Purpose: To assess the impact of toxoplasma immunoglobulin G (IgG) titers on the diagnosis of active ocular toxoplasmosis. Methods: We retrospectively analyzed the medical records of patients tested for toxoplasma IgG at our uveitis clinic. Active ocular toxoplasmosis was clinically diagnosed based on wide-angle fundus photography and disease progression. Patients with IgG titers ≥ 30 IU/mL were classified as seropositive-high titer, those with IgG titers of 1.6-30 IU/mL as seropositive-low titer, and the remaining patients as seronegative. We compared the proportion of active ocular toxoplasmosis among these groups. Additionally, we evaluated the sensitivity and specificity of each titer and attempted to determine an ideal reference titer for toxoplasma IgG in diagnosing active ocular toxoplasmosis. Results: Out of 824 patients, 86 (10.4%), 88 (10.7%), and 650 (78.9%) were categorized as seropositive-high titer, seropositivelow titer, and seronegative, respectively. Among these patients, 34 in the seropositive-high titer group and 2 in the seropositive- low titer group were clinically diagnosed with active ocular toxoplasmosis. The false-positive rate was significantly different between the groups, being 60.5% in the seropositive-high titer group and 97.7% in the seropositive-low titer group (p < 0.001). The receiver operating characteristic curve indicated that 37.70 IU/mL could be an ideal reference titer for diagnosing ocular toxoplasmosis. Conclusions The false-positive rate was notably lower (60.5%) in patients with IgG titers ≥ 30 IU/mL compared to those with titers of 1.6-30 IU/mL (97.7%). Therefore, not only the presence of IgG but also the level of titer appears to be important in diagnosing ocular toxoplasmosis.

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: Ventricular remodeling after myocardial infarction increase mortality and morbidity. Two-dimensional echocardiography in acute myocardial infarction provides a useful diagnostic tool for evaluation of ventricular remodeling. The aims of this study were to verify whether follow-up two-dimensional echocardiography could detect ventricular enlargement after acute myocardial infarction and to find early echocardiographic predictors and clinical charateristics of ventricular enlargement. METHODS: Two-dimensional echocardiography was done prospectively at 2 week, 3 month, and 6 month after the first Q-wave acute myocardial infarction in 18 patients. The control group was 11 patients of a normal chest roentgenogram and echocardiogram who were studied for chest pain or arrhythmia. The patients were divided by the mean value of the control group left ventricular end-diastolic volume index(LVEDVI) 56.8ml/m2. The group A was more than 60ml/m2(the control group LVEDVI 56.8ml/m2) and the group B was less than 60ml/m2 of LVEDVI at 2 week post myocardial infarction. The left vantricular volume was measured by the modified disk method at the apical four chamber view. The wall motion abnormality of left ventricle was examined by the recommendation of the American Society of Echcardiography. RESULTS: The left vntricular end-diastolic volume and the left ventricular end-systolic volume were enlarged after 3 month of acute myocardial infarction in the group A compare with those of the control group. There was no ventricular enlargement during 6 month after myocardial infarction in the group B. The frequency of ventricular enlargement was increased in anterior myocardial infarction. There was no difference in left ventricular ejection fraction at 2 week post myocardial infarction between the group A(51.4+/-15.7%) and the group B(50.8+/-10.3%). The wall motion score index more than 1.5 at 2 week post myocardial infarction means the enlarged LVEDVI more than 60ml/m2 and the group of ventricular enlargement. CONCLUSION: The left ventricular enlargement could be diagnosed by the follow-up two-dimensional echocardiography in acute myocardial infarction. The echocardiographic early predictors of ventricular enlagement were the left ventricular end-diastolic volume greater than 60ml/m2 and increased wall motion score index more than 1.5 at 2 week post myocardial infarstion. The anterior myocardial infarction was the electrocardiographic predictor of ventricular dilatation. Therefore these early predictors could identify the patients of ventricular enlargement and these patients could be a candidate of follow-up echocardiography and of a specific treatment for limiting ventricular remodeling.
Arrhythmias, Cardiac ; Chest Pain ; Dilatation ; Echocardiography* ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mortality ; Myocardial Infarction* ; Prospective Studies ; Stroke Volume ; Thorax ; Ventricular Remodeling

PURPOSE: The selection of systemic therapy for breast cancer is based on the expression pattern of biological prognostic markers. Neoadjuvant chemotherapy has been considered the standard care for locally advanced breast cancer. However, its effect on the expression of biological prognostic markers is controversial. The aim of this study was to determine whether neoadjuvant chemotherapy may alter these expression patterns in patients suffering with breast cancer. METHODS: We determined the protein expression levels of estrogen receptor (ER), progesterone receptor (PR), p53 and HER-2/neu in the preoperative core needle biopsies and the final surgical specimens from 15 patients who received neoadjuvant chemotherapy between January 2002 and June 2007. As a control group, we analyzed the samples from patients who did not receive neoadjuvant chemotherapy. RESULTS: The pathologic complete tumor response rate (pCR) of the neoadjuvant chemotherapy group was 6.7% (1/15). Of those patients who did not achieve a pCR (n=14), no significant differences in the biological prognostic markers expression were observed between the two groups. Alteration of the ER or PR status occurred in 42.8% (6/14) of the patients after neoadjuvant chemotherapy and in 14.3% (2/14) of the control patients, showing there was no significant difference between the two groups (P=0.210). The hormonal receptor status was changed in 3 cases (21.4%) after neoadjuvant chemotherapy. CONCLUSION: There were no significant differences for the changes in the expression of ER, PR, p53 and HER-2/neu from the preoperative core needle biopsy to the final surgical specimens between those patients who had received neoadjuvant chemotherapy and those patients who didn't. However, changes of the ER or PR status and the hormonal receptor status occurred in 42.8% and 21.4%, respectively, of the patients who underwent neoadjuvant chemotherapy. As these changes may impact treatment, we suggest that immunohistochemical assay is necessary before and after neoadjuvant chemotherapy in patients with breast cancer.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Polymerase Chain Reaction ; Receptors, Progesterone ; Stress, Psychological

PURPOSE: The selection of systemic therapy for breast cancer is based on the expression pattern of biological prognostic markers. Neoadjuvant chemotherapy has been considered the standard care for locally advanced breast cancer. However, its effect on the expression of biological prognostic markers is controversial. The aim of this study was to determine whether neoadjuvant chemotherapy may alter these expression patterns in patients suffering with breast cancer. METHODS: We determined the protein expression levels of estrogen receptor (ER), progesterone receptor (PR), p53 and HER-2/neu in the preoperative core needle biopsies and the final surgical specimens from 15 patients who received neoadjuvant chemotherapy between January 2002 and June 2007. As a control group, we analyzed the samples from patients who did not receive neoadjuvant chemotherapy. RESULTS: The pathologic complete tumor response rate (pCR) of the neoadjuvant chemotherapy group was 6.7% (1/15). Of those patients who did not achieve a pCR (n=14), no significant differences in the biological prognostic markers expression were observed between the two groups. Alteration of the ER or PR status occurred in 42.8% (6/14) of the patients after neoadjuvant chemotherapy and in 14.3% (2/14) of the control patients, showing there was no significant difference between the two groups (P=0.210). The hormonal receptor status was changed in 3 cases (21.4%) after neoadjuvant chemotherapy. CONCLUSION: There were no significant differences for the changes in the expression of ER, PR, p53 and HER-2/neu from the preoperative core needle biopsy to the final surgical specimens between those patients who had received neoadjuvant chemotherapy and those patients who didn't. However, changes of the ER or PR status and the hormonal receptor status occurred in 42.8% and 21.4%, respectively, of the patients who underwent neoadjuvant chemotherapy. As these changes may impact treatment, we suggest that immunohistochemical assay is necessary before and after neoadjuvant chemotherapy in patients with breast cancer.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Polymerase Chain Reaction ; Receptors, Progesterone ; Stress, Psychological

Metastatic breast cancer from a primary cervical cancer is extremely rare with few cases reported. A diagnosis of breast metastasis can present difficulties due to various clinical, radiological, and histological manifestations. The important factors that suggest an appropriate diagnosis are the history of the cancer, specific mammographic or ultrasonographic findings and a correlation between the histology of the metastatic and primary tumor. Only an accurate diagnosis can avoid an unnecessary mastectomy and is required to institute an appropriate systemic oncological therapy. An metastatic breast cancer has a poor prognosis. We report a case of a 39-year-old woman with primary cervical cancer who developed a breast metastasis with a review of the literature.
Adult ; Breast Neoplasms* ; Breast* ; Diagnosis ; Female ; Humans ; Mastectomy ; Neoplasm Metastasis ; Prognosis ; Uterine Cervical Neoplasms*

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

PURPOSE: The modulation of Bmi-1 is observed in several tumor tissues, with its heightened protein level suspected of being involved in tumorigenesis by acting as a transcriptional repressor in the INK4a/ARF locus. To elucidate the role of Bmi-1 in invasive ductal breast cancers, the expression of Bmi-1 at the mRNA and protein levels were examined. METHODS: Breast carcinoma samples were obtained from patients who underwent routine surgery for breast cancer at the Department of Surgery, Chonbuk National University Hospital, in 2000-2002. Cancerous breast and paired normal breast tissues were taken from a site distant from the tumorous lesion, and analyzed with reverse transcription-polymerase chain reaction (RT-PCR) and and immunohistochemical assay. We analyzed the correlations between the expression of Bmi-1 and various clinicopathological factors, such as age, lymph node metastases, estrogen receptor (ER), and progesterone receptor (PR), in invasive ductal carcinomas of the breast. RESULTS: The Bmi-1 mRNA level by RT-PCR was shown to be significantly up-regulated in 19 of the 22 breast carcinoma tissues specimen compared with the non-neoplastic tissues adjusted to tested specimens. The immunohistochemical staining for Bmi-1 also showed high a level of expression in 44 of the 71 invasive ductal breast cancers (62%), and was more intense in the invading fronts than in the central portions of the primary invasive breast cancers. Univariate and multivariate analyses showed that a high level of Bmi-1 expression was significantly correlated with axillary lymph node metastases and a positive estrogen receptor status. CONCLUSION: The Bmi-1 was differentially expressed in human breast carcinomas. These findings suggested that Bmi-1 might be involved in the progression of invasive ductal breast cancer, and it may be clinically useful in selecting patients who could benefit from adjuvant chemotherapy.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Chemotherapy, Adjuvant ; Estrogens ; Humans ; Jeollabuk-do ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis* ; Receptors, Progesterone ; RNA, Messenger

PURPOSE: The modulation of Bmi-1 is observed in several tumor tissues, with its heightened protein level suspected of being involved in tumorigenesis by acting as a transcriptional repressor in the INK4a/ARF locus. To elucidate the role of Bmi-1 in invasive ductal breast cancers, the expression of Bmi-1 at the mRNA and protein levels were examined. METHODS: Breast carcinoma samples were obtained from patients who underwent routine surgery for breast cancer at the Department of Surgery, Chonbuk National University Hospital, in 2000-2002. Cancerous breast and paired normal breast tissues were taken from a site distant from the tumorous lesion, and analyzed with reverse transcription-polymerase chain reaction (RT-PCR) and and immunohistochemical assay. We analyzed the correlations between the expression of Bmi-1 and various clinicopathological factors, such as age, lymph node metastases, estrogen receptor (ER), and progesterone receptor (PR), in invasive ductal carcinomas of the breast. RESULTS: The Bmi-1 mRNA level by RT-PCR was shown to be significantly up-regulated in 19 of the 22 breast carcinoma tissues specimen compared with the non-neoplastic tissues adjusted to tested specimens. The immunohistochemical staining for Bmi-1 also showed high a level of expression in 44 of the 71 invasive ductal breast cancers (62%), and was more intense in the invading fronts than in the central portions of the primary invasive breast cancers. Univariate and multivariate analyses showed that a high level of Bmi-1 expression was significantly correlated with axillary lymph node metastases and a positive estrogen receptor status. CONCLUSION: The Bmi-1 was differentially expressed in human breast carcinomas. These findings suggested that Bmi-1 might be involved in the progression of invasive ductal breast cancer, and it may be clinically useful in selecting patients who could benefit from adjuvant chemotherapy.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Chemotherapy, Adjuvant ; Estrogens ; Humans ; Jeollabuk-do ; Lymph Nodes* ; Multivariate Analysis ; Neoplasm Metastasis* ; Receptors, Progesterone ; RNA, Messenger

Extramammary Paget's disease is an uncommon intraepithelial malignancy that usually presents as a well circumscribed, reddish eczematous patch on the apocrine-bearing regions such as the genital and perineal areas. It progresses slowly with local extension. However, it may become invasive and may be associated with internal malignancies. Extramammary Paget's disease has high local recurrence rates after complete surgical excision and therefore, long-term follow-up is necessary. Extramammary Paget's disease of the axilla is extremely rare, with few reported cases. We report here a case of extramammary Paget's disease of the axilla in a 68-yr-old man, with a review of the literature.
Axilla ; Follow-Up Studies ; Paget Disease, Extramammary ; Recurrence