Engagement of the immunoreceptors initiates signaling cascades resulting in lymphocyte activation and differentiation to effector cells, which are essential for the elimination of pathogens from the body. For the transduction of these immunoreceptor-mediated signals, several linker proteins termed transmembrane adaptor proteins (TRAPs) were shown to be required. TRAPs serve as platforms for the assembly and membrane targeting of the specific signaling proteins. Among seven TRAPs identified so far, LAT and LIME were shown to act as a positive regulator in TCR-mediated signaling pathways. In this review, we will discuss the functions of LAT and LIME in modulating T cell development, activation and differentiation.
Calcium Compounds ; Lymphocyte Activation ; Lymphocytes ; Membranes ; Oxides ; Proteins

Recently, there have been many studies in medicine related to genetic analysis. Many genetic studies have been performed to find genes associated with complex diseases. To find out how genes are related to disease, we need to understand not only the simple relationship of genotypes but also the way they are related to phenotype. Multi-block data, which is a summation form of variable sets, is used for enhancing the analysis of the relationships of different blocks. By identifying relationships through a multi-block data form, we can understand the association between the blocks in comprehending the correlation between them. Several statistical analysis methods have been developed to understand the relationship between multi-block data. In this paper, we will use generalized canonical correlation methodology to analyze multi-block data from the Korean Association Resource project, which has a combination of single nucleotide polymorphism blocks, phenotype blocks, and disease blocks.
Genome-Wide Association Study ; Genotype ; Phenotype ; Polymorphism, Single Nucleotide

Customer relationship management (CRM) is a valuable method for establishing long-term customer relationships across different business areas. CRM system stores and analyzes a vast amount of customer information and provides alternatives to meet customer expectations using data warehouse and on-line analysis processing technology. Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of CRM systems to meet diverse customer satisfaction. Leading the adoption of information technology in the healthcare businesses has enabled the use of CRM technology to develop close patient-provider relationship. Especially, healthcare centers are using CRM system to provide better healthcare services as well as customer management services. This study aims to explore the current status and influential factors that will stimulate and drive the successful use of CRM system in healthcare centers. For this purpose, a survey has been conducted for CRM system users in 13 healthcare centers to investigate the current status of CRM system and the influential factors for successful use. The evaluation criteria include four categories; system quality, information quality, service quality and perceived usefulness. These criteria have been developed based on previous researches, especially DeLone & McLean information system success model. In addition, the system output is evaluated by user satisfaction, personal performance and organizational performance. The study showed that users evaluated information quality and service quality positively and to be higher than other factors in terms of influence. And the user evaluation proved that CRM system provides increased user satisfaction, organizational performance, and especially, individual performance. This is clear evidence that CRM system will improve organizational efficiency and effectiveness, which in turn, can provide competitive advantage for the healthcare centers.
Adoption ; Commerce ; Delivery of Health Care ; Efficiency, Organizational ; Health Care Sector ; Imidazoles ; Information Systems ; Nitro Compounds ; Personal Satisfaction

The purpose of this study was to identify the current status of the new graduate nurses' education system, to establish guidelines for the education of new graduate nurses, and to provide dates for the improvement of the education system. Eighty-nine hospitals participated in the survey from July to August 2018. The questionnaires consisted of 24 items including general characteristics, new graduate nurses' education system, operation of nursing education teams, and preceptorship programs. The average duration of education/training for new graduate nurses was 57.3 days, and 26.6%–58.5% of general hospitals, hospitals, and long-term care hospitals had less than 30 days of new graduate nurses education/training, which is shorter than the education/training period of tertiary hospitals. There were new nursing education guidelines in 88.8% of all medical institutions and 58.6% of them had nursing education teams. Most of the personnel in charge of nursing education were not dedicated to education. A total of 87.6% of the all participating medical institutions had preceptorship programs, while 23.1%–33.3% of hospitals and long-term care hospitals did not. The breakdown of preceptorship programs showed 68.4% as “preceptor and preceptee are in charge of one team, and preceptor is teaching preceptee,” and 19.7% were “preceptor and preceptee are in charge of each team, and preceptor is teaching preceptee at the same time.” These results show that standardization and management of new graduate nurses' education programs is necessary. For the standardization and management of new graduate nurses' education programs, joint efforts of nurses' associations and support from the government should be encouraged.
Education ; Education, Nursing ; Hospitals, General ; Joints ; Long-Term Care ; Nursing ; Preceptorship ; Tertiary Care Centers

The adaptor protein, LAD/TSAd, plays essential roles in T cell activation. To further understand the functions of this protein, we performed yeast two-hybrid screening using TSAd as bait and identified 67 kDa laminin binding protein (LBP) as the interacting partner. Subsequently, TSAd-LBP interaction was confirmed in D1.1 T cell line. Upon costimulation by T cell receptor (TCR) plus laminin crosslinking or TCR plus integrin alpha6 crosslinking, LBP was coimmunoprecipitated with TSAd. Moreover, TCR plus laminin costimulation-dependent T cell migration was enhanced in D1.1 T cells overexpressing TSAd but was disrupted in D1.1 cells overexpressing dominant negative form of TSAd or TSAd shRNA. These data show that, upon TCR plus integrin costimulation, TSAd associates with LBP and mediates T lymphocyte migration.
Adaptor Proteins, Signal Transducing/genetics/*metabolism ; Amino Acids, Diamino/metabolism ; Carrier Proteins/*metabolism ; *Cell Movement ; Humans ; Integrin alpha6/metabolism ; Jurkat Cells ; Mutation ; Protein Binding ; RNA, Small Interfering/genetics ; *Receptor Cross-Talk ; Receptors, Antigen, T-Cell/metabolism ; T-Lymphocytes/*metabolism ; Transgenes ; Two-Hybrid System Techniques

OBJECTIVE: To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. MATERIALS AND METHODS: This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated VNC images were reconstructed using two kinds of 2-material decomposition algorithms (material density iodine-water pair [MDW], material density iodine-calcium pair [MDC]) and a material suppressed algorithm (material suppressed iodine [MSI]). Two readers independently quantified calcium on VNC and TNC images. The Spearman correlation coefficient test and Bland-Altman method were used for statistical analyses. RESULTS: Coronary artery calcium scores from all three VNC images showed excellent correlation with those from the TNC images (Spearman's correlation coefficient [ρ] = 0.94, 0.88, and 0.89 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Measured coronary calcium volumes from VNC images also correlated well with those from TNC images (ρ = 0.92, 0.87, and 0.91 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Among the three VNC images, coronary calcium from MDW correlated best with that from TNC. The coronary artery calcium scores and volumes were significantly lower from the VNC images than from the TNC images (p < 0.001 for all pairs). CONCLUSION: The use of VNC images from contrast-enhanced CT using dual-energy material decomposition/suppression is feasible for coronary calcium scoring. The absolute value from VNC tends to be smaller than that from TNC.
Calcium* ; Coronary Artery Disease ; Coronary Vessels* ; Ethics Committees, Research ; Humans ; Iodine ; Prospective Studies ; Tomography, X-Ray Computed

To report a case of bilateral endophthalmitis as the initial presentation of bacterial meningitis in a young, immunocompetent Korean patient. A 35-year-old female with a one day history of bilateral swollen eyes, visual disturbance, headache, petechial skin rash, and nausea visited our clinic. She was diagnosed as having endogenous endophthalmitis associated with bacterial meningitis. Intravenous broad spectrum antibiotic therapy was initiated with cefotaxime 3 g and ubacillin 3 g, four times daily. Intravitreal antibiotic (vancomycin 1 mg/0.1 mL and ceftazidime 2 mg/0.1 mL) injections were performed in both eyes. Two weeks post presentation, the best corrected visual acuity in both eyes improved to 0.7, and inflammation of the anterior chamber and vitreous cavity was decreased. We recommend that when endogenous endophthalmitis is suspected along with meningitis, or if it is known to be present, intravitreal and intravenous antibiotics should be promptly administered to preserve vision.
Adult ; Anti-Bacterial Agents/therapeutic use ; Diagnosis, Differential ; Endophthalmitis/diagnosis/drug therapy/*etiology ; Eye Infections, Bacterial/diagnosis/drug therapy/*etiology ; Female ; Follow-Up Studies ; Humans ; Meningitis, Bacterial/*complications/diagnosis/drug therapy ; Ophthalmoscopy

PURPOSE: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. METHODS: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 microl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. RESULTS: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1alpha, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. CONCLUSIONS: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.
Animals ; Capillary Permeability ; Evans Blue ; Eye ; Hyperoxia ; Intercellular Adhesion Molecule-1 ; Intravitreal Injections ; Occludin ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; RNA, Messenger ; Triamcinolone ; Triamcinolone Acetonide ; Vascular Endothelial Growth Factor A

PURPOSE: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. METHODS: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 microl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. RESULTS: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1alpha, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. CONCLUSIONS: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.
Animals ; Capillary Permeability ; Evans Blue ; Eye ; Hyperoxia ; Intercellular Adhesion Molecule-1 ; Intravitreal Injections ; Occludin ; Rats ; Rats, Sprague-Dawley ; Retina ; Retinaldehyde ; RNA, Messenger ; Triamcinolone ; Triamcinolone Acetonide ; Vascular Endothelial Growth Factor A

Traumatic subclavian artery injury is a rare complication of clavicular fracture. An arterial injury can present as a pseudoaneurysm, which can cause a hypercoagulable state, thrombus formation, deep vein thrombosis, and distal embolism. We report a case of subclavian artery pseudoaneurysm that presented as embolic stroke in a 81-year-old man at 2015 1 month after clavicular fracture.
Aged, 80 and over ; Aneurysm, False* ; Embolism ; Humans ; Infarction* ; Stroke ; Subclavian Artery ; Thrombophilia* ; Thrombosis ; Venous Thrombosis