In excitable and endocrine organs, calcium influxes through the voltage-dependent calcium channel (VDCC), composed of four (alpha 1, alpha 2, beta, and gamma) subunits. Four isoforms of beta subunits (beta 1, beta 2, beta 3, beta 4) are known to exist, The cytoplasmic beta subunits regulate the channel activity by accelerating the kinetics of activation and inactivation through phosphorylation. Regulation of calcium channel activities are also provided by alternative splicing of the beta subunits. To elucidate the genomic organization of the VDCC beta 3 subunit gene, two genomic clones were isolated from human genomic liabrary using the whole rat cDNA for beta 3 subunit as a probe. The beta 3 subunit gene in lamda phage DNA was analyzed by Southern hybridization and sequencing. A 19.1 kb clone (2BHG13) contained the whole beta 3 cDNA sequence, consisting at least 14 exons. The deduced amino acid sequence from the exons shows 97% similarity with that of rat gene. Two alternatively spliced forms of beta 3 subunit at 5'-end were found. The beta 3 subunit had many possible phosphorylation sites. Alternative splicing of beta 3 subunit mRNA at 5'-end and phosphorylation of the beta 3 subunit protein may play a regulatory role in calcium influxes.
Alternative Splicing ; Amino Acid Sequence ; Animals ; Bacteriophages ; Calcium Channels* ; Calcium* ; Clone Cells ; Cytoplasm ; DNA ; DNA, Complementary ; Exons ; Genome, Human ; Humans* ; Kinetics ; Phosphorylation ; Protein Isoforms ; Rats ; RNA, Messenger

PURPOSE: The p27 gene as a tumor suppressor gene is associated with colorectal cancer, gastric cancer and breast cancer. Some studies have shown a relationship between the underexpression of p27 and lymph node metastasis in papillary thyroid carcinoma. The aim of this study is to evaluate the relationship between a p27 expression of the papillary thyroid cancer cells obtained by fine needle aspiration (FNA) and cervical lymph node metastasis. METHODS: This study included 60 patients with papillary thyroid cancer and who underwent total thyroidectomy or lobectomy. Central lymph node dissection was routinely done. Out of these patients, 30 patients underwent a FNA procedure during the operation. Immunohistochemical staining for p27 antibody was performed on the papillary thyroid cancer tissues and cells. RESULTS: Cervical lymph node metastasis is correlated with the tumor size and lymphovascular invasion (P<0.001). The underexpression of p27 for the papillary thyroid cancer tissues and cells was associated with lymph node metastasis (P=0.009). CONCLUSION: An evaluation of the p27 expression for the papillary thyroid cancer cells obtained by FNA may be useful as a predictor for lymph node metastasis before surgery.
Biopsy, Fine-Needle ; Breast Neoplasms ; Colorectal Neoplasms ; Genes, Tumor Suppressor ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Stomach Neoplasms ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). METHODS: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour. RESULTS: After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation. CONCLUSION: Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center driectly should be implemented for patients and/or caregivers.
Caregivers ; Education ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Information Systems ; Methods ; Myocardial Infarction* ; Transportation

OBJECTIVE: This study is designed to elucidate the requirements for angiographic evaluation and the selection of appropriate therapeutic approaches in patients who had strongly suggestive traumatic carotid arterial lesions. METHODS: Ten cases of traumatic internal carotid arterial lesions were analysed in this study. Injury mechanisms, neurological status, computed tomography scans, pre-and postoperative angiograms, and methods and results of the treatment were included. RESULTS: Of 10 cases, carotid-cavernous fistula(CCF) alone in three, CCF with intracranial pseudoaneurysms in three, pseudoaneurysm with dissection in one, extracranial internal carotid artery thrombosis in one, extracranial pseudoaneurysm in one, and the remaining one had all of the CCF, intracranial pseudoaneurysm and dissection. Seven of these 10 cases had sphenoid sinus wall fractures and six had subarachnoid hemorrhage. Six cases were treated with endovascular techniques, and four with direct parent artery occlusion and bypass surgery. No postoperative morbidity or additional permanent neurological deficits occurred except one patient who suffered from reperfusion hemorrhage after bypass surgery. CONCLUSION: Head trauma patients with facial bone fractures and thick subarachnoid hemorrhage should be evaluated for the development of traumatic injuries to the carotid artery as soon as possible. Endovascular treatment to these lesions have come to play an increasing role. Patients with traumatic internal carotid artery lesions who do not tolerate test occlusion require extracranial to intracranial bypass surgery before occlusion.
Aneurysm, False ; Arteries ; Carotid Arteries ; Carotid Artery Thrombosis ; Carotid Artery, Internal ; Craniocerebral Trauma ; Endovascular Procedures ; Facial Bones ; Hemorrhage ; Humans ; Parents ; Reperfusion ; Sphenoid Sinus ; Subarachnoid Hemorrhage

No abstract available.
Depression* ; Myocardial Ischemia*

OBJECTIVE: To confirm a relationship between the pharyngeal response and bolus volume, and examine whether increasing the fluid bolus volume can improve penetration and aspiration for stroke dysphagic patients. METHODS: Ten stroke patients with a delayed pharyngeal response problem confirmed by a videofluoroscopic swallowing study (VFSS) were enrolled. Each subject completed two swallows each of 2 mL, 5 mL, and 10 mL of barium liquid thinned with water. The pharyngeal delay time (PDT) and penetration-aspiration scale (PAS) were measured and the changes among the different volumes were analyzed. RESULTS: PDTs were shortened significantly when 5 mL and 10 mL of thin barium were swallowed compared to 2 mL. However, there was no significant difference in PAS as the bolus volume increased. CONCLUSION: The increased fluid bolus volume reduced the pharyngeal delay time, but did not affect the penetration and aspiration status.
Barium ; Deglutition Disorders* ; Deglutition* ; Fluoroscopy ; Humans ; Pilot Projects* ; Reaction Time ; Respiratory Aspiration ; Stroke ; Swallows ; Water

Pigs are the most likely source animals for cardiac xenotransplantation. However, an appropriate method for estimating the cardiac function of micropigs had not been established. Computed tomography (CT) analysis aimed at estimating cardiac function and assessing the coronary arteries has not been carried out in micropigs. This study determined the feasibility of evaluating cardiac function in a micropig model using multidetector row computed tomography (MDCT) and compared the cardiac function values with those of conventional pigs. The mean age of the conventional pigs and micropigs was approximately 80 days and approximately 360 days, respectively. The mean body weight in the conventional pigs and micropigs was 29.70 +/- 0.73 and 34.10 +/- 0.98 kg, respectively. Cardiac MDCT detected ejection fractions of 52.93 +/- 3.10% and 59.00 +/- 5.56% and cardiac outputs of 1.46 +/- 0.64 l/min and 1.21 +/- 0.24 l/min in conventional pigs and micropigs, respectively. There were no significant differences in cardiac function between conventional pigs and micropigs in the reconstructed CT images. There were also no differences in the coronary angiographic images obtained by MDCT. It is expected that the results of this study will help improve understanding of cardiac function in micropigs. The data presented in this study suggest that MDCT is a feasible method for evaluating cardiac function in micropigs.
Animals ; Coronary Angiography/*methods ; Heart/*physiology/radiography ; *Models, Animal ; Sus scrofa/*physiology ; Swine ; Swine, Miniature/*physiology ; Tomography, X-Ray Computed/*methods

OBJECTIVES: The purpose of this study was to review an implementation of u-Severance information system with focus on electronic hospital records (EHR) and to suggest future improvements. METHODS: Clinical Data Repository (CDR) of u-Severance involved implementing electronic medical records (EMR) as the basis of EHR and the management of individual health records. EHR were implemented with service enhancements extending to the clinical decision support system (CDSS) and expanding the knowledge base for research with a repository for clinical data and medical care information. RESULTS: The EMR system of Yonsei University Health Systems (YUHS) consists of HP integrity superdome servers using MS SQL as a database management system and MS Windows as its operating system. CONCLUSIONS: YUHS is a high-performing medical institution with regards to efficient management and customer satisfaction; however, after 5 years of implementation of u-Severance system, several limitations with regards to expandability and security have been identified.
Database Management Systems ; Electronic Health Records ; Electronics ; Electrons ; Hospital Records ; Information Systems ; Knowledge Bases

PURPOSE: To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics. METHODS: Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed. RESULTS: The mean gestational age (27(+6)2(+3) vs. 28(+5)+/-2(+6)) and birth weight (979+/-241 g vs. 1,071+/-271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period. CONCLUSION: GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.
Birth Weight ; Bronchopulmonary Dysplasia ; Cholestasis ; Enterocolitis, Necrotizing ; Gestational Age ; Hernia, Inguinal ; Humans ; Incidence ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Intestinal Perforation ; Laparotomy ; Leukomalacia, Periventricular ; Medical Records ; Retinopathy of Prematurity ; Retrospective Studies ; Survival Rate

BACKGROUND: A prospective multicenter study was performed to make a surgical site infections (SSI) surveillance system for hip (HRA) and knee (KRA) replacement arthroplasties and gastrectomies (GAST) in Korea. The rates, risk factors, and clinical characteristics of SSI were evaluated. METHODS: Demographic data, clinical and operative risk factors for SSI, and information of prophylactic antibiotic uses for the patients who took HRA/KRA and GAST in 7 and 5 hospitals, respectively were collected during July through December of 2007. SSI surveillance for HRA/KRA and GAST was done for 1 year and 1 month after operations, respectively. RESULTS: A total of 1,294 cases (HRA, 342; KRA, 453; GAST, 499) were monitored for SSI. The SSI rates of HRA, KRA, and GAST were 1.75 (6/342), 1.10 (5/453), and 4.41 (22/499) per 100 operations, respectively. Diabetes mellitus (DM) was more frequently accompanied and the dates of hospitalization before operations were longer in the infected group than the non-infected group of HRA. DM was more frequently found in the infected groups of KRA and GAST. Reoperation, emergent operation, and transfusion were more frequent in the infected group of GAST. Prophylactic antibiotics were used in 1,279 operations (99%) and started within 60 minutes before skin incision in 93% (1,190/1,279). The most frequently used antibiotics were 1st generation cephalosporins. Prophylactic antibiotics were used in combination in 33 operations (3%) and the median duration of antibiotic use was 4 days (0-89). CONCLUSION: The SSI rates of HRA, KRA, and GAST in this SSI surveillance system were 1.75, 1.10, and 4.41 per 100 operations, respectively.
Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement ; Cephalosporins ; Chronology as Topic ; Diabetes Mellitus ; Gastrectomy ; Hip ; Hospitalization ; Humans ; Knee ; Korea ; Prospective Studies ; Reoperation ; Risk Factors ; Skin