proposed to assess the exposure level. It is believed that measuring the plasma or tissue TCDD should be used only for a validation study assessing the level of exposure. For the health outcomes assessment, it is possible to obtain the mortality, cancer frequency, physical examination, screening and medical insurance record data.

• 한국산학기술학회논문지
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• 제10권9호
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• pp.2492-2500
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• 2009

본 연구에서는 베트남전 참전 군인 중 고엽제 후유(의)증 환자와 한국전쟁 참전 상이군인을 대상으로 전반적인 심리적 특성을 파악하기 위해 로샤 검사를 실시하고 반응결과를 한국전 참전 재향 군인 집단과 비교분석하였다. 이를 위해 베트남 참전 군인 중 고엽제 후유의증 환자 20명과 한국전쟁 참전 재향군인 21명을 대상으로 개별적으로 로샤 검사를 실시했다. 각각의 변인들을 Exner 종합체계(2006)의 구조적 요약의 대표적 군집들을 중심으로 비교분석하였다. 즉 핵심영역, 반응결정인, 결정적 특수지표에서의 차이를 비교분석하였다. 그 결과 베트남 참전 집단은 6.25 참전집단에 비해 (1)인지적 경직성 (2) 문제해결에 있어서의 비효율성, (3)정서억압 (4)과잉경계 (5)불안 (6)우울 등의 가능성이 더 높은 것으로 나타내었다. 이러한 결과들은 베트남전쟁 참전 재향군인에서 과거 전쟁 경험에서의 정신적 외상과 관련된 후유증이 지속되고 있을 가능성을 보여주는 것이다. 마지막으로 본 연구의 제한점과 시사점에 대해 논의하였다.

• 한국환경보건학회지
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• 제39권4호
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• pp.312-321
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• 2013

Objective: In May 2011, an interview with three United States Forces Korea veterans revealed that chemicals believed to be 'Agent Orange' were buried at Camp Carroll (situated in Waegwan, Chilgok-gun, Gyeongsangbuk-do, Korea) in 1978. Many hazardous chemicals, such as perchloroethylene (PCE), trichloroethylene (TCE), and organochlorines were subsequently found in a joint US-ROK environmental investigation, although dioxins or burial evidence related to 'Agent Orange' have been not uncovered. This study was carried out to investigate the relevance of hazardous chemical exposure and health effects of the residents around Camp Carroll. Methods: The authors conducted a health questionnaire survey among residents around Camp Carroll regarding Waegwan groundwater ingestion, length of residence in Waegwan, and physician-diagnosed disease history (such as cancer, hypertension, diabetes and etc.). Logistic regression was performed to identify the associations between hazardous chemical exposure and physician-diagnosed diseases. Results: Among the 5,320 residents, excluding those living outside the Waegwan area, 3,430 subjects age 30 and over were analyzed. Among females, upon correction of age, smoking history and Camp Carroll working history, a higher distribution in the Waegwan groundwater ingestion group was demonstrated for patients with physician-diagnosed cancer and hypertension. The odds ratios have a tendency to increase with increased length of Waegwan groundwater ingestion. Conclusions: This study may be limited by not adopting a cohort study for the evaluation of factors that may confound environmental exposure. Yet it is meaningful that the correlation between Waegwan groundwater ingestion and chronic diseases were found through regression analysis in female; and further, this outcome may be used as a sampling basis for a secondary epidemiologic study.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7473-7478
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• 2014

Cholangiocarcinoma (CCA) is a fatal cancer with poor prognosis and less than 10% of CCA patients can be offered surgical cure. Conventional chemotherapy results in unfavorable outcomes. At present, plant-derived compounds are gaining interest as potential cancer therapeutics, particularly for treatment-refractory cancers. In this study, antitumor activity of tiliacorinine, the major alkaloid isolated from a tropical plant, on CCA was first demonstrated. Antiproliferative effects of tiliacorinine on human CCA cell lines were investigated using SRB assays. Acridine orange/ethidium bromide staining, flow cytometric analysis and DNA laddering assays were used for apoptotic determination. Apoptosis-related proteins were verified by Western blotting and antitumor activity of tiliacorinine in vivo was demonstrated in CCA xenografted mice. Tiliacorinine significantly inhibited proliferation of human CCA cell lines with $IC_{50}$ $4.5-7{\mu}M$ by inducing apoptosis through caspase activation, upregulation of BAX, and downregulation of $Bcl_{xL}$ and XIAP. Tiliacorinine considerably reduced tumor growth in CCA xenografted mice. These results demonstrated antitumor effects of tiliacorinine on human CCA in vitro and in vivo. Tiliacorinine may be an effective agent for CCA treatment.