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.

Synthetic oligodeoxynucleotides (ODN) with a CpG-motif are recognized by Toll-like receptor 9 (TLR9) and pleiotropic immune responses are elicited. Stimulation of macrophages with TLR9 agonist prevented apoptosis induced by serum deprivation through increased expression of FLICE-like inhibitory protein (FLIP). CpG ODN-mediated anti-apoptosis depended on the TLR9-Akt-FoxO3a signaling pathway. Inhibition of TLR9 by small interfering (si) RNA or an inhibitor suppressed CpG ODN-mediated anti-apoptosis. Analysis of signaling pathways revealed that the anti-apoptotic effect of CpG ODN required phosphorylation of FoxO3a and its translocation from the nucleus to the cytosol. Overexpression of FoxO3a increased apoptosis induced by serum deprivation and CpG ODN blocked these effects through FLIP expression. In contrast, siRNA knock-down of FoxO3a decreased apoptosis by serum deprivation. In addition, Akt activation was involved in CpG ODN-induced phosphorylation of FoxO3a, expression of FLIP, and anti-apoptosis. Taken together, these results demonstrate the involvement of Akt-FoxO3a in TLR9-mediated anti-apoptosis and indicate that FoxO3a is a distinct regulator for FLIP expression.
Animals ; *Apoptosis ; CASP8 and FADD-Like Apoptosis Regulating Protein/*genetics/metabolism ; Cells, Cultured ; Forkhead Transcription Factors/genetics/*metabolism ; Macrophages/metabolism ; Mice ; Mice, Inbred C57BL ; Oligodeoxyribonucleotides/metabolism ; Oncogene Protein v-akt/metabolism ; RNA, Small Interfering/metabolism ; Signal Transduction ; Toll-Like Receptor 9/genetics/*metabolism

Resveratrol is a polyphenolic compound in red wine that has anti-oxidant and cardioprotective effects in animal models. Reactive oxygen species (ROS) and monocyte chemotactic protein-1 (MCP-1) play key roles in foam cell formation and atherosclerosis. We studied LPS-mediated foam cell formation and the effect of resveratrol. Resveratrol pretreatment strongly suppressed LPS-induced foam cell formation. To determine if resveratrol affected the expression of genes that control ROS generation in macrophages, NADPH oxidase 1 (Nox1) was measured. Resveratrol treatment of macrophages inhibited LPS-induced Nox1 expression as well as ROS generation, and also suppressed LPS-induced MCP-1 mRNA and protein expression. We investigated the upstream targets of Nox1 and MCP-1 expression and found that Akt-forkhead transcription factors of the O class (FoxO3a) is an important signaling pathway that regulates both genes. These inhibitory effects of resveratrol on Nox1 expression and MCP-1 production may target to the Akt and FoxO3a signaling pathways.
Antioxidants/*pharmacology ; Cells, Cultured ; Chemokine CCL2/genetics/*metabolism ; Enzyme Activation/drug effects ; Foam Cells/*drug effects/physiology ; Forkhead Transcription Factors/metabolism ; Humans ; Lipopolysaccharides/pharmacology ; NADH, NADPH Oxidoreductases/genetics/*metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; RNA, Messenger/metabolism ; Reactive Oxygen Species/*metabolism ; Signal Transduction ; Stilbenes/*pharmacology

OBJECTIVE: To compare the clinical effectiveness of transvaginal radiofrequency myolysis of the patients with leiomyomas and the patients with adenomyosis which have similar clinical symptoms. METHODS: From May 2005 to May 2006 at Eulji university hospital, 108 women who were diagnosed of leiomyoma and adenomyosis had undergone transvaginal radiofrequency myolysis. Before and after the procedure size, number of uterine myomas, location and the volume of the leiomyomas and adenomyosis were measured by ultrasound. And on every visit after the procedure improvement of the symptom was checked by questionnaire of the symptom and life quality. Using Wilcoxon signed ranked test, the statistical significance was proved and the P value lower than 0.05 was judged to be significant. RESULTS: 76 women with leiomyoma who had undergone transvaginal radiofrequency myolysis, were followed up 1 month, 3 months, 6 months and 9 months after the procedure. The average maximal diameter of the myoma was decreased by 14.6%, 23.3%, 30.6%, 33.6% respectively, and the average volume was decreased by 35.7%, 53.3%, 67.3%, 72.2% respectively. 32 women with adenomyosis who had undergone transvaginal radiofrequency myolysis were followed up, at the same period after the procedure. The average maximal diameter of the adenomyosis was decreased by 8.9%, 13.6%, 14.6%, 11.9% respectively, and the average volume was decreased by 22.6%, 30.0%, 32.3%, 28.4% respectively. Before and after the procedure the symptom score was 62.3, 52.2, 40.6, 32.6, 28.6 respectively, and the quality of life score was 68.9, 78.1, 82.9, 85.7, 87.3 respectively in the leiomyoma group. In the adenomyosis group, before and after the procedure the symptom score was 77.7, 37.6, 30.6, 54.4, 67.5 respectively, and the quality of life score was 48.1, 76.5, 85.5, 66.5, 55.1 respectively. CONCLUSION: Transvaginal radiofrequent myolysis had benefits in conserving the uterus, and was less invasive, and had great effect on the reducing the size of the leiomyoma and improving the symptoms, and also returning to normal life pattern was earlier. But in women with adenomyosis the symptoms were worsened after approximately 6 to 9 months after the procedure. Therefore additional research and follow-up is required and a strict criterion is needed.
Adenomyosis ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; Myoma ; Quality of Life ; Surveys and Questionnaire ; Uterus

PURPOSE: To examine the relationship between weight gain and the success of VBAC by using body mass index (BMI). To examine the relationship between weight gain and the success of VBAC by using body mass index (BMI). METHODS: The study compared clinical features taken from 112 patients who tried VBAC at our institute from January 2001 through December 2006. There were divided into two GROUPS: 92 patients for the success (82.1%) and 20 patients for the failure group (17.9%). Excluding 36 patients with no BMI data, we constructed Receive-operating characteristics (ROC) curve to make the optimum BMI value for the prediction of success of VBAC. Based on the BMI 26 or more, two groups of patient were surveyed the interrelation between weight gain and success of VBAC. RESULTS: Between success and failure group, the weight gain during pregnancy showed significant differences which are 11.2+/-4 kg of the success group and 13.2+/-5 kg of the other one (p<0.05) A survey on the availability of the BMI date to estimate success of VBAC, the criteria with the standard BMI 26 is not statistically valuable (p=0.837). By comparing normal weight and overweight based on BMI 26, some factors showed statistically significant discrepancies: number of prenatal visit, maternal weight gain, maternal weight at the time of delivery, use of oxytocin and birth weight. CONCLUSION: BMI value of 26 has limitations in using as an estimate criteria on success of VBAC. Patients, however, who had relatively small scale of weight gain, showed significant clinical factors to increased success rate of VBAC.
Body Mass Index ; Humans ; Overweight ; Oxytocin ; Parturition ; Pregnancy ; Vaginal Birth after Cesarean ; Weight Gain

PURPOSE: The nitric oxide (NO) release by inducible nitric oxide synthase (iNOS) is the key events in macrophage response to lipopolysaccharide (LPS) which is suggested to be a crucial mediator for inflammatory and innate immune responses. NO is an important mediator involved in many host defense action and may also lead to a harmful host response to bacterial infection. However, given the importance of iNOS in a variety of pathophysiological conditions, control of its expression and signaling events in response to LPS has been the subject of considerable investigation. MATERIALS AND METHODS: The Raw264.7 macrophage cell line was used to observe LPS-stimulated iNOS expression. The expression of iNOS is observed by Western blot analysis and real-time RT-PCR. Protein kinase C (PKC)-alpha overexpressing Raw264.7 cells are established to determine the involvement of PKC-alpha in LPS-mediated iNOS expression. NF-kappaB activity is measured by IkappaBalpha degradation and NF-kappaB luciferase activity assay. RESULTS: We found that various PKC isozymes regulate LPS-induced iNOS expression at the transcriptional and translational levels. The involvement of PKC-alpha in LPS-mediated iNOS induction was further confirmed by increased iNOS expression in PKC-alpha overexpressing cells. NF-kappaB dependent transactivation by LPS was observed and PKC-alpha specific inhibitory peptide abolished this activation, indicating that NF-kappaB activation is dependent on PKC-alpha. CONCLUSION: Our data suggests that PKC-alpha is involved in LPS-mediated iNOS expression and that its downstream target is NF-kappaB. Although PKC-alpha is a crucial mediator in the iNOS regulation, other PKC isozymes may contribute LPS-stimulated iNOS expression. This finding is needed to be elucidated in further study.
Bacterial Infections ; Blotting, Western ; Cell Line ; I-kappa B Proteins ; Immunity, Innate ; Isoenzymes ; Luciferases ; Macrophages ; NF-kappa B ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Protein Kinase C ; Protein Kinase C-alpha ; Protein Kinases ; Toll-Like Receptors ; Transcriptional Activation

OBJECTIVE: To compare clinical results of laparoscopic assisted vaginal hysterectomy for uteri weighing 500 g or more with less than 500 g. And we compared clinical results between laparoscopic coagulation of uterine vessel (LH) and conventional LAVH. METHODS: We reviewed medical records of 296 patient who underwent LAVH from February 2004 to May 2006. They were divided into two groups, uteri weighing greater than 500 g and less than 500 g. And each group was divided into two groups, LH and conventional LAVH. Each groups were compared by operative time, hemoglobin change, complication, transfusion and hospital days. RESULTS: Operation time ,hemoglobin change on the 1st postoperative day and transfusion were significant greater in the uteri > or =500 g group than in the <500 g. However, there was no significant difference in hospital days, hemoglobin change on the 4th postoperative day and complication. In the <500 g group, LH group was lower than conventional LAVH group in operative time, hemoglobin change on the 1st and 4th postoperative day. In the > or =500 g group, there was no signicant difference in hospital days, operative time, hemoglobin change on the 1st postoperative day. However, hemoglobin change was smaller in the LH group than conventional LAVH group on the 4th postoperative day. CONCLUSION: This study demonstrates that despite the increased operating time and blood loss, LAVH can be safely performed for large uterus. However, surgeons need to be aware of high risk of blood transfusion. Modification of surgical method can decrease operating time and blood loss in LAVH.
Blood Transfusion ; Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Medical Records ; Operative Time ; Uterus*

BACKGROUND: Phosphatidic acid (PA), an important second messenger, is involved in inflammation. Notably, cell-cell interactions via adhesion molecules play a central role in inflammation. This thesis show that PA induces expression of intercellular adhesion molecule-1 (ICAM-1) on macrophages and describe the signaling pathways. MATERIALS AND METHODS: Macrophages were cultured in the presence of 10% FBS and assayed cell to cell adhesion using HUVEC. For the gene and protein analysis, RT-PCR, Western blot and flow cytometry were performed. In addition, overexpressed cell lines for dominant negative PKC-delta mutant established and tested their effect on the promoter activity and expression of ICAM-1 protein by PA. RESULTS: PA-activated macrophages significantly increased adhering to human umbilical vein endothelial cell and this adhesion was mediated by ICAM-1. Pretreatment with rottlerin (PKC-delta inhibitor) or expression of a dominant negative PKC-delta mutant, but not Go6976 (classical PKC-alpha inhibitor) and myristoylated PKC-zeta inhibitor, attenuated PA-induced ICAM-1 expression. The p38 mitogen-activated protein kinase (MAPK) inhibitor blocked PA-induced ICAM-1 expression in contrast, ERK upstream inhibitor didn't block ICAM-1. CONCLUSION: These data suggest that PA-induced ICAM-1 expression and cell-cell adhesion in macrophages requires PKC-delta activation and that PKC-delta activation is triggers to sequential activation of p38 MAPK.
Blotting, Western ; Cell Adhesion ; Cell Line ; Endothelial Cells ; Flow Cytometry ; Humans ; Inflammation ; Intercellular Adhesion Molecule-1* ; Macrophages ; p38 Mitogen-Activated Protein Kinases ; Phosphatidic Acids ; Protein Kinase C ; Protein Kinases ; Second Messenger Systems ; Umbilical Veins

Uterine sacculation is a very rare complication associated with pregnancy in which a part of the uterine wall balloons, and it is difficult to diagnose because it is usually asymptomatic. It frequently contains the placenta and sometimes may be involved with the trapped placenta after delivery due to its structural characteristic. It is impossible to remove the retained placenta in the sac by using usual methods such as manual delivery or curettage so most of patients with it end up with having a laparotomy. Especially, if the placenta in it is accompanied by abnormal adherence of the placenta or serious hemorrhage, hysterectomy should be considered. Currently several conservative methods for the retained placenta including selective uterine artery embolization and administration of methotrexate have been introduced and these may be tried to treat the retained placenta in the uterine sacculation for avoiding operation and preserving future reproductive potential in selective cases. We experienced a case of placenta increta in the uterine sacculation that was diagnosed first during cesarian section and was treated with selective uterine artery embolization followed by methotrexate administration. This case is reported with a brief review of the literatures.
Curettage ; Hemorrhage ; Humans ; Hysterectomy ; Laparotomy ; Methotrexate ; Placenta Accreta* ; Placenta* ; Placenta, Retained ; Pregnancy ; Uterine Artery Embolization

Uterine sacculation is a very rare complication associated with pregnancy in which a part of the uterine wall balloons, and it is difficult to diagnose because it is usually asymptomatic. It frequently contains the placenta and sometimes may be involved with the trapped placenta after delivery due to its structural characteristic. It is impossible to remove the retained placenta in the sac by using usual methods such as manual delivery or curettage so most of patients with it end up with having a laparotomy. Especially, if the placenta in it is accompanied by abnormal adherence of the placenta or serious hemorrhage, hysterectomy should be considered. Currently several conservative methods for the retained placenta including selective uterine artery embolization and administration of methotrexate have been introduced and these may be tried to treat the retained placenta in the uterine sacculation for avoiding operation and preserving future reproductive potential in selective cases. We experienced a case of placenta increta in the uterine sacculation that was diagnosed first during cesarian section and was treated with selective uterine artery embolization followed by methotrexate administration. This case is reported with a brief review of the literatures.
Curettage ; Hemorrhage ; Humans ; Hysterectomy ; Laparotomy ; Methotrexate ; Placenta Accreta* ; Placenta* ; Placenta, Retained ; Pregnancy ; Uterine Artery Embolization