Jeon, Bo Ra;Kim, Su Jung;Hong, Seung Bok;Park, Hwa-Jin;Cho, Jae Youl;Rhee, Man Hee
Journal of Ginseng Research
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v.39
no.3
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pp.279-285
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2015
Background: Korean Red Ginseng has been used as a traditional oriental medicine to treat illness and to promote health for several thousand years in Eastern Asia. It is widely accepted that ginseng saponins, ginsenosides, are the major active ingredients responsible for Korean Red Ginseng's therapeutic activity against many kinds of illness. Although the crude saponin fraction (CSF) displayed antiplatelet activity, the molecular mechanism of its action remains to be elucidated. Methods: The platelet aggregation was induced by collagen, the ligand of integrin ${\alpha}_{II}{\beta}_I$ and glycoprotein VI. The crude saponin's effects on granule secretion [e.g., calcium ion mobilization and adenosine triphosphate (ATP) release] were determined. The activation of mitogen-activated protein kinases (MAPKs), including extracellular signal-regulated protein kinase 1/2 (ERK1/2), c-Jun N-terminal kinases (JNKs), and p38 MAPK, and phosphoinositide 3-kinase (PI3K)/Akt was analyzed by immunoblotting. In addition, the activation of integrin ${\alpha}_{II}b{\beta}_{III}$ was examined by fluorocytometry. Results: CSF strongly inhibited collagen-induced platelet aggregation and ATP release in a concentration-dependent manner. It also markedly suppressed $[Ca^{2+}]_i$ mobilization in collagen-stimulated platelets. Immunoblotting assay revealed that CSF significantly suppressed ERK1/2, p38, JNK, PI3K, Akt, and mitogen-activated protein kinase kinase 1/2 phosphorylation. In addition, our fraction strongly inhibited the fibrinogen binding to integrin ${\alpha}_{IIb}{\beta}_3$. Conclusion: Our present data suggest that CSF may have a strong antiplatelet property and it can be considered as a candidate with therapeutic potential for the treatment of cardiovascular disorders involving abnormal platelet function.
The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.
A terminal event such as death may censor an intermediate event such as relapse, but not vice versa in semi-competing risks data, which is often seen in medicine, public health, and epidemiology. We propose a Weibull regression model with a normal frailty to analyze semi-competing risks data when all three transition times of the illness-death model are possibly interval-censored. We construct the conditional likelihood separately depending on the types of subjects: still alive with or without the intermediate event, dead with or without the intermediate event, and dead with the intermediate event missing. Optimal parameter estimates are obtained from the iterative quasi-Newton algorithm after the marginalization of the full likelihood using the adaptive importance sampling. We illustrate the proposed method with extensive simulation studies and PAQUID (Personnes Agées Quid) data.
There is a need to investigate folk remedies used by patients with breast cancer because there is little information about the subject, even though many Korean women with breast cancer have used folk remedies during and after their treatment. The purpose of this study was to investigate and describe the phenomena and the meaning of folk remedies in order to better understand patients with breast cancer and to suggest directions for comprehensive nursing care. The Questions for the study were as follows What kinds of folk remedies do patients with breast cancer use\ulcorner What are the routes of knowing about folk remedies in patients with breast cancer\ulcorner What are the patterns of the usage of the folk remedies\ulcorner Why do patients with breast cancer use folk remedies\ulcorner What are the meanings of folk remedies to patients with breast cancer\ulcorner To answer these questions, a qualitative research method was used. Thirty-nine patients were recruited from university teaching hospitals from March, 1993 to November 1994. Many of them underwent either modified radical mastectomy or received various adjuvant therapy including chemotherapy, radiation therapy, and hormonal therapy. Data were collected by in-depth interviews, observations, medical records, and analyzed step-by-step using qualitative analysis. The results were as follows : 1. Patients with breast cancer have used many different kinds of folk remedies. 2. Patients with breast cancer did not know the exact effects of the folk remedies. Also the effects could not be exactly proven by the patients. 3. Patients with breast cancer received information about many kinds of folk remedies through various communication systems, such as other patients, their families and relatives, friends, and many types of mass media. 4. To use the folk remedies was one kind of illness behavior that was used by these patients. 5. Folk remedies were used to deal with not only anxiety by the patients themselves but also as the expression of affection and concern by families and relatives. 6. The use of folk remedies was one of the adaptation behaviors in patients with breast cancer whose disease was in the terminal stage. Based on the above findings, one suggestion was made : To continue further studies on folk remedies used by other patients with cancer in order to further explain health and illness behavior of Korean people.
Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Purpose: This study was done to evaluate the effects of dignity interventions on depression, anxiety and meaning of life in terminally ill patients. Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms indicating dignity intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.2.11 program of Cochrane Library. Results: Twelve clinical trials met the inclusion criteria with a total of 878 participants. Dignity intervention was conducted for a mean of 2.2 weeks, 2.8 sessions and an average of 48.7 minutes per session. Effect sizes were heterogeneous and subgroup analysis was done. Dignity interventions had a significant effect on depression (ES= -1.05, p<.001, $I^2$=15%) and anxiety (ES= -1.01, p<.001, $I^2$=0). For meaning of life, dignity interventions were effective (ES= -1.64, p=.005) and effect sizes were still heterogeneous. Conclusion: Results support findings that dignity interventions can assist terminal ill patients in reducing emotional distress and improving meaning of life. Further well-designed dignity studies will lead to better understanding of the effects of treatments on spiritual well-being.
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.
The purpose of this study is to identify the recent attitude of nurses toward euthanasia. and to provide necessary basic information for on-the-job-training and student education. The subject of this study are 521 nurses working in the hospital attached to university in Seoul. to whom I distributed questionnaires which were made on the basis of the instrument of Tordella & Neutens. from 21. July. 2000 to 27. July. 2000. The collected data were statistically examined through SPSS program and were analysed through Frequency. Means. Factor Analysis. T-test. and ANOVA. The study results are as follows: 1. General characteristics of nurses are in age of average 26.9. in education of junior college graduate $83.7\%$. in both parent alive $85.2\%$. in marital status of single $77.5\%$. in religion of christianity $34.8\%$ against non-religion 38.3%. The term of employment is average 52.7 months and are in various post. The experience of family dying $46.3\%$ and of terminal care $56.8\%\;and\;82.5\%$ are information oriented to euthanasia. 2. The attitude toward euthanasia reveals 3.40 score in average. and is significant in relation to religion among general characteristics (p<.000). 3. Passive euthanasia reveals 2.48 score in average with significance in religion(p<.000), and duty post (p<.046). Natural euthanasia is 4.09 score which is in most characteristics positive direction with significance in information oriented group. Indirect euthanasia reveals 2.98 score and are significant in various group of age (p<.004). both parents alive (p<.005), marital status (p<.000). term of employment (p<.022), duty post (p<.005), and family dying(p<.028). Family commitment is 3.51 score with significance in both parents alive (p<.023) and term of employment (p<.020). Clear definition of euthanasia and analysis of its effects need to be studied in order to improve proper courses of nursing patients with terminal illness.
In Cheol, Hwang;Jung Hun, Kang;Won-chul, Kim;Jeanno, Park;Hyun Sook, Kim;DaeKyun, Kim;Kyung Hee, Lee
Journal of Hospice and Palliative Care
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v.25
no.4
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pp.198-203
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2022
Purpose: To grasp public opinion accurately, we conducted an opinion poll on beliefs and attitudes toward physician-assisted suicide (PAS). Methods: A randomized telephone survey ensuring a representative sample was conducted, 1,007 participants aged 18 years or older (response rate, 9.5%). Results: The main results are as follows: i) 61.1% of participants thought that the current social support system for terminally ill patients and their families is insufficient; ii) 60% of participants did not recognize the term "hospice and palliative care"; iii) 81.7% of participants would not like to receive life-sustaining treatment if there is no possibility of recovery; iv) 58.4% of participants would like to receive hospice and palliative care if they are diagnosed with a terminal illness; v) the priorities for dignified dying were preparing a support system to reduce the burden of care (28.6%), economic support including reduction of medical expenses (26.7%), expansion of hospice and palliative care services (25.4%), and legalization of PAS (13.6%); and vi) 58.3% of participants agreed that the expansion of hospice and palliative care should precede the legalization of PAS. Conclusion: Koreans currently want other efforts, including expansion of hospice and palliative care services, instead of the legalization of PAS.
Purpose: The purpose of this study was to identify the stress and the coping methodes in the cancer patients and their caregivers. Method: The stress method was measured by V AS(Visual Analogue Scale). The coping methodes was measured using the modified Ways of Coping Questionnaire. The phases of patient illness consisted of Ist(initial) stage, and 2nd(recurred) stage and 3rd(terminal) stage based on Lewandowski & Jones(1988) method. The data were collected by a survey of convenience sampling of 257 cancer patients and 196 of their caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test. Result: The stress level of cancer patients was lower than their caregivers. The cancer patients used emotion-focused coping mode than problem-focused coping mode. The caregivers problem-focused coping mode over emotion-focused coping mode. In the problem-focused coping mode, the caregivers significantly used two coping strategies that were ‘positve cope’, ‘information seeking’ more than patients. In emotion-focused coping mode, the caregivers significantly used one coping strategies that was ‘wish’ more than patients. The patients tended to used two coping strategies that were ‘blame’ and ‘emotion expression’ more than the caregivers. Conclusion: Further study needs to be done to positively identify these coping methods and develop interventions to assist patients and their caregivers.
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