• 대한의생명과학회지
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• 제27권3호
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• pp.134-141
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• 2021

c-Jun N-terminal kinases (JNKs) have a Janus face, regulating both cell apoptosis and survival. The present study focused on understanding the function of JNK in tumor development and the chemoresistance underlying JNK-mediated cancer cell survival. We identified an inhibitor of JNK1, an important regulator of cancer cell survival. Kinase assay data showed that JNK1-dependent c-Jun phosphorylation was inhibited by indirubin derivatives. In particular, indirubin-3-monoxime (I3M) directly inhibited the phosphorylation of c-Jun in vitro, with a half inhibition dose (IC₅₀) of 10 nM. I3M had a significant inhibitory effect on JNK1 activity. Furthermore, we carried out assays to determine the viability, migration, and proliferation of breast cancer cells. Our results demonstrated that cell growth, scratched wound healing, and colony forming abilities were inhibited by the JNK inhibitor SP600125 and I3M. The combination of SP600125 and I3M significantly decreased cancer cell proliferation, compared with either SP600125 or I3M alone. Our studies may provide further support for JNK1-targeting cancer therapy using the indirubin derivative I3M in breast cancer.

• 가정간호학회지
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• 제26권2호
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• pp.180-188
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• 2019

Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.

• Journal of Hospice and Palliative Care
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• 제26권4호
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• pp.171-184
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• 2023

Purpose: The study explored the meaning of experiences within a family art therapy process among terminal cancer patients and their families. Methods: Ten participants, including four terminal cancer patients currently admitted to the hospice ward at an inpatient hospice facility in S City and four caregiving family members, engaged in four cycles of family art therapy sessions. The sessions were conducted weekly or bi-weekly, and each lasted approximately 50 minutes. Results: Nine cross-case themes emerged: "feeling unfamiliar and intimidated by the idea of expressing my thoughts through art," "trying to accept the present and positively overcome sadness," "expressing hope through emotional bonds during the process of parting," "conveying and preserving personal and family beliefs," "feeling upset about family imbalances caused by deteriorating health," "valuing togetherness and striving for stability amidst the current challenges," "art as a medium of empowerment for patients and facilitator of family conversations, even amidst difficulties," "sharing a range of emotions-not just joy, but concerns and sorrow-through art," and "gratitude for art' s role in improving family communication and connection through artwork. Conclusion: The findings of this study lead to several conclusions. First, patients and their families faced psychological challenges when confronted with impending death, yet they strove to remain optimistic by seeking meaning in their struggles. Second, families practiced open and expressive communication, sharing a spectrum of complex emotions with one another. Third, even as the patient's condition worsened, resulting in family fatigue, their support and cohesion strengthened.

• 한국환경성돌연변이발암원학회:학술대회논문집
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• 한국환경성돌연변이발암원학회 2004년도 KSOT/KEMS Fall Annual Meeting
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• pp.163-164
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• 2004

• Journal of Hospice and Palliative Care
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• 제17권2호
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• pp.85-89
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• 2014

유방암 환자의 흉막 전이는 흔한 소견이다. 흉수가 가장 흔한 증상이고 흉수를 동반하지 않는 흉막 결절이나 흉막 판은 비교적 드물다. 본 환자는 말기 유방암으로 인해 흉수를 동반하지 않는 빠른 속도로 악화되는 거대 흉막 종양이 생겨났고 그로 인해 심한 호흡곤란을 경험했던 환자로 보기 드문 증례로서 보고를 하며 이와함께 말기암환자의 호흡곤란의 치료에 대해 고찰해 보고자 한다.

• The Korean Journal of Pain
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• 제11권2호
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• pp.214-219
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• 1998

Pain is one of the most frequent and disturbing symptom of cancer patients. And almost of cancer patients are afraid of a attacks of pain related to cancer. Caring for the cancer patient can be divided into two phases. The phase of "active treatment" involves various interventions-surgical, chemical or radiological- that are designed to prolong the patient's life. "Terminal care" is the period from the end of active treatment until the patient's death. But in the majority of clinical settings, cancer pain is not being managed adequately results from a lack of education about how to treat the cancer pain management in the safest and most effective way during terminal phase. Althought organic factors represent the most important cause of their pain, it is also important to deal with the patient's psychological reactions and to take account of his or her social and family environment if treatment for chronic cancer pain is to prove adequate. Thus we try to evaluate a kinds of cancer related to pain, degree of pain, effectiveness of drugs, and patient's responses to management. In regard to the satisfaction for pain relief in pain clinics at Pusan National University Hospital(PNUH) are about 70% in patients and 90% in family. Average life expectancy in cancer patients are about 140 days (3 days- 5.7 years). Cancer patients are complained of several discomfortness (above 30 kinds) such as, pain associated with cancer (75%), nausea and vomitting (38%), sleeping disorder (38%), anorexia (38%), dyspnea (32%), constipation (31%), etc. Distributions of cancer associated with pain are stomach cancer (21%), lung cancer (16%), cervix cancer (10%), anorectal and colon cancer (8.6%), hepatoma (8%), pancreatic cancer (3%). About 1/3 of patients are suffer from incident pain in 3~5 times in a day especially in moving, coughing, and exercise. Methods for drug delivering system before death are transdermal fentanyl patch (42%), intravenous PCA (21%), oral intake of opioid (17%), epidural PCA (14%), etc.

• Journal of Korean Biological Nursing Science
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• 제7권1호
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• pp.57-68
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• 2005

Purpose : The purpose of this study was to develop a tool to assess the need for hospice care in families of patients with cancer. Method : Research design was a methodological study. The tool was developed in 3 stages : first, preliminary items were developed based on a questionnaire about the needs for hospice care that was given to 8 families of patients with cancer; second, a panel of specialists reduced the number of preliminary items using 2 validity tests on the contents. Finally, reliability and validity were tested by a sample of 98 families who have a patient with cancer from April 2003 to July 2004. Result: Cronbach's alpha coefficient for internal consistency was .94 for the final total 22 items. Using the factor analysis, 4 factors with eigenvalue of more than 1.0 were extracted and these factors explained 65% of the total variance. The four factors were labeled as 'control of terminal physical problems', 'emotional care', 'spiritual care for preparing for death', and 'family support'. The final items of the tool developed on the need of hospice care consisted of 22 items. Conclusion : The instrument, for accessing the need for hospice care in families of patients with cancer, developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for implementing and improving hospice care for patients with terminal cancer.

• Journal of Hospice and Palliative Care
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• 제2권2호
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• pp.109-113
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• 1999

목적 : 말기 암 환자들을 위한 적절한 의료서비스가 제공되지 않음에 따라 비정상저인 의료행태가 발생되고 있어 말기 암 환자의 관리를 위한 포괄적인 프로그램의 필요성이 제기되고 있다. 고가의 생명유지장치의 무익성과 말기 암 환자 관리의 고 비용에 대한 관심이 늘어나고 있다. 본 연구는 의료보험에서 말기 암환자들에게 지출된 의료비용을 분석하고자 하였다. 방법 : 1997년 1월부터 1998년 6월까지 사망한 암 등록환자 중 공무원 교직원 의료보험 자료 이용이 가능한 151명의 급여내역을 추출하여 입 내원 일수와 의료보험 진료비를 조사하였다. 결과 : 사망 전 6개월 동안의 암 환자 일인당 평균 입원일수는 39일 외래일수는 14일이었다. 진료 일당 평균 진료비는 85,362원이었으며 입원 일당 평균 진료비는 105,908원, 외래 내원 일당 평균 진료비는 40,173원이었다. 진료비의 95%가 종합병원에서 지출되었으며, 진료비의 85%가 입원을 통해 지출되었다. 사망 전 6개월 동안의 진료비는 점차 증가하는 경향을 보여 사망에 가까울수록 사망 전 2개월 동안에 약 50%, 1개월 동안에 약 30%가 지출되었다. 외래진료비는 사망 전 3개월 전까지는 증가하다가 2개월 전부터는 감소하는 반면, 입원진료비는 사망에 가까울수록 증가하는 경향을 보였다. 결론 : 본 연구의 사망 전 6개월간의 의료비 분포는 미국의 메디케어의 자료와 비슷한 분포를 보였다. 향후 보다 큰 규모와 세부적인 진료서비스 내용의 분석을 통해 말기 암 환자의 관리에 대한 정책적 대안을 제시할 필요가 있다.

• Journal of Hospice and Palliative Care
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• 제5권2호
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• pp.146-154
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• 2002

배경 : 세계적으로 암의 발생률과 사망률은 증가하는 추세로, 그로 인한 의료비 상승의 문제로 국가 정책의 필요성이 대두되고 있다. 이에 저자 등은 호스피스 케어를 위해 입원한 말기 암 환자들의 의료비용 실태를 조사하고 이와 관련된 요인도 함께 살펴보아 불필요한 의료비용 부분의 효과적 감소에 도움이 되고자 하였다. 방법 : 2000년 7월 1일부터 2002년 6월 30일 사이에 경기도 고양시에 소재한 모 병원 가정의학과에 말기 암으로 입원하여 사망한 환자 259명을 대상으로 인구통계학적 자료 암의 기왕력, 임상소견, 의료비용을 조사하였다. 의료비용은 환자의 사망직전 입원 당시의 원무과 계산서를 근거로 세부 항목을 조사하였다. 인구통계학적 특성, 암의 기왕력, 임상 소견과 평균 의료비용과의 상관관계를 ANOVA로 조사하였다. 결과 : 말기 암 환자 259명중 남자가 135명(52.1%), 여자가 124명(47.9%)이었으며, 암의 종류는 위암이(58명, 22.4%) 제일 많았다. 입원 당시의 임상소견은 식욕부진이 227명(87.6%), 통증이 199명(76.8%), 오심 구토가 152명(58.7%) 순으로 높게 나타났다. 총 의료비용은 740,628,045원이었으며 환자 1인당 평균 의료비용은 $285,968{\pm}3,070,272$원이었다. 총 의료비용 중에서 주사료가 237,038,259원(32.0%)로 가장 많았고 병실료가 206,416,669원(27.9%), 검사료(임상병리 검사료와 진단 방사선료)가 103,417,747원(14.0%) 순이었다. 평균 의료비용은 주사료, 치료방사선료, 병실료 순으로 높았다. 인구통계학적 특성, 암의 기왕력, 임상소견의 항목 중 통증만 유일하게 평균 의료비용과 상관관계가 있었다(P<0.05). 결론 : 호스피스 케어를 받는 말기 암 입원 환자들에서 불필요한 마약성 진통제 등 주사 투여를 가능하면 줄이고 가정 내 호스피스를 활성화하고 과도한 검사를 줄임으로써 보다 더 효과적인 비용 절감을 도모할 수 있을 것으로 보인다.

• Molecules and Cells
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• 제39권5호
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• pp.403-409
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• 2016

NME1 is a well-known metastasis suppressor which has been reported to be downregulated in some highly aggressive cancer cells. Although most studies have focused on NME1, the NME1 gene also encodes the protein (NME1L) containing N-terminal 25 extra amino acids by alternative splicing. According to previous studies, NME1L has potent anti-metastatic activity, in comparison with NME1, by interacting with $IKK{\beta}$ and regulating its activity. In the present study, we tried to define the role of the N-terminal 25 amino acids of NME1L in $NF-{\kappa}B$ activation signaling. Unfortunately, the sequence itself did not interact with $IKK{\beta}$, suggesting that it may be not enough to constitute the functional structure. Further construction of NME1L fragments and biochemical analysis revealed that N-terminal 84 residues constitute minimal structure for homodimerization, $IKK{\beta}$ interaction and regulation of $NF-{\kappa}B$ signaling. The inhibitory effect of the fragment on cancer cell migration and $NF-{\kappa}B$-stimulated gene expression was equivalent to that of whole NME1L. The data suggest that the N-terminal 84 residues may be a core region for the anti-metastatic activity of NME1L. Based on this result, further structural analysis of the binding between NME1L and $IKK{\beta}$ may help in understanding the anti-metastatic activity of NME1L and provide direction to NME1L and $IKK{\beta}$-related anti-cancer drug design.