• 제목/요약/키워드: Clinical pathways

검색결과 415건 처리시간 0.026초

Clinical and Neurobiological Relevance of Current Animal Models of Autism Spectrum Disorders

  • Kim, Ki Chan;Gonzales, Edson Luck;Lazaro, Maria T.;Choi, Chang Soon;Bahn, Geon Ho;Yoo, Hee Jeong;Shin, Chan Young
    • Biomolecules & Therapeutics
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    • 제24권3호
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    • pp.207-243
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    • 2016
  • Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social and communication impairments, as well as repetitive and restrictive behaviors. The phenotypic heterogeneity of ASD has made it overwhelmingly difficult to determine the exact etiology and pathophysiology underlying the core symptoms, which are often accompanied by comorbidities such as hyperactivity, seizures, and sensorimotor abnormalities. To our benefit, the advent of animal models has allowed us to assess and test diverse risk factors of ASD, both genetic and environmental, and measure their contribution to the manifestation of autistic symptoms. At a broader scale, rodent models have helped consolidate molecular pathways and unify the neurophysiological mechanisms underlying each one of the various etiologies. This approach will potentially enable the stratification of ASD into clinical, molecular, and neurophenotypic subgroups, further proving their translational utility. It is henceforth paramount to establish a common ground of mechanistic theories from complementing results in preclinical research. In this review, we cluster the ASD animal models into lesion and genetic models and further classify them based on the corresponding environmental, epigenetic and genetic factors. Finally, we summarize the symptoms and neuropathological highlights for each model and make critical comparisons that elucidate their clinical and neurobiological relevance.

적작약 추출물의 대식세포에 대한 염증억제 효과 (Suppression Effect of the Inflammatory Response in Macrophages by Paeoniae Radix Rubra Extracts)

  • 박종필;손정현;김용민;정준희;임강현;이은용;김이화
    • 한국약용작물학회지
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    • 제19권5호
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    • pp.373-379
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    • 2011
  • Paeoniae Radix Rubra is a preparation consisting of desiccated roots of Paeonia lactiflora PALL (belonging to Ranunculaceae). Paeoniae Radix Rubra is used as a medicinal herb in Asian countries to treat many diseases. Ethanol- or water-based extracts of Paeoniae Radix Rubra were prepared and tested on RAW 264.7 cells, a murine macrophage cell line. The expression of some pro-inflammatory proteins, including inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), extracellular signal-regulated kinase 1/2 (ERK1/2) and phosphorylated ERK1/2 was detected by Western blot analyses, while PGE2 expression was quantified by ELISA. Both the water and ethanol extracts of Paeoniae Radix Rubra suppressed LPS-induced nitric oxide (NO) production and exhibited cell toxicity in accordance with increased NO production. Also, both extracts reduced the expression of COX-2 and iNOS, and inhibited phosphorylation of ERK1/2 in LPS-stimulated RAW 264.7 cells. Extracts prepared from Paeoniae Radix Rubra contain anti-inflammatory agents that inhibit the iNOS and MAPK pathways.

Effects of Schisandra chinensis fruit extract and gomisin A on the contractility of penile corpus cavernosum smooth muscle: a potential mechanism through the nitric oxide - cyclic guanosine monophosphate pathway

  • Choi, Bo Ram;Kim, Hye Kyung;Park, Jong Kwan
    • Nutrition Research and Practice
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    • 제12권4호
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    • pp.291-297
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    • 2018
  • BACKGROUND/OBJECTIVES: This study evaluated the effects and molecular mechanisms of the Schisandra chinensis fruit extract (SC) and its major compound gomisin A (GA), on the contractility of rabbit penile corpus cavernosum smooth muscle (PCCSM). MATERIALS/METHODS: PCCSM was exposed to SC or GA after appropriate pretreatment with nitric oxide synthase (NOS) blocker, guanylate cyclase blocker, adenylyl cyclase blocker or protein kinase A blocker. Subsequently, we evaluated the cyclic nucleotide in the perfusate by radioimmunoassay, protein expression level of neuronal NOS (nNOS) and endothelial NOS (eNOS) by western blot, and the interaction of SC or GA with udenafil and rolipram. RESULTS: Both SC and GA induce PCCSM relaxations in a concentration-dependent manner. Pretreatment with NOS blocker, guanylate cyclase blocker, adenylyl cyclase blocker or protein kinase A blocker result in significantly decreased relaxation. SC and GA also induce the levels of cyclic nucleotide in the perfusate in a concentration-dependent manner. Perfusion with GA also showed significantly higher levels of eNOS protein. Furthermore, the udenafil and rolipram induced relaxations of PCCSM were enhanced after exposure to SC and GA. Our results indicate that SC and GA induce the relaxation of PCCSM via the nitric oxide (NO)-cGMP and cAMP signaling pathways. CONCLUSIONS: The SC and GA are potential alternative treatments for men who want to consume natural products to ameliorate erectile function, or who do not respond to the commercially available medicines.

Detection and Characterization of PCR-SSCP Markers of the Bovine Lactoferrin Gene for Clinical Mastitis

  • Zhou, Lei;Yang, Yuan-Yuan;Li, Zhong-Hao;Kong, Li-Juan;Xing, Guan-Dong;Di, He-Shuang;Wang, Gen-Lin
    • Asian-Australasian Journal of Animal Sciences
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    • 제19권10호
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    • pp.1399-1403
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    • 2006
  • A total of 80 cows, including 40 top mastitis resistant and 40 top mastitis susceptible animals as Group I and Group II, were selected from a population of 520 cows based on clinical mastitis occurrence. PCR-SSCP analysis on four fragments within the 5'region and two fragments of Exons 4,15 of bovine lactoferrin (bLF) revealed that four fragments-P1,P4,E4,E15-had polymorphisms which totally included six base mutations, and only two of them had significant differences in allele frequencies between resistant and susceptible groups, P1 (53.7% vs. 70.0%, p<0.05) and P4 (55.0% vs. 68.8%, p<0.05). Further study on these two promising markers combined with the milk performance traits of cows demonstrated that their selection would result in higher fat percentage (p<0.05), lower Somatic Cell Score (SCS) (p<0.05) and Clinical Mastitis Residuals (CMR) (p<0.01) indicating higher mastitis resistance and lower milk yield (p<0.05). The putative transcription factor binding sites in the 5'region were also studied by using MatInspector 7.2.2 software, and two signal pathways regulating the expression of bLF including the NF-${\kappa}B$ pathway and nuclear hormone receptor pathway were predicted.

후두결핵의 임상양상과 진단 (Clinical Characteristics and Diagnosis of Laryngeal Tuberculosis)

  • 조현진;소윤경;손영익
    • 대한후두음성언어의학회지
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    • 제19권1호
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    • pp.43-46
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    • 2008
  • Background and Objectives : Clinical suspicion and appropriate diagnostic procedures are essential for the timely management of extrapulmonary type of mycobacterial disease. In the hope of suggesting a suitable guideline for the early diagnosis of laryngeal tuberculosis, the authors reviewed their clinical pathways and the characteristics of patients with laryngeal tuberculosis who were managed in the recent 10 years at a single tertiary referral hospital, Samsung Medical Center. Subjects and Method : Retrospective chart review was performed for the 25 adult patients with laryngeal tuberculosis. Among 25 cases, 12 were pathologically confirmed by laryngeal biopsy and the other 13 were clinically diagnosed by cumulative clinical information; definite laryngitis on laryngoscopy, positive AFB (acid fast bacillus) smear/culture or active pulmonary tuberculosis on chest X-ray, and substantial response to anti-tuberculosis medication. Results : Chest X-ray revealed active pulmonary tuberculosis in 72% of patients (N=18/25). Sputum AFB smear/culture was positive in 95% of all tested patients (N=21/22) and in 100% of the tested patients who have stable or no evidence of pulmonary tuberculosis (N=5/5). All patients except one who had coexisting laryngeal malignancy showed considerable improvement in their subjective symptoms and laryngeal findings within the first 2 months of anti-tuberculosis medications and they achieved complete response on subsequent sputum studies, chest X-ray and laryngeal findings after $7.0{\pm}2.3$ months of the medications. Conclusion : We suggest that chest X-ray and sputum AFB smear/culture to be the first step of work-up for the patients having laryngeal tuberculosis in suspicion since laryngeal tuberculosis is largely associated with active pulmonary tuberculosis and/or sputum AFB study offers high yield even in case of primary laryngeal tuberculosis. However laryngeal biopsy must be considered in case showing unsatisfactory response to the anti-tuberculosis medication for more than 2 months.

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비침습 유방암의 양·한방 협진 표준임상경로 모형 개발 (Development of Clinical Pathway Model in Integrative Korean Medicine: Treatment of Non-invasive Breast Cancer)

  • 조수연;고성규;박선주
    • 대한예방한의학회지
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    • 제26권1호
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    • pp.11-23
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    • 2022
  • Objectives : The aim of this study was to develop a clinical pathway (CP) model for the integrative treatment of non-invasive breast cancer, with western medicine and Korean traditional medicine. Methods : The checklist model was composed in four types according to the target patients: DCIS inpatients, DCIS outpatients, LCIS inpatients, LCIS outpatients. The vertical axis of the pathway consists of 11 categories of actions applied to the patient. The horizontal axis was in accordance with the flow of time, comprising three periods during inpatient care and seven periods during outpatient care. In addition, CP was also composed in flow chart form. The pathway model was developed through a literature review of clinical practice guidelines, conference publications, papers, books, and websites. Results : The integrative CP model for non-invasive breast cancer was developed. Conclusions : The goal of the CP suggested in this study was to improve non-invasive breast cancer patients' quality of life and to supplement conventional treatment, by alleviating the side effects. The model developed through this study could serve as the basis when developing CPs in a real-world integrative medical environment. This could lead to a reduction in cost and time for CP development, thus bringing about efficiency in the clinical setting.

Protective effects of lutein against vancomycin-induced acute renal injury in mice via upregulation of peroxisome proliferator-activated receptor gamma/nuclear factor erythroid 2-related factor 2 and inhibition nuclear factor-kappaB/caspase 3

  • Emeka, Promise M.;Rasool, Sahibzada T.;Morsy, Mohamed A.;Islam, Mohamed I. Hairul;Chohan, Muhammad S.
    • The Korean Journal of Physiology and Pharmacology
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    • 제25권4호
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    • pp.321-331
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    • 2021
  • Vancomycin, an antibiotic used occasionally as a last line of treatment for methicillin-resistant Staphylococcus aureus, is reportedly associated with nephrotoxicity. This study aimed at evaluating the protective effects of lutein against vancomycin-induced acute renal injury. Peroxisome proliferator-activated receptor gamma (PPARγ) and its associated role in renoprotection by lutein was also examined. Male BALB/c mice were divided into six treatment groups: control with normal saline, lutein (200 mg/kg), vancomycin (250 mg/kg), vancomycin (500 mg/kg), vancomycin (250 mg/kg) with lutein, and vancomycin (500 mg/kg) with lutein groups; they were euthanized after 7 days of treatment. Thereafter, samples of blood, urine, and kidney tissue of the mice were analyzed, followed by the determination of levels of N-acetyl-β-D-glucosaminidase (NAG) in the urine, renal creatine kinase; protein carbonyl, malondialdehyde, and caspase-3 in the kidney; and the expression of PPARγ, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappaB (NF-κB) in renal tissue. Results showed that the levels of protein carbonyl and malondialdehyde, and the activity of NAG, creatine kinase and caspase-3, were significantly increased in the vancomycin-treatment groups. Moreover, the levels of Nrf2 significantly decreased, while NF-κB expression increased. Lutein ameliorated these effects, and significantly increased PPARγ expression. Furthermore, it attenuated vancomycin-induced histological alterations such as, tissue necrosis and hypertrophy. Therefore, we conclude that lutein protects against vancomycin-induced renal injury by potentially upregulating PPARγ/Nrf2 expression in the renal tissues, and consequently downregulating the pathways: inflammation by NF-κB and apoptosis by caspase-3.

혈관미주신경실신의 새로운 기전 -삼차신경-심장반사- (New Mechanism of Vasovagal Syncope -Trigeminocardiac Reflex-)

  • 윤지영;김철홍
    • 대한치과마취과학회지
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    • 제12권3호
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    • pp.151-155
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    • 2012
  • A vasovagal reaction is defined as the 'development of hypotension and bradycardia associated with the typical clinical manifestations of pallor, sweating and weakness'. The most profound degree of vasovagal reaction results in fainting or syncope. Incidence of vasovagal reactions in the local anesthetic department of a dental hospital is around 2%. The pathophysiology of the hypotension/bradycardia reflex responsible for vasovagal syncope is not completely understood. Central as well as peripheral mechanisms have been implicated in its pathogenesis: however their relative contribution is not fully elucidated. Recently, trigeminocardiac reflex, previously known as oculocardiac reflex, may serve as syncope. The management of vasovagal syncope is evolving. Non-pharmacological treatment options are a fundamental first step of all treatment pathways. In this article, we would like to review new mechanism of vasovagal syncope and hope to be of help to manage the syncopal patients.

Atypical Teratoid Rhabdoid Tumour : From Tumours to Therapies

  • Richardson, Elizabeth Anne;Ho, Ben;Huang, Annie
    • Journal of Korean Neurosurgical Society
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    • 제61권3호
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    • pp.302-311
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    • 2018
  • Atypical teratoid rhabdoid tumours (ATRTs) are the most common malignant central nervous system tumours in children ${\leq}1year$ of age and represent approximately 1-2% of all pediatric brain tumours. ATRT is a primarily monogenic disease characterized by the bi-allelic loss of the SMARCB1 gene, which encodes the hSNF5 subunit of the SWI/SNF chromatin remodeling complex. Though conventional dose chemotherapy is not effective in most ATRT patients, high dose chemotherapy with autologous stem cell transplant, radiotherapy and/or intrathecal chemotherapy all show significant potential to improve patient survival. Recent epigenetic and transcriptional studies highlight three subgroups of ATRT, each with distinct clinical and molecular characteristics with corresponding therapeutic sensitivities, including epigenetic targeting, and inhibition of tyrosine kinases or growth/lineage specific pathways.

Effects of Costunolide Derived from Saussurea lappa Clarke on Apoptosis in AGS Stomach Cancer Cell Lines

  • Sun, Seung-Ho;Ko, Seong-Gyu
    • 대한한의학회지
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    • 제27권4호
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    • pp.84-95
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    • 2006
  • Costunolide is an active sesquiterpene lactone isolated from the root of Saussurea lappa Clarke and is known to exhibit a variety of biological activities, including anti-carcinogenic and anti-inflammatory effects. Nevertheless, the pharmacological pathways of costunolide have not yet been fully elucidated. In this study, its cytotoxic effects were examined using AGS gastric cancer cells. Its treatment resulted in apoptosis in a dose- and time-dependent manner. The effects were attributed to the regulation of pro-apoptotic molecules and suppression of anti-apoptotic molecules. These results suggest that costunolide may be a candidate to deal with gastric cancers by chemopreventive agents.

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