• Title/Summary/Keyword: Good Death

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A Study on MCG Imaging (MCG 영상진단 검사에 관한 연구)

  • Kim, Jong-Gyu
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.2
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    • pp.135-140
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    • 2006
  • Magnetocardiography (MCG) is the measurement and analysis of the magnetic component of the electro-magnetic field of the human heart, usually conducted externally, using extremely sensitive devices such as a Superconducting Quantum Interference Device (SQUID). MCG is a totally noninvasive method, it uses neither radiation nor ultrasonics. The magnetic activity of the heart is registered from outside the thorax. MCG has a very high sensitivity and a high spatial resolution for very a small, local myocardial current. In comparison to the electrical signals measured by an ECG, the magnetic signal does not disturb the boundaries of tissues with different electrical properties. MCG measures the myocardial function rather than describing the morphology. MCG is a relatively new technique that promises good spatial resolution and extremely high temporal resolution, thus complementing other heart activity measurement techniques such as Electrocardiography (ECG). The clinical uses of MCG are in detecting various cardiac disorders including myocardial infarction, ventricular hypertrophy, ventricular conduction defects, Wolff-Parkinson-White (WPW) syndrome, sudden cardiac death and fetal magnetocardiography. Magnetocardiography may be used alone or together with electrcardiography for the measurement of spontaneous or overloaded activity and for research or clinical purposes.

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Some Aspects of Thai culture on the folktale "Pla Boo Thong" (태국 민담 <쁠라 부텅>류에 나타난 태국인의 문화적 특성)

  • Kim, Young Aih
    • The Southeast Asian review
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    • v.21 no.1
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    • pp.287-314
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    • 2011
  • There are many versions of the thai folktale "Pla Boo Thong" in Thailand, which is a typical type of stepmother story and in many ways resembles Cinderella story. This study, the author took 6 versions, some from books, some from internet. The main story of those 6 version is consist of the death of mother, stepmother and step sister, the maltreat of the stepmother to the heroine, tiding over the critical moments with the help of the dead mother and others, getting married with the king and happy of the heroine, death of the heroine by the slander of stepmother, posing as a queen of the stepsister, reincarnation of the dead heroine, meeting with the king again, and punishment and the stepmother and stepsister. The main theme of this narrative is a conflict in the polygamic family and is followed by the pattern of the Cinderella tale such as the distinct contrast of Good and Evil. This tale also teaches teachings of Buddha such as the punitive justice, the promotion of virtue and reproval of vice, and forgiveness. And otherwise it gives the people the courage and hope to overcome fortitude in their life.

The Meaning of Good Dying of Chinese Terminally Ill Cancer Patients in Taiwan

  • Chao, Co-Shi Chantal
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2000.12a
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    • pp.162-174
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    • 2000
  • The purpose of this hermeneutic study was to investigate the meaning of "good dying" of Chinese terminally ill cancer patients in Taiwan; the factors related to this morning; and the strategies cancer patients used to ensure "good dying". Indepth unstructured interviews, prolonged participant observations, and review of clinical records were selected as the methods for data collection. In the four and one-half month period of data collection, the researcher was in the role of a full time clinical nurse specialist who directly took care of the subject patients in 4 hospitals and in patients' homes. The 20 subject were selected purposively according to selection criteria and various demographic backgrounds. Interview transcripts and field notes comprised the data for analysis. The results were composed by 3 constitutive patterns and 12 themes. Achieving inner peace appeared to herald the good dying state. The "good dying" for Chinese terminally ill cancer patients in Taiwan meant peace of body, peace of mind, and peace of thought. The constitutive pattern of peace of body included 4 themes: (1)minimizing the agony of physical symptoms; (2)short period of dying process without lingering death; (3) cleanliness, neatness, and integrity of the body; and (4) mobility. The constitutive pattern of peace of mind included 5 themes: (1) yielding; (2) non-attachment; (3) not to be lonely; (4) settle down all affairs; and (5) being in a preferred environment and enjoying nature. The third constitutive pattern of peace of thought included 3 themes: (1) getting through day by day without thinking; (2) meaningful life; and (3) expectation that the suffering would be ending. Through understanding of the terminally ill cancer patient' needs in their meanings of "good dying", recommendations can be made for humanistic care. The findings of this study have recommendations for care givers daily contact with dying patients and for medical and nursing education.

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Inhibition of c-FLIP by RNAi Enhances Sensitivity of the Human Osteogenic Sarcoma Cell Line U2OS to TRAILInduced Apoptosis

  • Zhang, Ya-Ping;Kong, Qing-Hong;Huang, Ying;Wang, Guan-Lin;Chang, Kwen-Jen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2251-2256
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    • 2015
  • To study effects of cellular FLICE (FADD-like IL-$1{\beta}$-converting enzyme)-inhibitory protein (c-FLIP) inhibition by RNA interference (RNAi) on sensitivity of U2OS cells to tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL)-induced apoptosis, plasmid pSUPER-c-FLIP-siRNA was constructed and then transfected into U2OS cells. A stable transfection cell clone U2OS/pSUPER-c-FLIP-siRNA was screened from the c-FLIP-siRNA transfected cells. RT-PCR and Western blotting were applied to measure the expression of c-FLIP at the levels of mRNA and protein. The results indicated that the expression of c-FLIP was significantly suppressed by the c-FLIP-siRNA in the cloned U2OS/pSUPER-c-FLIP-siRNA as compared with the control cells of U2OS/pSUPER. The cloned cell line of U2OS/pSUPER-c-FLIP-siRNA was further examined for TRAILinduced cell death and apoptosis in the presence of a pan-antagonist of inhibitor of apoptosis proteins (IAPs) AT406, with or without 4 hrs pretreatment with rocaglamide, an inhibitor of c-FLIP biosynthesis, for 24 hrs. Cell death effects and apoptosis were measured by the methods of MTT assay with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and flow cytometry, respectively. The results indicated that TRAIL-induced cell death in U2OS/pSUPER-c-FLIP-siRNA was increased compared with control cells U2OS/pSUPER in the presence or absence of AT406. Flow cytometry indicated that TRAIL-induced cell death effects proceeded through cell apoptosis pathway. However, in the presence of rocaglamide, cell death or apoptotic effects of TRAIL were similar and profound in both cell lines, suggesting that the mechanism of action for both c-FLIP-siRNA and rocaglamide was identical. We conclude that the inhibition of c-FLIP by either c-FLIP-siRNA or rocaglamide can enhance the sensitivity of U2OS to TRAIL-induced apopotosis, suggesting that inhibition of c-FLIP is a good target for anti-cancer therapy.

The psychological factors of creation of virtue women based on the relationship between Mrs. Park in and Samganghaengsildo's the virtuous women volume (<열녀함양박씨전>의 박씨와 『삼강행실도: 열녀편』의 관계를 통해 본 열녀제작의 심리적 요인)

  • Seo, Eun-A
    • Journal of Korean Classical Literature and Education
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    • no.16
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    • pp.273-296
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    • 2008
  • The author analyzed the psychological factors which affected on the way of Mrs. Park in the became a virtuous woman and compared these psychological factors with a virtuous women in Samganghaengsildo based on the relationship between Mrs. Park in and Samganghaengsildo's the virtuous women volume. First of all, it's about the power of authority on women. The volume of Samganghaengsildo's virtuous women was about the group of women who were recognized as virtuous women by the king who had absolute power at the time period. The volume of Samganghaengsildo's virtuous women was very well known for women. This book had a huge impact on women since the government authority educated the women using this book. In addition, the incredible events which were written in Samganghaengsildo indicated that the behavior of virtue was the right thing to follow since even super power recognized it as a good thing to do and the woman might be punished when she didn't follow the behavior of virtue. Second, it was based on the similarity of circumstance and uncertainty for the future. Mrs. Park in showed similar behavioral patterns with a virtuous woman in Samganghaengsildo since she took her role model from the virtuous woman. When Mrs. Park lost her husband, she was not sure about her future and the volume of Samganghaengsildo pointed out that there was another world after the death and she would meet her husband again after the death. In addition, the incorrect information that she would feel better psychologically when she followed her dead husband instead of living herself. Third, it is about the resemblance of obsessive mind and self internalization. The examination of the record of Mrs. Park showed that Mrs. Park tried to internalize integrity, loyalty, and virtue of virtuous women in Samganghaengsildo and became herself like virtuous women. In addition, the woman's obsessive mindset remarkly reflected in Samganghaengsildo. For instance, Mrs. Park in held to the time of death of her husband and the writer who wrote about the behavior of Mrs. Park also emphasized that the time of death of Mrs. Park was closed to the time of the death of her husband. This explained that the obsessive mindset of women in the epic of virtue women could have influence on the women's mind who tried to show the similar behavior with a virtue woman and internalize it. Finally, the people of the day also were not free from it.

Surgical Results of Unruptured Intracranial Aneurysms in the Elderly: Single Center Experience in the Past Ten Years

  • Jung, Young-Jin;Ahn, Jae-Sung;Park, Eun-Suk;Kwon, Do-Hoon;Kwun, Byung-Duk;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.329-333
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    • 2011
  • Objective : As medical advances have increased life expectancy, it has become imperative to develop specific treatment strategies for intracranial aneurysms in the elderly. We therefore analyzed the clinical characteristics and outcomes of the treatment of unruptured intracranial aneurysms in patients older than 70 years. Methods : We retrospectively reviewed the medical records and results of neuroimaging modalities on 54 aneurysms of 48 consecutive patients with un ruptured intracranial aneurysms. ($mean{\pm}SD$ age, $72.11{\pm}1.96$ years; range, 70-78 years) who underwent surgical clipping over 10 years (May 1999 to June 2010). Results : Of the 54 aneurysms, 22 were located in the internal carotid artery, 19 in the middle cerebral artery, 12 in the anterior cerebral artery, and 1 in the superior cerebellar artery. Six patients had multiple aneurysms. Aneurysm size ranged from 3 mm to 17 mm ($mean{\pm}SD$, $6.82{\pm}3.07$ mm). Fifty of the 54 aneurysms (92.6%) were completely clipped. Three-month outcomes were excellent in 50 (92.6%) aneurysms and good and poor in 2 each (3.7%), with 1 death (2.0%). Procedure-related complications occurred in 7 aneurysms (13.0%), with 2 (3.7%) resulting in permanent neurological deficits, including death. No postoperative subarachnoid hemorrhage occurred during follow-up. The cumulative rates of stroke- or death-free survival at 5 and 10 years were 100% and 78%, respectively. Conclusion : Surgical clipping of unruptured intracranial aneurysms in elderly group could get it as a favorable outcome in well selected cases.

Risk Factors Predicting Unfavorable Neurological Outcome during the Early Period after Traumatic Brain Injury

  • Park, Jung-Eon;Kim, Sang-Hyun;Yoon, Soo-Han;Cho, Kyung-Gi;Kim, Se-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.90-95
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    • 2009
  • Objective : We aimed to identify clinico-radiological risk factors that may predict unfavorable neurological outcomes in traumatic brain injury (TBI), and to establish a guideline for patient selection in clinical trials that would improve neurological outcome during the early post TBI period. Methods : Initial clinico-radiological data of 115 TBI patients were collected prospectively. Regular neurological assessment after standard treatment divided the above patients into 2 groups after 6 months : the Favorable neurological outcome group (GOS : good & moderate disability, DRS : 0-6, LCFS : 8-10) and the Unfavorable group (GOS : severe disability-death, DRS : 7-29 and death, LCFS : 1-7 and death). Results : There was a higher incidence of age $\geq$35 years, low initial GCS score, at least unilateral pupil dilatation, and neurological deficit in the Unfavorable group. The presence of bilateral parenchymal lesions or lesions involving the midline structures in the initial brain CT was observed to be a radiological risk factor for unfavorable outcome. Multivariate analysis demonstrated that age and initial GCS score were independent risk factors. The majority of the Favorable group patients with at least one or more risk factors showed improvement of GCS scores within 2 months after TBI. Conclusion : Patients with the above mentioned clinico-radiological risk factors who received standard treatment, but did not demonstrate neurological improvement within 2 months after TBI were deemed at risk for unfavorable outcome. These patients may be eligible candidates for clinical trials that would improve functional outcome after TBI.

PARK Index and S-score Can Be Good Quality Indicators for the Preventable Mortality in a Single Trauma Center

  • Park, Chan Yong;Lee, Kyung Hag;Lee, Na Yun;Kim, Su Ji;Cho, Hyun Min;Lee, Chan Kyu
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.126-130
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    • 2017
  • Purpose: Preventable Trauma Death Rate (PTDR) using Trauma and Injury Severity Score (TRISS) has been most widely used as a quality indicator in South Korea. However, this method has a small number of deaths corresponding to the denominator. Therefore, it is difficult to check the change of quality improvement for annual mortality, and there is a disadvantage that variation is severe. Therefore, we attempted to improve the quality of the mortality evaluation by reducing the variation by applying the PARK Index (preventable major trauma death rate, PMTDR) which can increase the number of denominator significantly. And the Save score (S-score) was also examined as another quality indicator. Methods: In the PARK Index, the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths among these. The PARK Index includes only patients with ISS >15. The S-score is calculated in the same way as the W-score, but the S-score includes only patients with ISS >15, which is a difference from the W-score. Results: PARK Index decreased annually and was 12.9 (37/287) in 2014, 9.6 (33/343) in 2015, and 7.3 (52/709) in 2016. S-score increased annually and was -0.29 in 2014, 4.21 in 2015, and 8.75 in 2016. Conclusions: PARK Index and S-score improved annually. This shows that both quality indicators are improving year by year. PARK Index (PMTDR) has 9.5-fold increase in denominator overall compared to PTDR by TRISS. The S-score used only ISS >15 patients as a denominator. Therefore, there is an advantage that the numerical value change is larger than the W-score. In addition, S-score is not affected by the ratio of major trauma patients to minor trauma patients.

A Study on How Elderly People are Preparing for Dying Well (웰다잉을 어떻게 준비하고 있는가: 노인을 대상으로)

  • Lim, HyoNam;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.9
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    • pp.432-439
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    • 2019
  • This study was a qualitative study that attempted to find out the meaning of preparation for dying well that the elderly think through a question of how to prepare for dying well. The focus group interview was conducted on 10 elderly people aged 65 or older who visited the elderly welfare center in B city, Gyeonggi-do, and a total of two groups were interviewed with five subjects as one group. As a result, eight themes were drawn from four dimensions of physical, psychological, social, and spiritual aspects. In physical preparation, 'health management' and 'doing what you want to do' were derived. In psychological preparation, 'not regretting' and 'giving to others' were derived, and in social preparation, 'organizing property', 'determining a place of death you wish', and 'writing a letter of advance life sustaining care directives' were derived. In spiritual preparation, 'relying on religion' was derived. The elderly were preparing for well-being in various aspects, and when developing a program for well-being, the program should be planned to prepare for actual death in various aspects.

PDCD4 as a Predictor of Sensitivity to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

  • Dou, Xue;Wang, Ren-Ben;Meng, Xiang-Jiao;Yan, Hong-Jiang;Jiang, Shu-Mei;Zhu, Kun-Li;Xu, Xiao-Qing;Chen, Dong;Song, Xian-Rang;Mu, Dian-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.825-830
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    • 2014
  • Objective: The purpose of this study was to examine the role of programmed cell death 4 (PDCD4) expression in predicting tumor response to neoadjuvant chemoradiotherapy and outcomes for patients with locally advanced rectal cancer. Methods: Clinicopathological factors and expression of PDCD4 were evaluated in 92 patients with LARC treated with nCRT. After the completion of therapy, 4 cases achieved clinical complete response (cCR), and thus the remaining 88 patients underwent a standardized total mesorectal excision procedure. There were 38 patients (41.3%) with a good response (TRG 3-4) and 54 (58.7%) with a poor one (TRG 0-2). Results: Immunohistochemical staining analyses showed that patients with high expression of PDCD4 were more sensitive to nCRT than those with low PDCD4 expression (P=0.02). High PDCD4 expression before nCRT and good response (TRG3-4) were significantly associated with improved 5-year disease-free survival and 5-year overall survival (P<0.05). Multivariate analysis demonstrated that the pretreatment PDCD4 expression was an independent prognostic factor. Conclusion: Our study demonstrated that high expression of PDCD4 protein is a useful predictive factor for good tumor response to nCRT and good outcomes in patients with LARC.