• 제목/요약/키워드: clinical pathway

검색결과 615건 처리시간 0.034초

해마와 정신분열병 (Hippocampus and Schizophrenia)

  • 정영철
    • 생물정신의학
    • /
    • 제10권1호
    • /
    • pp.20-44
    • /
    • 2003
  • Schizophrenics suffer not only psychotic symptoms but also cognitive deficits such as an attentional difficulty, memory impairment, poor abstraction, etc. These cognitive abnormalities have been reported to be significantly related to the social and occupational outcome in schizophrenia. Thus, it is important to explore the cause and pathophysiology for the cognitive abnormalities in patients with schizophrenia. In this regard, hippocampus is one of the most promising brain areas to search for the clue because it is closely involved in memory related function. In fact, during the past several decades, there have been extensive studies supporting hippocampal abnormalities as a cause of schizophrenia in both clinical and preclinical field. In this review, basic anatomical knowledge about hippocampus and major findings of preclinical and clinical studies which investigated the correlation between schizophrenia and hippocampus were highlighted. The contents are 1) anatomical structure of hippocampus, 2) neuronal pathway and receptor distribution in hippocampus, 3) function of hippocampus, 4) hippocampal animal model for schizophrenia, 5) hippocampus-related studies on antipsychotic drugs, and 6) clinical studies in hippocampus in patients with schizophrenia.

  • PDF

Mouse models of breast cancer in preclinical research

  • Park, Mi Kyung;Lee, Chang Hoon;Lee, Ho
    • Laboraroty Animal Research
    • /
    • 제34권4호
    • /
    • pp.160-165
    • /
    • 2018
  • Breast cancer remains the second leading cause of cancer death among woman, worldwide, despite advances in identifying novel targeted therapies and the development of treating strategies. Classification of clinical subtypes (ER+, PR+, HER2+, and TNBC (Triple-negative)) increases the complexity of breast cancers, which thus necessitates further investigation. Mouse models used in breast cancer research provide an essential approach to examine the mechanisms and genetic pathway in cancer progression and metastasis and to develop and evaluate clinical therapeutics. In this review, we summarize tumor transplantation models and genetically engineered mouse models (GEMMs) of breast cancer and their applications in the field of human breast cancer research and anti-cancer drug development. These models may help to improve the knowledge of underlying mechanisms and genetic pathways, as well as creating approaches for modeling clinical tumor subtypes, and developing innovative cancer therapy.

Wolff-Parkinson-White syndrome in young people, from childhood to young adulthood: relationships between age and clinical and electrophysiological findings

  • Jung, Hae-Jung;Ju, Hwang-Young;Hyun, Myung-Chul;Lee, Sang-Bum;Kim, Yeo-Hyang
    • Clinical and Experimental Pediatrics
    • /
    • 제54권12호
    • /
    • pp.507-511
    • /
    • 2011
  • Purpose: The aim of the present study was to evaluate the characteristics of electrophysiologic studies (EPS) and radiofrequency ablation (RFA) performed in subjects aged less than 30 years with Wolff-Parkinson-White (WPW) syndrome, particularly pediatric patients under 18 years of age, based on our experience. Methods: Two hundred and one consecutive patients with WPW syndrome were recruited and divided to 3 groups according to age: group 1, 6 to 17 years; group 2, 18 to 29 years; and group 3, 30 to 60 years. The clinical, electrophysiological, and therapeutic data for these patients were evaluated by a retrospective medical record review. Results: A total of 73 (36%) of these patients were <30 years of age. Although there were more males than females in group 2 (male:female, 31:11), there was no sex difference in group 1 (male:female, 16:15). Left accessory pathway was detected less frequently in group 1 (32%, 10/31) than in group 2 (57%, 24/42) and group 3 (63%, 81/128) (P=0.023 and P=0.002, respectively). Conclusion: The present study describes several different electrophysiological characteristics in children and adolescents with WPW syndrome. Therefore, when EPS and RFA are performed in children and adolescence with WPW syndrome, we recommend that these characteristics be considered.

Neuronal Apoptosis: Pathological Basis of Behavioral Dysfunctions Induced by Angiostrongylus cantonensis in Rodents Model

  • Luo, Shiqi;OuYang, Lisi;Wei, Jie;Wu, Feng;Wu, Zhongdao;Lei, Wanlong;Yuan, Dongjuan
    • Parasites, Hosts and Diseases
    • /
    • 제55권3호
    • /
    • pp.267-285
    • /
    • 2017
  • Angiostrongylus cantonensis invades the central nervous system (CNS) of humans to induce eosinophilic meningitis and meningoencephalitis and leads to persistent headache, cognitive dysfunction, and ataxic gait. Infected mice (nonpermissive host), admittedly, suffer more serious pathological injuries than rats (permissive host). However, the pathological basis of these manifestations is incompletely elucidated. In this study, the behavioral test, histological and immunohistochemical techniques, and analysis of apoptotic gene expression, especially caspase-3, were conducted. The movement and motor coordination were investigated at week 2 post infection (PI) and week 3 PI in mice and rats, respectively. The cognitive impairs could be found in mice at week 2 PI but not in rats. The plaque-like lesion, perivascular cuffing of inflammatory cells, and dilated vessels within the cerebral cortex and hippocampus were more serious in mice than in rats at week 3 PI. Transcriptomic analysis showed activated extrinsic apoptotic pathway through increased expression of TNFR1 and caspase-8 in mice CNS. Immunohistochemical and double-labeling for NeuN and caspase-3 indicated the dramatically increased expression of caspase-3 in neuron of the cerebral cortex and hippocampus in mice but not in rats. Furthermore, western-blotting results showed high expression of cleaved caspase-3 proteins in mice but relatively low expression in rats. Thus, extrinsic apoptotic pathway participated in neuronal apoptosis might be the pathological basis of distinct behavioral dysfunctions in rodents with A. cantonensis infection. It provides the evidences of a primary molecular mechanism for the behavioral dysfunction and paves the ways to clinical diagnosis and therapy for A. cantonensis infection.

무릎 관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 전자우편 설문 조사 (E-mail Survey for Developing Clinical Trial Protocol on Individualized Acupuncture Treatment for Knee Osteoarthritis)

  • 이승덕;김선웅;최선미;서정철;이상훈;김용석
    • Journal of Acupuncture Research
    • /
    • 제22권4호
    • /
    • pp.197-204
    • /
    • 2005
  • Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture prescriptions for knee osteoarthritis in real clinical practice. Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. The questionnaires were distributed via e-mail to 3,306 members of Korea Oriental Medical Association from March 15th to March 23rd in 2005.84 members completed answers, and the computerized data were analyzed by ISP statistical program. Results : 1. 68 out of 84 Korean medical doctors used pattern diagnosis. 2. 61 out of 84 Korean medical doctors used both local and remote points, 20 doctors remote points only, and 3 doctors local acupuncture points only. 3. In case of doctors who use remote acupuncture points only, the acupuncture prescription principle was Saam or five element acupuncture (66%), along the meridian pathway (14%), Eight constitutional acupuncture (11%), Taegeuk acupuncture (2%), and miscellaneous (18%). Conclusion : In our e-mail survey, Korean medical doctors who experienced more than 10 year practice answered that they use five element acupuncture or Saam acupuncture according to meridian pathway theory as the most common principle of their acupuncture treatment prescription.

  • PDF

CT-26 대장암 세포에서 Dominant Negative ATM 유전자에 의하여 유도되는 세포자멸사의 경로 (Apoptotic Pathway Induced by Dominant Negative ATM Gene in CT-26 Colon Cancer Cells)

  • 이정창;이호근;김선영;이대열;황평한;박진우
    • Clinical and Experimental Pediatrics
    • /
    • 제46권7호
    • /
    • pp.679-686
    • /
    • 2003
  • 목 적 : AT는 드물게 발생하는 상염색체성 열성질환으로, 소뇌의 퇴화에 의한 운동장애와, 암 발생의 소인이 증가하는 등 많은 임상적 징후가 보인다. AT 질환을 유발하는 ATM 유전자는 DNA 손상시 세포주기 정지를 유도시키지 못하며, 방사선 조사 후 세포 생존력을 유지시키지 못하여 세포자멸사를 유도하게 된다. 따라서 암세포에 DN-ATM 유전자를 발현시켜 AT 세포의 표현형으로 변화시킨다면, 이러한 암세포는 방사선에 의해 유도되는 세포자멸사가 훨씬 더 증가된다. 그러나 지금까지 ATM 세포에서 방사선에 의해 야기되는 세포자멸사 경로는 밝혀져 있지 않다. 그러므로 본 연구에서는 DN-ATM이 발현되는 CT-26 대장암 세포를 이용하여 방사선 조사 후에 유도되는 세포자 멸사 경로를 구명하고자 하였다. 방 법 : DN-ATM 아데노바이러스(Ad/DN-ATM)와 표식 유전자 GFP만을 함유한 대조 아데노바이러스(Ad/GFP)를 제작하여 CT-26 세포에 감염시켰다. DN-ATM이 발현되는 CT-26세포에서 방사선 조사로 유도되는 세포자멸사 경로는 [$^3H$]-thymidine assay, DNA fragmentation, 및 Western immunoblot analysis으로 실험하였다. 결 과 : 실험 결과에서 방사선 조사 후 세포의 성장이 감소하는 것으로 보아 CT-26 대장암 세포가 AT 환자에서 보여지는 표현형으로 변화되었다는 것을 보여주었고, 방사선 조사에 의한 세포자멸사가 유도되었다. 방사선 조사 후 시간이 지날수록 Bcl-2의 발현이 감소되고, Bax의 발현이 증가하며, caspase 9, caspase 3 및 PARP가 활성화되었다. 결 론: 이러한 실험 결과들은 DN-ATM이 발현되고 있는 CT-26 세포에서 방사선 조사 후 야기되는 세포자멸사 경로는 미토콘드리아를 통하여 caspase 9, caspase 3와 PARP의 활성에 의해 일어나는 세포자멸사임을 시사한다.

가려움증의 신경전달 경로 (The Neurotransmitter Pathway of Itching)

  • 조정원;김지연
    • 생명과학회지
    • /
    • 제27권5호
    • /
    • pp.600-610
    • /
    • 2017
  • 가려움증의 분류는 수용체성 가려움증(Pruritoceptive itch), 신경병증 가려움증(Neuropathic itch), 신경성 가려움증(Neurogenic itch), 심인성 가려움증(Psychogenic itch)의 신경생리학적 기전에 따른 4가지 카테고리로 분류하는 것이 일반적이었으나 최근 임상적인 기준을 통해 분류하기도 한다. 가려움증의 신경전달 경로는 히스타민-의존 경로와 히스타민-비의존 경로 2가지로 나뉘며 각 가려움증 매개체마다 서로 다른 수용체와 신경펩티드가 작용한다. 히스타민, BAM8-22, chloroquine 등의 가려움증 매개체는 히스타민-의존 경로를 통해 신호가 전달되며 cowhage spicule, 단백분해효소(protease), TSLP (Thymic stromal lymphopoietin) 등의 매개체가 히스타민-비의존 경로와 관련있다는 보고가 있다. 이러한 가려움증 매개체, 수용체, 신경펩티드는 가려움증 치료의 대상이 된다. 가려움증과 통증은 대표적인 유해자극으로서 과거에는 두 감각이 하나의 유해자극수용체를 통해 전달된다는 주장이 있었지만 최근 밝혀진 바에 따르면 가려움증과 통증은 독립적인 신경전달체계를 가지고 있으며 두 신경체계는 서로 억제작용을 한다. 가려움증 뉴런의 선택적 소집단이 존재한다는 주장을 뒷받침하는 연구들이 이 주장에 무게를 싣고 있다. 또한 가려움증과 통증의 상호 길항작용에 대해서도 다양한 기전으로 설명되고 있다. 최근에도 새롭게 연구되는 매개체와 수용체들이 많은 연구들을 통해 밝혀지고 있다. 특히 최근에는 히스타민 4 수용체에 대한 연구가 활발히 진행되고 있는데, 이는 T 세포 같은 면역세포 자체에 발현되어 있어 이 H4 수용체를 차단하는 치료제는 말초의 매개체를 차단하는 기존의 히스타민 수용체 차단제와는 달리 가려움증 만성화에 중요한 염증 반응 자체를 억제할 수 있다는 점에서 그 유용성이 크다고 할 수 있다. 가려움증의 기본적인 발생 기전에 대한 이해와 새로운 가려움증 매개체에 대한 연구는 효과적인 치료법의 개발로 이어질 것이며 이것이 가려움증 연구가 나아갈 바로 생각한다.

측두하악관절 장애에 대한 임상진단의 유효성 연구 (EVALUATION OF CLINICAL METHODS IN THE DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DISORDERS: A COMPARISON STUDY WITH MAGNETIC RESONANCE IMAGING)

  • 김형욱;신성수;김종식;김기영;김윤지;홍순민;천세환;박양호;최원철;박준우
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제33권4호
    • /
    • pp.367-374
    • /
    • 2007
  • Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

FK506과 cyclosporin A가 기관지상피세포, 단핵구, 림프구 및 폐포대식세포에서 $I{\kappa}B{\alpha}$ 분해 및 $IKK{\alpha}$ 활성에 미치는 효과 (Effect of FK506 and Cyclosporin A on $I{\kappa}B{\alpha}$ Degradation and $IKK{\alpha}$ Pathway in Bronchial Epithelial Cells, Monocytes, Lymphocytes and Alveolar Macrophages)

  • 윤호일;이창훈;이희석;이춘택;김영환;한성구;심영수;유철규
    • Tuberculosis and Respiratory Diseases
    • /
    • 제54권4호
    • /
    • pp.449-458
    • /
    • 2003
  • 연구배경 : Cyclosporin A(CsA)와 tacrolimus(FK506)은 현재 임상에서 널리 쓰이는 면역억제제이다. CsA와 FK506이 $I{\kappa}B/NF-{\kappa}B$ 경로에 미치는 영향에는 세포에 따라 다양한 효과가 알려져 있다. 그러나 CsA와 FK506이 기관지 상피세포에서 $I{\kappa}B/NF-{\kappa}B$ 경로에 미치는 효과에 관해서는 알려져 있지 않고, 각종 염증 세포에서의 차이에 관해서도 보고가 미미한 실정이다. 본 연구에서는 비염증세포인 기관지상피세포와, 폐의 염증에 중요한 역할을 하는 염증 세포(폐포대식세포, 단핵구, 림프구)에서 CsA와 FK506이 $I{\kappa}B{\alpha}$의 분해에 미치는 영향과 그 기전을 평가하였다. 방 법 : 비염증세포로는 BEAS-2B와 A549 세포주를 이용하였다. FK506 또는 CsA 전처치 후 TNF-${\alpha}$로 자극하고 anti-$I{\kappa}B{\alpha}$ 항체를 이용한 Western blot으로 $I{\kappa}B{\alpha}$의 분해 여부를 관찰하였다. 염증세포로는 폐포대식세포, 말초혈액 단핵구 및 림프구를 이용하였고, 역시 FK506 또는 CsA 전처치 후 TNF-${\alpha}$, IL-$1{\beta}$, LPS로 자극하고 anti-$I{\kappa}B{\alpha}$ 항체를 이용한 Western blot으로 $I{\kappa}B{\alpha}$의 분해 여부를 관찰하였다. IKK의 활성도는 GST-$I{\kappa}B{\alpha}$를 기질로 이용한 in vitro immune complex kinase assay로 평가하였다. 결 과 : 사용된 모든 세포에서 CsA와 FK506은 $I{\kappa}B{\alpha}$의 발현에 영향을 미치지 않았다. 기관지 상피세포에서 TNF-${\alpha}$ 자극에 의한 $I{\kappa}B{\alpha}$의 분해는 CsA의 전처치로 억제되었으나, FK506의 전처치로는 억제되지 않았다. 단핵구, 림프구 및 폐포대식세포에서 외부자극에 의한 $I{\kappa}B{\alpha}$의 분해는 CsA 또는 FK506의 전처치로 억제되었으나 IKK활성은 억제되지 않았다. 결 론 : CsA와 FK506은 각각 기관지 상피세포와 단핵구, 림프구, 폐포대식세포에서 외부 자극에 의한 $I{\kappa}B{\alpha}$의 분해를 억제하는데, 이는 IKK 활성화의 억제가 아닌 다른 경로를 통하는 것으로 생각된다.

Smooth Muscle Relaxation by the Herbal Medicine Ssanghwatang associated with Nitric Oxide Synthase Activation and Nitric Oxide Production

  • Kim, Joong-Kil;Shim, Ha-Na;Lee, Seung-Hee;Yoo, Kwan-Suk;Song, Bong-Keun
    • 대한한의학회지
    • /
    • 제27권4호
    • /
    • pp.74-83
    • /
    • 2006
  • Ssanghwatang (SHT) has been known to prove effective in the treatment for erectile dysfunction (ED), and its modified formula is widely used in clinical practice. However, its fundamental mechanism of action is not clearly known. It is well known that endothelial cells can achieve the relaxation of vascular smooth muscles by the release of nitric oxide (NO). NO is synthesized by the enzyme NO synthase (NOS) from L-arginine and oxygen. It is widely accepted that NO plays an important role in the relaxation of corpus cavernous smooth muscle and vasculature. In addition, in terms of the penile erection, the NO/cGMP pathway is more potent than the PCE1/cAMP pathway. The main purpose of the present study was to investigate the mechanism of the erectile effects of SHT by focusing on its direct effects on corpus cavernous smooth muscle cells. We investigated the NOS activity, nitrite concentration and cGMP levels in rat corpus cavernous smooth muscle cell lines activated by SHT extracts. Furthermore, we evaluated the effect of SHT extracts on penile smooth muscle relaxation following oral administration of SHT extract powder to rats by the dosage of 1 g/kg over fifteen days. As a result, we found that SHT stimulated NO release. NOS activity and cGMP levels were increased by SHT respectively. Furthermore, SHT relaxed the corpus cavernous smooth muscle. These results are consistent with the concept that penile erection by SHT is carried out through the NO/cGMP pathway. In conclusion, the present study shows that SHT increases the NOS activity, synthesizes NO and augments the cGMP, which mediates penile erection. Further determination of the SHT mechanism related with the NO/cGMP pathway strongly indicates that SHT can be used as a remedy for erectile impotence.

  • PDF