호스피스 환자의 증상조절에 따른 가족간병인의 삶의 질과 우울, 불안

김윤희,이승훈,임호섭,최영진,김윤진,이상엽,이정규,정동욱,유경화,Kim, Yun Hee,Lee, Seung Hun,Lim, Ho Seop,Choi, Young Jin,Kim, Yun Jin,Lee, Sang Yeoup,Lee, Jeong Gyu,Jeong, Dong Wook,Yu, Kyoung Hwa 한국호스피스완화의료학회 2015 한국호스피스.완화의료학회지 Vol.18 No.4

Purpose: It is well known that a terminal cancer condition affects not only patient themselves but their family members because the patients experience a variety of symptoms. This study was aimed to investigate modifiable factors that influence family caregivers' quality of life, depression, and anxiety. Methods: From January 2015 through May 2015, a survey was conducted with 61 family caregivers of hospice patients who were hospitalized in two university hospitals and one municipal hospital in Busan. The questionnaire was consisted of characteristics of family caregivers and patients, the Korean version of the Caregiver Quality of Life Index-Cancer (CQOLC-K), Beck's Depression Inventory II (BDI-II), Beck's Anxiety Inventory (BAI), and patient's symptom controlling scores rated by family caregivers. Results: Family caregivers' depression was associated with religion. Quality of life and depression of family caregivers were also influenced by monthly household income. Patient age was inversely related to family caregiver's quality of life ($r_s=-0.259$, P=0.043). Family caregivers' quality of life was associated with patient's anxiety (r=0.443, P=0.001). Family caregivers' depression was affected by patient's constipation (r=0.276, P=0.046), anxiety (r=0.508, P<0.001), and daytime drowsiness (r=0.377, P=0.005). And family caregivers' anxiety was influenced by patients' sleep disturbance (r=0.276, P=0.046), depression (r=0.297, P=0.031), and anxiety (r=0.357, P=0.009). Conclusion: According to our findings, family caregivers had higher quality of life and less depression and anxiety when symptoms in hospice patients were well controlled. 목적: 말기암환자는 다양한 증상을 경험하기 때문에 말기 암이라는 상태는 환자뿐만 아니라, 그들의 가족 구성원들에게도 영향을 준다. 이 연구에서는 가족간병인의 삶의 질, 우울, 불안지수에 영향을 주는 환자의 증상조절과 같은 교정 가능한 요소들을 알아보고자 한다. 방법: 2015년 1월부터 2015년 5월말까지, 5개월 동안 부산광역시 내의 2개 대학병원 호스피스병동, 1개의 시립병원 호스피스병동에 입원한 61명의 가족간병인을 대상으로 설문조사를 시행하였다. 설문지는 가족간병인의 특성과 환자의 특성, 가족간병인의 CQOLC-K, BDI-II, BAI와 가족간병인이 수치화한 환자의 증상조절 점수로 구성되어 있다. 결과: 가족간병인의 우울지수는 종교와 연관성이 있으며, 삶의 질과 우울지수는 한달 가정소득에 영향을 받았다. 환자의 나이는 가족간병인의 삶의 질과 역의 상관관계를 가지고 있다. 가족간병인의 CQOLC-K는 환자의 불안조절 점수에 영향을 받았으며, 가족간병인의 BDI-II는 환자의 변비, 불안, 주간 졸음조절 점수에 영향을 받았다. 가족간병인의 BAI는 환자의 수면장애, 우울, 불안조절 점수에 영향을 받았다. 결론: 가족 간병인의 삶의 질, 우울, 불안지수는 환자의 증상이 잘 조절될 때 삶의 질이 높고, 우울, 불안지수가 낮은 경향을 보여주었다.

Corrigendum to : 취연탕(取淵湯) 및 치효산가미방(治哮散加味方)이 기도점액 분비 및 기관평활근 긴장도에 미치는 영향

김윤희,한재경,김윤희,Kim, Yun Hee,Han, Jae Kyung,Kim, Yun Hee 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.4

만성기침을 동반한 영아에서 상부 식도 24시간 pH 검사의 유용성

김윤희,김자경,김정희,임대현,손병관,Kim, Yun Hee,Kim, Ja Kyoung,Kim, Jung Hee,Lim, Dae Hyun,Son, Byong Kwan 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.12

목 적 : 다른 특별한 병력이 없는 영아들에서 흡인으로 인한 만성 기침이 의심되는 경우, 상부 식도 24시간 pH 검사를 시행하여, 그 결과를 일반적으로 위식도 역류를 진단하기 위해 시행하는 하부 식도 24시간 pH 검사의 결과치와 비교하여 상부 식도 24시간 pH 검사에 대한 유용성을 평가하고자 하였다. 방 법 : 3주 이상의 만성 기침을 주소로 인하대병원 소아과에 입원한 1세 이하 영아들 중, 흉부 단순 촬영상 특이소견이 없고 그 원인이 뚜렷하지 않은 환아들을 상대로 흉부 전산화 단층 촬영을 시행한 결과, 의존성 위치에서 폐 경화를 보여 역류로 인한 흡인의 가능성이 높은 17명의 환아들을 본 연구의 대상으로 하여 상부와 하부 식도 24시간 pH 검사를 시행하였다. 결 과 : 1) 대상 환아는 17명(남아 12명, 여아 5명)으로 평균 연령은 4.3개월($4.3{\pm}1.8$개월)이었다. 2) 총 17명의 환아들 중, 상부 식도에서 병적인 위산 역류를 보인 환아는 15명(88.2%)이었고, 하부 식도에서는 4명(23.5%)으로, 상부 식도에서 이상 소견을 보인 환아들이 더 많았다(P<0.01). 하부 식도에서 정상 범위의 역류를 보이더라도 상부 식도에서 병적인 역류를 보이는 경우는 13명 중 12명(92.3%)이었다. 3) 상부 식도 24시간 pH 검사에서 역류지표와 역류빈도가 하부 식도 24시간 pH 검사에서보다 통계적으로 의미 있게 낮았다(P<0.05). 4) 하부 식도 24시간 pH 검사 결과와 상부 식도 24시간 pH 검사 결과들 사이에는 상관관계가 없었다. 5) 하부 식도 24시간 pH 검사에 있어서, 위식도 역류로 진단을 받은 군(group 1)과 정상으로 진단을 받은 군(group 2)의 상부 식도 24시간 pH 검사 결과와의 차이를 비교했을 때, group 2에서 상부 식도에서도 역류빈도가 통계적으로 의미 있게 낮았다(P<0.05). 결 론 : 만성 기침을 보이는 영아들에 있어서 뚜렷한 위식도 역류 증상은 없지만 위식도 역류에 의한 흡인이 의심되는 경우에 상부 식도 24시간 pH 검사가 필수적인 진단 방법으로 제시하는 것에 본 연구의 의의가 있다. Purpose : Gastroesophageal reflux disease(GERD) is known as one of the most common causes of chronic cough, especially in children. The purpose of this study is to evaluate the efficacy of parameters from proximal esophageal 24-hr pH monitoring through its comparison with those of distal esophageal 24-hr pH monitoring that we generally use for diagnosis of GERD. Methods : We performed chest CT scans to find out the cause of chronic cough in infants with no clinical manifestation suggesting GERD. Then, in case that they had air space consolidation in posterior segment of both upper lobes and superior segment of both lower lobes(dependent position), we performed proximal and distal esophageal 24-hr pH monitoring. Results : The proximal and distal pH monitoring were performed in 17 infants(male 12; female five). The patients with positive pathologic reflux in proximal esophagus were 15 of 17(88.2%) and in distal esophagus were four of 17(23.5%). Reflux index and the total number of reflux episodes were statistically significantly lower in the proximal than in the distal esophagus(P<0.05). There was no correlation between each parameters of proximal and distal esophageal 24-hr pH monitoring. Conclusion : This study suggests that proximal esophageal 24-hr pH monitoring can be used as a very useful diagnostic tool in infants with chronic cough in which there are suspicions that it resulted from aspiration due to GERD.

대사증후군의 체질병증 모델 구축을 위한 예비연구 - 40대 태음인을 중심으로 -

김윤희,이준희,이의주,고병희,Kim, Yun-Hee,Lee, Jun-Hee,Lee, Eui-Ju,Koh, Byung-Hee 사상체질의학회 2009 사상체질의학회지 Vol.21 No.2

1. Objectives : This study is a pilot study to construct of metabolic syndrome model with constitutional type. We focused on the correlation of Metabolic syndrome(MetS) and ordinary symptoms with Taeumin at 40. 2. Methods : 32 subjects who had taken health examinations and diagnosis of Sasang constitution from Oct 1, 2008 to Dec 31, 2008 at Kyung-Hee medical center were included and underwent B-mode ultrasonography for measurement of intima-media thickness of common carotid arteries. MetS was defined by the criteria of the criteria of the National Cholesterol Education Program Adult Treatment Panel III. 3. Results and Conclusions : Mean intima-media thickness of common carotid artery was higher in subjects with MetS compared with control subjects(0.56$\pm$0.12 vs 0.54$\pm$0.08mm) however. The ordinary symptoms shown to differentiate the MetS group and the control group were related to "dark urine color," "dryness of eyes," and "night sweat". Therefore, these ordinary symptoms can be said to be indicators of the Taeumin with Mets syndrome.

가미강활산(加味羌活散)이 집먼지 진드기 추출물로 유도된 NC/Nga mouse의 아토피 피부염에 미치는 영향

김윤희,한재경,김윤희,Kim, Yun-Hee,Han, Jae-Kyung,Kim, Yun-Hee 대한한방소아과학회 2008 대한한방소아과학회지 Vol.22 No.1

Objectives The purpose of this study is to investigate the effect of KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to this condition in humans. Methods To investigate the effect of KKHS on atopic dermatitis (AD), we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells(PBMCs), splenocytes, draining lymph node(DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis of NC/Nga mouse in vivo. Results In vivo, clinical skin severity score was significantly lower in the KKHS group than in the control group. IgE, IL-6, TNF-${\alpha}$, IgM, IgG2a and IgG2b levels in serum decreased remarkably in the KKHS group than in the control group, and the level of IFN-${\gamma}$ production which is secreted from Th1 cell was increased by KKHS. After this experiment we analyzed immunological cells ($CD3^+$, $CD19^+$, $CD4^+$, $CD8^+$, $CD3^+CD69^+$, $CD4^+CD25^+$ and $CD49b^+$) by flow cytometry. It results that the total absolute number of $CD3^+$, $CD19^+$, $CD4^+$ and $CD8^+$ cells were recovered as much as normal state, and the level of $CD3^+CD69^+$ in isolated DLN and PBMCs were significantly decreased, and total absolute number of $Gr-1^+$, $CD11b^+$ and $CD3^+$ in dorsal skin of NC/Nga mouse were decreased by KKHS. We analyzed ear, DLN, and neck-back skin after biopsy and dyeing by hematoxyline/eosin(H&E), toluidine staining (mast cells marker). KKHS were very effective to the histological symptoms which are in dermal and epidermal thickening, hyperkeratosis and inflammatory cell infiltration. Ear thickness was significantly decreased compared with the control group and the size of inflammatory lymphocytes cells (ILC) and plasma cells (PC) in DLN were also decreased. Conclusions KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse was very effectiveness to the atopy dermatitis treatment.

Corrigendum to : 가미강활산(加味羌活散)이 집먼지 진드기 추출물로 유도된 NC/Nga mouse의 아토피 피부염에 미치는 영향

김윤희,한재경,김윤희,Kim, Yun Hee,Han, Jae Kyung,Kim, Yun Hee 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.4

비수한표한병(脾受寒表寒病)으로 접근한 소양인(少陽人) 현훈(眩暈) 치험(治險) 일례(一例)

김윤희,김상혁,이갑수,석재화,이준희,이의주,송일병,고병희,Kim, Yun-Hee,Kim, Sang-Hyuk,Lee, Kab-Soo,Seok, Jae-Hwa,Lee, Jun-Hee,Lee, Eui-Ju,Song, Il-Byung,Koh, Byung-Hee 사상체질의학회 2007 사상체질의학회지 Vol.19 No.1

1. Objectives This case is to report that a Soyangun patient with Dizziness treated by Soyangin's Contitutional medications-Dojuckkangki-tang(導赤降氣湯). 2. Methods This patient was treated by several Constitutional medications (導赤降氣湯-地黃白虎湯-荊芳地黃湯) and acupuncture treatment according to the result of Sasang Constitutional diagnosis with western medical management. We used Visual analogue scale(VAS) for the assessment of dizziness. 3. Results and Conclusions This patient's chief complaints was dizziness. So he was treated by Soyangin's Constitutional medications (especially Dojukkangki-tang) and showed a positive response about his symptom. But then we consider that studies about that case like this are more needed.

3차원 안면자동인식기(3D-AFRA)의 인식도 연구

김윤희,양춘석,이준희,정용재,유정희,이승현,고병희,이의주,Kim, Yun-Hee,Yang, Chun-Seok,Lee, Jun-Hee,Jung, Yong-Jae,Yoo, Jung-Hee,Lee, Seung-Hyun,Koh, Byung-Hee,Lee, Eui-Ju 사상체질의학회 2008 사상체질의학회지 Vol.20 No.1

1. Objectives We had been developing a 3D Automatic Face Recognition Apparatus (3D-AFRA) in order to evaluate the external appearances with more objectivity. This apparatus provides a 3D image and numerical data on facial configuration, and this study aims to evaluate the accuracy of 3D-AFRA recognition. 2. Methods Each scanned pictures were pointed with the 3D Automatic Face Recognition Apparatus(3D-AFRA). And the results were compared with data pointed pictures with manual. And we analysed the difference between Automatic and manual by paired -test. 3. Results and conclusions In frontal face, the P-value was more than 0.05. In conclusion, We assessed that accuracy of recognition of 3D Automatic Face Recognition Apparatus(3D-AFRA) is considerably good. But we should develop methods of measurement for lateral face and indistinct points of frontal face.

태음인(太陰人) 조열병증(燥熱病證)의 임상적 특징에 대한 연구(硏究)

김윤희,김상혁,장현수,황민우,이준희,이의주,고병희,Kim, Yun-Hee,Kim, Sang-Hyuk,Jang, Hyun-Su,Hwang, Min-U,Lee, Jun-Hee,Lee, Eui-Ju,Koh, Byung-Hee 사상체질의학회 2009 사상체질의학회지 Vol.21 No.1

1. Objective The object of this study was to understand the clinical characteristics of the Taeeumin Symptomatic Pattem. 2. Methods The patients visiting the department of Sasang Constitution of Traditional Korean Medicine clinic from June to November of 2008 were used in this study. Those who showed a favorable turn after over ten days of medication and who showed up for at least two follow-up sessions were chosen among first-time visitors. Of these, 75 patients identified and verified to be of the TE type were chosen for the study sample. The Taeeumin were verified into two groups according to clinical symptoms into Exterior Cold Disease and Interior Heat Disease groups, of which the Interior Heat Disease group was further subdivided into the Galgeun-medicament group and the Cheongshimyeonja-tang group, based on questionnaire results. The Exterior Cold Disease group was set as the control group in order to contrast and compare it with the study group, the Interior Heat Disease group. 3. Results and Conclusions The questionnaire items shown to differentiate the Exterior Cold Symptomatic Patterm and the Interior Heat Symptomaic Pattern (indicating Heat-affceted Liver Symptomatic Pattern) were related to "dryness of stool," "dark urine colorm," "dryness of nose," and "dryness of lips." The items shown to differentiate the Galgeun-medicament group and the Cheongshimyeonja-tang group (of the Dry - Heat Symptomatic Pattern) were related to "nausea," "stifling sensations and palptation," "disturbed sleep," and "dizziness." Therefore, the sleep pattern, palpitation, dizziness, and nausea can be said to be indicators of the Interior Heat Symptomatic Pattern, and Dry-Heat symptoms are better distinctions between the Chongshimyeonja-tang group and the Galgeun-medicament group than Heat-affected Liver symptoms.

양신탕(養神湯)의 항(抗)스트레스 효과(效果)에 대(對)한 실험적(實驗的) 연구(硏究)

김윤희,윤지연,Kim, Yun-Hee,Yoon, Ji-Yeon 대한한방소아과학회 2004 대한한방소아과학회지 Vol.18 No.1

Objective: The study aimed to evaluate the anti-stress effect of YST on the cold-stressed Mice. Method: The experimental animals were stressed in cold room ($4{\pm}0.5^{\circ}C$) for 1 hour in a day during 2weeks, and administerd 115mg/100g YST extract for 2weeks before stress. For 2weeks, we conducted a research about the change of weight and content of norepinephrine, epinephrine, dopamine, cortisol and GOT, GPT in the mice serum. Results: YST significantly inhibited the decrease of body weight induced by stress, compared with the control group. YST had no significant decreasing effect on the change of content of the serum GOT But decreased the content of the serum GPT. YST decreased the content of the serum cortisol. YST decreased the content of the serum dopamine a little and decreased the content of the serum epinephrine significantly. Conclusion: According to the above results, it is concluded that YST will be useful as a remedy against stress disease.