Many patients carried into the emergency room or intensive care unit are suspected to have risk factors for deep-seated mycosis. Using the Actions Bundle, which itemizes diagnosis and treatment of invasive candidiasis, we carried out investigations into facts about the use of antifungal drugs in the intensive care unit of our hospital. The subjects of this retrospective study were 11 ICU patients who were given antifungal drugs intravenously between April 2013 and March 2014. Their medication records revealed that micafungin was administered to five patients, fosfluconazole to another five patients and fulconazole to the remaining one patient. The ratio of the cases where the dugs were used in compliance with what the Actions Bundle suggested worked out at 71.4±15.9%. When it came to the collection rate of two sets of blood culture and the proper dosage, the compliance rates were the lowest with 36% each. As regards dosage, 18% was excessive, 36% proper and 45% insufficient. As pharmacists in charge of the ICU, we have to use the checklist more effectively and intervene in the care of patients with invasive candidiasis at an early stage.

Angiopoietin-1 (Ang1) binds to and activates Tie2 receptor tyrosine kinase. Ang1-Tie2 signal has been proposed to exhibit two opposite roles in the controlling blood vessels. One is vascular stabilization and the other is vascular angiogenesis. There has been no answer to the question as to how Tie2 induces two opposite responses to the same ligand. Our group and Dr. Alitalo's group have demonstrated that trans-associated Tie2 at cell-cell contacts and extracellular matrix (ECM)-anchored Tie2 play distinct roles in the endothelial cells. The complex formation depends on the presence or absence of cell-cell adhesion. Here, we review how Ang1-Tie2 signal regulates vascular maintenance and angiogenesis. We further point to the unanswered questions that must be clarified to extend our knowledge of vascular biology and to progress basic knowledge to the treatment of the diseases in which Ang1-Tie2-mediated signal is central.
Angiopoietin-1/*physiology ; Animals ; Cell Adhesion/physiology ; Cell Movement/physiology ; Endothelial Cells/*physiology ; Endothelium, Vascular/physiology ; Extracellular Matrix/*metabolism ; Humans ; Neovascularization, Physiologic/physiology ; Receptor, TIE-2/*physiology ; Signal Transduction/*physiology