• Title/Summary/Keyword: Terminal Cancer

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WNT11 is a direct target of early growth response protein 1

  • Kim, JuHwan;Jung, Euitaek;Ahn, Sung Shin;Yeo, Hyunjin;Lee, Jeong Yeon;Seo, Jeong Kon;Lee, Young Han;Shin, Soon Young
    • BMB Reports
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    • v.53 no.12
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    • pp.628-633
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    • 2020
  • WNT11 is a member of the non-canonical Wnt family and plays a crucial role in tumor progression. However, the regulatory mechanisms underlying WNT11 expression are unclear. Tumor necrosis factor-alpha (TNFα) is a major inflammatory cytokine produced in the tumor microenvironment and contributes to processes associated with tumor progression, such as tumor invasion and metastasis. By using site-directed mutagenesis and introducing a serial deletion in the 5'-regulatory region of WNT11, we observed that TNFα activates the early growth response 1 (EGR1)-binding sequence (EBS) in the proximal region of WNT11 and that the transcription factor EGR1 is necessary for the TNFα-induced transcription of WNT11. EGR1 bound directly to the EBSs within the proximal 5'-regulatory region of WNT11 and ectopic expression of EGR1 stimulated WNT11 promoter activity, whereas the knockdown of EGR1 expression by RNA interference reduced TNFα-induced WNT11 expression in T47D breast cancer cells. We also observed that mitogen-activated protein kinases (MAPK), extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 kinase mediated TNFα-induced transcription of WNT11 via EGR1. Our results suggest that EGR1 directly targets WNT11 in response to TNFα stimulation in breast cancer cells.

Evaluation of the Adequacy of Pain Management in the Admitted Cancer Patients (입원중인 암환자에 대한 통증관리의 적절성평가 - 한 3차 의료기관 내과 전공의를 대상으로 -)

  • Kim, Kuk-Hyoe;Jang, Won-Il;Joh, Yo-Han;Choi, In-Sil;Park, Sook-Ryun;Lee, Sang-Yoon;Kim, Jee-Hyun;Kim, Do-Yeun;Lee, Se-Hoon;Kim, Tae-You;Bang, Yung-Jue;Kim, Noe-Kyeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.137-144
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    • 2001
  • Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

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The Disclosure of Cancer Diagnosis and its Prognosis (암 환자 병명통고)

  • Park, Jean-No;Choi, So-Eun;Choi, Kyung-Mee;Hong, Young-Seon;Lee, Kyung-Shik;Yang, Soo
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.169-178
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    • 2004
  • Purpose: The aim of the study was to assess changes of the attitudes and opinions about disclosure of cancer diagnosis to patients. Methods: We analyzed the attitudes and opinions of in-patients with metastatic cancer, their families, physicians, nurses, medical students, nursing students. Three questionnaires were used for in-patients, families, and surroundings in hospital. Data was collected in the St. Mary hospital for 3 months from October, 2002. We investigated the preference of disclosure, the reason the patients should be informed of disclosure, when, how and who to tell the cancer diagnosis to patients. 242 persons participated in these questionnaires (50 in-patients, 50 their families, 51 physicians and nurses, 41 medical students, 50 nursing students). Only 34 in-patients with metastatic cancer were enrolled, and so 16 in-patients with lymphoma were added. All in-patients were undergoing anticancer chemotherapy. Results: 89.3% of the participants wanted to be told about disclosure of cancer and terminal illness (in-patients 98.0%, their families 88.0%, physicians and nurses 90.2%, medical students 73.2%, nursing students 94.0%, in-patients with metastatic cancer 97.1%). 79.8% of the respondents hoped that the moment to tell the truth was immediately when the disease was diagnosed (in-patients 94.0%, their families 80.0%, physicians and nurses 68.6%, medical students 68.3%, nursing students 86.0%). 64.4% of all prefered to be told the truth once for alt including patients' diagnosis, present status and prognosis (in-patients 81.6%, their families 66.0%, physicians and nurses 56.0%, medical students 48.8%, nursing students 70.0%). Most indicated the first reason to be told the truth was the possibility to participate in treatment design. 86.4% responded that physicians were the proper persons to disclose the diagnosis. Conclusion: Not only in-patients, families but also physicians, nurses, medical students and nursing students all preferred the disclosure of cancer diagnosis. This preference was increased compared with the previous papers. The first reason to be told the truth was the possibility to participate in treatment design. Most of the participants wanted to be told the truth once for all.

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Factors Associated with Care Burden among Family Caregivers of Terminally Ill Cancer Patients (말기암환자 가족 간병인의 간병 부담과 관련된 요인)

  • Lee, Jee Hye;Park, Hyun Kyung;Hwang, In Cheol;Kim, Hyo Min;Koh, Su-Jin;Kim, Young Sung;Lee, Yong Joo;Choi, Youn Seon;Hwang, Sun Wook;Ahn, Hong Yup
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.61-69
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    • 2016
  • Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.

Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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Clinical Aspects of Pulmonary Radioactivity Observed in Radiocolloid Liver Scintigraphy (간 스캔에서 관찰되는 폐 방사능에 관한 임상적 고찰)

  • So, Young;Lee, Kang-Wook;Lee, Heon-Young;Lee, Won-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.185-194
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    • 2002
  • Purpose: We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Materials and Methods: Forty-nine patients with pulmonary radioactivity were classified into 5 disease groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence or absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Results: Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Conclusion: Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver destruction in liver diseases.

Effects of a Palliative Care Program based on Home Care Nursing (가정간호기반 완화케어프로그램의 효과)

  • Hwang, Moon-Sook;Ryu, Ho-Sihn
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.528-538
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    • 2009
  • Purpose: This study was done to develop and test a palliative care program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. Results: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. Conclusion: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.

An Antiproliferative Ribonuclease from Fruiting Bodies of the Wild Mushroom Russula delica

  • Zhao, Shuang;Zhao, Yong Chang;Li, Shu Hong;Zhang, Guo Qing;Wang, He Xiang;Ng, Tzi Bun
    • Journal of Microbiology and Biotechnology
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    • v.20 no.4
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    • pp.693-699
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    • 2010
  • An antiproliferative ribonuclease with a new N-terminal sequence was purified from fruiting bodies of the edible wild mushroom Russula delica in this study. This novel ribonuclease was unadsorbed on DEAE-cellulose, but absorbed on SP-Sepharose and Q-Sepharose. It had a molecular mass of 14 kDa, as judged by fast protein liquid chromatography on Superdex 75 and SDS-polyacrylamide gel electrophoresis. Its optimal pH and optimal temperature were pH 5 and $60^{\circ}C$, respectively. The ranking of its activity toward various polyhomoribonucleotides was poly C> poly G>poly A>poly U. It could inhibit proliferation of HepG2 and MCF-7 cancer cells with an $IC_50$ value of $8.6\;{\mu}M$ and $7.2\;{\mu}M$, respectively. It was devoid of antifungal and HIV-1 reverse transcriptase inhibitory activity.

Stereotaxic Neurotomy of the Ganglion Impar in the Management of Perineal Pain -A case report- (회음부통증 환자를 위한 Ganglion Impar의 정위적 신경절제술 -증례 보고-)

  • Shin, Keun-Man;Kim, Jin-Soo;Cho, Yong-Roew;Lim, So-Young;Hong, Soon-Yong;Choi, Young-Ryong
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.415-418
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    • 1996
  • The first reported the neural blockade of ganglion impar for pain control of perineal pain in 1990 by Plancarte and his fellows. they used 6ml of 10 percent phenol. but the point of issues, same as other neurolytics, are that it is impossible to check and control its spreading, so it might be possible to destruct the coccygeal plexus and sacral nerve, and also it has only short action time. Because of these problems, it could be very dangerous to attempt this procedure especially not for relieving the pain on cancer terminal patient, but for the sympathectomy of ganglion impar on the other purpose. We used the RF generator which had the control ability to point out the destructive lesion accurately. inserted We made the small burr hole on the sacrum near the sacrococcygeal junction directly, through the hole, and performed thermocoagulation to the ganglion impar.

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Comparison of Spiritual Well-being and Quality of Life between Hospice Patients and Nonhospice Patients (호스피스 환자와 비호스피스 환자의 영적 안녕과 삶의 질)

  • Lee, Hae-Sook;Doh, Bok-Num
    • Korean Journal of Adult Nursing
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    • v.15 no.3
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    • pp.364-372
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    • 2003
  • Purpose: This study was conducted to find out the effects of hospice care by evaluating the spiritual well-being and quality of life in the hospice and nonhospice patients. Method: The research design was composed of descriptive study. The data were collected using the questionnaire with interview from 30 hospice patients at three hospice institutes and 30 nonhospice patients at two general hospitals. The tools used for this study were 14-item questionnaire regarding general characteristics, a revised Spiritual Well-being Survey(Paloutzion and Ellision, 1982) and 22-item of revised Mcgill Quality of Life questionnaire. Result: The spiritual well-being of the hospice patients was higher than that of nonhospice patients(F=5.52, p=0.023). The global quality of life of the hospice patients was higher than that of nonhospice patients(F=8.84, p=0.004). There was a significant positive correlation between spiritual well-being and quality of life of the hospice patients and non hospice patients. Conclusion: The hospice care effects on spiritual well-being and quality of life of the terminal cancer patients.

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