• Title/Summary/Keyword: systemic approach

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Genetics of Pre-eclampsia

  • Kim, Shin-Young;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.17-27
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    • 2011
  • Pre-eclampsia is a major cause of maternal and perinatal mortality and morbidity worldwide, but remains unclear about the underlying disease mechanisms. Pre-eclampsia is currently believed to be a two-stage disease. The first stage involves shallow cytotrophoblast invasion of maternal spiral arteriole, resulting in placental insufficiency. The hypoxic placenta release soluble factors, cytokines, and trophoblastic debris into maternal circulation, which induce systemic endothelial damage and dysfunction. This cause the second stage of the disease: maternal syndrome. Epidemiological research has consistently demonstrated a familial predisposition to pre-eclampsia. Intensive research efforts have been made to discover susceptibility genes that will inform our understanding of the pathophysiology of preeclampsia and that may provide direction for therapeutic or preventative strategies. In this review, we summarize the current understanding of the role of genetic factors in the pathophysiology of pre-eclampsia and explain the molecular approach to search for genetic clues in pre-eclampsia.

Comparative Proteomic Analyses of Synovial Fluids and Serums from Rheumatoid Arthritis Patients

  • Noh, Ran;Park, Sung Goo;Ju, Ji Hyeon;Chi, Seung-Wook;Kim, Sunhong;Lee, Chong-Kil;Kim, Jeong-Hoon;Park, Byoung Chul
    • Journal of Microbiology and Biotechnology
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    • v.24 no.1
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    • pp.119-126
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    • 2014
  • Rheumatoid arthritis (RA) is a chronic and systemic inflammatory disorder that primarily affects the flexible joints and may also affect a number of tissues and organs. The progression of RA involves an inflammatory response of the capsule around the joint, swelling of synovial cells with excess synovial fluid (SF), and the development of fibrous tissue in the synovium. Since the progressive pathology of the disease often leads to the irreversible destruction of articular cartilage and ankylosis of the joint, early diagnosis of RA is essential. Thus, we undertook a comparative proteomic approach to investigate novel biomarkers for early diagnosis using SFs and serums from RA patients. As a result, we identified 32 differentially expressed spots in SFs and 34 spots in serums. The differential expression of the STEAP4 and ZNF 658 proteins were validated using immunoblotting of the SFs and serums, respectively. These data suggest that differentially expressed proteins in SFs and serums could be used as RA-specific biomarkers for the diagnosis and monitoring of RA. Furthermore, these findings advance our understanding of the molecular etiopathogenesis of RA.

A Study on SNP of IL10 in Cerebral Infarction Patients

  • Jung, Tae-Young;Choi, Sung-Hun;Kim, Kyung-Woon;Lee, Yoon-Kyung;Lim, Seong-Chul;Lee, Kyung-Min;Seo, Jung-Chul
    • Journal of Acupuncture Research
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    • v.23 no.2
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    • pp.173-179
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    • 2006
  • Objectives : In this study, we investigated the SNP (single-nucleotide polymorphism) of IL10 in patients with stroke. The present study was undertaken to see if specific genotypic and allelic variations are associated with stroke in the Korean population. Methods : Blood samples from all subjects were obtained for DNA extraction and collected in EDTA tube. Genomic DNA was extracted using DNA isolation kit for Mammalian Blood (Boehringer Mannheim, IN, USA). The extracted DNA was amplified by polymerase chain reaction (PCR). Pyrosequencing was performed according to manufacturer's standard protocol. Results : There was no statistically significant genotypic distribution difference between control and stroke group. The frequencies of A/A homozygotes and A/C heterozygotes among control subjects were 91 (87.5%) and 13 (12.5%). The frequencies of A/A and A/C among the stroke patients were 85 (89.5%) and 10 (10.5%). There was not statistically significant allelic frequency difference between control and stroke group. The allelic frequency of A and C was 195 (93.8%) and 13 (6.2%) among the control subjects and 180 (94.7%) and 10 (5.3%) in stroke patients, respectively. Conclusion : The cytokine IL10 may not be pathogenetic factors in stroke. But further studies including different cytokine gene can be a useful for predicting stroke. Establishment of more systemic approach and high quality of prospective cohorts will be necessary for the good prediction of genetic markers.

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Influence of Phenobarbital on the Hepatic Clearance of Organic Anionic Drugs in Rats - On the Basis of Pharmacokinetics of Indocyanine Green - (Rat에 있어서 Phenobarbital이 유기음이온성 의약품의 간클리어란스에 미치는 영향 - Indocyanine Green의 체내동태를 중심으로 -)

  • Lee, Yong-Bok;Shin, Sang-Chul;Koh, Ik-Bae
    • Korean Journal of Clinical Pharmacy
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    • v.3 no.1
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    • pp.31-43
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    • 1993
  • The influence of phenobarbital(PB) pretreatment(75mg/kg/day, Lp. for 4 days) on the hepatic clearance of indocyanine green(ICG) as a model compound of organic anionic drugs was investigated in rats in order to elucidate the relative contributions of change in the hepatic blood flow versus increase in the hepatic intrinsic activity to remove ICG due to PB pretreatment. ICG(1mg/kg) was injected single bolus via femoral or portal vein to the control and the PB-pretreated rats. The initial hepatic uptake clearance$(V_{d.c.}K_{12})$ obtained from plasma concentration-time data was increased by $38.4\% in the PB-pretreated rats, which may be due to the increased hepatic blood flow by PB pretreatment. Using a pharmacokinetic approach, hepatic blood flows were estimated of 67.5ml/min/kg in control rats and 91.9ml/min/kg in PB-pretreated rats. They were in good agreement with other's blood flow estimates observed experimentally. It may be concluded that the $38\%$ increased initial hepatic uptake clearance of ICG was due to the $36\%$ increased hepatic blood flow with phenobarbital, and that the increased hepatic blood flow and the activated hepatic intrinsic clearance with phenobarbital contributed to $49\%\;and\;51\%$ of the increased systemic clearance of ICG, respectively.

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A Case Study on R&D Process Innovation Using PI6sigma Methodology (PI6sigma를 이용한 R&D 프로세스 혁신 사례 연구)

  • Kim, Young-Jin;Jeong, Woo-Cheol;Choi, Young-Keun
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.33 no.1
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    • pp.17-23
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    • 2010
  • The corporate R&D(Research and Development) has a primary role of new product development and its potential is the most crucial factor to estimate corporate future value. However, its systemic inadequacies and inefficiencies, the shorten product life-cycle to satisfy customer needs, the global operations by outsourcing strategy, and the reduction of product cost, are starting to expose to R&D business processes. The three-phased execution strategy for R&D innovation is introduced to establish master plan for new R&D model. From information technology point of view, PLM(Product Life-cycle Management) is one of the business total solutions in product development area. It is not a system, but the strategic business approach that collaboratively manage the product from beginning stage to end of life in all business areas PLM functions and capabilities are usually used as references to re-design new R&D process. BPA(Business Process Assessment) and 5DP(Design Parameters) in PI6sigma developed by Samsung SDS Consulting division are introduced to establish R&D master plan and re-design process respectively. This research provides a case study for R&D process innovation. How process assessment and PMM(Process Maturity Model) can be applied in business processes, and also it explains process re-design by 5DP method.

Suggestions for the Work of Dental Hygienists and a Reflection of Health Insurance Charges according to Demographic Changes

  • Lee, Myung-Jin;Oh, Sang-Hwan
    • Journal of dental hygiene science
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    • v.20 no.1
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    • pp.1-8
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    • 2020
  • Given that the demand for dental care for elderly individuals is expected to increase according to demographic changes, long-term roadmaps for the current health insurance system should be actively planned. The study aimed to investigate the health insurance system in Korea, compared to that of Japan, and suggest directions for the work of dental hygienists to provide basic data on efficient improvements in the health insurance system. Based on the collected data, the website was used to collect additional related data from Korea and Japan. The most common cause of death in Korea was malignant neoplasms, and most patients were hospitalized for diseases and disorders of the musculoskeletal system and connective tissue. Dental care covered by Korean medical insurance for individuals aged 65 years or older was treatment oriented, such as dentures and implants, while in Japan, treatment-intensive items, such as visiting a dental hygienist for guidance and provision of home-care professional oral hygiene treatment, were covered. The percentages of remaining teeth in Korea and the percentage of remaining 20 teeth were 68.9% in those aged 65 to 74 years and 51.2% in those aged 75 to 84 years in Japan. A strategy for promoting oral health among elderly individuals should be established, and a multilateral intervention approach is required to prevent oral problems from leading to deterioration of whole-body health. The role of dental hygienists in providing comprehensive assessment to elderly individuals is important. In order to provide systemic oral care, it is necessary to introduce oral care systems according to the national policy.

Review about using Herbal medicine on steroid tapering and steroid overuse in Skin disease (피부과 영역에서 steroid 테이퍼링 및 남용 완화를 위한 한약 사용에 대한 고찰)

  • Han, Chang-Yi;Kim, Jun-Dong;Kang, Dong-Won;Kim, Kyu-Seok;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.3
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    • pp.115-124
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    • 2020
  • Objectives : The purpose of this study is to investigate the effect and side effects of steroids on dermatitis and skin barrier through lipid metabolism. And to propose using Herbal medicine to suppress Steroid rebound and prevent side effects. Methods : We reviewed recent studies about the relationship between dermatitis, skin lipid, steroid, and herbal medicine through Google scholar. Results : In various inflammatory skin diseases, the corticosteroid is selected as the primary drug due to its strong anti-inflammatory and immunosuppressive effect. However, long-term use of steroids has a variety of side effects, especially lipid metabolism disruption, which aggravates skin barrier damage underlying various skin diseases and is more susceptible to inflammatory reactions. Conclusions : Herbal medicine is used as a comprehensive approach, and it can be used to reduce the frequency of steroid exposure by protecting against barrier damage by controlling anti-inflammatory, antioxidant, and systemic/sebaceous lipid metabolism and stratum corneum protein differentiation.

A Proposal and Considerations for Treatment Approaches of Psoriasis (건선의 치료 접근법에 대한 고찰 및 제언)

  • Kang, Dong-Won;Han, Chang-Yi;Kim, Jun-Dong;Kim, Kyu-Seok;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.3
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    • pp.99-114
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    • 2020
  • Objectives : To investigate treatment approaches of psoriasis, and to provide universal and holistic standards to assist in optimizing patient care and future research. Methods : Review articles of psoriasis regarding pathophysiology, risk factor or treatment were searched from Pubmed (January 2016 to June 2020). Treatment approaches were investigated based on the searched articles. Additional data collecting was done for further discussion by searching Pubmed and Google scholar with keywords relevant to the approaches, and the relevant references of articles retrieved were manually inspected to be included. Results : Modalities to directly regulate the relevant helper T cell or inflammatory cytokines can constitute the treatment approaches of psoriasis. Modalities to treat gastrointestinal tract inflammation, to correct metabolic syndrome and to improve epidermal lipid abnormality via whole body lipid metabolism can also constitute the treatment approaches of psoriasis. Probable adverse effects of long term use of western medication should be addressed carefully, and alleviating the hazards of western medication can be a treatment approach of psoriasis. Conclusion : Treatment of psoriasis should take account of systemic aspects such as gastrointestinal tract and lipid metabolism. Treatment approaches of psoriasis established on the pathophysiological basis can serve as universal standards.

Radionuclide Angiocardiographic Evaluation of Left-to-Right Cardiac Shunts: Analysis of Time-Activity Curves (핵의학적 심혈관 촬영술에 의한 좌우 심단락의 진단 : 시간-방사능 곡선의 분석)

  • Kim, Ok-Hwa;Bahk, Yong-Whee;Kim, Chi-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.2
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    • pp.155-165
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    • 1987
  • The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis-of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atrium, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intra cardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs, intracardiac shunt could be differenciated from extracardiac shunts.

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Radiopharmaceuticals for the Therapy of Metastatic Bone Pain (뼈전이의 방사성동위원소 통증치료)

  • Ahn, Byeong-Cheol
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.82-89
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    • 2006
  • Bone metastasis is a common sequelae of solid malignant tumors such as prostate, breast, lung, and renal cancers, which can lead to various complications, including fractures, hypercalcemia, and bone pain, as well as reduced performance status and quality of life it occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequelae occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. A multidisciplinary approach is usually required not only to address the etiology of the pain and its complicating factors but also to treat the patient appropriately. Pharmaceutical therapy of bone pain, includes non-steroidal analgesics, opiates, steroids, hormones, bisphosphonates, and chemotherapy. While external beam radiation therapy remains the mainstay of pain palliation of a solitary lesions, bone seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. $^{32}P,\;^{89}SrCl,\;^{153}Sm-EDTMP,\;^{188}Re/^{186}Re-HEDP,\;and\;^{177}Lu-EDTMP$ can be used to treat painful osseous metastases. These various radiopharmaceuticals have shown good efficacy in relieving bone pain secondary to bone metastasis. This systemic form of metabolic radiotherapy is simple to administer and complements other treatment options. This has been associated with improved mobility in many patients, reduced dependence on narcotic and non-narcotic analgesics, improved performance status and quality of life, and, in some studios, improved survival. All of these agents, although comprising different physical and chemical characteristics, offer certain advantages in that they are simple to administer, are well tolerated by the patient if used appropriately, and can be used alone or in combination with the other forms of treatment. This article illustrates the salient features of these radiopharmaceuticals, including the usual therapuetic dose, method of administration, and indications for use and also describe about the pre-management checklists, and jndication/contraindication and follow-up protocol.