PURPOSE: Peroxisome proliferator-activated receptor gamma (PPARgamma) has become a potential target for the prevention and treatment of human cancers. PPARgamma ligands inhibit cell proliferation of estrogen receptoralpha(ERalpha)-positive breast cancer cells. However, it has recently been shown that ERalpha-negatively inhibits PPARgamma signaling in breast cancer cells, indicating that PPARgamma ligand may be more useful for treating ERalpha-negative breast cancer cells compared to ERalpha-positive breast cancer cells. In this study, we attempted to elucidate the role of PPARg in ERalpha-negative breast cancer cells. METHODS: The effect of PPARgamma ligand on the growth of MDA-MB-231 cells was measured by MTT assay and flow cytometric analysis. TUNEL staining and Hoechst 33342 fluorescent staining were used to observe the effects of PPARgamma ligand on cell apoptosis. The regulatory proteins of the cell cycle were measured by Western blot. RESULTS: The treatment of MDA-MB-231 human breast cancer cells with the PPARgamma ligand, trgoglitazone, was shown to induce inhibition of cell growth in a dose-dependent manner. Cell cycle analysis showed a G1 arrest in MDA-MB-231 cells exposed to troglitazone. The apoptotic effect by troglitazone demonstrated that apoptotic cells were elevated from 2.5-fold of the control level at 10 mM, to 3.1-fold at 50micrometer and to 3.5-fold at 75 mM of troglitazone. Moreover, troglitazone treatment dose-dependently caused a marked decrease in the pRb, cyclin D1, cyclin D2, cyclin D3, cdk2, Cdk4 and Cdk6 expressions and there was a significant increase in the p21 and p27 expressions. CONCLUSION: These results indicate that trgoglitazone induces cell-cycle G1 arrest and apoptosis in ERalpha-negative MDA-MB-231 breast cancer cells. Collectively, this paper shows that PPARgamma ligand is an important player as a member of the chemotherapeutic candidates for treating ERalpha-negative breast cancer.
Apoptosis* ; Blotting, Western ; Breast Neoplasms* ; Breast* ; Cell Cycle ; Cell Proliferation ; Cyclin D1 ; Cyclin D2 ; Cyclin D3 ; Estrogens ; Humans ; In Situ Nick-End Labeling ; Ligands ; Peroxisomes* ; PPAR gamma*

BACKGROUND: This study was designed to determine the optimal sedative dose of propofol to start brain magnetic resonance imaging (MRI) in children with cerebral palsy (CP). METHODS: Twenty children, aged 0.5-5 years, were administered propofol to achieve a University of Michigan Sedation Scale (UMSS) score > or = 3 in the MRI room. The proper dose of propofol was determined using the up-and-down method. RESULTS: The ED50 and ED95 for successful sedation with a UMSS > or = 3 were 2.07 mg/kg (95% CI 1.69-2.56) and 2.69 mg/kg (95% CI 2.35-5.59). Respiratory events occurred in 5 patients and were resolved with neck extension, chin lift, or transient respiratory assistance with successful sedation. CONCLUSIONS: Low dose propofol can safely facilitate the initiation of MRI in children with CP.
Aged ; Brain ; Cerebral Palsy ; Child ; Chin ; Humans ; Magnetic Resonance Imaging ; Michigan ; Neck ; Propofol

PURPOSE: The aim of this study was to evaluate the utility of contrast-enhanced MRI with first-pass and delayed images in prediction of myocardial viability after acute myocardial infarction. MATERIALS AND METHODS: Ten patients (M:F=:4, mean age =6 5 years) with acute myocardial infarction underwent first-pass image after bolus injection of gadolinium (one image/sec for 120sec)and delayed image (7 2 minutes later). According to 60 segments on midventricular level, the assessment of MRI were concerned about location of lesion, depth of lesion, enhancement on first-pass image and enhancement pattern on delayed image. MRI findings were compared with wall motion on resting echocardiography and stress or follow-up echocardiography. RESULTS: 1) MRI findings were classified into 4 types: normal enhancement on first-pass and delayed images (type 1), normal enhancement on first-pass image and nontransmural hyperenhancement on delayed image (type 2), non-transmural enhancing defect on first-pass image and transmural enhancement with endocardial non-enhancing defect on delayed image (type 3), and transmural enhancing defect on first-pass image and transmural hyperenhancement on delayed image (type 4).2) Type 2 suggested viable myocardium and type 3 had high porbability of viability. Type was compatible with non-viable myocardium. CONCLUSION: Enhancing defect on first-pass image and involving thickness on both the first-pass image and delayed image in contrast enhanced MRI may predict myocardial viability.
Echocardiography ; Follow-Up Studies ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Myocardial Infarction* ; Myocardium

OBJECTIVE: To compare the effects of cardiac rehabilitation between patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). METHOD: Thirty three patients with STEMI or NSTEMI who underwent percutaneous transluminal coronary angioplasty were recruited. All patients participated in cardiac rehabilitation program including ECG monitoring exercise for 6 weeks. Several parameters such as exercise duration, oxygen consumption, heart rate, blood pressure and rate pressure product were evaluated through graded exercise test before and 6 months after initiation of cardiac rehabilitation program. RESULTS: After cardiac rehabilitation program, the STEMI group showed significant changes in exercise time, maximum oxygen consumption, resting heart rate and submaximal rate pressure product. The NSTEMI group also showed significant improvement of exercise time, maximum oxygen consumption and submaximal rate pressure product. There was no significant difference in the changing rate between two groups. CONCLUSION: Both the STEMI and the NSTEMI groups showed similar improvement of cardiopulmonary exercise capacity 6 months after cardiac rehabilitation program.
Angioplasty, Balloon, Coronary ; Blood Pressure ; Electrocardiography ; Exercise Test ; Heart ; Heart Rate ; Humans ; Myocardial Infarction ; Oxygen Consumption ; Physical Fitness

OBJECTIVE: To investigate the effect of self exercise in cardiac rehabilitation on cardiopulmonary exercise capacity for selected patients with coronary artery disease. METHOD: The subjects of this study were patients who received percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery and who participated in a cardiac rehabilitation program. The supervised exercise group participated in 6-8 weeks of aerobic exercise training with telemetry ECG monitoring in hospital. The self exercise group, whose exercise risk was low, was instructed to participiate in self exercise training in a community exercise environment according to the exercise tolerance test (ETT) using a modified Bruce protocol. Both groups underwent ETTs before and 6 months after initiation of the cardiac rehabilitation program. We compared the supervised group with the self exercise groups on exercise capacity. RESULTS: After 6 months, the supervised exercise group showed significant changes in maximum oxygen consumption, maximal heart rate, resting heart rate, and submaximal rate pressure product. The self exercise group also showed significant improvement of maximum oxygen consumption and submaximal rate pressure product. However, the changing rate of maximum oxygen consumption was significantly higher in the supervised exercise group than the self exercise group. CONCLUSION: Both the supervised and self exercise groups showed similar improvement of cardiopulmonary exercise capacity after 6 months' participation in the cardiac rehabilitation program. However, the changing rate of maximum oxygen consumption, maximal heart rate, and resting heart rate were significantly higher in the supervised exercise group than the self exercise group.
Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Electrocardiography ; Exercise ; Exercise Tolerance ; Heart Rate ; Humans ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Telemetry ; Transplants

The term MYH9-related disorders indicates a group of autosomal dominant illnesses, formerly known as May-Hegglin anomaly, Sebastian syndrome, Fechtner syndrome and Epstein syndrome, caused by mutations of MYH9, the gene encoding for the heavy chain of non-muscle myosin IIA (NMMHC-IIA). We experienced a family with macrothrombocytopenia without leukocyte inclusion. A 5-year-old girl was found to have macrothrombocytopenia incidentally. Her father also had macrothromtocytopenia, but had been suffering from hearing loss and chronic renal failure. Meticulous search by light and electron microscopy failed to detect leukocyte inclusions. To our knowledge, these cases seem to be the first description of autosomal dominant Epstein giant platelet syndrome in Korea.
Bernard-Soulier Syndrome* ; Child, Preschool ; Fathers ; Female ; Hearing Loss ; Humans ; Kidney Failure, Chronic ; Korea ; Leukocytes ; Microscopy, Electron ; Nonmuscle Myosin Type IIA

Purpose: Microinvasive breast cancer (MIBC) is an invasive carcinoma with a tumor dimension not exceeding 1 mm. Owing to its low incidence, the rate of axillary node metastasis and its management are not well established. The aim of this study was to assess the incidence of lymph node metastasis (LNM) and identify variables associated with LNM, as well as to evaluate the need for axillary staging in MIBC patients by analyzing nationwide data. Methods: The Korean Breast Cancer Society registry was searched to identify MIBC patients diagnosed between January 1996 and April 2020. Patients without neoadjuvant chemotherapy experiences, systemic metastasis, and missing or discordant data were eligible for the analysis. The incidence rate of LNM was determined, and variables associated with LNM were identified by multivariable regression analysis. Results: Of 2,427 MIBC patients identified, 98 (4.0%) had LNM and 12 (0.5%) had N2/3 disease. Type of breast operation (odds ratio [OR], 2.093; 95% confidence interval [CI], 1.332–3.290; P = 0.001), age (OR, 2.091; 95% CI, 1.326–3.298; P = 0.002), hormone receptor status (OR, 2.220; 95% CI, 1.372–3.594; P = 0.001), and lymphovascular invasion (OR, 11.143; 95% CI, 6.354–19.540; P < 0.001) were significantly related to LNM. Conclusion The incidence of LNM in MIBC patients was only 4.0% in our study, suggesting that de-escalation of axillary surgical interventions could be carefully considered. The indications for axillary staging should be individualized considering tumor volume, age, hormone receptor status, and lymphovascular invasion to improve the quality of life of MIBC survivors.

Postoperative emesis is still a troublesome problem in patients undergoing general anesthesia. We compared the efficacy and safety of ondansetron, a selective antagonist of serotonin 5HT3 receptors, within the 24hours postoperative period. Forty patients between the ages of 12 and 75 and ASA class I-III, having general anesthesia, undergoing elective abdominal surgery (except gynecologic surgery) were assigned to one of two treatment groups according to uncontrolled parallel comparative study design. A standard anesthetic technique consisting of thiopental-atracurium for induction and N2O-Enflurane for maintenance of anesthesia was used. The data showed that intravenous ondansetron 4mg i.v. before induction was significantly more effective in preventing emesis (n=20, 85%) than placebo (n=20, 60%). Nausea severity scores were also significantly decreased from 1.5+/-0.6 (mean+/-SE) in placebo group to 0.30.1 in ondansetron group (p<0.05). All patients receiving of ondansetron 4mg intravenously tolerated their treatment well, without any special adverse events. Conclusion; Ondansetron(4mg) given intravenously before induction to prevent postoperative nausea and vomiting in patients undergoing elective abdominal surgery was effective and safe.
Anesthesia ; Anesthesia, General ; Humans ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Serotonin ; Vomiting

PURPOSE: The aim of this study is to evaluate the clinical utility of automated breast volume scanner (ABVS) for detecting and diagnosing the breast lesions. METHODS: From December 2010 to January 2012, bilateral whole breast examinations were performed with ABVS for 139 women. Based on the Breast Imaging Reporting and Data System (BI-RADS) categories, the breast lesions were evaluated on coronal multiplanar reconstruction images using the ABVS workstation. Then, the imaging results were compared with those on conventional handheld ultrasound (HHUS) images. Histological diagnoses were performed on BI-RADS category 4 and 5 lesions. RESULTS: A total of 453 lesions were detected by ABVS. On the HHUS, 33 new lesions were detected but 69 lesions were not detected. BI-RADS category 2 and 3 matched to those on ABVS at 73.5% (61/83) and 85.4% (276/323). In 47 lesions of BI-RADS category 4 or 5, there was an exact match to those on ABVS. In addition, 47 lesions were classified as BI-RADS category 4 and 5, for which an ultrasound-guided core needle biopsy was performed. The malignant lesions of BI-RADS category 4 and 5 showed the following: 2/27 (7.4%) in 4A, 4/5 (80%) in 4B, 2/2 (100%) in 4C, and 13/13 (100%) in 5. The ABVS showed 21 true positives and a positive predictive value of 44.7% (21/47). CONCLUSION: There was considerable agreement in the assessment of the breast lesions by ABVS and HHUS. The ABVS had advantages of high diagnostic accuracy, examiner-independence, multislice visualization of the whole breast and less time-consuming. Our results indicate that ABVS might be a useful modality in diagnosing breast lesions.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Female ; Humans ; Information Systems ; Pilot Projects