• Journal of Trauma and Injury
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• 제25권2호
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• pp.49-56
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• 2012

Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

• 대한치과보철학회지
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• 제49권3호
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• pp.214-221
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• 2011

연구 목적: 기존 대부분의 유한요소 연구에서는 100%의 골-임플란트 접촉을 가정하여 왔으나 인간사체연구(human retrieval study)에서는 골-임플란트 부착비율이 20-80%라고 보고되었다. 본 연구에서는 비선형 삼차원 유한요소법을 이용하여 실제적인 골-임플란트 접촉을 재현하기 위해 무작위 골접촉 양상을 비교연구하고자 하였다. 연구 재료 및 방법: 컴퓨터단층촬영에서 얻은 영상을 근거로 하여 제작한 골모형에 두 가지 디자인의 임플란트(MK III Br${\aa}$nemark$^{(R)}$, Inplant$^{(R)})$를 상악제2소구치에 해당하는 위치에 식립한 모형을 만들었다. 골질은 골형 2로서 Lekholm과 Zarb의 분류를 따랐다. 각 임플란트 디자인마다 두 가지(40%, 70%)의골-임플란트 접촉비율을 가정하였다. 각디자인과 골접촉율마다 5개의 모형을 제작하여 총 40 개의 모형을 만들었다. 이골-임플란트 접촉을 무작위 섞기방식(random shuffle method)으로 하였고 피질골과 해면골을 다 포함하여 골유착을 시킨 군(wholly randomized osseointegration; W)과 피질골과 해면골을 분리하여 골접촉시키기 위해서 각 0.75 mm마다 무작위 골접촉을 시킨 군(segmentally randomized osseointegration; S)을 비교연구하였다. 결과: 골-임플란트 접촉율이나 임플란트 디자인에 상관없이 W군과 S군 간 maximum von Mises strain의 평균에 있어서 유의성 있는 차이가 없었다(P=.939). 골-임플란트 접촉율이40%보다70%가 von Mises strain이 유의하게 낮았다(P=.007). 골-임플란트 접촉율이 40%일때는 Inplant$^{(R)}$과 MK III Br${\aa}$nemark$^{(R)}$의 변형율 간에는 유의성 있는 차이가 없었으나(P=.116), 골-임플란트 접촉율이 70%일때 Inplant$^{(R)}$에서는 $4886{\pm}1034\;{\mu}m/m$, MK III Br${\aa}$nemark$^{(R)}$에서는 $7134{\pm}1232\;{\mu}m/m$로서 Inplant$^{(R)}$의 von Mises strain이MK III Br${\aa}$nemark$^{(R)}$의 것보다 유의하게 낮았다(P<.0001). 결론: 골-임플란트 접촉을 가정함에 있어서 무작위 섞기방식(random shuffle method)을 이용하여 임플란트 전체에 대해서나 피질골과 해면골을 분리하여 무작위 골-임플란트 접촉을 시키든 간에 통계적으로 유의한 차이가 없어서 표본의 크기에 상관없이 둘 다 유효한 방법이라 할 수 있었다.

• 한국산학기술학회논문지
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• 제14권5호
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• pp.2293-2303
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• 2013

목적: 본 연구의 목적은 국내 환자안전지표 산출 가능성을 확인하는 것이다. 조사방법: 환자안전지표의 정의는 OECD에서 AHRQ에 근거하여 작성한 보건기술문서 19의 기준을 이용하였고, 이에 따라 2004-2008년 퇴원손상심층조사 875,622건에서 환자안전지표(PSIs)를 산출하였다. 로지스틱 회귀분석을 이용하여 환자안전지표별 비율의 변이요인을 확인하였다. 분석결과: 2004-2008년간 약 80만 건의 퇴원 중에서 8개의 환자안전지표에 해당하는 위해사건은 3,084건이었다. 욕창(PSI3, 4.88), 시술 중 이물질 체내 잔류(PSI5, 0.05), 수술 후 패혈증(PSI13, 1.32), 출생손상-신생아(PSI17, 7.92), 산과적 외상-도구를 이용한 질식 분만(PSI18, 32.81)의 퇴원 1,000건당 비율은 모두 OECD 환자안전지표 비율의 최소-최대 범위 내에 포함되었다. 그러나 내과적 치료에 의한 감염(PSI7, 0.22), 수술 후 폐색전증 또는 심부정맥혈전증(PSI12, 0.90), 우발적 천공 또는 열상(PSI15, 0.71)의 퇴원 1,000건당 비율은 OECD 환자안전지표 최소값에 못 미쳤다. PSI 18을 제외한 7개의 지표값 모두 부진단명의 개수와 유의한 상관관계가 있는 것으로 나타났다. 또한 환자안전지표 비율은 환자특성을 보정했을 때, 병상규모 및 병원소재지 등 병원특성에 따른 유의한 차이를 보였다. 결론: 본 연구는 국가적인 행정자료를 이용하여 위해사고를 스크리닝 하는 환자안전지표를 산출한 최초의 실증적 연구이다. 본 연구의 결과는 자료의 질, 임상 관련 변수 등의 결과에 영향을 미치는 요소가 여전히 있지만, 환자안전에 대한 국가적인 통계를 추계하는 기초자료를 제공하였다는데 의의가 있다. 향후 본 연구결과를 바탕으로 위해사건으로 인한 사망 규모 산출 등의 결과연구가 필요하다.

• 대한미생물학회지
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• 제22권1호
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• pp.79-93
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• 1987

The result of various researches mainly in search of 194 Shigella strains, isolated by the Health Research Centers(situated in Seoul city, Inchon city, Pusan city, Kyonggi-Do, Kangwon-Do, Chungchongnam and Buk-Do, Kyongsangnam and Buk-Do, Jollanam and Buk-Do, and Jaeju-Do) in addition to those clinical laboratories of all the general hospitals situated down twon Seoul, conducted during the month of Jan. through Dec. 85, through the reisolating-activity program following its transportation into the laboratory, particularly for a complete check on its correctiveness, are as follows: 1. Isolation processes were performed with the 194 strains obtained from each placeduring the period of investigation: 164 Strains(84.5%) of Sh. flexneri, B group; 6 Strains(3.1%) of Sh. boydii, C group; 24 Strains(12.3%) of Sh. sonnei, D group, which means there's quite a lot in B group while Sh. dysenteriae, A group was not isolated at all. 2. The isolation rate of the 164, B group for subserotype was 1b, 84(51.2%) the highest one, 2(1.2%) on 3a the lowest one, 4, on C group; In D group subserotype II showed 14(58.4%) more than subserotype I. 3. The biological data on sexuality regarding the isolation-strain showed traditional particularity. But the subserotype 1b in B group 2(2.4%) showed gas-growth from glucose. In subserotype 1a, the indole-growth was 88.9% on masculine which was considerably a good one. In the test of arginine dihydrolase subserotype I among D group showed 100% masculine rate. The subserotype 6 among B group showed 92.5% masculine. In the dissolution test of manitol, all subserotypes showed 100% maculine except subserotype 1b. In the dissolutioning test of rhamnose, the subserotype I among D group showed 100% masculine which is the unusual one. 4. Interms of the area among 13 districts examined, Kangwon-Do had 41(21.1%) which is the highest one on its ratio. 5. In terms of season on the strain isolation category, 44(22.7%) is the number isolated in April which is the highest one. 6. In terms of ages, the strain isolation ratio was notably high above the ages of 60 which was 34(17.5%). Next one was 29(14.9%) which was under the ages of 4. 7. In terms of sex, female was 113 or 58.2% while male was 74 or 38.2%, which means the female had more than the male. 8. The result of the resisting capability on the usage of 12 antibiotic medication was; 100% on chloramphenicol; 94.3% on tetracycline, 82.0% on streptomycin, 76.3% on carbenicillin, 74.7% on ampicillin, in regular order. The strain source bearing multimedication resisivity against the 5 antibiotic medication is as many as 117 or 60.3%. Of which 43.3% of 1b sub serotype, B group was the best one, and thus the resistivity against the antistrain medication seems the tendency is being changed. The summing up of the above result shows the total specific strains isolated in each branch in Korea is 194, of which the main type is Sh. flexneri 84.5%. The isolating rate is almost evenly spreading, although the Kangwon-Do showed the highest rate on the above data. It also shows female is higher than male on its statistics. The tendency on age category showed both on old and infancy generations high. However, the resistant capability against antibacteria medication or vaccine was still remaining on habitual one, particularly tending towards multimedication or vaccine trend.

• Journal of Acupuncture Research
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• 제22권6호
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• pp.229-239
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• 2005

목적: 알레르기비염은 이환율이 높은 질환이다. 비폐색은 알레르기비염의 주요 증상으로 수면장애, 우울, 주의력 저하, 기억력 감퇴 등을 유발한다. 비염에 대한 침치료는 문헌에 언급되어 있고 임상에서 많이 사용되지만 잘 디자인된 임상연구는 많지 않다. 본 연구는 알레르기비염환자의 비폐색에 대한 침치료의 효과에 대해 알아보고자 하였다. 방법: 본 연구는 단일맹검, 무작위배정, 대조군연구로 치료혈은 영향(Il20), 상성(GV23), 합곡(IL4)으로 하였고, 유효성 평가는 음향비 강통기도검사를 통한 총비강용적, 총비강최소단면적의 변화로 하였다. 결과: 101명의 피험자가 연구를 종료하였으며 연령, 성별, 체중, 신장, 맥박, 호흡수, 지속성 비염의 중증도, 양성반응을 보인 항원의 수에서 대조군과 침치료군에서 차이는 없었다. 침치료군과 대조군 모두에서 치료직후 총비강용적이 유의성(침치료군: p=0.0007, 대조: p=0.0175)있게 증가하였고, 치료15 분후 침치료군에서 대조군에 비하여 증가된 총비강용적이 경계수준의 유의성(p=0.0871)으로 유지되었다. 침치료군과 대조군 모두에서 치료직후 총비강최소단면적이 유의성(침치료군: p<0.0001, 대조군: p=0.0005)있게 증가하였고, 치료15분후 침치료군에서 대조군에 비하여 증가된 총비강최소단면적이 경계수준의 유의성(p=0.0929)으로 유지되었다. 결론: 지속성 알레르기비염의 비폐색에 대한 침치료는 비강용적과 비강단면적을 증가시켜 비폐색을 완화시키는 효과가 있었으나 지속적인 효과에 대하여는 추가적 연구가 필요하다.

• Journal of Acupuncture Research
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• 제24권1호
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• pp.13-28
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• 2007

Objectives : Clinical character of chronic tension-type headache is bilateral, moderate intensity, persistent and chronic, repeating disease and CTTH is a common prevalent disease, but pathophysiology and likely mechanism remain unclear. It impedes subjective quality of life. The purpose of this research is to examine the effect of sa-am acupuncture method for chronic tension-type headache. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of chronic tension-type headache. Volunteers who satisfied the requirements were enrolled in study. Evaluation of chronic tension-type headache was measured by VAS and Headache Disability Inventory(HDI), Six point Linkert Scale before and after treatments. Results : 26 subjects finished study. There were not difference between two groups on age, sex, weight, height, blood pressure, pulse, respiratory rate, Byeonjeung, sunrise of treatment. In change of VAS, there were not difference between two groups on before treatment. Before treatment per visit, VAS of 6th and 7th visit were significantly decreased in active acupuncture(each p=0.039, p=0.008) and were not decreased in sham acupuncture. In change of VAS on a withdrawing needling after treatment, VAS of 1st, 2nd, 6th and 7th visit were significantly decreased in active acupuncture (each p=0.001, 0.038, 0.035, 0.008) and VAS of 2nd, 4th and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.033, 0.032, 0.035, 0.031). In change of VAS on 2hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.014, 0.023, 0.027) and 5th visit were significantly decreased in sham acupuncture(each p=0.004, 0.009). In change of VAS on 4hrs after treatment, VAS of 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.018, 0.011, 0.015) and 5th, 6th visit were significantly decreased in sham acupuncture(each p=0.020, 0.015). In change of VAS on the next day after treatment, VAS of 3th and 4th and 5th, 6th visit were significantly decreased in active acupuncture(each p=0.032, 0.011, 0.005, 0.012) and 4th, 5th visit were significantly decreased in sham acupuncture(each p=0.001, 0.012). In change of VAS according to a current time(before treatment, after a withdrawing needling, 2hrs, 4hrs, the next day), total score of VAS was decreased more active acupuncture group than sham acupuncture group, but there were no statistical significance compared with sham acupuncture group. In change of HDI score, after treatment was decreased than before treatment in two group, but there were no statistical significance compared with two group. In change of Six point Linkert scale score, after treatment was decreased than before treatment in two group on 6th, 7th visit(active acupuncture 6th 7th each p=0.002, 0.003, sham acupuncture 6th 7th each 0.003, 0.009), but there were no statistical significance compared with tow group. Conclusion : Sa-am acupuncture treatment is effective to improve the symptoms and quality of life in patients with chronic tension-type headache.

• 여성건강간호학회지
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• 제6권2호
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제14권2호
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• pp.183-196
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• 2003

연구목적：본 연구에서는 정상 아동 및 외래 내원 아동을 대상으로 한국어판 코너스 부모 및 교사용 평가 척도 (Korean-Conners' Parent Rating Scale：K-CPRS and Korean-Conners' Teacher Rating Scale：KCTRS) 의 간편형에 대한 신뢰도와 타당도를 조사하였다. 방 법：경기도 중소도시 지역에 소재한 두 초등학교에 재학 중인 아동들과 같은 지역 대학 병원 외래에 내원한 ADHD 아동 환자들이 연구 대상에 포함되었다. 연구대상의 교사 및 부모는 코너스 평가 척도를 완성하였으며 추가로 한국어판 ADHD 평가 척도(Korean-ADHD Rating Scale：K-ARS)를 작성하였고 부모는 별도로 한국어판 아동·청소년 평가 척도(Korean-Children Behavior Check List：K-CBCL)를 작성하였다. 자료 분석 방법으로는 기술 통계, 상관 분석, 신뢰도 분석, 요인 분석, t검증과 일원 변량 분석이 실시되었다. 결 과：한국어판 코너스 평가 척도(Korean-Conners' Rating Scale：K-CRS)의 평정자간 신뢰도에서 부모 평가의 정신신체 문제와 불안 요인을 제외하고는 부모 및 교사용 평가 척도의 각 하위 척도들은 서로 유의한 상관을 보였다. 또한 두 척도의 문항들은 비교적 높은 내적 합치도를 보여주었는데, 둘 중에서 교사용 평가 척도가 더 높은 내적 합치도를 나타내었다. K-CRS의 하위 척도치들과 K-CBCL 및 K-ARS의 각 하위척도치는 통계적으로 유의한 상관을 보여주었다. K-CRS에 대한 요인 분석 결과 부모용은 5개 요인 모델이, 교사용은 3개 요인 모델이 가장 최적의 설명 모델인 것으로 나타났다. 부가적으로 ADHD 임상군과 정상군간의 척도 점수에서의 차이를 살펴보았을 때 두 군 간에 통계적으로 유의한 차이가 나타났다. 결 론：한국어판 Conners 부모 및 교사용 평가 척도는 아동들의 문제 행동을 평가하는데 있어 적정한 신뢰도와 타당도를 가지고 있었으며 임상 장면에서 아동의 행동 문제에 대한 평가 및 진단에 유용하게 사용될 수 있을 것으로 보인다.

• 치위생과학회지
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• 제14권1호
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• pp.67-73
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• 2014

본 연구는 치위생과학회지의 질적 향상과 치위생 관련 연구의 보다 나은 발전을 모색하기 위해 2001년부터 2012년까지 발간된 치위생과학회지의 게재논문 총 548편을 조사하고 분석함으로써 다음과 같은 결론을 얻었다. 논문의 연구설계에 의한 분석으로는 단면연구가 434편으로 가장 높게 조사되었고, 실험연구 100편, 2차 자료를 이용한 연구 38편, 기타 14편의 순으로 조사되었다. 실험논문을 제외한 434편의 논문 연구대상자를 살펴보면, 치과위생사 대상이 100편으로 가장 많았고, 치위생과 학생 대상이 82편, 치과 병 의원의 내원환자 대상이 52편, 일반인 대상이 39편, 초등학생 대상이 28편, 대학생 대상이 26편 순으로 조사되었다. 논문의 저자 수에 대한 분석에서는 2인이 206편으로 가장 많았고, 3인이 142편, 1인이 114편, 4인이 37편 순으로 나타났다. 자료분석방법으로는 기술통계가 424회로 가장 많았고, t-test, ANOVA, X2 검정, 상관관계 순으로 조사되었으며, 그 밖의 분석방법으로 회귀분석, 비모수 검정 관련 분석, 경로분석, 공분산분석, 구조방정식 등이 사용된 것으로 조사되었다. 연구주제 분류에 있어서는 구강건강행동과학이 251편으로 가장 많았고, 임상치위생 123편, 기초치위생 93편, 기타 35편, 치위생교육과정 26편, 치위생관리 20편 순으로 나타났다. 연구비 수혜여부에서는 548편의 논문 중 97편만이 연구비를 지원받았고, 년도 별로는 2012년이 31편으로 가장 많았으며, 2011년에 18편, 2009년에 13편 순으로 조사되었다. 논문의 참고문헌 수는 평균 21.7편으로 국내 참고문헌 수 13.1편, 국외 참고문헌 수 8.6편이 인용되었음을 보여주었다. 또한 본 학회지의 자기인용 수준은 평균 1.26편으로 나타났다. 본 논문의 조사에 의하면 단면연구 외의 다른 연구 설계 논문들이 현저히 적은 것으로 나타났으며, 장애인이나 임산부 등의 특수집단을 대상으로 한 연구논문은 그 편수가 상당히 미비한 것으로 조사되었다. 따라서 단면연구 뿐 아니라 다양한 설계의 논문들이 쓰여져야 할 것이며 치위생 관련 활동이나 연구가 반드시 어느 특정한 대상을 위해서만이 아닌 모든 국민 전체가 대상이 되어야 하는 만큼 소외된 계층이나 특수 대상을 위한 연구 또한 활발히 이루어져야 할 것으로 생각된다.

• Journal of Hospice and Palliative Care
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• 제17권4호
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• pp.241-247
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• 2014

목적: 혈청 비타민 C 수치는 체내 항산화상태를 나타내는 지표로서, 암환자에서는 정상인에 비해 감소되어 있다. 하지만, 이 지표가 말기암환자에서 어느 정도 감소되어 있고, 그 감소에 어떤 요인들이 관련되는지에 대한 연구는 매우 드물다. 방법: 두 개 기관의 완화의료병동에 입원했던 암환자 65명을 대상으로 하였다. 환자의 나이, 성별, 암의 종류, 기능상태, 임상증상, 완치 목적의 암 치료력, 그리고 혈청 비타민 C를 포함한 혈액검사 자료를 수집하였다. 혈청 비타민 C 수치의 사분위수를 기준으로 두 군(3사분위수 이하 vs. 4 사분위수)으로 분류한 후 각 군의 차이를 비교하였고, 단계적 다중 로지스틱 회귀분석을 통해 혈청 비타민 C 수치와 관련된 인자를 확인하였다. 결과: 대상자의 혈청 비타민 C의 평균은 $0.44{\mu}g/mL$이었으며, 대상자 전체가 비타민 C 결핍에 해당되었다. 단변량 분석에서는, 비폐암 환자이거나(P=0.041) 발열이 있는 환자(P=0.034)에서 낮은 혈청 비타민 C 수치를 보였다. 폐암, 발열, 삼킴곤란, 호흡곤란, C 반응단백, 그리고 항암화학요법 등의 잠재적인 인자들을 보정한 다변량 분석에서, 낮은 혈청 비타민 C 수치를 나타낼 가능성은 항암화학요법을 받은 군에서 그렇지 않은 군에 비해 3.7배 높았고(P=0.046), 발열이 있는 군에서 그렇지 않은 군에 비해 7.22배 높았다(P=0.020). 결론: 말기암환자에서 비타민 C 부족은 매우 심각하였고, 항암화학요법 치료력과 발열이 관련 있었다.