Purpose: To derive the optimized intraocular lens (IOL) constants from automated and manifest refraction after cataract surgery in Korean patients, and to evaluate whether there is a difference in optimized IOL constants according to the refraction method. Methods: This retrospective multicenter cohort study enrolled 4,103 eyes of 4,103 patients who underwent phacoemulsification and in-the-bag IOL implantation at 18 institutes. Optimized IOL constants for the SRK/T, Holladay, Hoffer Q, and Haigis formulas were calculated via autorefraction or manifest refraction of samples using the same biometry and IOL. The IOL constants derived from autorefraction and manifest refraction were compared. Results: Of the 4,103 eyes, the majority (62.9%) were measured with an IOLMaster 500 followed by an IOLMaster 700 (15.2%). A total of 33 types of IOLs were used, and the Tecnis ZCB00 was the most frequently used (53.0%). There was no statistically significant difference in IOL constants derived from autorefraction and manifest refraction when IOL constants were optimized with a large number of study subjects. On the other hand, optimized IOL constants derived from autorefraction were significantly smaller than those from manifest refraction when the number of subjects was small. Conclusions It became possible to use the IOL constants optimized from Koreans to calculate the IOL power. However, if the IOL constant is optimized using autorefraction in a small sample group, the IOL constant tends to be small, which may lead to refractive error after surgery.

OBJECTIVE: To compare the diagnostic accuracy of dynamic computed tomography (CT) and gadoxetate-enhanced magnetic resonance imaging (MRI) for characterization of hepatic lesions by using the Liver Imaging Reporting and Data System (LI-RADS) in a multicenter, off-site evaluation.MATERIALS AND METHODS: In this retrospective multicenter study, we evaluated 231 hepatic lesions (114 hepatocellular carcinomas [HCCs], 58 non-HCC malignancies, and 59 benign lesions) confirmed histologically in 217 patients with chronic liver disease who underwent both gadoxetate-enhanced MRI and dynamic CT at one of five tertiary hospitals. Four radiologists at different institutes independently reviewed all MR images first and the CT images 4 weeks later. They evaluated the major and ancillary imaging features and categorized each hepatic lesion according to the LI-RADS v2014. Diagnostic performance was calculated and compared using generalized estimating equations.RESULTS: MRI showed higher sensitivity and accuracy than CT for diagnosing hepatic malignancies; the pooled sensitivities, specificities, and accuracies for categorizing LR-5/5V/M were 59.0% vs. 72.4% (CT vs. MRI; p < 0.001), 83.5% vs. 83.9% (p = 0.906), and 65.3% vs. 75.3% (p < 0.001), respectively. CT and MRI showed comparable capabilities for differentiating between HCC and other malignancies, with pooled accuracies of 79.9% and 82.4% for categorizing LR-M, respectively (p = 0.139).CONCLUSION: Gadoxetate-enhanced MRI showed superior accuracy for categorizing LR-5/5V/M in hepatic malignancies in comparison with dynamic CT. Both modalities had comparable accuracies for distinguishing other malignancies from HCC.
Academies and Institutes ; Carcinoma, Hepatocellular ; Contrast Media ; Humans ; Information Systems ; Liver ; Liver Diseases ; Magnetic Resonance Imaging ; Retrospective Studies ; Tertiary Care Centers

Breast cancer is a common malignancy in women and metastasizes to the liver, the lung, the brain, and the bone, but metastasis to the colon is rare. We describe a 58-year-old woman with colon metastasis of breast cancer. She was diagnosed with right colon cancer, and during investigation for colon cancer, we found a breast cancer. She received a palliative right hemicolectomy due to obstruction before chemotherapy. The histology of the tissue taken from the right colon was shown to be the same as that of the left breast mass. This is a case of colonic metastasis from breast cancer and we report this case with a review of literature.
Brain ; Breast ; Breast Neoplasms ; Colon ; Colonic Neoplasms ; Female ; Humans ; Liver ; Lung ; Middle Aged ; Neoplasm Metastasis

BACKGROUND: The objective of this study was to evaluate the clinical applicability of the repeatability criteria recommended by the American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry guidelines and to determine which factors affect the repeatability of spirometry in Korean adults. METHODS: We reviewed the spirometry data of 4,663 Korean adults from the Korean National Health and Nutritional Examination Survey (KNHANES) Chronic Obstructive Pulmonary Disease Cohort (COPD cohort) and the Community-based Cohort Study VI-Fishing village/Islands (community cohort). We measured the anthropometric factors and differences between the highest and second-highest FVC (dFVC) and FEV1 (dFEV1) from prebronchodilator spirometry. Analyses included the distribution of dFVC and dFEV1, comparison of the values meeting the 1994 ATS repeatability criteria with the values meeting the 2005 ATS/ERS repeatability criteria, and the performance of linear regression for evaluating the influence of subject characteristics and the change of criteria on the spirometric variability. RESULTS: About 95% of subjects were able to reproduce FVC and FEV1 within 150 ml. The KNHANES based on the 1994 ATS guidelines showed poorer repeatability than the COPD cohort and community cohort based on the 2005 ATS/ERS guidelines. Demographic and anthropometric factors had little effect on repeatability, explaining only 0.5 to 3%. CONCLUSION: We conclude that the new spirometry repeatability criteria recommended by the 2005 ATS/ERS guidelines is also applicable to Korean adults. The repeatability of spirometry depends little on individual characteristics when an experienced technician performs testing. Therefore, we suggest that sustained efforts for public awareness of new repeatability criteria, quality control of spirograms, and education of personnel are needed for reliable spirometric results.
Adult* ; Cohort Studies ; Education ; Humans ; Linear Models ; Pulmonary Disease, Chronic Obstructive ; Quality Control ; Spirometry*

No abstract available.
Bronchial Arteries* ; Hemoptysis* ; Risk Factors*

No abstract available.
Bronchial Arteries* ; Hemoptysis* ; Risk Factors*

BACKGROUND: In combination with standard-dose CHOP (cyclophosphamide, vincristine, adriamycin, and prednisolone), the addition of rituximab produces a better clinical response in the treatment of aggressive B-cell non-Hodgkin's lymphoma (NHL) than CHOP alone. METHODS: Thirty-four patients with previously untreated diffuse large B-cell NHL received at least three or four cycles of rituximab 375 mg/m2 or 500 mg per dose on day 1 of each cycle in combination with CHOP chemotherapy. RESULTS: The median age of patients were 61.5 years (range, 28-83 years). After the end of therapy, twenty-five patients (73.5%) experienced a complete response, four patients (11.8 %) had a partial response, and two patients (5.9%) were classified as having progressive disease. The median follow-up duration was 9.4 months (range, 0.2-19.5 months) and 1-year overall survival and progression free survival was 84.8+/-8.7% and 80.3+/-9.4%, respectively. Two patients (5.9%) experienced fever, myalgia, and skin eruption due to rituximab. Neutropenia of grade 3 or 4 occurred in thirty-one patients (91.2%). CONCLUSION: The benefits of rituximab in combination with CHOP chemotherapy include high response rates and good tolerance. However, further prospective, randomized studies are needed to draw definitive conclusions.
B-Lymphocytes* ; Disease-Free Survival ; Doxorubicin ; Drug Therapy* ; Fever ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Myalgia ; Neutropenia ; Skin ; Vincristine ; Rituximab

BACKGROUND/AIMS: Gelatinase (matrix metalloproteinase (MMP) -2 and 9) has an important role in the pathogenesis of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). In this study, we evaluated the relationship of gelatinase to chronic liver disease. METHODS: Four groups of subjects were examined; healthy control (10 cases), chronic hepatitis (18 cases), LC (15 cases), and HCC (28 cases). The plasma of each subject was obtained, and the equal quantification of plasma protein was done. The plasma activities of MMP-2 and 9 were measured by zymography. RESULTS: The activities of plasma MMP-2 in patients with LC were significantly higher than those in controls (p=0.009) and in patients with chronic hepatitis (p=0.011), but not different from those in patients with HCC. The activities of plasma MMP-9 in patients with LC were significantly higher than those in controls, but not different from those in patients with chronic hepatitis or HCC. In patients with LC (regardless of having HCC), the activities of MMP-2 correlated with total bilirubin (r=0.323, p=0.048) and Child-Pugh score (r=0.414, p=0.012). The activities of MMP-2 and 9 were higher in patients with LC (regardless of having HCC) caused by alcohol than caused by HBV (p=0.009 and 0.002 for each one). CONCLUSIONS: The plasma activity of MMP-2 may be a useful marker for the diagnosis and determination of the severity of LC. The plasma activity of MMP-9 was not useful for HCC, but may be a marker for alcoholic LC. Further study is needed to determine why the plasma activity of gelatinase was higher in patients with LC caused by alcohol than by HBV.
Adult ; Aged ; Biological Markers/blood ; Carcinoma, Hepatocellular/*diagnosis ; Chronic Disease ; Female ; Hepatitis B, Chronic/diagnosis ; Humans ; Liver Cirrhosis/*diagnosis/etiology ; Liver Neoplasms/*diagnosis ; Male ; Matrix Metalloproteinase 2/*blood ; Matrix Metalloproteinase 9/*blood ; Middle Aged

BACKGROUND/AIMS: Long-term efficacy and the rate of viral breakthrough in patients with HBeAg- negative chronic hepatitis B receiving lamivudine therapy is uncertain. This study was conducted to determine the rate of viral breakthrough according to the HBeAg status and the relation of viral breakthrough with YMDD mutants. METHODS: Two hundred and five patients with HBeAg-positive and 49 patients with HBeAg-negative chronic hepatitis B, who had received lamivudine for at least 9 months, were included. The mean durations of the lamivudine treatment were 176 months and 155 months in HBeAg-positive and negative patients, respectively. Analysis of HBV genome for YMDD mutations was performed by restriction-fragment-length polymorphism assay and direct sequencing. RESULTS: While the cumulative rates of viral breakthrough at 12th and 24th months of the lamivudine therapy were 0% and 7% in the HBeAg-negative group, they were 12% and 39% in the HBeAg-positive group. The cumulative rate of viral breakthrough in the HBeAg-negative group was significantly lower than in the HBeAg-positive group (p<0.01). In multivariate analysis, the only significant factor related to viral breakthrough was the HBeAg status (p<0.05). The YMDD mutants were detected in all patients with viral breakthrough irrespective of HBeAg status. However, in patients without viral breakthrough, the rate of YMDD mutants was significantly higher in the HBeAg-negative group than in the HBeAg-positive group (13.3% vs 5.1%; p<0.01). CONCLUSIONS: Lamivudine is expected to be more persistently effective in HBeAg-negative chronic hepatitis B because of a lower viral breakthrough rate than in HBeAg-positive chronic hepatitis B in spite of the emergence of YMDD mutants.
Adult ; Amino Acid Motifs/genetics ; Antiviral Agents/*therapeutic use ; English Abstract ; Female ; Hepatitis B Virus/genetics/isolation & purification ; Hepatitis B e Antigens/*blood ; Hepatitis B, Chronic/*drug therapy/*virology ; Human ; Lamivudine/*therapeutic use ; Male ; Middle Aged

Reactive oxygen species such as superoxides, hydrogen peroxide (H2O2) and hydroxyl radicals have been suggested to be involved in the catalytic action of nitric oxide synthase (NOS) to produce NO from L-arginine. An examination was conducted on the effects of oxygen radical scavengers and oxygen radical-generating systems on the activity of neuronal NOS and guanylate cyclase (GC) in rat brains and NOS from the activated murine macrophage cell line J774. Catalase and superoxide dismutase (SOD) showed no significant effects on NOS or GC activity. Nitroblue tetrazolium (NBT, known as a superoxide radical scavenger) and peroxidase (POD) inhibited NOS, but their inhibitory actions were removed by increasing the concentration of arginine or NADPH respectively, in the reaction mixture. NOS and NO-dependent GC were inactivated by ascorbate/FeSO4 (a metal-catalyzed oxidation system), 2'2'-azobis-amidinopropane (a peroxy radical producer), and xanthine/xanthine oxidase (a superoxide generating system). The effects of oxygen radicals or antioxidants on the two isoforms of NOS were almost similar. However, H2O2 activated GC in a dose-dependent manner from 100 microM to 1 mM without significant effects on NOS. H2O2-induced GC activation was blocked by catalase. These results suggested that oxygen radicals inhibited NOS and GC, but H2O2 could activate GC directly.
Animal ; Antioxidants/pharmacology ; Brain/enzymology ; Catalase/pharmacology ; Cell Line ; Guanylate Cyclase/metabolism* ; Hydrogen Peroxide/pharmacology ; Macrophages/enzymology ; NADP/pharmacology ; Nitric-Oxide Synthase/metabolism* ; Nitroblue Tetrazolium/pharmacology ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species/metabolism* ; Signal Transduction ; Superoxide Dismutase/pharmacology