포제한약재의 최종당화산물 생성 억제 활성 및 항산화 효과

이아름 ( Ahreum Lee ),권오준 ( Ojun Kwon ),최준영 ( Joonyoung Choi ),노성수 ( Seong-soo Roh ) 대한본초학회 2017 大韓本草學會誌 Vol.32 No.3

Objectives: Advanced glycation end product (AGEs) is combine formation of glucose and protein. AGEs and reactive oxygen species are potential therapeutic targets for the various disease such as diabetic complications, renal injury, skin damage. The aim of this study was investigated the AGEs inhibitory activity and antioxidant activity of water extracts from 40 Korean medicines and 5 heating-processed Korean medicines. Methods: AGEs formation inhibitory activities of Korean medicines measured using bovine serum albumin (BSA), glucose, and fructose. Then, five effective Korean medicines were selected and heated with 30% ethanol. The AGEs inhibitory activities of heated Korean medicine were measured compared with not-heated Korean medicines. The antioxidant activities were evaluated through radical scavenging assays using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2`-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radicals. Furthermore, we examined total phenol and flavonoids contents. Results: Scutellariae Radix, Corni Fructus, Persimmon Fruit, Paeoniae Radix, Mori Folium respectively reduced AGEs production. Morever, heating-processed Scutellariae Radix has AGEs inhibitory activities better than not-processed Scutellariae Radix. Heating- processed Scutellariae Radix scavenged DPPH and ABTS effectively and IC50 of DPPH and ABTS radical scavenging activity of Heat processed Scutellariae Radix were 15.47±0.26 ㎍/㎖ and 12.07±1.23 ㎍/㎖. It caused heat processing methods of Scutellariae Radix up regulated total phenol and flavonoids contents (26.68±0.01 to 46.15±0.10, 20.30±0.38 to 64.20 ±0.52). Conclusion: It has AGEs inhibitory activities that 20 kind of medicinal plants of 40 medicinal plants. Especially, heat processed Scutellariae Radix has excellent AGEs inhibitory activities and antioxidant effect.

일본 고령자를 위한 End of Life Care 정책

가부모토 치즈루(Chizuru Kabumoto) 대한임상노인의학회 2020 대한임상노인의학회지 Vol.21 No.2

In Japan, it is expected that the aging population will make it difficult to secure End-of-Life Care (EOLC) resource. Therefore, it is necessary to strengthen the system of EOLC by resources other than hospitals and clinics. In this paper, I consider how the EOLC policy for the elderly has been developed in such a situation, and what issues it has. First, I confirm the position of EOLC in recent economic and social policies. Next, I will consider the spread of decision-making support, the enhancement of home care medicine, the promotion of cooperation between medical services and long-term care services, and the construction of the system to supply EOLC in long-term care facilities. As a result of consideration, the issues clarified are as follows; 1) the formulation of a plan with priority targets to respond to needs, 2) the establishment of operations that lead to the substantial effects of Advance care planning (ACP), 3) the establishment of a stable supply system for home care medicine resources with EOLC functions, and 4) cooperation enhancement between medical professionals and care workers in long-term care facilities.

임종과정에 있는 환자의 연명의료결정과 신뢰에 기반한 환자-의사 관계

오승민(Seung Min Oh),김평만(Pyung Man Kim) 가톨릭대학교(성심교정) 인간학연구소 2018 인간연구 Vol.0 No.35

호스피스 완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률은 의사-환자 관계 모형 중 환자의 자율성을 중시하는 대등한 동반자로서의 계약 관계 모형을 토대로 기술되어 있다. 임상 상황에서는 환자의 자기 결정권을 우선순위로 하여 이러한 결정이 이루어지기 어려운 상황임에도 불구하고 이에 근거한 법률을 시행하게 되는 것은 현실과의 괴리를 낳을 수 있다. 환자의 자율성을 기반으로 한 이러한 연명의료결정 과정은 의사-환자 관계에서 본연적으로 존재하는 불평등, 임종과정 자체가 내포하고 있는 환자 개인의 자율성 제한 상황, 가족의 영향이 큰 의료문화, 사회적 지원 체계 부족 등으로 인하여 많은 한계점을 갖고 있다. 그럼에도 불구하고 현행의 의사-환자 관계 모형이 환자의 자율성을 중시하는 계약 모형이라는 이유로 의사와 환자의 상호 신뢰를 기반한 온정적 간섭주의의 가치를 평가절하해서는 안된다. 의사와 환자의 상호 신뢰를 기반으로 한 선행의 원칙을 강조하는 온정적 간섭주의 모형이 임종 과정의 연명의료 결정에 있어서 더욱 윤리적인 결과를 도출할 수 있을 것이다. 의료인들이 신뢰 안에서의 선행을 기반으로 온정적 간섭주의의 관계를 환자들과 맺는다는 것은 환자들의 신뢰를 바탕으로 그리스도의 치유와 돌봄을 대신하는 것이기 때문이다. Last year, a Korean law regarding life–sustaining medical decisions of patients in hospice and end-of-life processes was promulgated. This law was based on patients autonomy and the contract model of doctorpatient relationship. However, in end-of-life care decision considerations of patients autonomy should be limited. Without limits, patients are not seen and treated in context. It is only possible to practice “good clinical medicine” when patients are considered this way. When “good clinical medicine” is not practiced, the practice of medicine is not ethical. This study argues that doctor-patient relationship models, for determining end-of-life care decisions should be based on the principle of beneficence- in-trust, in which the best interests of patients, including patient autonomy interests, are held in trust by physicians, and patients alike. It is concluded that each doctor must continuously remind him or herself of the principal and of ways in which he or she can orient his or her personal character, behavior, and identity. Therefore, virtue is an unavoidable element in all medical ethics systems regarding end-of-life care decisions.

인간 배아의 유전적 향상 - 치료와 향상, 그리고 의학의 새로운 도전들 -

최진일(Choi, Jinil) 가톨릭대학교(성심교정) 인간학연구소 2024 인간연구 Vol.- No.52

이 글은 인간 향상을 위해 인간 배아를 대상으로 하는 유전적 개입의 문제를 고찰한다. 인간 배아에 대한 유전적 개입은 궁극적으로 출산을 목적으로 하므로, 이 문제는 인간 배아 연구 그 이상의 차원에서 검토되어야 한다. 인간 배아에 대한 유전적 개입은 그 당사자인 배아의 현 단계뿐 아니라 이후 그 배아의 모든 삶에 영향을 미친다는 점에서 매우 중요한 논제이다. 따라서 인간 배아의 생명과 존엄의 보호가 전제되지 않은 유전적 개입은 미래 세대의 생명과 존엄성을 위협할 것이므로, 인간 배아를 환자의 지위로서 대우해야 할 근거를 규명할 필요가 있다. 본 연구는 이를 치료와 향상, 건강과 질병, 웰빙, 그리고 의학의 목적과 목표와 연관된 의학의 새로운 도전들과 함께 고찰한다. This study examines the issue of genetic intervention targeting human embryos for human enhancement. Since this genetic intervention ultimately aims at reproduction, this issue should be examined in a dimension beyond human embryo research. Genetic intervention in human embryos is a highly significant topic as it not only affects the current stage of the embryo but also influences all aspects of the child’s future life. It is therefore necessary to establish the rationale for treating human embryos as patients, since genetic interventions that fail to protect the life and dignity of human embryos may endanger the dignity of future generations. This study explores these issues in relation to the new challenges in medicine related to therapy and enhancement, health and disease, well-being, and the ends and goals of medicine.

Complementary and Alternative Medicine Use among Cancer Patients at the End of Life: Korean National Study

Choi, Jin-Young,Chang, Yoon-Jung,Hong, Young-Seon,Heo, Dae-Seog,Kim, Sam-Yong,Lee, Jung-Lim,Choi, Jong-Soo,Kang, Ki-Mun,Kim, Si-Young,Jeong, Hyun-Sik,Lee, Chang-Geol,Choi, Youn-Seon,Lim, Ho-Yeong,Yun, Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4

Objectives: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. Design and location: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. Results: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1%. The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. Conclusions: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.

완화 병동에서 임종기 섬망의 변화 양상과 선행 요인

임미루,김상구,최서현,조진현,이문희,김혜영,배재남,이정섭,김원형 한국정신신체의학회 2018 정신신체의학 Vol.26 No.2

Objectives:The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods:From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results:The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions:Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors. 연구목적: 본 연구는 완화병동에 입원한 환자들에서 사망 직전에 발생하는 임종기 섬망의 발생을 사망 전 2주시점 전부터 관찰하여 변화양상과 선행 요인을 관찰한 연구이다. 방 법: 2015년 10월부터 2017년 8월까지, 일 대학병원 완화병동에 입원한 말기 암환자 최종 180명을 대상으로 후향적 연구를 진행하였다. 대상자는 매일 3회 Richmond Agitation Sedation Scale과 Nursing Delirium Screening Scale로써 섬망의 세가지 아형으로 진단되었다. 결 과: 임종 13일 전 섬망의 빈도는 46%였으며, 그 중 18.3%는 과활동성, 13.8%는 저활동성 그리고 혼합성 아형은13.8%를 차지하였다. 과활동성 섬망은 임종일까지 점차 감소하는 양상이었으며, 저활동성 아형과 혼합성 아형의 섬망은 임종 4일 전까지 점차 증가하는 양상이었다. 임종 하루 전 86.9%의 환자들은 섬망으로 진단되었다. 다변량 분석에서 위장관 암보다 혈액학적 암이 낮은 임종기 섬망과 연관이 있었으며 과체중도 낮은 임종기 섬망과 연관이 있었다. 결 론: 많은 완화의료 환자들은 섬망을 경험하였으며, 과체중은 임종기의 모든 아형의 섬망을 낮추는 보호인자로고려되었다. 차후 임종기 섬망의 빈도와 위험 인자를 밝히는 전향적 연구가 필요할 것이다.

한국약용식물의 최종당화산물 생성저해활성 검색 (II)

이윤미,김영숙,장대식,유정림,김종민,김주환,김진숙 한국생약학회 2008 생약학회지 Vol.39 No.3

Advanced glycation end products (AGEs) contribute to the progression of micro and macrovsacular complicationof diabetes and therefore present a promising target for therapeutic agents. In this study, 40 Korean herbal medicines have beeninvestigated with an in vitro evaluation system using AGEs inhibitory activity. Of these, 21 herbal medicines (IC50<50 μg/ml)exhibited an inhibitory activity against AGEs formation compared with anminoguanidine (IC50=72.12 μg/ml). Particularly, 7herbal medicines, Actinidia arguta (root and stem), Crataegus pinnatifida (twig), Camellia japonica (whole), Kalopanax pictus(bark), Lagerstroemia indica (leaf-stem), Reynoutria sachalinensis (root) showed more potent inhibitory activity (approximately3-10 fold) than the positive control aminoguanidine

한국약용식물의 최종당화산물 생성저해활성 검색 (IX)

이윤미,김진숙,김영숙,김주환 한국생약학회 2013 생약학회지 Vol.44 No.3

In this study, 64 Korean herbal medicines have been investigated with an in vitro evaluation systems using glycation end products (AGEs) formation inhibitory activity. Of these, 30 herbal medicines (IC50<50 µg/ml) were found to have significant AGEs formation inhibitory activity. Of these, four herbal medicines (IC50<5 µg/ml) were found to have significant AGEs formation inhibitory activity. Particularly, Cornus controversa (branches and leaves), Acer ginnala (stems and leaves),Platycarya strobilacea (flowers) and Picrasma quassioides (stems), showed more potent inhibitory activity (approximately 17-27 fold) than the positive control aminoguanidine (IC50=77.04 µg/ml).

산수유 씨의 최종당화산물의 형성 및 교차결합에 미치는 효과

김찬식,장대식,이가영,이윤미,김영숙,김정현,김진숙 한국생약학회 2008 생약학회지 Vol.39 No.3

An 80% EtOH extract and the solvent fractions of the seeds of Cornus officinalis were evaluated for their inhibitory activities against advanced glycation end products (AGEs) formation and AGEs-induced protein cross-linking in vitro. In vitro assay for AGEs-bovine serum albumin (BSA) formation showed that the 80% EtOH extract, n-hexane, EtOAc, n-BuOH and water fractions significantly inhibited AGEs formation with observed IC50 values of 1.13, 17.64, 1.52, 1.24 and 3.27μg/ ml, respectively. In indirect AGEs-ELISA assay, the 80% EtOH extract, EtOAc and n-BuOH fractions exhibited more potent inhibitory activity on AGEs-BSA formation than aminoguanidine, a well know AGEs inhibitor. Furthermore, the 80% EtOH extract and all the solvent fractions inhibited concentration-dependently AGE-BSA cross-linking to collagen. The 80% EtOH extract, EtOAc, n-BuOH and water fractions also had a breaking activity against preformed AGE-BSA cross-linking concentration dependently. Thus these results suggest that the 80% EtOH extract and fractions of the seeds of C. officinalis could be an inhibitor as well as breaker of AGE-BSA cross-linking.

중국 약용식물의 최종당화산물 생성저해활성 검색 (X)

김영숙,이윤미,김주환,김진숙 한국생약학회 2013 생약학회지 Vol.44 No.3

Advanced glycation end products (AGEs) have been postulated to play a central role in the development of diabetic complications. A variety of different agents that inhibit AGEs have been under investigation. In this study, 54 herbal medicines from China have been investigated with an in vitro evaluation system using AGEs formation inhibitory activity. Of these,6 herbal medicines (IC50<5 µg/ml) were found to have significant AGEs formation inhibitory activity. Particularly, herbal medicines Punica granatum (peels), Terminalia chebula (fruits), Rheum palmatum (roots), Oxyria digyna (stems and leaves), Anisodus luridus (roots) and Quercus schottkyana(stems and leaves) showed more potent inhibitory activity (approximately 9-43fold) than the positive control aminoguanidine (IC50=77.04 µg/ml).