• Korean Journal of Adult Nursing
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• v.13 no.2
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• pp.317-326
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• 2001

The purpose of this study was to identify correlation of stress, coping patterns and physical symptoms in cancer patient's caregiver. The stress was measured by VAS(Visual Analogue Scale). The coping methods were measured using the modified Ways of Coping Questionnaire by Yang (1998) and the actual physical symptoms were investigated. The phases of patient illness consisted of 1st (initial) stage, and 2nd (recurred) stage and 3rd (terminal) stage based on literature (Lewandowski & Jones, 1988). The data were collected by a survey conducted from March to July, 2000 and which included 196 cancer patients' caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test, ANOVA, Scheffe test and Pearson correlation coefficient. The results were as follows: 1. The average of caregivers' stress scores was 62.5. Problem-focused coping methods were significantly used more than emotion-focused coping methods by the cancer patients' caregiver. The mean number of caregivers' physical symptom was 1.03. 2. There were significantly high level of stress in women, those who were more than 60 years old, those who had a low education level, those who had no job, those who are patients' wives' and those who are terminal patients' caregiver. There were significantly low levels of coping in women, those who were more than 60 years old, those who had low education levels, those who had no job and those who are patients' wives. There were significantly higher number of physical symptoms in women, and those who have no job. 3. Caregivers' stress was significantly correlated to problem-focused coping methods (r=-.21, p=.006), and physical symptom (r=-.28, p=.0001). In conclusion, attempts to develop nursing interventions for cancer patients' caregiver in women, those who are more than 60 years old, with a low education level, have no job, and are cancer patients' wives could have an improvement on positive coping methods and provide relaxation from stress in the patients' experience.

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.51-57
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• 2003

Purpose : Anorexia-cachexia syndrome is one of the most common symptoms and main cause of death in terminal cancer patients. This symptom is due to the enlarged cancer mass as well as tumor released cytokines. Some doctors have suggested that vitamin C was preferentially toxic to tumor cells in vitro and in vivo, and improved clinical symptoms in terminal cancer patients. Therefore, we measured cytokines in serum of terminal cancer patients to determine whether vitamin C treatment improved the anorexia-cachexia syndrome. Methods : We investigated that 49 terminal cancer patients admitted to the department of family medicine, National Health Insurance Corporation Ilsan hospital from March 1, 2002 to August 31, 2002. The study was done on 22 patients who were given 10 g/day of vitamin C infusions during 1 week and 27 patients who were not infused. We measured the cytokines levels ($IL-1{\beta}$, IL-6, and $TNF-{\alpha}$) before and after 1 week between terminal cancer patients treated vitamin C and without vitamin C. Results : Out of 49 patients, patents treated with vitamin C infusions were 22 (12 male, 10 female), and these without vitamin C were 27 (18 male, 9 female). In patients treated with vitamin C, $IL-1{\beta}\;were\;6.19{\pm}5.17$ before day and $8.76{\pm}5.72$ after 1 week, IL-6 were $3.07{\pm}8.09$ before day and $1.31{\pm}2.36$ after 1 week, and $TNF-{\alpha}\;were\;2.74{\pm}14.24$ before day and $0.50{\pm}2.00$ after 1 week. In patients treated without vitamin C, $IL-1{\beta}\;were\;2.50{\pm}3.58$ before day and $6.49{\pm}12.01$ after 1 week, IL-6 were $1.00{\pm}2.19$ before day and $17.16{\pm}81.55$ after 1 week, and $TNF-{\alpha}\;were\;1.19{\pm}2.98$ before day and $1.27{\pm}1.52$ after 1 week. The level of cytokines in patients treated with vitamin C decreased more than those without vitamin C. However, this represented no statistical value (P=0.0598 in $IL-1{\beta}$, P=0.1664 in IL-6, and P=0.5395 in $TNF-{\alpha}$). Conclusion : In terminal cancer, even if there was no statistical difference in the cytokines levels between patients treated with vitamin C and those not treated, those who were treated had a decrease all cytokines levels. Vitamin C is very safe with almost no side effects. Therefore, vitamin C treatment in terminal cancer patients can be seen as beneficial and helpful for clinical symptoms.

• Journal of Hospice and Palliative Care
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• v.15 no.2
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• pp.77-87
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• 2012

Purpose: This study investigated the effects that music therapy by self-selected music listening has on the affect and stress relief in adult patients who have been diagnosed with terminal cancer by pain level. Methods: Participants were 20 terminally ill cancer patients who were over 18 years old and were admitted to the hospice and palliative care unit of a local hospital. At the beginning of each session, participants selected music of their choice. Each participant had a total of six 30-minute music listening sessions. Participants were grouped into two according to their self-rated perceived pain scores on the visual analogue scale and numeric rated score: 5 and above and less than 5. Each participant completed a questionnaire on their affect state before and after each session and a questionnaire on their stress level before the first session and after the last session. Further analysis was performed to compare differences between the two groups according to pain level. Results: There were significant differences in patients' affect before and after each session (P<0.001) and stress level before and after the therapy (P=0.001). Conclusion: In this study, self-selected music listening had positive effects on terminal cancer patients' affect and stress regardless of perceived pain level. Therefore, self-selected music listening can be used as an appropriate intervention to improve affect and reduce stress in terminal cancer patients in the hospice and palliative care unit.

• Journal of Hospice and Palliative Care
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• v.7 no.1
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• pp.64-72
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• 2004

Purpose: This research aims to assess the effect of a single session of group education of hospice program at Seoul National University Hospital for the advanced and terminal cancer patients and their family members. Methods: Response to questionnaires from 89 participants were evaluated using SAS and CHISQ analysis. The questionnaires included the following items: 1) the characteristics of participants; 2) the characteristics of patients; 3) the difficulties of patient care; 4) the satisfaction with the program Results: The participants consist of 33 patients (37.5%) and 56 family members (56.2%). Diagnosis included mainly stomach, lung, breast, and colon cancer. Participants of family members consisted of spouse, parent, children, daughter-in-law, and siblings (in decreasing order). The participants were interested in the medical information, nutrition, pain and symptom management, and psychosocial adaptation. They had difficulties in emotional problem, nutrition and symptom management. Even though it was a single session of group education, the level of satisfaction was high (95%). Conclusion: This research shows that even the single session of the group education for the advanced and terminal cancer patients and their family members is very helpful by giving them the necessary information. In order to develop comprehensive care-giving services, more specific informations, more opportunities to participate in such sessions and longer question-answer time is required.

• Journal of Korean Academy of Nursing
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• v.28 no.4
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• pp.958-969
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• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.181-189
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• 2010

Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

• BMB Reports
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• v.38 no.6
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• pp.633-638
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• 2005

Biosynthesis of prostanoids is regulated by three sequential enzymatic steps, namely phospholipase $A_2$ enzymes, cyclooxygenase (COX) enzymes, and various lineage-specific terminal prostanoid synthases. Prostaglandin E synthase (PGES), which isomerizes COX-derived $PGH_2$ specifically to $PGE_2$, occurs in multiple forms with distinct enzymatic properties, expressions, localizations and functions. Two of them are membrane-bound enzymes and have been designated as mPGES-1 and mPGES-2. mPGES-1 is a perinuclear protein that is markedly induced by proinflammatory stimuli, is down-regulated by anti inflammatory glucocorticoids, and is functionally coupled with COX-2 in marked preference to COX-1. Recent gene targeting studies of mPGES-1 have revealed that this enzyme represents a novel target for anti-inflammatory and anti-cancer drugs. mPGES-2 is synthesized as a Golgi membrane-associated protein, and the proteolytic removal of the N-terminal hydrophobic domain leads to the formation of a mature cytosolic enzyme. This enzyme is rather constitutively expressed in various cells and tissues and is functionally coupled with both COX-1 and COX-2. Cytosolic PGES (cPGES) is constitutively expressed in a wide variety of cells and is functionally linked to COX-1 to promote immediate $PGE_2$ production. This review highlights the latest understanding of the expression, regulation and functions of these three PGES enzymes.

• Development and Reproduction
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• v.24 no.1
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• pp.53-62
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• 2020

Natural killer (NK) cells are innate lymphocytes that play an essential role in preventing cancer development by performing immune surveillance to eradicate abnormal cells. Since ex vivo expanded NK cells have cytotoxic activity against various cancers, including breast cancers, their clinical potential as immune-oncogenic therapeutics has been widely investigated. Here, we report that the pyrazole chemical XRP44X, an inhibitor of Ras/ERK activation of ELK3, stimulates NK-92MI cells to enhance cytotoxic activity against breast cancer cells. Under XRP44X stimulation, NK cells did not show notable apoptosis or impaired cell cycle progression. We demonstrated that XRP44X enhanced interferon gamma expression in NK-92MI cells. We also elucidated that potentiation of the cytotoxic activity of NK-92MI cells by XRP44X is induced by activation of the c-JUN N-terminal kinase (JNK) signaling pathway. Our data provide insight into the evaluation of XRP44X as an immune stimulant and that XRP44X is a potential candidate compound for the therapeutic development of NK cells.

• Journal of Hospice and Palliative Care
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• v.24 no.4
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• pp.254-260
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• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• Journal of The Korea Institute of Healthcare Architecture
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• v.8 no.1
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• pp.45-52
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• 2002

Recently cancer, AIDS, chronic sickness have increased according to the elevation of socioeconomic level and fast change of lifestyle. The number of patients receiving terminal care increased fairly because the span of life is extended by development of medicinal technology. Also necessity of hospice and palliative care was risen according to the request of terminal patients that remove pain and keep calm life by interest about quality of life. However architectural plan and type specialization of facility which can correspond team's composition and supplied nursing program are not consisting. This study researches about care environment of hospice facility plan through investigation into terminal patient's special quality. The purpose of this study is to propose fundamental datas of hospice facility for architectural plan through comparative analysis of cases of domestic and outside facilities.