• Clinical and Experimental Reproductive Medicine
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• 제26권2호
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• pp.137-148
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• 1999

Purpose of the present study was to find the optimal ovulation induction medicine for the maturation and development of immature oocytes and culture media for 2-cell embryos in the mouse model. ICR female mouse aged 6 to 8 weeks, were stimulated with 5 IU PMSG injection. At 47 to 50 hour post-PMSG injection, ovaries were dissected out and oocytes-cumulus complexes were punctured. The oocyte-cumulus complexes were cultured in media containing various ovulation induction medicine, CC, HMG and Metrodin for 18 hours. Female ICR mice were stimulated with 5 IU PMSG and 48 hours later were injected 5 IU of hCG, then female and male mice were mated. At 48 hour post-hCG injection, oviducts were dissected out and 2-cell embryos were flushed. The 2-cell embryos were cultured in various media, Ham's F-10 media of milli-Q water $(3^{\circ})$, Ham's F-10 media of HPLC (high performance liquid chromatography, Baxter) water, Medicult media, HTF (human tubal fluid) media for 96 hours. The results were as follows. 1. When the oocytes-cumulus complexes were cultured in $10^{-9}{\mu}g/ml{\sim}10^{-8}{\mu}g/ml$ of CC, those were suppressed in meiotic maturation $(28.2{\sim}33.7%)$. Whereas the oocytes-cumulus complexes were cultured in $10^{-7}{\mu}g/ml{\sim}10^{-4}{\mu}g/ml$, these were not effected in meiotic maturation $(54.5{\sim}72.7%)$. 2. When the oocytes-cumulus complexes were cultured in $10^{-4}{\mu}g/ml{\sim}10^{-1}{\mu}g/ml$ of Metrodin, those were suppressed in meiotic maturation $(35.7{\sim}41.5%)$. Meanwhile the oocytes-cumulus complexes were cultured in $10^{-7}{\mu}g/ml{\sim}10^{-5}{\mu}g/ml$, those were not effected in meiotic maturation $(54.2{\sim}70.3%)$. 3. When the oocytes-cumulus complexes were cultured in $10^{-5}{\mu}g/ml{\sim}10^{-4}{\mu}g/ml$ of HMG, those were suppressed in meiotic maturation $(48.2{\sim}50.4%)$. As being cultured in $10^{-7}{\mu}g/ml{\sim}10^{-6}{\mu}g/ml$, increased in meiotic maturation $(75.8{\sim}80.7%)$. 4. When the 2-cell embryos were cultured in Ham's F-10 media of milli-Q water $(3^{\circ})$, Ham's F-10 media of HPLC (high performance liquid chromatograpy, Baxter) water, Medicult media, HTF (human tubal fluid) media, developmental rates to blastocyst and hatching for 96 hour were 50.0%, 45.2%, 71.5% and 95.6%, respectively.

• Clinical and Experimental Reproductive Medicine
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• 제29권1호
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• pp.1-12
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• 2002

Objective: In order to acquire the technique for the establishment of human embryonic stem cells (ESe) derived from the human frozen-thawed embryos produced in IVF-ET program, this study was performed to establish mouse ESC derived from the in vitro fertilized embryos. Materials and Methods: After Fl hybrid (C57BL female $\times$ CBA mael) female mice were superovulated with PMSG and hCG treatment, their oocytes were retrieved and inseminated, and the fertilized embryos were cultured for 96-120 hours until the expected stages of blastocysts were obtained. To isolate the inner cell mass (ICM), either the blastocysts were treated with immunosurgery, or the whole embryos were cultured for 4 days. Isolated ICMs were then cultured onto STO feeder cell layer, and the resultant ICM colonies were subcultured with trypsin-EDTA treatment. During the subculture process, ESC-like cell colonies were observed with phase contrast microscopy. To identify ESC in the subcultured ESC-like cell colonies, alkaline phosphatase activity and Oct-4 (octamer-binding transcription factor-4) expression were examined by immunohistochemistry and RT-PCR, respectively. To examine the spontaneous differentiation, ESC-like cell colonies were cultured without STO feeder cell layer and leukemia inhibitory factor (LIF). Results: Seven ESC-like cell lines were established from ICMs isolated from the in vitro fertilized embryos. According to the developmental stage, the growth of ICMs isolated from the expanded blastocysts was significantly better than that of ICMs isolated from the hatched blastocysts (80.3% vs. 58.7%, p<0.05). ESC-like cell colonies were only obtained from ICMs of expanded blastocysts. However, the ICMs isolated from the embryos treated with immunosurgery were poorly grown and frequently differentiated during the culture process. The established ESC-like cell colonies were positively stained with alkaline phosphatase and expressed Oct-4, and their morphology resembled that observed in the previously reported mouse ESC. In addition, following the extended in vitro culture process, they maintained their expression of cell surface markers characteristic of the pluripotent stem cells such as alkaline phosphatase and Oct-4. When cultured without STO feeder cell layer and LIF, they were spontaneously differentiated into the various types of cells. Conclusion: The findings of this study suggest that the establishment of mouse ESC can be successfully derived from the in vitro fertilized embryos. The established ESC-like cells expressed the cell surface markers characteristic of the pluripotent stem cells and spontaneously differentiated into the various types of cells.

• 혜화의학회지
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• 제11권1호
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• pp.137-149
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• 2002

Dong-Eui-Bo-Gham Oriental medicine clinic on the purpose of losing their weight, from March 1, 2001 to March 1, 2002. The characteristics studied were gender, average weight, average height, distribution of body fat rate, base body metabolism rate, distribution of bmi, purpose of losing weight, treatment history, cause of gaining weight, clinical symptoms, distribution of Sahsang constitution, and change of body constituent. The conclusions drawn from this study were: 1. Among patients who came to the clinic for weight loss, there were 16 females (80%), and 4 males (20%). The ratio of gener was 1 to 4 (male to female) The distribution of their ages were 1 in one's teens (5%), 6 in their 20s (30%), 7 in their 30s (35%), and 6 in their 40s (30%). 2. The average weight of the patients was 72.155kg, and their average height was 163.2 cm. 3. The body fat rates of patients were distributed as: 2 were below 25 (10%), 3 were 25 to 30 (15%), 8 were 30 to 35 (40%), 5 were 35 to 40 (25%), and 2 were 40 to 45 (10%). 4. The base body metabolism rates of the patients were distributed as: 1 was below 1000Kcal (5%), 6 were 1100 to 1200Kcal (30%), 5 were 1200 to 1300Kcal (25%), 6 were 1300 to 1400Kcal (30%), and 2 were 1400 to 1500Kcal (10%). 5. The distribution of the patients bmi was: 4 were below 20 (20%), 5 were 20 to 25 (5%), 11 were 25 to 30 (55%), and 4 were 30 to 35 (20%). 6. The patients visited the clinic to lose their weight for the follwoing purposes: 5 were related to health concerns (25%), and 15 were to imprve their physical apprearnce (75%). Among patients who wanted to lose their weight becase of health concerns, 4 were married (20%) and 1 was single (5%). Among patiens who wanted to lose their weight to improve their physical appearance, 6 were married (30%) and 9 were single (45%). 7. As for the past treatment methods, physical exercises were most frequently used (19 patiens, 43%). 14 tried diet (32%), 8 used food substitues (19%), 1 was treated through Western medicine, and 1 was not related to any of these (2%). 8. Main reasons for weight gains were: 12 were related to overeating (40%), 10 were stress (33%), and 8 were lack of physical exercise (27%). 9. Physical symptoms included: 15 were fatigue (29%), 14 were constipation (26%), 13 were body swelling (25%), 3 were headache (5%), menstruation pain (4%), one was stomach upset (2%), 2 were related to physical structure, and 2 were related to other (4%). 10. As for the distribution of Sahsang constitution, 10 were Taeum (50%), 9 were Sohyang (45%), and 1 was Sohum (5%). 11. The average muscle weight was 44.87kg, average abdomen fat rate was 0.8999, and average base body metabolism rate was1369.2Kcal. 12. For the 5-week period, The body fat rate changes were 35.93 1.56% to 30.40 1.98% for A group, and 34.27 1.19% to 31.73 1.38% for B group. The abomen fat rate changes were 0.90 0.02% to 0.86 0.03 for A group, and 0.89 0.02% to 0.83 0.02% for B group. The body fat weight changes were 26.92 2.04kg to 20.74 1.98kg for A group, and 27.86 3.37kg to 24.58 3.02kg for B group. The body weight chages were 72.36 3.18kg to 64.54 2.55kg for A group, and 72.48 3.14kg to 67.74 3.11kg for B group. The muscle rate changes were 43.86 1.63kg to 43.10 1.76kg for A group, and 42.72 1.22kg to 41.60 1.86kg for B group. Overall, A group was superior to B group. 13. After being treated for obesity, 13 patients used exercise treatment (65%), 5 continued to receive obesity treatment (25%), and 2 used diet (10%). Based on these results, we could conclude that the importande of setting a criterion of obesity and weight control have changed according to changes in social and cultural values, and that treatment of obesity through Oriental medicine and research should keep up with changes in esthetic and psychological values.

• 대한화장품학회지
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• 제44권3호
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• pp.211-218
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• 2018

즉각 리프팅 화장품은 피부 표면에 주름을 펴주는 다양한 필름 형성제를 함유하고 있다. 그러나 대부분의 필름 형성 고분자는 점착성이 있으며, 피부에 문지르면 밀려 나오는 현상이 있다. 본 연구에서는 신속한 박막 형성 효과가 있는 규산나트륨이 피부 표면에 미치는 영향 및 즉각적인 주름 감소 효과에 초점을 두었다. 물유리 또는 가용성 유리로도 알려진 규산나트륨은 산화나트륨과 실리카를 함유한 화합물이다. 규산나트륨은 물에 쉽게 용해되어 알칼리성 용액을 생성하는 흰색 분말이다. 규산나트륨은 중성 및 알칼리성 용액에서 안정적이며, 규산나트륨 용액은 공기 중에서 건조되어 경화되고 박막을 신속하게 형성한다. 해당 용액을 피부에 도포할 경우, 물 증발 및 이온 결합 재형성에 의해 얇은 막이 형성된다. 또한 피부 표면에 강한 실록산(Si-O) 결합을 형성한다. 이러한 고착성을 화장품에 적용하면 탁월한 피부 수축 효과를 나타낼 수 있다. 규산나트륨 용액은 적절한 농도로 배합될 경우, 피부에 필름을 형성하여 리프팅 효과를 제공할 수 있다. 그러나 높은 농도의 규산나트륨이 적용될 경우, 피부 자극을 일으킬 수 있다. 본 연구에서는 끈적임이 없고, 밀림 현상이 없는 피부 탄력 관리 제형을 개발하기 위해 규산나트륨의 농도 및 다른 고정제와의 바람직한 조합을 연구했다. 규산나트륨과 다양한 증점 시스템을 사용하여 즉각적인 리프팅 효과가 있는 젤 제형을 개발했다. 다양한 증점제 중에서 알루미늄 마그네슘 실리케이트는 단시간에 느껴지는 리프팅 효과를 위해 규산나트륨과 가장 우수한 상용성을 지닌다. 즉각적인 물리적 리프팅 젤은 피부 임상 시험을 통해 낮은 자극성을 지니고 있음을 확인했다.

• 대한한방부인과학회지
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• 제28권2호
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• pp.193-203
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• 2015

목 적: 상열감과 발한과다는 갱년기 증후군의 대표적 증상이다. 본 연구에서는 약침을 이용한 수화조절법을 사용하여 갱년기 증후군 환자의 상열감과 발한과다 증상 감소에 유의한 효과를 얻어 이를 보고하고자 한다. 방 법: 황련해독탕 약침을 양측 견정(GB21), 풍지(GB20) 혈에 각각 0.1 cc씩 총 0.4 cc를 주입하고, BUM(웅담, 우황, 사향)약침은 전중(CV17), 중완(CV12), 기해(CV16)혈에 각각 0.05cc씩 총 0.15cc를 주입한다. 시술은 매일 시행하였으며, 증상에 관하여 상열감점수(Hot flush score), 발한에 대한 Visual Analogue Scale(VAS) 및 발한 부위를 기록하여 증상변화 정도를 평가하였다. 결 과: 1번 증례는 약침 수화조절법 시행 후 상열감점수는 24에서 4로, 발한에 관한 VAS는 7에서 2로 감소하였다. 상열감 및 발한과다 증상의 감소와 더불어 손발이 화끈거리는 증상도 함께 감소되었다.2번 증례는 약침 수화조절법 시행 후 상열감점수가 28에서 2로, 발한에 관한 VAS는 10에서 3으로 감소하였다. 상열감 및 발한과다 증상의 감소와 더불어 불안, 우울, 분노 증의 정서적 증상도 70%정도 감소하였다.3번 증례는 약침 수화조절법 시행 후 상열감점수가 8에서 1로, 발한에 관한 VAS는 6에서 1로 감소하였다. 상열감 및 발한과다 증상의 감소와 더불어 두통, 가슴 답답함 등의 증상도 함께 소실되었다.모든 증례에서 발한 부위의 변화는 없었다. 결 론: 본 증례에서 약침을 이용한 수화조절법은 갱년기 상열감과 발한과다 증상을 감소시키는 효과가 있었으며 부가적으로 호소하던 증상도 감소하거나 소실되는 효과가 있었다. 그러므로 약침을 이용한 수화조절법은 상열감과 발한과다를 호소하는 갱년기 증후군 환자에게 효과적인 치료법이라 사료된다.

• 대한임상독성학회지
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• 제4권1호
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• pp.7-16
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• 2006

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 followed by vitamin C may improve their antioxidant effect more.

• 한국치위생학회지
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• 제7권1호
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• pp.73-89
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• 2007

The purpose of this study was to examine the reality of inservice education provided to members of Korean Dental Hygienists Association, the state of relevant academic conferences, and the perception of the members about inservice education and academic conference. It's basically meant to help boost their participation in inservice education and their satisfaction with it, and to show some of the right directions for that. The subjects in this study were dental hygienists who attended a symposium on July 1, 2006. After a survey was conducted, the answer sheets from 489 participants were analyzed, and the findings of the study were as follows: 1. General hospitals and university hospitals made up the largest group(91.4%) that gave a monthly leave of absence, and the second largest group was dental hospitals(75.4%), followed by dental clinics(58.3%) and public dental clinics(48.0%). The most common closing time in dental clinics and dental hospitals was 5 p.m., and that was 12 p.m. in general hospitals and university hospitals. The dental hygienists in public dental clinics didn't work on Saturdays. By type of workplace, treatment was the most common duty for the dental hygienists in dental clinics and dental hospitals to perform, and those who worked at general hospitals, university hospitals and public health clinics were in charge of extensive range of jobs. 2. The rates of the dental hygienists who took that education stood at 94.9% in public dental clinics, 78.7% in dental hospitals and 75.3% in dental clinics, general hospitals and university hospitals. Regarding how many marks they got on an yearly basis, those who got eight marks or more made up the largest group(55.6%), followed by four marks or more(11.8%), six marks or more(3.4%), and two marks or more(1.5%). As for the usefulness of inservice education for their job performance, the largest number of the dental hygienists(40.8%) found it to be helpful, and the second greatest group(37.5%) considered its effectiveness to be so-so. The third largest group(8.4%) found it to be of great use, and the fourth biggest group(4.2%) considered it to be of no service. The fifth biggest group(l.3%) thought it was absolutely useless. By type of workplace, the workers in dental clinics, dental hospitals, general hospitals and university hospitals wanted the most to learn how to take care of clinical work(acquisition of up-to-date technology), and those in public health clinics hoped the most to learn about public dental health. By type of workplace, the workers in dental clinics had their sight set on self-development the most, and the dental hygienists in dental hospitals, general hospitals, university hospitals and public health clinics were most in pursuit of acquiring new knowledge. By type of workplace, the specific given conditions at work were most singled out by the dental clinic workers as the reason, and the dental hospital employees pointed out time constraints the most. The dental hygienists in general hospitals and university hospitals cited time constraints and financial burden the most, and the public health clinic personnels mentioned inaccessibility of a place for inservice education as the reason. 3. The public health clinic workers participated in academic conferences the most(90.8%), followed by the general and university hospital personnels(68.8%), dental hospital employees(65.6%) and dental clinic workers(65.5%). By type of workplace, the public health clinic workers(73.5%) expressed the most satisfaction, followed by the general and university hospital employees(67.7%), dental clinic workers(62.3%) and dental hospital personnels(54.1%). By type of workplace, the employees of dental clinics, dental hospitals, general hospitals and university hospitals preferred Saturdays, and the public health clinic workers had a liking for weekdays. As for a favored place, hotels were most preferred, followed by university hospitals, general hospitals, college lecture rooms, district halls and local public institutions. Hotels were most favored regardless of the type of workplace. 4. Regarding outlook on inservice education, they had the highest opinion on the facilities and given conditions of lecture rooms($3.41{\pm}0.83$), followed by the professionalism of lecturers($3.34{\pm}0.83$), procedures of receipt and attendance confirmation($3.34{\pm}0.83$) and class size($3.13{\pm}0.89$). On the contrary, they took the most dismal view of the inaccessibility of a place of inservice education($2.08{\pm}0.92$), followed by limited opportunity and limited date for that education($2.51{\pm}0.99$), extra financial burden($2.53{\pm}1.18$) and high tuition fee($2.57{\pm}0.96$).

• Journal of Hospice and Palliative Care
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• 제18권2호
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• pp.85-96
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• 2015

한국의 현대적 예술치료는 1960~1970년대 국내 정신과 환자들을 대상의 보조치료인 활동요법(activity program)의 형태에서, 1982년 정신과 의사들을 중심으로 한국임상예술학회가 창립되면서, 음악치료(music therapy), 미술치료(art therapy), 무용치료(dance therapy), 시치료(poetry therapy), 정신치료극(Psychodrama) 등의 예술치료가 정신장애환자를 대상으로 발전하였다. 1990년대에는 한국미술치료학회와 한국음악치료학회 등 분야별 전문단체가 본격적으로 출범하였고, 2001년 한국예술치료학회가 창립되었다. 통합예술치료의 예술은 한 개인의 내적인 세계와 연관된 인간자체가 가지는 본연의 능력인 창조적 활동이며, 여기에는 음악치료, 미술치료, 무용치료, 시치료 등이 포함된다. 통합예술치료는 인간의 체험현상을 그대로 인정하고 자각하게 하는 현상학적 측면에서 신체와 창조성의 회복을 목표로 예술매체를 활용한 심신치료활동이면서 심신의 성장과 발달을 목표로 하는 치료예술활동이다. 최근 국내 음악치료, 미술치료, 무용동작치료, 통합예술치료를 중심으로 예술치료의 효과에 대한 메타분석 결과, 신체기능 효과 변인군을 제외한 모든 변인군에서 효과크기가 유의했고, 심리적응 효과, 행동적응 효과 그리고 생리적 효과 변인군 순으로 효과크기가 확인되었다. 2015년 7월, 보건복지부는 완화의료 건강보험수가 급여를 일당정액제로 시행하면서, 국내 56개 호스피스전문기관에서 대부분 시행중인 음악치료, 미술치료, 원예치료에 대한 수가를 인정하는 방향으로 논의하고 있다. 이것은 1977년 정신과 환자에 대한 예술요법의 수가가 인정된 이후, 호스피스 완화의료 환자에 대한 예술치료의 수가가 인정된다는 데 그 의의가 있다. 그러나, 예술치료매체와 중재유형, 그리고 치료효과간의 인과관계의 명확한 제시, 즉 치료기전의 문제와 무분별하게 발급되는 자격증 취득자의 교육 수련 수퍼비젼을 통한 전문성과 정체성의 문제를 해결하기 위해, 전문학회 및 협회 등 전문단체간의 유기적인 협력과 노력이 요구된다.

• Journal of Hospice and Palliative Care
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• 제14권1호
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• pp.28-33
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• 2011

목적: 임박사건(impending event)에 대한 인지는 보호자와의 보다 효과적인 의사소통을 위해 필요할 뿐 아니라, 임종실로 옮기는 시점을 결정하는데 있어서 매우 중요하다. 이 주제에 대한 지금까지의 연구는 대부분 임종 48시간을 전후한 시점에서 이미 '발생되어 있는' 증상의 나열에 불과하였다. 이에 '변화'의 시점에서 사망까지의 시간을 기준으로 하여 임박사건 간 48시간 이내 임종예측도를 비교하였다. 방법: 인천소재 완화의료병동에서 임종을 맞이한 160명의 환자 중 임종 전 일주일 동안의 의무기록이 있는 80명을 대상으로 하였다. 환자 및 보호자가 호소하는 주관적 증상 9가지와 의료인에 의해 관찰되는 객관적 징후 8가지를 선정하고 각 항목에 대한 '의미 있는 변화'의 기준을 사전에 정하였다. 결과: 증상에서는 수면량의 증가(53.8%), 징후에서는 혈압의 감소(87.5%)가 가장 높은 발생빈도를 보였다. 임종까지의 평균시간은 증상의 경우 안정 시 호흡곤란(46.8시간)이, 징후의 경우 산소포화도의 감소(13.6시간)와 혈압의 감소(36.9시간)가 48시간 이내였다. 48시간 임박사건으로서의 예측도는 증상의 경우, 양성예측도는 안정 시 호흡곤란이 가장 높았고(83%) 음성예측도는 안정 시 호흡곤란과 의식혼탁/섬망의 조합이 가장 높았으며(86%), 징후의 경우 양성 예측도는 모두 95% 이상이었고 음성예측도는 혈압의 감소와 산소포화도 감소의 조합에서 가장 높았다(60%). 증상과 징후의 발생양상은 유의한 차이를 보였다. 결론: 증상에서는 안정 시 호흡곤란과 의식혼탁/섬망이, 징후에서는 산소포화도나 혈압의 감소가 임종임박을 예측하는데 가장 유용한 임상지표로 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.