• 제목/요약/키워드: Critical Pathway

검색결과 430건 처리시간 0.026초

일 병원의 대장절제술 환자를 위한 표준진료지침의 임상적용 효과와 변이분석 (The Effects and Variances of the Critical Pathway of Laparoscopic Colon Resection in Colon Cancer Patients)

  • 정혜정;최모나;김소선;김남규;이강영
    • 종양간호연구
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    • 제12권3호
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    • pp.204-212
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    • 2012
  • Purpose: To investigate the effectiveness and variance of a critical pathway (CP) for laparoscopic colon resection in colon cancer patients, and nurses'satisfaction with the CP. Methods: A CP for laparoscopic colon resection was applied to the CP-group that included 50 patients, who underwent elective colon resection between March and May, 2011. The non-CP group included 51 patients who had the same operation without the CP applied from March to May, 2010. Results: The means of length of hospital stay were 11.7 and 7.3 days (p<.001) and the lengths of postoperative hospital stay were 8.6 and 5.1 days (p<.001) in the non-CP group and CP group, respectively. There was no significant difference between two groups for total healthcare costs, pain score, complications, or emergency room visits within 30 days after discharge. By examining variances of the CP, there were 162 variances and the most frequent cause was patient's condition. Nurses'satisfaction with the use of CP was favorable and the mean score of satisfaction was 3.76 on the 5 point Likert scale. Conclusion: There are clear benefits to use of CP, resulting in standardized and effective patient care. In conclusion, analysis of variance data can assist in evaluating and revising CP for optimal care and reducing variances.

Vitamin B6 Deficiency, Genome Instability and Cancer

  • Wu, Xia-Yu;Lu, Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5333-5338
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    • 2012
  • Vitamin B6 functions as a coenzyme in >140 enzymatic reactions involved in the metabolism of amino acids, carbohydrates, neurotransmitters, and lipids. It comprises a group of three related 3-hydroxy-2-methyl-pyrimidine derivatives: pyridoxine (PN), pyridoxal (PL), pyridoxamine (PM) and their phosphorylated derivatives [pyridoxal 5'-phosphate (PLP) and pyridoxamine 5'-phosphate (PMP)], In the folate metabolism pathway, PLP is a cofactor for the mitochondrial and cytoplasmic isozymes of serine hydroxymethyltransferase (SHMT2 and SHMT1), the P-protein of the glycine cleavage system, cystathionine ${\beta}$-synthase (CBS) and ${\gamma}$-cystathionase, and betaine hydroxymethyltransferase (BHMT), all of which contribute to homocysteine metabolism either through folate-mediated one-carbon metabolism or the transsulfuration pathway. Folate cofactors carry and chemically activate single carbons for the synthesis of purines, thymidylate and methionine. So the evidence indicates that vitamin B6 plays an important role in maintenance of the genome, epigenetic stability and homocysteine metabolism. This article focuses on studies of strand breaks, micronuclei, or chromosomal aberrations regarding protective effects of vitamin B6, and probes whether it is folate-mediated one-carbon metabolism or the transsulfuration pathway for vitamin B6 which plays critical roles in prevention of cancer and cardiovascular disease.

Connections Between Various Trigger Factors and the RIP1/RIP3 Signaling Pathway Involved in Necroptosis

  • Zhang, Yuan-Yuan;Liu, Hao
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7069-7074
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    • 2013
  • Programmed cell death is a basic cellular process that is critical to maintaining tissue homeostasis. In contrast to apoptosis, necrosis was previously regarded as an unregulated and uncontrollable process. However, as research has progressed, necrosis, also known as necroptosis or programmed necrosis, is drawing increasing attention, not least becasu of its possible impications for cancer research. Necroptosis exhibits a unique signaling pathway that requires the involvement of receptor interaction protein kinases 1 and 3 (RIP1 and RIP3), mixed lineage kinase domain-like (MLKL), and phosphoglycerate mutase 5 (PGAM5) and can be specifically inhibited by necrostatins. Not only does necroptosis serve as a backup cell death program when apoptosis is inhibited, but it is now recognized to play a pivotal role in regulating various physiological processes and the pathogenesis of a variety of human diseases such as ischemic brain injury, immune system disorders and cancer. The control of necroptosis by various defined trigger factors and signaling pathways now offers the opportunity to target this cellular process for therapeutic purposes. The purpose of this paper is to review current findings concerning the connections between various trigger factors and the RIP1/RIP3 signaling pathway as it relates to necroptosis.

The Stress-Activated Signaling (SAS) Pathways of a Human Fungal Pathogen, Cryptococcus neoformans

  • Jung, Kwang-Woo;Bahn, Yong-Sun
    • Mycobiology
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    • 제37권3호
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    • pp.161-170
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    • 2009
  • Cryptococcus neoformans is a basidiomycete human fungal pathogen that causes meningoencephalitis in both immunocompromised and immunocompetent individuals. The ability to sense and respond to diverse extracellular signals is essential for the pathogen to infect and cause disease in the host. Four major stress-activated signaling (SAS) pathways have been characterized in C. neoformans, including the HOG (high osmolarity glycerol response), PKC/Mpk1 MAPK (mitogen-activated protein kinase), calcium-dependent calcineurin, and RAS signaling pathways. The HOG pathway in C. neoformans not only controls responses to diverse environmental stresses, including osmotic shock, UV irradiation, oxidative stress, heavy metal stress, antifungal drugs, toxic metabolites, and high temperature, but also regulates ergosterol biosynthesis. The PKC(protein kinase C)/Mpk1 pathway in C. neoformans is involved in a variety of stress responses, including osmotic, oxidative, and nitrosative stresses and breaches of cell wall integrity. The $Ca^{2+}$/calmodulin- and Ras-signaling pathways also play critical roles in adaptation to certain environmental stresses, such as high temperature and sexual differentiation. Perturbation of the SAS pathways not only impairs the ability of C. neoformans to resist a variety of environmental stresses during host infection, but also affects production of virulence factors, such as capsule and melanin. A drug(s) capable of targeting signaling components of the SAS pathway will be effective for treatment of cryptococcosis.

An Important Role of Nrf2-ARE Pathway in the Cellular Defense Mechanism

  • Lee, Jong-Min;Johnson, Jeffrey A.
    • BMB Reports
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    • 제37권2호
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    • pp.139-143
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    • 2004
  • The antioxidant responsive element (ARE) is a cis-acting regulatory element of genes encoding phase II detoxification enzymes and antioxidant proteins, such as NAD(P)H: quinone oxidoreductase 1, glutathione S-transferases, and glutamate-cysteine ligase. Interestingly, it has been reported that Nrf2 (NF-E2-related factor 2) regulates a wide array of ARE-driven genes in various cell types. Nrf2 is a basic leucine zipper transcription factor, which was originally identified as a binding protein of locus control region of ss-globin gene. The DNA binding sequence of Nrf2 and ARE sequence are very similar, and many studies demonstrated that Nrf2 binds to the ARE sites leading to up-regulation of downstream genes. The function of Nrf2 and its downstream target genes suggests that the Nrf2-ARE pathway is important in the cellular antioxidant defense system. In support of this, many studies showed a critical role of Nrf2 in cellular protection and anti-carcinogenicity, implying that the Nrf2-ARE pathway may serve as a therapeutic target for neurodegenerative diseases and cancers, in which oxidative stress is closely implicated.

비전통핵생성 이론 관점에서 탄산칼슘의 반응경로에 대한 시간분해 분극 및 탈분극 추적 (Time-resolved polarization and depolarization tracking on reaction pathway of calcium carbonates in a view of non-classical nucleation theory)

  • 김광목
    • 도시과학
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    • 제9권2호
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    • pp.45-50
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    • 2020
  • The formation characteristics of calcium carbonates are closely related to the durability and mechanical properties of cement-based materials. In this regard, a deep understanding of the reaction pathway of calcium carbonates is critical. Recently, non-classical nucleation theory was summarized and it was presumed that prenucleation clusters are present. The formation of the prenucleation cluster at undersaturated condition (≈ 0.1 ml) in the present study was investigated via electrical characteristics of an electrolytic solution. Calcium chloride dihydrate (CaCl2·2H2O) and sodium carbonate (Na2CO3) were used as starting materials to supply calcium and carbonate sources, respectively. Furthermore, the reaction pathway of calcium carbonates was investigated by time-resolved polarization and depolarization characteristics of the electrolytic solution. The time-resolved polarization and depolarization tests were conducted by switching polarity with an interval of 20 seconds for 1 hr and by measuring the variation of electrical resistance. It can be inferred from the results obtained in the present study that the reactive constituent for the formation of calcium carbonates was mostly consumed in the period possibly associated with the prenucleation and the reaction pathways may be governed by the monomer-addition mechanism.

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
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    • 제54권4호
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    • pp.449-458
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    • 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.

낙지다리 식물 추출물의 알레르기 억제효과 (Inhibitory Effect of Penthorun chinense Extract on Allergic Responses in vitro and in vivo)

  • 조소영;김영미
    • 한국식품위생안전성학회지
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    • 제30권4호
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    • pp.376-382
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    • 2015
  • Allergic diseases have rapidly increased in recent years. Mast cells play a critical role in IgE-mediated allergy responses and, therefore, closely associated with rhinitis, asthma, and atopic dermatitis. We studied anti-allergic effect of Penthorum chinense extract (PCE) in vitro and in vivo. PCE inhibited the degranulation of mast cells by antigen stimulation and its effect was dose-dependent and reversible in mast cells. PCE also suppressed the production of inflammatory cytokines such as TNF-${\alpha}$ and IL-4 by antigen in mast cells. Mechanistically, PCE inhibited the activation of Syk/LAT pathway which is a key signaling pathway for the activation of mast cells by antigen. Notably, PCE suppressed IgE-mediated allergic responses by antigen in mice. These results strongly suggest that PCE is a potential candidate for anti-allergic treatment.

Positive and negative regulation of the Drosophila immune response

  • Aggarwal, Kamna;Silverman, Neal
    • BMB Reports
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    • 제41권4호
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    • pp.267-277
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    • 2008
  • Insects mount a robust innate immune response against a wide array of microbial pathogens. The hallmark of the Drosophila humoral immune response is the rapid production of anti-microbial peptides in the fat body and their release into the circulation. Two recognition and signaling cascades regulate expression of these antimicrobial peptide genes. The Toll pathway is activated by fungal and many Gram-positive bacterial infections, whereas the immune deficiency (IMD) pathway responds to Gram-negative bacteria. Recent work has shown that the intensity and duration of the Drosophila immune response is tightly regulated. As in mammals, hyperactivated immune responses are detrimental, and the proper down-modulation of immunity is critical for protective immunity and health. In order to keep the immune response properly modulated, the Toll and IMD pathways are controlled at multiple levels by a series of negative regulators. In this review, we focus on recent advances identifying and characterizing the negative regulators of these pathways.

Mechanisms of Type-I Interferon Signal Transduction

  • Uddin, Shahab;Platanias, Leonidas C.
    • BMB Reports
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    • 제37권6호
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    • pp.635-641
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    • 2004
  • Interferons regulate a number of biological functions including control of cell proliferation, generation of antiviral activities and immumodulation in human cells. Studies by several investigators have identified a number of cellular signaling cascades that are activated during engagement of interferon receptors. The activation of multiple signaling cascades by the interferon receptors appears to be critical for the generation of interferon mediated biological functions and immune surveillance. The present review summarizes the existing knowledge on the multiple signaling cascades activated by Type I interferons. Recent developments in this research area are emphasized and the implications of these new discoveries on our understanding of interferon actions are discussed.