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암환자와 비-암환자의 임종기 치료 강도 비교: 단일 연구기관 자료
김재민,백선경,김시영,맹치훈,한재준,박소영,박재훈,Kim, Jae Min,Baek, Sun Kyung,Kim, Si-Young,Maeng, Chi Hoon,Han, Jae Joon,Park, Soyoung,Park, Jae Hun 한국호스피스완화의료학회 2015 한국호스피스.완화의료학회지 Vol.18 No.4
목적: 의학의 발달로 인구가 고령화됨에 따라, 사망의 원인이 되는 질환 및 동반질환의 유병기간은 함께 증가하고 있으며, 고령환자의 임종기 관리에 대한 연구의 필요성도 더욱 증가하고 있다. 그러나 임종기 치료 강도에 대한 국내연구는 암환자에 국한되어 있으며, 비-암환자의 임종기 치료 강도에 대한 국내 연구는 없었다. 그래서 본 연구는 암환자와 비-암환자의 임종기 치료 강도에 대해 연구하였다. 방법: 경희대학교병원에서 2014년 12월 1일부터 2015년 3월 31일까지 4개월간 사망자의 의무기록을 조사하여 암환자와 비-암환자의 기본 인구학적 정보, 임종기 치료 강도, 심폐소생술 금지 요청서 경향 등에 대해 비교 연구하였다. 결과: 비-암환자가 암환자에 비해 나이가 많았음에도 불구하고(73.7 vs. 67.4, P=0.001), 중환자실 치료(87.4% vs. 36.0%, P<0.001), 기도 삽관 및 기계 호흡(63.2% vs. 24%, P<0.001), 응급 투석(28.7% vs. 8.0%, P=0.001)을 더 많이 받은 것으로 나타났으며, 나이(P=0.038), 암의 유병 여부(P<0.001)가 임종기 침습적 치료에 영향을 미치는 인자로 나타났다. 결론: 임종기 치료 강도는 비-암환자에서 더 높은 것으로 나타났으며, 나이와 암의 유병여부가 임종기 치료 강도를 결정하는 중요한 인자였다. Purpose: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. Methods: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. Results: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. Conclusion: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.
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부영민 ( Yung Min Bu ),백선경 ( Sun Kyung Baek ),김진화 ( Zhen Hua Jin ),강동호 ( Tong Ho Kang ),노승주 ( Seung Ju Rho ),김호철 ( Ho Cheol Kim ) 대한본초학회 2004 大韓本草學會誌 Vol.19 No.2
N/A Objectives: The root of Rhodiola sachalinensis A. bor (RS), which has been used to strengthen qi(補氣), reduce heat of lung (淸縮), nourish heart (養心), stop bleeding (止血), reduce edema(消腫) for the treatment of fatigue, amnesia, bleeding and edema. It`s flavour and channel tropism is sweet (甘), acting on the lung (肺). The purpose of the study we report here was to determine the neuroprotective effect of the roots of RS on transient focal cerebral ischemia in SD rats. Methods: The root of RS was lyophilized after extraction with 85% methanol. We occluded middle cerebral artery for 90 minutes and reperfused for 24 hours. The brain slices were stained by 2 % 2, 3, 5-triphenyltetrazolium chloride and the infarct volume was measured by graphic analyzer. Results: The root extracts of RS showed significant neuroprotective effects (100 mg/kg, p〈0.05) compared with control group. The neuroprotective efficacy was about 35%. Immunohistochemical data explained the protective effects of RS via attenuation of COX-2 induction in neocortex and inhibition of microglia activation in the penumbral region. Conclusions: The root of RS has neuroprotective effects on transient focal cerebral ischemia in Spargue-Dawley rats and the mechanism might be the attenuation of COX-2 induction and microglial activation.
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중등도 이상의 암성통증을 호소하는 노인 환자에 대한 고용량의 마약성 진통제의 이용: 전향적 관찰 연구
김정은(Jung Eun Kim),최윤선(Youn Seon Choi),이경희(Kyung Hee Lee),김준석(Jun Suk Kim),고수진(Su Jin Koh),백선경(Sun Kyung Baek),김시영(Si Young Kim),송홍숙(Hong Suk Song),임보라미(Bo Rami Lim) 대한임상노인의학회 2016 대한임상노인의학회지 Vol.17 No.1
Background: Despite the large number of elderly individuals who are dying of cancer in Korea, the quality of pain management remains poor. Thus, in this study, the safety and efficacy of using high-dose opioids to treat has been evaluated pain in elderly patients with cancer. Methods: Data from cancer patients (N=94) aged ≥65 years who were administered high-doses of opioids (≥120 mg/day) were collected at 38 hospitals between February 2009 and March 2010. After 8 weeks, changes in pain severity were examined using a numeric rating scale; in addition, the opioid dosages, quality of life parameters, and opioid-based adverse events were investigated. Results: Ninety-two patients were prescribed opioids at the beginning of the study and followed for 8 weeks. The mean pain intensity changed from 5.61±1.56 at baseline to 4.02±2.17 (P<0.001) after 8 weeks. The mean opioid dosage, expressed as oral morphine equivalents, changed from 178.86±76.88 at baseline to 288.54±389.09 (P=0.0025) after 8 weeks. The quality of life parameters, including daily activities, ambulation, and sleep, improved significantly after 8 weeks (P<0.001). At baseline, 44 patients (47.8%) complained of adverse effects such as constipation, dizziness, and nausea; the frequency of adverse events did not increase after 8 weeks. Conclusion: The use of high-dose opioids for treating cancer pain is safe, effective, and tolerable in elderly patients.
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박정일(Jeong Hill Park),신영근(Young Geun Shin),신언경(Un Kyung Shin),백선경(Sun Kyung Baek),이승기(Seung Ki Lee),정명희(Myung Hee Chung),박영인(Young In Park) 대한약학회 1997 약학회지 Vol.41 No.4
To isolate biologically active compounds which exhibit tyrosinase inhibition activity and ultimately express skin whitening effect, 14 oriental herbal drugs were screened in terms of tyrosinase inhibition. For this purpose, in vitro enzyme assay system for tyrosinase, so called Pomerantz method with some modifications has been established. Crude methanolic extracts from 14 herbal drugs were made and examined for their inhibitory activity against tyrosinase. Those extracts fromCnidii Rhizoma, Arecae Semen, Caryophylli Flos, and Ephedrae Herba showed strong inhibitory activities on mushroom tyrosinase. Therefore, crude methanolic extracts from those 4 herbal drugs were further fractionated using ether, butanol and water. respectively. The ether and n-butanol extracts from Arecae Semen and the n-butanol and water extracts from Caryophylli Flos, respectively, showed relatively strong tyrosinase inhibitory activity compared to arbutin.
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동종 조혈모세포 이식 이후 고빌리루빈혈증과 경막하출혈을 보인 증례
고원진 ( Weon Jin Ko ),김태영 ( Tae Young Kim ),박소영 ( So Young Park ),최은용 ( Eun Yong Choi ),김시영 ( Si Young Kim ),윤휘중 ( Hwi Joong Yoon ),조경삼 ( Kyung Sam Cho ),정재헌 ( Jae Heon Jeong ),백선경 ( Sun Kyung Baek ) 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.2
Hyperbilirubinemia is commonly observed following allogenic hematopoietic stem cell transplantation (HSCT). It is sometimes associated with severe complications after HSCT with a major impact on transplant outcomes. Here, we describe a case of a Ph-positive acute lymphoblastic leukemia (ALL) patient with moderate thrombocytopenia who developed subdural hemorrhage (SDH) following allogenic HSCT. He presented with hyperbilirubinemia after a HSCT, so drugs that were known to cause hepatotoxicity were stopped and his situation was reexamined to rule out other causes. But the hyperbilirubinemia was continuous, and we came to the conclusion that hyperbilirubinemia was caused by the blood from the ruptured blood vessel that occurred with the appearance of increased intracranial pressure.
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