• Journal of Chest Surgery
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• v.55 no.6
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• pp.442-451
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• 2022

Background: This meta-analysis was conducted to evaluate the effect of fractional flow reserve (FFR) on clinical outcomes after coronary artery bypass grafting (CABG). Methods: Five online databases were searched for studies that (1) enrolled patients who underwent isolated CABG or CABG with aortic valve replacement and (2) demonstrated the effect of an FFR-guided strategy on major adverse cardiac events (MACE) after surgery based on a randomized controlled trial or adjusted analysis. MACE included cardiac death, acute myocardial infarction (MI), and repeated revascularization. The primary outcomes were all MACE outcomes and a composite of all-cause death and MI, and the secondary outcomes were the individual MACE outcomes. Publication bias was assessed using a funnel plot and the Egger test. Results: Six articles (3 randomized and 3 non-randomized studies: n=1,027) were selected. MACE data were extracted from 4 studies. The pooled analyses showed that the risk of MACE was not significantly different between patients who underwent FFR-guided CABG and those who underwent angiography-guided CABG (hazard ratio [HR], 0.80; 95% CI, 0.57-1.12). However, the risk of the composite of death or MI was significantly lower in patients undergoing FFR-guided CABG (HR, 0.62; 95% CI, 0.41-0.94). The individual MACE outcomes were not significantly different between FFR-guided and angiography-guided CABG. Conclusion: FFR-guided CABG might be beneficial in terms of the composite outcome of death or MI compared with angiography-guided CABG although data are limited.

• The Korean journal of internal medicine
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• v.39 no.1
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• pp.95-109
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• 2024

Background/Aims: Sex differences in the prognosis of heart failure (HF) have yielded inconsistent results, and data from Asian populations are even rare. This study aimed to investigate sex differences in clinical characteristics and long-term prognosis among Korean patients with HF. Methods: A total of 5,625 Korean patients hospitalized for acute HF were analyzed using a prospective multi-center registry database. Baseline clinical characteristics and long-term outcomes including HF readmission and death were compared between sexes. Results: Women were older than men and had worse symptoms with higher N-terminal pro B-type natriuretic peptide levels. Women had a significantly higher proportion of HF with preserved ejection fraction (HFpEF). There were no significant differences in in-hospital mortality and rate of guideline-directed medical therapies in men and women. During median follow-up of 3.4 years, cardiovascular death (adjusted hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.07-1.78; p = 0.014), and composite outcomes of death and HF readmission (adjusted HR, 1.13; 95% CI, 1.01-1.27; p = 0.030) were significantly higher in men than women. When evaluating heart failure with reduced ejection fraction (HFrEF) and HFpEF separately, men were an independent risk factor of cardiovascular death in patients with HFrEF. Clinical outcome was not different between sexes in HFpEF. Conclusions: In the Korean multi-center registry, despite having better clinical characteristics, men exhibited a higher risk of all-cause mortality and readmission for HF. The main cause of these disparities was the higher cardiovascular mortality rate observed in men compared to women with HFrEF.

• Journal of Korean Academy of Nursing
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• v.10 no.2
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• pp.21-40
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• 1980

In order to take cue of the dying persons and their survivors in a more positive and affirmative atti-tube. and to understand the valuable meaning of and dying. a survey was performed to 550 cases of health care personnels including 116 nursing students. 238 medical students. 137 nurses. and 59 doctors. Samplings were made through census Procedure from the entire group of medical and nursing students in College of Medicine. Chung-Ang University. and of licenced nurses and doctors in Chung-Ang University Hospital. and in Han-Gang Sacred Heart Hospital from the first to the end of march. 1980. These collected data were computerized at KIST by SPSS programming and were statistically analyzed by chi-square test. Through content analysis of the word associated with death and descriptive analysis of the death-re-lated variables. the following conclusion in is reached. First. Total numbers of death-word percieved by health care personnels were 198 kinds. Among them, 40 kinds of words associated with death were responded from than 1% of the total. As to the 10 death related word responded by free word association method. it was revealed that individual average number of death related word was 7.70 word. which came from higher number of words in the senior students (8.96 word) or the graduates (8.10 word) compared with the freshman (6.84 word). Second. In Content specific analysis of the death related word. more frequently perceived types summarized as the following order; the affective context of death. the diseases. the disasters. the religion, the funeral ceremonies. the separation, the drakness. and the life. Third. The most prevalent 10 words associated with death which the the respondents gave response to the the first recalling word. were as following o order； the dieases. the sadness, the vanity. the darkness, the frustration. the suicide. the incurable dieases, the graves. the dead. and the catastrophes. By sex, the diease is outstanding in females, but the vanity is in males. By occupation. the vanity and the dead was frequently observed in student group including senior students. while the incurable dieases presented by doctors. Fourth. In health care personnels. the first perceived ages of death were 11.47 $\pm$3.33 years (8.14- 15.80 years). Among them. senior students were inclined to percept death at the earliest age of life (11.28years). while doctors and nurses perceived death later in their life (12.98 years). Fifth, It is revealed in this survey that the most frequently responded death perceiving motives by health care personnels ar“psychological conflict”and“death of those around them”. Death perceiving motives can be classified in two factors; personality and life circumstances. Sixth It is of interest that only 11.3% health care personnels was found to feel death as inevitable or acceptable event. whereas 58.3% deny or reject it.

• Journal of Korean Public Health Nursing
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• v.34 no.2
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• pp.251-262
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• 2020

Purpose: This study attempts to provide basic data for establishing and implementing an advanced directive (AD) system that helps identify dignified death attitudes and reduces death anxiety of the preliminary, through preparation of an AD. Methods: Data were collected from 135 preliminary elderly aged 55 to 64 years, recruited from health centers and welfare facilities. All data were analyzed using SPSS 22.0. Results: Overall scores of the participants were 2.26±0.64 for death anxiety scale, and 3.16±0.44 for dignified death attitude. Scores of individuals who prepared an AD were determined to be 2.19±0.64 for death anxiety, and 3.34±0.44 for dignity of death. The difference in scores obtained for dignified death attitude was significantly higher for the group that signed an AD, as compared to the group with no AD (F=14.81, p<0.001). Conclusions: Results of this study reveal that preliminary elderly who sign an AD have a higher dignified death attitude score as compared to subjects who do not sign an AD. Additionally, the former group of participants desire a dignified end to their life. This indicates a necessity to promote public campaigns for ADs, and to develop educational programs that assist the elderly to prepare for a dignified death and make autonomous decisions.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.143-149
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• 2006

Purpose: This study was done to evaluate the incidence, type of injury, medical consequences, mortality, and prognostic factors associated with stab wounds in patients who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea. Methods: A retrospective analysis of the clinical data of 40 patients with abdominal stab wounds who visited Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from January 1, 2000 to December 31, 2004. Results: 1) The most prevalent age group was patients in their the twenties to fourties (77.5% of all patients), and average age of the patients was 39.3 years. The male-to-female ratio was 2.07:1. 2) The external site of stab wounds was most commonly the periumbilcal area of the abdomen (14 cases, 33.3%). 3) The most commonly injured organs were the liver and the stomach (10 cases each, 16.9%). 4) Operations were performed on all 40 patients, with 9 (22.5%) negative operation findings. 5) Death occurred in 5 cases (12.5%). 6) The trauma indices of the death group were TRISS 51.9%, RTS 3.6 points, and APACHE II 23.0 points. 7) The average transfusion amount of the death group was 13.8 pints Conclusion: These data suggest that the transfusion amount and the trauma index of abdominal stab injuries may be statistically significant factors for predicting mortality.

• The Journal of Internal Korean Medicine
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• v.27 no.3
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• pp.725-736
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• 2006

Objective: In order to investigate cell death mechanisms by Gunbibosinhangam-Tang(G.B.H) in cancer cells, the activities of apoptosis signaling pathway were tested in human neuroblastoma cell line BE2. Methods: Viability of BE2 cells was markedly decreased by treatment of the water extract of G.B.H in a dose-dependent manner. G.B.H-induced cell death was confirmed as apoptosis characterized by chromatin condensation, We tested whether the water extract of G.B.H affects the anti-apoptotic proteins such as Bcl-$X_L$ Results: Bcl-$X_L$ was uneffected by the addition of the water extract of G.B.H in a time-dependent manner. Cleavage of PARP(poly-ADP-ribose polymerase) by activation of caspase-8 protease was also observed in BE2 cells by the treatment of the water extract of G.B.H. Conclusion: These results suggest that the water extract of G.B.H exerts anti-cancer effects on human neuroblastoma BE2 cells by inducing the apoptotic death via activation of intrinsic caspase cascades.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4873-4878
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• 2012

Apoptosis is programmed cell death which is essential for development and survival of living organisms. It is a sequentially regulated suicidal programme where cells activate certain enzymes which dissolute their own nuclear component and various protein component of nucleus and cytoplasm. Disturbance of this regulatory pathway may lead to various diseases like autoimmune diseases, neurodegenerative diseases and cancers. The potential mechanisms of apoptosis and its role in cancer are discussed. The ability of apoptosis to modulate the life or death of a cell is also recognized for its immense therapeutic potential. Understanding the mechanisms from this review will give us better insight to the pathogenesis of various diseases including cancer and will open new horizons to therapeutic approaches.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.164-175
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• 2003

Objectives: To evaluate the performance of models to predict AMI patients death using severity adjustment measures in Korea. Methods: Medical records of 861 patients treated by AMI in 7 general hospitals during 1996 and 1997 were reviewed by trained nurses. We measured the severity of patients by APACHE III, MedisGroups, CSI and DS. Using each severity method a predictive mortality for each patient was calculated from a logistic regression model including the severity score. The statistical performance of each severity method model was evaluated by using c-statistics and R2. For each hospital, z scores compared actual and expected mortality rates. Results: The overall in-hospital mortality was 14.5%, ranged from 10.0% to 22.2%. The distributions of severity scores for each method was significantly different by hospitals. The four severity-adjusted models to predict AMI patients death varied in their statistical performance for discrimination power of patients death. Order of Severity-adjusted mortality rates and z scores by four severity measures was different. Conclusion: Severity-adjusted mortality rates of AMI patients might be applied as an indicator for hospital performance evaluation in Korea. Because different severity methods frequently produce different impressions about relative hospital performance, more studies has to be done to use it as quality indicator and more attention should be paid to select appropriate severity measures.

• Journal of Korean Clinical Nursing Research
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• v.26 no.1
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• pp.86-96
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• 2020

Purpose: The purpose of study was to provide basic data for developing interventions that could help middle-aged adults prepare for dignified death in the future by examining their attitudes toward death and advance directives (AD), and knowledge of AD. Methods: Data were collected through a survey of 211 middle-aged adults from January 28 to February 28, 2019, in a city located in Gangwon Province. To analyze the data, descriptive statistics, t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient and stepwise linear regression were utilized using SPSS/WINdows 21.0. Results: The average score of the participants' attitudes toward death and AD, and knowledge of AD was 91.82±10.89, 15.53±4.27, 46.00±9.45, respectively. There were positive correlations between attitudes toward dignified death and attitudes toward AD, and knowledge of AD. Factors that influence attitudes toward AD were shown in the order of attitudes toward dignified death, knowledge of AD, and intentions to write AD (Adjusted R²=.24). Conclusion: For the dignified death in the future, it is necessary to provide middle-aged adults with an opportunity to think about the need of AD. In addition, extensive education and promotion of AD are required to correct the misunderstanding of AD.

• Journal of Hospice and Palliative Care
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• v.26 no.4
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• pp.160-170
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• 2023

Purpose: The aim of this study was to examine the effects of death anxiety and perceived end-of-life care competencies on the fear of terminal care among clinical nurses. Methods: This correlational study was conducted from June to July 2021. The study included 149 clinical nurses employed at a tertiary hospital and seven other hospitals. The measurement tools used in this study were the Thanatophobia Scale (Cronbach's α=0.87), the Death Anxiety Scale (Cronbach's α=0.80), and the Scale of End-of-life Care Competencies (Cronbach's α=0.94). These instruments were chosen to assess the levels of fear of terminal care, death-related anxiety, and competencies in end-of-life care. Results: The mean score for fear of terminal care was 3.32±1.32. Differences in fear of terminal care were observed based on the working unit, position, number of patients requiring terminal care, and experience with end-of-life care education. Fear of terminal care was significantly positively correlated with death anxiety and significantly negatively correlated with end-of-life care competencies. In multiple regression analysis, the factors influencing fear of terminal care were attitudes toward end-of-life care competencies (𝛽=-0.39, P<0.001), death anxiety (𝛽=0.24, P<0.001), knowledge of end-of-life care competencies (𝛽=-0.22, P=0.005), and behaviors related to end-of-life care competencies (𝛽=-0.16, P=0.021). These factors explained 64.6% of the total variance (F=25.54, P<0.001). Conclusion: This study suggests that developing nurses' end-of-life care competencies and reducing death anxiety are crucial for managing the fear of terminal care. Therefore, providing end-of-life care education and psychological support programs is important.