• Journal of Chest Surgery
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• 제27권3호
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• pp.255-258
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• 1994

I have experienced with 6 cases traumatic injury of diaphragm from May 1991 to October 1993 at the Youngdong Hospital in Tonghae. This cases included 4 penetrating injuries and 2 nonpenetrating injuries. Associated injuries occurred 4 cases and 2 cases occurred stomach herniation. All cases, operative treatment were done. Result of this treatment cases were good. Complications included 1 early death and only 1 wound infection. Cause of death was related to associated injury.

• Journal of Nutrition and Health
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• 제32권3호
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• pp.318-326
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• 1999

Apoptotic cell death, characterized by DNA fragmentation and morphological changes, has previously been shown to occur in vascular endothelial cells cultured with hydrogen peroxide. The present study examined the induction of apoptosis by hydrogen peroxide and whether pyruvate, a key glycolytic intermediate and $\alpha$-keto-monocarboxylate, can inhibit the apoptotic effects in bovine pulmonary artery endothelial cells(BPAECs). Culture with 500uM hydrogen peroxide resulted in 30% cell death and induced morphological changes and DNA fragmentation. Cell injury was inhibited by the treatment with pyruvate. Pyruvate(0.1-5.0mM), and cell viability increased in a dose-dependent manner. In the presence of pyruvate(10~20mM), the viability was improved to over 95%. In contrast, treatment with lactate, a reduced form of phyuvate, did not protect against cell death oxidative stress-induced loss of viability and apoptosis was examined with $\alpha$-cyano-3-hydroxycinnarmate(COHC) as a selective mitochondrial monocarboxylate transport blocker. Incubation with COHC(500uM) did not significantly affect cell viability in the presence of hydrogen peroxide. The cytoprotection by pyruvate(3mM)against hydrogen peroxide stress was abolished by COHC. This indicates that the cytoprotection by pyruvate against oxidative stress in endothelial cells is mediated, at least in part, by mitochondrial pyruvate uptake and hence endothelial enerygetics. However, cytosolic mechanisms related, at least in part, by mitochondrial pyruvate uptake and hence endothelial energetics. However, cytosolic mechanisms related to the glutathione system may also contribute. The results suggest that pyruvate has therapeutic potential in the treatment of oxidative stress-induced cytotoxicity associated with increased apoptosis.

• International Journal of Oncology
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• 제54권2호
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• pp.665-672
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• 2019

The tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a dynamic cytokine that initiates the apoptosis of cancer cells, but exhibits little or no toxicity in normal cells. Luteolin is a flavonoid compound frequently used in the treatment of cancer. In the current study, we demonstrate that treatment with luteolin and TRAIL exerts a synergistic effect and the mechanisms on TRAIL-resistant Huh7 cells. The results demonstrated that luteolin induced an autophagic flux in human liver cancer cells. The attenuation of the autophagic flux by applying the specific inhibitor of autophagy, chloroquine, significantly suppressed DR5 expression. Treatment with genetically modified autophagy-related 5 siRNA abrogated the luteolin-mediated sensitizing effect of TRAIL. Furthermore, pre-treatment with the c-Jun N-terminal kinase (JNK) inhibitor, SP600125, significantly attenuated the luteolin-induced upregulation of DR5 expression, thereby suggesting that JNK activation promotes DR5 expression. Our findings also revealed that Akt phosphorylation was required for TRAIL sensitization. On the whole, the findings of this study indicated that luteolin effectively enhanced TRAIL-initiated apoptosis, and that these effects were likely to be mediated by autophagy and JNK-mediated DR5 expression.

• 의료법학
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• 제10권1호
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• pp.263-305
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• 2009

Is it lawful to withhold or withdraw life-sustaining treatment applied to a patient in a terminal condition or permanent unconscious condition? In Korea, there are no such laws or regulations which control affairs related to the withholding or withdrawal life-support treatment and active euthanasia as the Natural Death Act or the Death with Dignity Act in the U. S. A. And in addition there has had no precedent of Supreme Court. Recently Supreme Court has pronounced a historical judgment on a terminal care case. The court allowed the withdrawal of life-sustaining treatment from a patient in a permanent unconscious state. Fundamentally the court judged that the continuation of that medical treatment would infringe dignity and value of a patient as a human being. And the court required some legal grounds to consider such withdrawal or withholding of medical care lawful. The legal grounds are as follow. First, the patient is in a incurable and irreversible condition and already entered a stage of death. Second, the patient executed a directive, in advance, directing the withholding or withdrawal of life-support treatment in a incurable and irreversible condition or in a terminal condition. Otherwise, at least, the patient's will would be presumed through his/her character, view of value, philosophy, religious faith and career etc. I regard if a patient is in a incurable and irreversible condition or in a terminal condition, the medical contract between a patient and a doctor would be terminated because of the actual impossibility of achievement of it's purpose. So I think the discontinuation of life-sustaining care would be legally allowed without depending on the patient's own will.

• 임상간호연구
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• 제28권3호
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• pp.289-298
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• 2022

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion: Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

• Journal of Digestive Cancer Research
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• 제10권1호
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• pp.22-30
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• 2022

Immune checkpoint inhibition has been established as a new treatment option for various types of carcinoma, and many clinical trials are being actively conducted as a treatment for advanced or metastatic gastric cancer, either as a monotherapy with an immune checkpoint inhibitor or as a combination therapy with standard chemotherapy. In the CheckMate-649 clinical trial to confirm the efficacy of the combination of nivolumab and chemotherapy (FP) in advanced gastric cancer and gastroesophageal junction cancer, nivolumab group showed improvement in overall survival in programmed death ligand 1-positive cancer patients compared with placebo group. Also, the combination therapy of pembrolizumab, trastuzumab and chemotherapy (FP) in first-line treatment was tested through the KEYNOTE-811 trial. The pembrolizumab group showed 22.7% of improvement in objective response rate compared with placebo group. Accordingly, the combination of nivolumab/pembrolizumab with standard chemotherapy was approved for the first-line treatment. In KEYNOTE-059 trials for patients with progressive disease after at least two lines of chemotherapy, pembrolizumab monotherapy showed improvement in objective response rate and overall survival, and the use of pembrolizumab was approved for the third-line or more treatment. In this article, we review the result of clinical trials related to immune checkpoint inhibitors that have been recently introduced in the treatment of gastric cancer.

• 의료법학
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• 제25권1호
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• pp.193-222
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• 2024

세계적 추세에서 볼 때, 환자의 존엄사에 대한 논의는 연명의료중단의 문제에서 점차 조력사망의 허용 여부와 그 요건에 대한 문제로 진행되고 있다. 미국의 여러 주와 캐나다, 벨기에, 네덜란드 등 서구유럽 국가에서는 의사의 조력을 통하여 사망시기를 앞당기는 치료를 제도화하였다. 프랑스에서는 오랜 시간 동안의 문제 제기와 검토 끝에, 다른 유럽 국가에 비해서는 완만한 속도로 관련 법제에 대한 논의가 이루어지고 있다. 프랑스에서는 20세기 후반부터 존엄사에 대한 사회적 논의와 입법적 시도가 활발히 이루어져 왔다. 2005년의 레오네티 법에 의해 환자의 의사에 반하는 무의미한 치료의 지속이 금지되었고 2016년 클레이-레오네티 법 이후 환자에게 강도 높고 지속적인 진정제를 사망시까지 투여하는 것을 합법화하였다. 그러나 이웃하는 다수의 유럽국가와 달리 프랑스에서는 사망 시기 자체를 앞당기는 처치는 환자가 원한다고 하여도 여전히 금지되고 있다. 임종기의 환자가 의사의 조력을 받아 고통 없이 사망에 이르는 것을 허용할 것인가에 대한 실존적이고 보편적인 질문이 최근 중요한 문제로 부각되면서 다수의 국회의원들이 조력사망을 합법화하는 내용의 법률안을 제출하였다. 이 논문에서는 프랑스에서 존엄한 죽음에 대한 환자의 권리(droit de mourir dans la dignité)와 관련하여 전개된 입법과정을 살펴보고 최근 조력사망의 합법화를 시도하는 프랑스의 법률안들을 우리 연명의료결정법 개정안과 비교·검토하고자 한다.

• 대한한방부인과학회지
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• 제19권3호
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• pp.135-149
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• 2006

Purpose : This study was aimed to investigate the inhibitory effect of Millettia Reticulatas on the proliferation of human uterine leiomyoma cells and the expression of gene related the mechanism of cell apoptosis. Methods : We counted the number of death cells treated with indicated concentration of Millettia Reticulatas and investigated cell death rate by MTS assay. Furthermore, flow cytometry analyis and DNA fragmentation assay were used to dissect between necrosis and apoptosis. and then we observed the differential gene expression by western blot analysis. Results : 1) The inhibitory effect on the growth of uterine leiomyoma cell treated with Millettia Reticulatas was increased in a concentration proportional. 2) The result of flow cytometry analysis. subG1 phase arrest related3 cell apoptosis was investigated 23.49% in uterine leiomyoma cell treated Millettia Reticulatas and showed the fession of proportional concentration. 3) The gene expression of p27, p53, p21, p16 related cell cycle was increased according to increasing concentration but cyclin E was none exchanged. 4) The character of apoptosis, DNA fragmentation was significantly observed the fession of proportional concentration. 5) The expression of pro-caspase3 and PARP were decreased dependent on treatment concentration. Conclusion : This study showed that Millettia Reticulatas have the inhibitory effect on the proliferation of human uterine leiomyoma cell and the effect was related with apoptosis. The apoptotic mechanism was observed that the gene expression of p27, p53, p21, p16 related cell cycle was increased according to increasing treatment concentration, induced G1 phase arrest and finally cell death was occurred. The decreased expression of pro-caspase 3 and PARP were noted that apoptosis was related with caspase pathway.

• 동서간호학연구지
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• 제28권2호
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• pp.142-150
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• 2022

Purpose: The purpose of this study is to identify the factors affecting the role of nurses with regard to the perception of good death, knowledge of advance directives, and stress and attitude toward withdrawing life-sustaining treatment. Methods: Data were collected from 102 nurses working at a general hospital. Data were analyzed by descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson correlation coefficient, and multiple linear regression using the SPSS 28.0.1.0 program. Results: Educational level (β=.37, p=.001 for bachelor; β=.33, p=.005 for master or higher) and good death perception (β=.22, p=.024) were significant factors of the role of nurses associated with withdrawing life-sustaining treatment. Conclusion: Based on the result of this study, information about awareness of good death should be included in development of an educational program in order to strengthen the role of nurses in withdrawing life-sustaining treatment of patients.

• 대한약침학회지
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• 제25권4호
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• pp.390-395
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• 2022

Objectives: Sweet bee venom (sBV) is purified from Apis mellifera, containing a high level of melittin-its main component. It has been used as a therapeutic agent for pain relief and anti-inflammation, as well as for treating neuronal abnormalities. Recently, there have been studies on the therapeutic application of sBV for anticancer treatment. In the present study, we investigated the pharmacological effect of sBV treatment in A549 human lung cancer cells. Methods: We used microscopic analysis to observe the morphological changes in A549 cells after sBV treatment. The MTT assay was used to examine the cytotoxic effect after dose-dependent sBV treatment. Molecular changes in sBV were evaluated by the expression of apoptosis marker proteins using western blot analysis. Results: Microscopic analysis suggested that the growth inhibitory effect occurred in a dose-dependent manner; however, cell lysis occurred at a concentration over 20 ㎍/mL of sBV. The MTT assay indicated that sBV treatment exhibited a growth inhibitory effect at a concentration over 5 ㎍/mL. On fluorescence activated cell sorting analysis, G0 dead cells were observed after G1 arrest at treatment concentrations up to 10 ㎍/mL. However, rapid cell rupture was observed at a concentration of 20 ㎍/mL. Western blot analysis demonstrated that sBV treatment modulated the expression of multiple cell death-related proteins, including cleaved-PARP, cleaved-caspase 9, p53, Bcl2, and Bax. Conclusion: sBV induced cell death in A549 human lung cancer cells at a pharmacological concentration, albeit causing hemolytic cell death at a high concentration.