• Title/Summary/Keyword: Care pathway

Search Result 170, Processing Time 0.027 seconds

Effect of Rhei Rhizoma and Scutellariae Radix Mixture in Chronic Acid Reflux Esophagitis Rats (만성 역류성 식도염에서 황련과 오수유 혼합물이 식도 점막에 미치는 영향)

  • Lee, Jin A;Oh, Min Hyuck;Shin, Mi-Rae;Roh, Seong-Soo;Park, Hae-Jin
    • Korean Journal of Pharmacognosy
    • /
    • v.52 no.3
    • /
    • pp.177-185
    • /
    • 2021
  • Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder in which stomach contents reflux into the esophagus, causing complications such as mucosal damage. The purpose of this study was to determine the effect of Rhei Rhizoma and Scutellariae Radix mixture (RS) in chronic acid reflux esophagitis (CARE), one of the GERD. After inducing reflux esophagitis through surgery, the group was separated and the drug was administered for 2 weeks; Normal rats (Normal, n=8), chronic acid reflux esophagitis rats (Control, n=8), tocopherol 30 mg/kg-treated chronic acid reflux esophagitis rats (Toco, n=8), Rhei Rhizoma and Scutellariae Radix mixture 100 mg/kg-treated chronic acid reflux esophagitis rats (RSL, n=8), Rhei Rhizoma and Scutellariae Radix mixture 200 mg/kg-treated chronic acid reflux esophagitis rats (RSH, n=8). Gross lesion of esophageal mucosa after RS treatment showed a superior enhancement compared with that of Control group. Additionally, RS significantly decreased the levels of MPO and MDA, effectively inhibited NADPH oxidase, and regulated the expression of the AMPK/LKB1/NF-κB pathway. Moreover, it significantly increased the expression of tight junction proteins. Taken together, RS not only alleviates inflammation of the esophageal mucosa via the AMPK/LKB1/NF-κB pathway by reducing oxidative stress, but also improves esophageal function by modulating tight junction proteins.

Examination of Generating Mechanism Concerning Father's Participation in Child-rearing (맞벌이 가정 부친의 육아참가 발생과정)

  • Park, Ji-Sun;Kondo, Rie;Kim, Jung-Suk;Sasai, Tsukasa;Takahashi, Shigesato;Park, Chun-Man;Nakajima, Kazuo
    • Korean Journal of Health Education and Promotion
    • /
    • v.26 no.5
    • /
    • pp.57-70
    • /
    • 2009
  • Objectives: This purpose of this study was to make clear the fitness to data of the causality model related to father's child-rearing participation in a double-income household. Methods: Subjects of this survey consisted of the fathers of 2,006 households that use 21 day-care centers and 4 kindergartens whose cooperation was received via the city government departments that have jurisdiction over day-care centers and kindergartens in cities A and B in prefecture I and in city C in prefecture II (city A: 499 households; city B: 1,113 households; city C: 988 households). The surveyed items consisted of the father's age, the father's educational history, the number of children, the age of the youngest child, the father's parental-role awareness, the father's daily working hours, the father's return-home time, and child-rearing participation by the father. Results: The fit indices were found to be CFI = 0.912, GFI = 0.948, and RMSEA = 0.082. Regarding the path coefficients, the path coefficient of the pathway from the age of the youngest child to the father's parent positivity (0.08) and the path coefficient of the pathway from the father's parent positivity to child-rearing participation (0.19) were both at statistically significant levels. Also, the father's return-home time and the working hours, which were considered as disincentives exhibited a direct effect on child-rearing participation without being influenced by the father's parent positivity or parent negativity. The path coefficient of the pathway from return-home time to child-rearing participation was -0.43, and the path coefficient of the pathway from working hours to child-rearing participation was -0.13. The value of the path coefficient expressing the relationship between the return-home time and working hours was 0.80. Conclusion: Authors infered that it'll be the basic material to build a generation mechanism about vanity and father's child-rearing participation appropriately as a result of this research.

Retrospective Analysis of Patients Suffering from Dementia or Mild Cognitive Impairment Treated by Collaboration between Western and Korean Medicine (한양방 협진치료를 받은 치매와 경도인지장애 환자에 대한 후향적 의무기록 분석)

  • Lee, Go Eun;Cheong, Moon Joo;Lee, Sung Ik;Kim, Nam Kwen;Kim, Jinwon;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
    • /
    • v.29 no.2
    • /
    • pp.111-119
    • /
    • 2018
  • Objectives: To investigate the characteristics of patients diagnosed with dementia or mild cognitive impairment who are treated by means of a blend between Western and Korean medicine. Methods: We searched for outpatients with dementia or mild cognitive impairment by means of a collaboration between Western and Korean medicine from August 1, 2015, to July 31, 2017, through electronic medical records in Wonkwang Hospital. The records were retrospectively analyzed according to the patients' demographic and clinical characteristics, pathway of medical care, diagnostic tests, treatment, and medical expenses. Results: Thirteen patients were included in the analysis. Among them, six patients were diagnosed with mild cognitive impairment, five with dementia, Alzheimer's type, one patient with frontotemporal dementia, and one patient with unspecified dementia. Twelve of the thirteen patients were over 60 years of age. The number of pathways from the Dept. of Neurology to the Dept. of Neuropsychiatry of Korean Medicine was almost the same as the opposite pathway. The most used diagnostic test in Korean medicine was a neuropsychological test such as SNSB, MMSE and GDS. In Western medicine, hematology and neuroimaging were frequently used for patients. Acupuncture in Korean medicine and medication in Western medicine were the most frequently used. In Korean medicine, uncovered service costs were much higher than covered service costs,. whereas, in Western medicine, covered service costs were higher than uncovered service costs. Conclusions: This study describes the basic characteristics of dementia and mild cognitive impairment patients treated by a collaboration between Western and Korean medicine. Based on these results, a clinical pathway of the collaborative practice system between Western and Korean medicine for dementia patients needs to be developed.

Study on Soil Extraction Methods for the Human Health Risk Assessment of Crop Intake Pathway around Abandoned Metal Mine Areas (폐금속광산 지역 농작물섭취경로의 인체위해도 산정을 위한 생물농축계수와 토양분석방법에 관한 연구)

  • Lim, Tae-Yong;Lee, Sang-Woo;Yun, Seong-Taek;Kim, Soon-Oh
    • Journal of Soil and Groundwater Environment
    • /
    • v.21 no.6
    • /
    • pp.56-66
    • /
    • 2016
  • Generally, the contribution of crop-intake pathway (CIP) is remarkable in human health assessment (HHA) of heavy metal contamination. Although the crop exposure concentrations (Cp) should directly be used for calculating the average daily dose (ADD) of CIP, the soil exposure concentration (Cs) multiplied by soil-crop bio-concentration factor (BCF) has frequently been used instead of using Cp values. Thus, the BCF values are significant in the HHA, and care should be taken to ensure the reasonable acquisition of BCF values. Meanwhile, the BCF values are known to be significantly affected by analytical methods. Nevertheless, they have been calculated from the concentrations of soil and crop analyzed by only one method: total digestion (aqua regia extraction). For this reason, this study was initiated to seek appropriate soil analysis methods for effective computation of the ADD of CIP. The concentrations of 5 metal contaminants (As, Cd, Cu, Pb, and Zn) in 127 soil samples obtained from 4 abandoned metal mine areas were analyzed by several methods including total digestion and partial digestions using 0.1/1 N HCl, 1M $NH_4NO_3$, 0.1 M $NaNO_3$, and 0.01M $CaCl_2$. The heavy metal concentrations in 127 crop samples (rice grains) were analyzed by total digestion as well. Using the concentrations of soils and crops, the BCF values of each contaminant were calculated according to the kind of soil extraction methods applied. Finally, the errors between Cp and $C_s{\times}BCF$ were computed to evaluate the relevance of each method. The results indicate that the partial extraction using 0.1 N and 1 N HCl was superior or equivalent to total digestion. In addition, the 0.1M $NaNO_3$ method combined with total digestion is recommended for improving the reliability of BCF values.

Role of Insulin in the Activation of $NF-{\kappa}B/I{\kappa}B$ Pathway in Macrophage Cells (대식세포주에서 인슐린이 $I{\kappa}B/NF-{\kappa}B$ 경로 활성화에 미치는 영향)

  • Lee, Sang-Min;Jang, Yeon-Sil;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
    • /
    • v.68 no.3
    • /
    • pp.168-174
    • /
    • 2010
  • Background: Sepsis still has a high mortality rate despite adequate supportive care. Newer therapeutic modalities have been developed but they have generally ended in failure. Recently, insulin was reported to have an anti-inflammatory effect by inhibiting the $I{\kappa}B/NF-{\kappa}B$ pathway, and may have therapeutic potential in sepsis. However, the precise mechanism of the anti-inflammatory effect of insulin is unclear. This study examined the role of insulin in activating $I{\kappa}B/NF-{\kappa}B$ in macrophage. Methods: Raw 264.7 cells, a murine macrophage cell line, were used in this experiment. Western blotting using $I{\kappa}B$ Ab and phosphor-specific $I{\kappa}B$ Ab was performed to evaluate the degradation and phosphorylation of $I{\kappa}B$ cells. For the $I{\kappa}B$ Kinase (IKK) activity, an immune complex kinase assay was performed. The level of interleukin-6 (IL-6) was measured by ELISA to determine the level of proinflammatory cytokine. Results: $I{\kappa}B{\alpha}$ degradation began 30 min after lipopolysaccharide (LPS) treatment. However, an insulin pretreatment suppressed the $I{\kappa}B{\alpha}$ degradation caused by the LPS treatment. The phosphorylation of $I{\kappa}B{\alpha}$ and IKK activity was also inhibited by the insulin pretreatment. Finally, the insulin pretreatment showed a tendency to suppress the induction of IL-6 by LPS. Conclusion: Insulin might have an anti-inflammatory effect though partial inhibition of the $I{\kappa}B/NF{\kappa}B$ pathway in macrophage cell lines.

Effective Radiologic Doses and Lifetime Attributable Risks in Patients with Trauma Critical Pathway Activation (중증외상환자의 전산화단층촬영 및 중재술에 의한 방사선 유효선량 및 생애 귀속위험도)

  • Lee, Wonhyo;Kong, Taeyoung;Kim, Seunghwan;You, Je Sung;Park, Yoo Seok;Lee, Jae Gil;Chung, Sung Phil
    • Journal of Trauma and Injury
    • /
    • v.26 no.3
    • /
    • pp.198-206
    • /
    • 2013
  • Purpose: This study was performed to calculate and analyze the effective radiation doses from computed tomography (CT) and radiologic intervention in patients in the emergency department (ED) with trauma critical pathway (CP) activation and further to estimate the lifetime attributable risks (LARs) for the incidence of and mortality from cancers induced by the radiation dose. Methods: Through a retrospective electrical chart review of 104 injured patients who trauma critical pathway were activated from November 2012 to March 2013, we calculated effective radiologic doses by taking the product of the dose-linear product of the scan and the conversion coefficient. After a determination of the image results, we divided the patients into two groups, negative or positive, and calculated the effective dose for each group. With these results, we estimated the LARs for the incidence of and the mortality from cancers by using the table in the Biologic Effects of Ionizing Radiation (BEIR)-VII report. Results: A total of 76 patients were enrolled. The mean age was $49.0{\pm}8.5$ years. The mean injury severity score (ISS) was $12.7{\pm}8.4$. The cumulative effective dose (CED) for individual patients varied from 2.8 mSv to 238.8 mSv, and the mean was $47.6{\pm}39.9$ mSv. The CED in patients with an $ISS{\geq}16$($63.2{\pm}26.6$ mSv) was higher than that of patients whose ISS<16($33.5{\pm}23.1$ mSv) (p<0.001). The CED in patients who were treated with surgery or intervention($69.0{\pm}45.2$ mSv) was higher than that of patients who were treated conservatively($33.6{\pm}22.4$ mSv) (p<0.001). The LARs for cancer incidence and mortality were $328.5{\pm}308.6$ and $189.0{\pm}159.3$ per 100,000 people, respectively. Conclusion: The CED and the LAR for trauma CP-activated patients in the ED were significant, so efforts should be made to decrease the effective dose received by severely injured patients.

Gaseous signal molecule SO2 regulates autophagy through PI3K/AKT pathway inhibits cardiomyocyte apoptosis and improves myocardial fibrosis in rats with type II diabetes

  • Zhao, Junxiong;Wu, Qian;Yang, Ting;Nie, Liangui;Liu, Shengquan;Zhou, Jia;Chen, Jian;Jiang, Zhentao;Xiao, Ting;Yang, Jun;Chu, Chun
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.26 no.6
    • /
    • pp.541-556
    • /
    • 2022
  • Myocardial fibrosis is a key link in the occurrence and development of diabetic cardiomyopathy. Its etiology is complex, and the effect of drugs is not good. Cardiomyocyte apoptosis is an important cause of myocardial fibrosis. The purpose of this study was to investigate the effect of gaseous signal molecule sulfur dioxide (SO2) on diabetic myocardial fibrosis and its internal regulatory mechanism. Masson and TUNEL staining, Western-blot, transmission electron microscopy, RT-qPCR, immunofluorescence staining, and flow cytometry were used in the study, and the interstitial collagen deposition, autophagy, apoptosis, and changes in phosphatidylinositol 3-kinase (PI3K)/AKT pathways were evaluated from in vivo and in vitro experiments. The results showed that diabetic myocardial fibrosis was accompanied by cardiomyocyte apoptosis and down-regulation of endogenous SO2-producing enzyme aspartate aminotransferase (AAT)1/2. However, exogenous SO2 donors could up-regulate AAT1/2, reduce apoptosis of cardiomyocytes induced by diabetic rats or high glucose, inhibit phosphorylation of PI3K/AKT protein, up-regulate autophagy, and reduce interstitial collagen deposition. In conclusion, the results of this study suggest that the gaseous signal molecule SO2 can inhibit the PI3K/AKT pathway to promote cytoprotective autophagy and inhibit cardiomyocyte apoptosis to improve myocardial fibrosis in diabetic rats. The results of this study are expected to provide new targets and intervention strategies for the prevention and treatment of diabetic cardiomyopathy.

Early Detection and Successful Treatment of Vertically Transmitted Fulminant Enteroviral Infection Associated with Various Forms of Arrhythmia and Severe Hepatitis with Coagulopathy

  • Lee, So Ra;Ko, Sun Young;Yoon, So Young;Lee, Yeon Kyung;Shin, Son Moon
    • Pediatric Infection and Vaccine
    • /
    • v.26 no.3
    • /
    • pp.199-205
    • /
    • 2019
  • Enteroviral infections are common in neonates. One important infection pathway is vertical transmission from an infected mother to her neonate. Here, we report the early detection and successful treatment of a vertically transmitted fulminant enteroviral infection associated with myocarditis and hepatitis. The patient had a sudden onset of high fever on the fourth day of life and developed severe, rapidly progressing symptoms of disseminated intravascular coagulopathy (DIC), hepatitis, and myocarditis accompanied by tachyarrhythmia. As it was the peak season for enteroviral infections and both the mother and the patient's 36-month-old sibling had a high fever around the time of delivery, we suspected an enteroviral infection. Thus, we initiated prompt evaluation of enteroviral infection, as well as close observation and intensive care of the neonate. We strongly recommend evaluation for the possibility of vertical enterovirus infection in neonates when the mother is suspected of having a viral infection (e.g., high fever and negative results from bacterial infectious studies) around the time of delivery and when the neonate shows some early symptoms of infectious diseases such as thrombocytopenia, DIC, hepatitis, and myocarditis. Early detection of enteroviral infections and prompt implementation of proper treatment are key to reduce the risk of complications and mortality associated with enteroviral infections in neonates.

Prevention of Protein Loss Using A Shield Coating According to Moisture Behavior in Human Hair (수분거동 패턴에 따른 차폐막 설정을 통한 모발단백질 소실방지)

  • Song, Sang-Hun;Lim, Byung Tack;Son, Seong Kil;Kang, Nae-Gyu
    • Journal of the Society of Cosmetic Scientists of Korea
    • /
    • v.46 no.1
    • /
    • pp.57-65
    • /
    • 2020
  • To prevent loss of hair protein during hair washing process by water through, a shield coating the pathway of water molecules was studied. Hydrophobic virgin hair, hydrophilic hair, which was damaged only methyleicosanoic acid (18-MEA) on the surface, and a repaired hair re-bound 18-MEA, were prepared and water mass changes by as heat were measured. Results showed that hydrophobic hairs followed bi-exponential function of 39 s and 151 s and other two hairs exhibited fast- and mono-exponential decay with 83 s, reflecting the extraction of water molecules without any resistance at the hydrophobic surface. On the assumption that hydrophobic surface resists an extraction of protein in water during the wash, the protein concentrations were compared from the hair of hydrophobic and hydrophilic surface. The extracted hair proteins were 179 and 148 ㎍/mL from the hair coated with hydrophilic polyethylene glycol (PEG) and hydrophobic polydimethylsiloxane (PDMS), respectively. This study suggested that hydrophobic coating on the hair surface could be used to prevent protein loss in wash, represented by LFM. In conclusion, this research provides some useful information to contribute to the development of hair washing products that can prevent protein loss in the cleaning process by granting hydrophobic coatings.

Effectiveness of a Clinical Pathway for Breast Cancer Patients Undergoing Surgical Operation on Clinical Outcomes and Costs

  • Jeong Hyun Park;Danbee Kang;Seok Jin Nam;Jeong Eon Lee;Seok Won Kim;Jonghan Yu;Byung Joo Chae;Se Kyung Lee;Jai Min Ryu;Yeon Hee Park;Mangyeong Lee;Juhee Cho
    • Quality Improvement in Health Care
    • /
    • v.30 no.1
    • /
    • pp.120-131
    • /
    • 2024
  • Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.