• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5389-5393
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• 2014

Background: A clinical pathway (CP) can standardize and improve perioperative care for a number of interventions. In hepatic surgery, however, pertinent evidence is very limited. This study was conducted to implement a CP for hepatocellular carcinoma (HCC) patients undergoing hepatectomy, and to evaluate its effects on hospital costs, length of hospital stay (LOHS) and early clinical outcomes. Materials and Methods: Medical records for HCC patients undergoing hepatectomy were retrospectively reviewed before implementation of a CP (the non-CP group) from March 2012 to August 2012. This information was compared with the data collected prospectively from patients after implementation of the CP (the CP group) between September 2012 and April 2013. Hospital costs, LOHS and early clinical outcomes were evaluated and compared between groups. Results: There were no significant differences in terms of patient clinical characteristics between the two groups. For clinical outcome measures, no significant differences were found in postoperative complications, mortality and readmission rate. The hospital costs were significantly reduced from 24,844 RMB in the non-CP group to 19,761 RMB in the CP group (p<0.01). In addition, patients of the CP group also had shorter LOHS compared with the non-CP group (8.3 versus 12.3 days, p<0.001). Conclusions: The CP proved to be an effective approach to minimize hospital costs and LOHS with hepatectomy for HCC without compromising patient care.

• 한방재활의학과학회지
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• 제32권4호
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• pp.73-82
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• 2022

Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2^nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.642-651
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• 2023

Objective : Endothelial colony-forming cells (ECFCs) have been reported to play an important role in the pathogenesis of moyamoya disease (MMD). We have previously observed stagnant growth in MMD ECFCs with functional impairment of tubule formation. We aimed to verify the key regulators and related signaling pathways involved in the functional defects of MMD ECFCs. Methods : ECFCs were cultured from peripheral blood mononuclear cells of healthy volunteers (normal) and MMD patients. Low-density lipoproteins uptake, flow cytometry, high content screening, senescence-associated β-galactosidase, immunofluorescence, cell cycle, tubule formation, microarray, real-time quantitative polymerase chain reaction, small interfering RNA transfection, and western blot analyses were performed. Results : The acquisition of cells that can be cultured for a long time with the characteristics of late ECFCs was significantly lower in the MMD patients than the normal. Importantly, the MMD ECFCs showed decreased cellular proliferation with G1 cell cycle arrest and cellular senescence compared to the normal ECFCs. A pathway enrichment analysis demonstrated that the cell cycle pathway was the major enriched pathway, which is consistent with the results of the functional analysis of ECFCs. Among the genes associated with the cell cycle, cyclin-dependent kinase inhibitor 2A (CDKN2A) showed the highest expression in MMD ECFCs. Knockdown of CDKN2A in MMD ECFCs enhanced proliferation by reducing G1 cell cycle arrest and inhibiting senescence through the regulation of CDK4 and phospho retinoblastoma protein. Conclusion : Our study suggests that CDKN2A plays an important role in the growth retardation of MMD ECFCs by inducing cell cycle arrest and senescence.

• 한국통신학회논문지
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• 제39C권6호
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• pp.497-502
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• 2014

일반적으로 모든 전문분야 의사들은 어느 정도 표준화된 진단, 치료 방식을 취하고 있다. 그러나 세부적인 처방 및 검사, 입원일수 등은 병원 규모 및 시스템, 의료 장비 구축정도에 따라 차이가 발생할 수 있다. 이러한 차이를 줄이기 위해 최근 진료지침의 표준화에 대한 관심이 높아지면서 다양한 연구가 진행되고 있다. 표준화된 진료지침은 의료의 질을 보장하고 의사의 자율성을 보장하기 위해 병원규모 및 구축된 시스템 등에 상관없이 똑같은 진료지침을 제공하는 것이 아니라 각 병원의 상황과 환경에 맞도록 임상데이터를 기반으로 진단 및 처치, 검사 등을 제공할 수 있어야 한다. 따라서 본 논문에서는 병원 내 같은 과의 두 전문의의 임상데이터를 분석하고 이를 기반으로 해당 질병 및 병원에 맞춘 표준 진료지침을 자동으로 생성할 수 있는 시스템을 연구 및 구현하여 적용 가능한 표준 진료지침을 제시하고자 한다.

• 대한예방한의학회지
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• 제26권1호
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• pp.11-23
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• 2022

Objectives : The aim of this study was to develop a clinical pathway (CP) model for the integrative treatment of non-invasive breast cancer, with western medicine and Korean traditional medicine. Methods : The checklist model was composed in four types according to the target patients: DCIS inpatients, DCIS outpatients, LCIS inpatients, LCIS outpatients. The vertical axis of the pathway consists of 11 categories of actions applied to the patient. The horizontal axis was in accordance with the flow of time, comprising three periods during inpatient care and seven periods during outpatient care. In addition, CP was also composed in flow chart form. The pathway model was developed through a literature review of clinical practice guidelines, conference publications, papers, books, and websites. Results : The integrative CP model for non-invasive breast cancer was developed. Conclusions : The goal of the CP suggested in this study was to improve non-invasive breast cancer patients' quality of life and to supplement conventional treatment, by alleviating the side effects. The model developed through this study could serve as the basis when developing CPs in a real-world integrative medical environment. This could lead to a reduction in cost and time for CP development, thus bringing about efficiency in the clinical setting.

• 대한물리치료과학회지
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• 제3권1호
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• pp.907-918
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• 1996

Evoked potentials(EP) are defined as electric responses of the nerves system to sensory stimulation. EPs are used mainly to test conduction in the visual, auditory, and somatosensory systems, especially in the central parts of these systems. Somatosensory evoked potentials (SEP) are the potentials elicited by stimulation of peripheral nerves and recorded at various sites along the sensory pathway. SEPs types consist mainly of SEPs to electric stimulation of arm or leg nerves. SEPs to arm stimulation are usually recorded simultaneously from clavicular, cervical, and scalp electrodes; SEPs to leg stimulation are recorded from lumbar, low thoracic, and scalp electrodes. Subject variables that have practical impotance are age, limb length, body height, and temperature. General clinical interpretation of abnormal SEPs wave decreases of peripheral conduction time, and abolition of SEPs recorded from different levels to identify lesions of peripheral nerves, plexus, nerve root, spinal cord, cauda equina, hemispheric brainstem, and cerebral parts of the somatosensory pathway.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1781-1787
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• 2015

Background: miRNAs are relatively recently discovered cancer biomarkers which have important implications for cancer early diagnosis, treatment and estimation of prognosis. Here we focussed on expression of mir-196a-5p in gastric cancer tissues and cell lines so as to analyse its significance for clinicopathologic characteristics and generate enriched KEGG pathways clustered by target genes for exploring its potential roles as a biomarker in gastric cancer. Materials and Methods: The expression of mir-196a-5p in poorly, moderate and well differentiated gastric cancer cell lines compared with GES-1 was detected by RT-qPCR, and the expression of mir-196a-5p in gastric cancer tissues comparing with adjacent non cancer tissues of 58 cases were also assessed by RT-qPCR. Subsequently, an analysis of clinical significance of mir-196a-5p in gastric cancer and enriched KEGG pathways was executed based on the miRWalk prediction database combined with bioinformatics tools DAVID 6.7 and Mirfocus 3.0. Results: RT-qPCR showed that mir-196a-5p was up-regulated in 6 poorly and moderate differentiated gastric cancer cell lines SGC-7901, MKN-45, MKN-28, MGC-803, BGC-823, HGC-27 compared with GES-1, but down-regulated in the highly differentiated gastric cancer cell line AGS. Clinical data indicated mir-196a-5p to beup-regulated in gastric cancer tissues (47/58). Overexpression of mir-196a-5p was associated with more extensive degree of lymph node metastasis and clinical stage (P < 0.05; x2 test). Enriched KEGG pathway analyses of predicted and validated targets in miRWalk combined with DAVID 6.7 and Mirfocus 3.0 showed that the targeted genes regulated by mir-196a-5p were involved in malignancy associated biology. Conclusions: Overexpression of mir-196a-5p is associated with lymph node metastasis and clinical stage, and enriched KEGG pathway analyses showed that targeted genes regulated by mir-196a-5p may contribute to tumorgenesis, suggesting roles as an oncogenic miRNA biomarker in gastric cancer.

• 대한의생명과학회지
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• 제17권3호
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• pp.177-184
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• 2011

Potassium cyanate (KOCN) is an inorganic compound and induces the carbamylation of proteins with cytotoxic effects on human cells. Although there is a potential cytotoxic molecule, the role of KOCN on the apoptosis of cancer cell is not well understood. The present study investigated the effects of KOCN on the human colorectal cancer cell line, HCT 116 cells. To understand the anti-cancer effect of KOCN on HCT 116 cells, we examined alteration of apoptosis, the intracellular $Ca^{2+}$ concentration, the intracellular signaling pathway and generation of reactive oxygen species (ROS) in these cells treated with KOCN. The apoptosis of HCT 116 cells was induced by KOCN in a dose-dependent manner at 24 hours and 48 hours, respectively. The apoptosis was processed via the cleavage of poly ADP-ribose polymerase (PARP) and activation of caspase 3 in HCT 116 cells. KOCN induced the elevation of intracellular $Ca^{2+}$ concentration and changed the expressions of Bcl-2 family proteins. The pro-apoptotic Bax was continuously up-regulated, and the anti-apoptotic Bcl-2 was down-regulated by KOCN. KOCN also induced the hyperpolarization of mitochondria and the generation of ROS in HCT 116 cells. Taken together, these results indicate that KOCN induces the apoptosis of HCT 116 cells by disruption of $Ca^{2+}$ homeostasis and via mitochondrial pathway. This study provides the compound that may be used as a potent agent for the treatment of colorectal cancer.

• 한방재활의학과학회지
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• 제32권3호
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• pp.141-151
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• 2022

Objectives The purpose of this study is to improve the accessibility of Korean medicine by standardizing managements, improving quality of medical services, and reducing medical costs in ankle sprain by develop clinical pathway (CP). Methods The development of CP in this study is based on clinical practice guideline (CPG) for ankle sprain, and aims to maximize the quality of treatment, such as reducing treatment time and medical costs, and increasing patient satisfaction through standardized pathway. The CP was revised after consultation and review by the advisory committee. The advisory committee is consisted of a stakeholder group applying the CP. Results In previous research studies, there were no Korean medicine CP studies on ankle sprain. Based on CPG for ankle sprain and analysis of medical records, 6 types of time task matrix type CP (for Korean medicine doctors, medical assistant, patients) and 4 types of algorithm type CP (for Korean medicine clinics, Korean medicine hospitals, and cooperative practicing hospitals, public medical centers) were derived as a result. Conclusions Ankle sprain CP is expected to not only increase patient satisfaction and maximize the quality of treatment, but also reduce the financial burden of health insurance by reducing medical costs.

• 한국컴퓨터정보학회논문지
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• 제23권4호
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• pp.115-120
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• 2018

A Clinical Pathway(CP) is standard process to way of treat diseases or injuries which is adapted to each hospital based on National Clinical Practice Guideline(CPG). Since CP is standard guideline for doctors and nurses working in a hospital, making and modifying CP is one of the most important administrational work for hospital and also rare work because once it is fixed, it's not changed whether there are new kind of disease discovered or new treatment is developed. However, in present, patient's waiting time during hospital residence process, is discussed as service competitive for patients. In this research, we utilize process mining tool to verify patients treatment process follows CP with EMR(Electronic Medical Record) in a sample hospital, and suggest modifcation point of CP through verification.