• Title/Summary/Keyword: clinical pathway

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Job Analysis of Coordinator Working in the Regional Cardiocerebrovascular Center (권역별 심뇌혈관질환센터 코디네이터 직무분석)

  • Cho, Kyung-Sook;Kwon, Sung-Bok;Lee, Kun Sei;Son, Haeng-Mi
    • Journal of muscle and joint health
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    • v.21 no.2
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    • pp.153-163
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    • 2014
  • Purpose: This study was to analyze the job of coordinators working in the regional cardiocerebrovascular center. Methods: Using Developing a Curriculum (DACUM) method, the role of coordinators was defined and their duties and tasks were identified. The developed duties and tasks were classified and validated according to importance, difficulty, and frequency of the job. Results: A coordinator is defined as a clinical nurse specialist affiliated in a cardiocerebrovascular center. The coordinator is responsible for managing the major critical pathway to provide adequate medical service and providing education to the patient with myocardial infarction and cerebrovascular attack admitted via emergency room for prevention and management of disease. Ten duties and sixty-nine tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks showed as A, B, C respectively. Based on determinant coefficient of the task, the highest ranked task was 'analysis for variation of CP' and the lowest was'investing the articles in stock'. Conclusion: The results of study showed that coordinators were doing various duties and tasks and they felt burden from their work and were in confusion. The results of this study can be used to develop training programs for coordinators and evaluation-scale of the coordinators' job performance as the basic data.

The Effects of Injinchunggantang-derivative on Cell Viability, Cell Cycle Progression and Apoptosis of Hepatocytes (인진청간탕가미방(茵陳淸肝湯加味方)이 간세포활성(肝細胞活性), 세포주기(細胞週期) 및 APOPTOSIS에 미치는 영향(影響))

  • Hong, Sang-Hoon;Lee, Jang-Hoon;Woo, Hong-Jung
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.337-372
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    • 1998
  • To evaluate the effects of Injinchunggantang-derivative on cell viability, cell cycle progression, and apoptosis, MTT assay, cell cycle analysis, Cpp32 protease assay, DNA fragnemtation assay, quantitative RT-PCR, and Western blotting were performed. The results were as followes. In MTT assay, etoposide+Injinchunggantang-derivative-treated cells as well as Injinchunggantang-derivative-treated cells showed higher viability than etoposide-treated cells with no time-concentration-dependence, which implied that Injinchunggantang-derivative has hepato-protective effect Cell cycle analysis showed that Injinchunggantang-derivative has no significant effect on the cell cycle. Cpp32 protease assav and DNA fragmentation assay Injinchunggantang-derivative carry inhibitory effects on apoptosis induction. It was suggested that Injinchunggantang-delivative might regulate the cell cycle, in particular $G_1$ checkpoint by blocking p53 and Watl pathway. Injinchunggantang-derivative inhibited the mRNA expressions of Cpp32, Fas, and Bcl-2, which could result in inhibition of apoptosis. These results imply that Injinchunggantang-derivative increases hepatocyte viability, and protects hepatocyte from damage by regulating the expression of genes associated with cell cycle and apoptosis, which explains the mechanism of the clinical effect of Injinchunggantang-derivative on liver diseases.

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The Study on Tajiquan with Three Yin & Yang and Gehapchu Theory (삼음삼양(三陰三陽)과 개합추(開闔樞) 이론(理論)을 활용한 태극권(太極拳) 수련(修練)에 관한 고찰(考察))

  • Kim, Tae-Young;Yoon, Il-Ji;Oh, Min-Suck
    • Journal of Haehwa Medicine
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    • v.14 no.1
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    • pp.141-147
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    • 2005
  • The most fundamental and important medical treatment is science of acupuncture and moxibution, which is based on twelve channels theory. Meridian is a pathway that conveys material and energy in a human body. Twelve channels are divided into channels of hand & foot, channels of yin & yang. Yang channels are divided into taiyang, yangming, shaoyang, yin channels are divided into taiyin, shaoyin, jueyin. These are referred to twelve channels, and this theory is being used for diagnosis and test in oriental medicine. Meridian-doin-tajiquan is born, combining taijiquan which is recently handed down from China and Korean traditional method for health protection and treatment in ancient times and twelve channels, three yin & yang theory. I report this because meridian-doin-tajiquan which is non-medical and non-invasive way can be used in the treatment of disease, just like three yin & yang theory, the heart of the meridian theory, and Gehapchu theory are adjusted in the clinical science of acupuncture and moxibution. And I report this because I could mater the appropriateness of the traditional theory and I believed this corresponded with it, training myself by meridian-din-tajiquan. It is considered that this will be used in the treatment of pain disease of muscles and joints system and the diabetes, hypertension, obesity caused by stress in the near future.

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The Experimental Study on Inhibitory Effects of Wild Ginseng Pharmacopuncture Solution on Melanin Biosynthesis

  • Jo, Na Young
    • Journal of Acupuncture Research
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    • v.35 no.4
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    • pp.182-186
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    • 2018
  • Background: The purpose of this study was to investigate the effects of wild ginseng pharmacopuncture on melanin production in B16/F10 murine melanoma cells. Methods: To determine the effect of wild ginseng pharmacopuncture solution on B16/F10 cells, cytotoxicity was evaluated using the 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyl-tetrazolium bromide (MTT) method. To observe B16/F10 cell growth, death, and morphological changes, Trypan blue solution was used. The Hosoi method was used to investigate the effect of wild ginseng pharmacopuncture solution on melanin production. The Martinez-Esparza method was used to investigate the effect of wild ginseng pharmacopuncture solution on tyrosinase activity. To determine the pathway involved in the melanogenesis in cells exposed to wild ginseng pharmacopuncture solution, a cell-free tyrosinase was used. Results: Following treatment with $200{\mu}L$ of wild ginseng solution, the cell survival rate was $76.32{\pm}2.45%$ which significantly decreased with higher concentrations (${\mu}L$) of wild ginseng (up to $200{\mu}L$). When $100{\mu}L$ of wild ginseng was used, the cell survival rate was $89.95{\pm}2.07%$. No morphological changes or abnormalities were observed in the B16/F10 murine melanoma cells as observed in the Trypan blue test. Melanin production was significantly reduced to $72.17{\pm}3.74%$ at $100{\mu}L$. Using $100{\mu}L$ of wild ginseng solution, tyrosinase activity was significantly decreased to $80.15{\pm}1.05%$. Wild ginseng pharmacopuncture solution reduced melanin production both directly and indirectly. Conclusion: This study suggests that wild ginseng pharmacopuncture solution may be effective in inhibiting melanin production. Further studies are needed to determine safe and effective clinical applications.

A Case of Swyer Syndrome Which showed a Positive SRY Gene in Peripheral Blood and Gonad (말초혈액과 생식선에서 SRY유전자 양성을 보인 Swyer증후군 1례)

  • Nam, Y.S.;Lee, S.H.;Han, J.H.;Cho, S.W.;Yoon, T.K.;Lee, C.N.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.275-280
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    • 1999
  • Male sexual differentiation involves a cascade of events initiated by the presence on the Y chromosome of the of the SRY (sex determining region of Y chromosome) gene, which causes the indifferent gonad to develop into a testis. Hormonal products of the testis, predominantly testosterone and Mullerian inhibiting subtance (MIS), then control the sexual differentiation of the developing fetus. SRY is a transcription factor; however, target genes for its action have yet to be identified, because the DNA recognition sequence for SRY is found in many genes. Therefore the study of intersex disorders is being used to identify other genes active in the pathway of sexual differentiation. Patients with 46,XY gonadal dysgenesis, or Swyer's syndrome, have streak gonads, normal stature, and a sexually infantile phenotype with Mullerian structures present. The inheritance is usually sporadic but can be autosomal dominant or X-linked recessive. Unlike 45,X patients, stigmata of Turner syndrome are rare. As many as 20 to 30% of patients are at risk for malignant gonadal tumor formation and should undergo gonadectomy soon after the diagnosis is made. We have experienced a case of Swyer syndrome which showed a positive SRY gene in peripheral blood and gonad. So we report this case with a brief review of literatures.

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THE EFFECT OF SODIUM FLUORIDE ON THE PHYSIOLOGICAL ROLE OF OSTEOBLASTIC CELL (불화나트륨이 조골세포의 생리적 활성에 미치는 영향)

  • Kim, Dae-Eop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.635-648
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    • 1998
  • The clinical use of fluoride with a well known osteogenic action in osteoporotic patients is rational, because this condition is characterized by impaired bone formation. However, its anabolic effect has not been demonstrated well in vitro. The purpose of this study was to investigate the effects of sodium fluoride on the physiological role of osteoblastic cell. Osteoblastic cells were isolated from fetal rat calvaria. The results were as follows : 1. Mineralized nodules were shown in osteoblastic cell cultures, which had been maintained in the presence of ascorbic acid and ${\beta}-glycerophosphate$ up to 21 days. When cultures were treated with pulses of 48 hr duration before apparent mineralization was occurring, 2-fold increased in their number was detected. 2. Alkaline phosphatase activity of osteoblastic cells was inhibited by sodium fluoride in dose dependent manner. 3. The effect of sodium fluoride on the osteoblastic cell proliferation was measured by the incorporation of $[^3H]$-thymidine into DNA. As a result, sodium fluoride at $1{\sim}100{\mu}M$ increased the $[^3H]$-thymidine incorporation into DNA in a dose dependent manner. 4. The signaling mechanism activated by sodium fluoride dose-dependently enhanced the tyrosine phosphorylation of the adaptor molecule $Shc^{p66}$ and their association with Grb2, one of earlier events in a MAP kinase activation pathway cascade used by a significant subset of G protein-coupled receptors. 5. The phosphorylation of CREB(cAMP response element binding protein)was inhibited by the sodium fluoride in MC3T3E1 cells. In conclusion, the results of this study suggested that the mitogenic effect of the sodium fluoride in MC3T3E1 cell was stimulated in a dose-dependent manner and suggested "an important role for the interaction between She and Grb2" in controlling the proliferation of osteoblasts.

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Cobalt Chloride-induced Apoptosis and Extracellular Signal-regulated Protein Kinase 1/2 Activation in Rat C6 Glioma Cells

  • Yang, Seung-Ju;Pyen, Jhin-Soo;Lee, In-Soo;Lee, Hye-Young;Kim, Young-Kwon;Kim, Tae-Ue
    • BMB Reports
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    • v.37 no.4
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    • pp.480-486
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    • 2004
  • Brain ischemia brings about hypoxic insults. Hypoxia is one of the major pathological factors inducing neuronal injury and central nervous system infection. We studied the involvement of mitogen-activated protein (MAP) kinase in hypoxia-induced apoptosis using cobalt chloride in C6 glioma cells. In vitro cytotoxicity of cobalt chloride was tested by MTT assay. Its $IC_{50}$ value was $400\;{\mu}M$. The DNA fragment became evident after incubation of the cells with $300\;{\mu}M$ cobalt chloride for 24 h. We also evidenced nuclear cleavage with morphological changes of the cells undergoing apoptosis with electron microscopy. Next, we examined the signal pathway of cobalt chloride-induced apoptosis in C6 cells. The activation of extracellular signal-regulated protein kinase 1/2 (ERK 1/2) started to increase at 1 h and was activated further at 6 h after treatment of 400 M cobalt chloride. In addition, pretreatment of PD98059 inhibited cobalt chloride-induced apoptotic cell morphology in Electron Microscopy. These results suggest that cobalt chloride is able to induce the apoptotic activity in C6 glioma cells, and its apoptotic mechanism may be associated with signal transduction via MAP kinase (ERK 1/2).

OSTEOGENESIS BY BMP-2 IN ADULT STEM CELL DERIVED FROM BUCCAL FAT PAD (BMP-2에 의한 협부 지방 성체 줄기세포의 골형성)

  • Kim, Chang-Hyen;Park, Cheol-Hun;Lee, Il-Kyu;Pyo, Sung-Woon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.412-418
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    • 2008
  • Bone morphogenetic proteins (BMPs) in combination with stem cells gain more significance for their use in bone tissue engineering. The mesenchymal stem cell can be differentiated into osteoblast by the treatment of BMP. The aim of this study is to characterize the osteogenic differentiation process of adult stem cells derived from buccal fat pad according to BMP-2 within culture media and decide the appropriate concentration of BMP-2 to facilitate osteogenesis. The authors procured the stem cell from buccal fat pad and analyzed for presence of stem cell by flow cytomety against CD-34, CD-105 and STRO-1. The buccal fat derived stem cells (BFDC) were treated by application of the different concentration with BMP-2 of 0, 10, 50, 100 and 200ng/ml, respectively. And their ability to differentiate into osteogenic pathway were checked by alkaline phosphatase(ALP) staining, Alizarin red staining and RT-PCR for osteocalcin(OC) gene expression at 7, 14 and 21day of culture. Flow cytometric analysis and biochemical assays demonstrated that BFDC might be a distinguished stem cells, and mineralization was accompanied in proportion to BMP-2 concentration. However, with 100ng/ml concentration of BMP-2, the BFDC demonstrated most efficient staining pattern of ALP and Alizarin red. The feasibility of the osteogenic differentiation in the group of both 50ng/ml and 200ng/ml of BMP-2 showed similar activity and relatively weaker than that of 100ng/ml. These results suggest that the BMP-2 stimulate osteogenesis by BFDC effectively and that bone induction might be controlled through negative regulatory feedback in higher concentration.

Effect of 19-norandrostenedione on Steroidogenesis in Rat Testis (19-norandrostenedione이 흰쥐 정소내 스테로이드 대사에 미치는 영향)

  • Kim, Jeong-Wook;Yoon, Yong-Dal
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.3
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    • pp.305-314
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    • 1994
  • 19-norandrostenedione(19-NORA) is known as an intermediate in the metabolic pathway from androstenedione to estrone. Administration of esterified 19-nortestosterone, anabolic steroid, reduces serum gonadotropin and testosterone concentration, and results in reversible azoospermia in men. 19-NORA have been isolated from testis, but its function in testis is not clear yet. Therefore, this study was designed to determine the effect of 19-NORA on steroidogenesis and on spermatogenesis. 19-NORA was administrated by single intratesticular injection to adult male rats weighing 350-400 g in dose of 1 mg/50${\mu}l$. The serum and testis were collected on 1, 3, 7, 12, 48 hr after injection. The histological differences in testis were observed by routine paraffin method. The concentrations of testosterone and estradiol in serum and in left testis were determined by the conventional radioimmunoassays. One hour after 19-NORA treatment, serum concentrations of testosterone and estradiol increased significantly, compared to those of pre-treated(0 hr) group, and reduced gradually to the control level on 7 hour after injection. The concentration of testosterone in left testis increased slightly 1 hour after injection, and estradiol level increased significantly(p<0.05). Also, testosterone and estradiol level of control group revealed no difference with pre-treated (0 hr) group. Gonad index, structure of seminiferous tubules, and the number of step 7 th spermatid were simillar to control group. The present study suggests that the elevation of testosterone level results from increment of estradiol followed by the rapid metabolism of 19-NORA at 7 hour after injection, and then testosterone concentration may be recovered to control level by feedback mechanism of hypothalamus-hypothysis-testis axis.

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Ameliorative effects of black ginseng on nonalcoholic fatty liver disease in free fatty acid-induced HepG2 cells and high-fat/high-fructose diet-fed mice

  • Park, Miey;Yoo, Jeong-Hyun;Lee, You-Suk;Park, Eun-Jung;Lee, Hae-Jeung
    • Journal of Ginseng Research
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    • v.44 no.2
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    • pp.350-361
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    • 2020
  • Background: Black ginseng (BG) is a type of Korean ginseng prepared by steaming and drying raw ginseng to improve the saponin content. This study examined the effects of BG on nonalcoholic fatty liver disease (NAFLD) in HepG2 cells and diet-induced obese mice. Methods: HepG2 cells were treated with free fatty acids to induce lipid accumulation before supplementation with BG. NAFLD-induced mice were fed different doses (0.5%, 1%, and 2%) of BG for 8 weeks. Results: BG significantly reduced lipid accumulation and expression of lipogenic genes, peroxisome proliferator-activated receptor gamma, CCAAT/enhancer-binding protein alpha, sterol regulatory element-binding protein-1c, and fatty acid synthase in HepG2 cells, and the livers of mice fed a 45% high-fat diet with 10% fructose in the drinking water (HFHF diet). BG supplementation caused a significant reduction in levels of aspartate aminotransferase and alanine aminotransferase, while antioxidant enzymes activities were significantly increased in 45% high-fat diet with 10% fructose in the drinking water diet-fed mice. Expression of proliferator-activated receptor alpha and carnitine palmitoyltransferase I were upregulated at the transcription and translation levels in both HepG2 cells and diet-induced obese mice. Furthermore, BG-induced phosphorylation of AMP-activated protein kinase and acetyl CoA carboxylase in both models, suggesting its role in AMP-activated protein kinase activation and the acetyl CoA carboxylase signaling pathway. Conclusion: Our results indicate that BG may be a potential therapeutic agent for the prevention of NAFLD.