The effect of upper limb loading with external weights on gait and trunk control in ambulatory children with spastic hemiplegic cerebral palsy: a randomized controlled trial

OBJECTIVE

Children with hemiplegic cerebral palsy (CP) are typically ambulant with high motor functioning levels but with gait asymmetry and a greater risk of instability and falling. Physiotherapy is considered the core part of CP rehabilitation due to the risk of neurosurgery and the side effects of drug interventions. Although growing evidence has looked at the effect of upper limb loading during walking in many populations, such interventions in children with CP remain unexplored yet. The purpose of this study was to investigate if loading the upper limbs with external weights could improve walking speed, trunk control, and balance in ambulatory children with hemiplegic CP.

PATIENTS AND METHODS

The following outcome measures were recorded at baseline and six weeks after the intervention: gait speed [10-Meter Walk Test (10 MWT)], trunk control [Trunk Control Measurement Scale (TCMS)], and balance [Pediatric Balance Scale (PBS)]. Multiple 2 (groups) x 2 (time-points) mixed analysis of variance models (ANOVAs) were used for analysis.

RESULTS

Both groups showed a significant improvement (p < 0.001) in 10 MWT, TCMS, and PBS scores post-intervention. However, the magnitude of change in the outcome measures was higher in the intervention group (10 MWT = 0.59 m/s, TCMS = 10.41, PBS = 9.35) compared to the control group (10 MWT = 0.37 m/s, TCMS = 6.43, PBS = 4.68).

CONCLUSIONS

This study demonstrated that although both control and intervention groups showed improvements in terms of gait speed, trunk control, and balance, the intervention group that had upper limb loading showed higher significant improvements.  Clinicaltrial.gov ID: NCT05444387.

A scientometric analysis and recent advances of emerging chitosan-based biomaterials as potential catalyst for biodiesel production: A review

Chitosan is a widely available polymer with a reasonably high abundance, as well as a sustainable, biodegradable, and biocompatible material with different functional groups that are used in a wide range of operations. Chitosan is frequently employed in widespread applications such as environmental remediation, adsorption, catalysts, and drug formulation. The goal of this review is to discuss the potential applications of chitosan and its chemically modified solids as a catalyst in biodiesel production. The existing manuscripts are integrated based on the nature of materials used as chitosan and its modifications. A short overview of chitosan's structural characteristics, properties, and some ideal methods to be considered in catalysis activities are addressed. This article includes an analysis of a chitosan-based scientometric conducted between 1975 and 2023 using VOS viewer 1.6.19. To identify developments and technological advances in chitosan research, the significant scientometric features of yearly publication results, documents country network, co-authorship network, documents funding sponsor, documents institution network, and documents category in domain analysis were examined. This review covers a variety of organic transformations and their effects, including chitosan reactions against acids, bases, metals, metal oxides, organic compounds, lipases, and Knoevenagel condensation. The catalytic capabilities of chitosan and its modified structures for producing biodiesel through transesterification reactions are explored in depth.

Construction of a Copper Bismuthate/Graphene Nanocomposite for Electrochemical Detection of Catechol

Binary metal oxides with carbon nanocomposites have received extensive attention as research hotspots in the electrochemistry field owing to their tunable properties and superior stability. This work illustrates the development of a facile sonochemical strategy for the synthesis of a copper bismuthate/graphene (GR) nanocomposite-modified screen-printed carbon electrode (CBO/GR/SPCE) for the electrochemical detection of catechol (CT). The formation of an as-prepared CBO/GR nanocomposite was comprehensively characterized. The electrochemical behavior of the CBO/GR/SPCE toward CT was investigated by voltammetry and amperometry techniques. The fabricated CBO/GR/SPCE manifests an excellent electrocatalytic performance toward CT with a lower peak potential and a higher current value compared to those of CBO/SPCE, GR/SPCE, and bare SPCE. It is attributed to enhanced electro-catalytic activity, synergetic effects, and good active sites of the CBO/GR nanocomposite. Under the electrochemical condition, the CBO/GR/SPCE displayed a wide linear sensing range, trace-level detection limit, acceptable sensitivity, and excellent selectivity. Furthermore, our proposed CBO/GR electrode was employed successfully for CT detection in water samples.

Research and economic perspectives on an integrated biorefinery approach for the simultaneous production of polyhydroxyalkanoates and biohydrogen

Alarming environmental impacts have been resulted across the globe due to the recovery and consumption of fossil fuels. The elevated global carbon footprint has paved the way to an alternative to combat the prevalent pollution. On the other hand, the fossil-based plastics produced from the byproducts of petroleum remain intact in the environment leading to pollution. Fossil abated bioproducts are in high demand due to the increase in pollution. This call to utilize feedstock for simultaneous production of biologically useful products through carbon capture utilisation where the leftover carbon-rich substrate is converted into usable chemicals like bioplastics, methanol, urea and various other industrially essential components. The present review extensively focuses on the research and economic perspectives of an integrated biorefinery and addresses technical breaches, bottlenecks, and efficient strategies for the simultaneous production of biohydrogen and polyhydroxyalkanoates.

One-pot green synthesis of iron oxide nanoparticles from Bauhinia tomentosa: Characterization and application towards synthesis of 1, 3 diolein

The green synthesis of NPs through plant extracts can be a modest, one-pot alternative synthesis to the conventional physical or chemical method. The prime focus of this study is to produce MNPs by the reducing effect of Bauhinia tomentosa leaf extract, and it was immobilized in porcine pancreatic lipase (PPL). Synthesized NPs were characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and Raman spectroscopy, UV-Vis Spectrometry, Thermogravimetry, and Differential Scanning Calorimeter (DSC), Zeta potential test, VSM, BET and Fourier Transform Infrared Spectroscopy (FTIR). The effect of process parameters was studied, about the efficiency of immobilization are enzyme stability, the extent of enzyme reusability, its separation from products, the activity of immobilized enzyme, recovery, and its loss. Finally, the immobilized lipase was used for the synthesis of 1,3-diolein using enzyme-mediated esterification of oleic acid and glycerol. Under optimized condition (reaction temp-55 [Formula: see text]C; molar ratio-2.5:1; pH-7) diolein yield was achieved to be 94%. Therefore, this work was further used for the industrial production of 1,3-diacylglycerol since a perfect enzyme-catalyzed process was observed.

A Systematic Review of Clinical Practice Guidelines for Identification and Management of Frailty

OBJECTIVE

This study aims to appraise and summarize consistent recommendations from clinical practice guidelines (CPGs) for identification and management of frailty to maintain and improve functional independence of elderly population.

METHODS

A systematic search of Ovid MEDLINE, Embase, PubMed, PsycINFO, and CINAHL electronic databases using database-specific search terms in two broad areas "guidelines" and "frailty", and a manual search of websites with the key phrase "frailty guideline" was performed. The inclusion criteria included CPGs focusing on identifying and managing frailty in population >65 years old, published in English since January 2010. Three reviewers independently assessed guideline quality using the AGREE II instrument. Data extraction was performed, followed by compilation and comparison of all recommendations to identify the key consistent recommendations.

RESULTS

Six CPGs met the inclusion criteria; however, only three CPGs had high methodological quality in accordance with AGREE II appraisal. The average AGREE II scores of all six CPGs were: 84.5%, 68%, 46.5%, 81.5%, 56.3%, and 60.2% for domains 1-6 (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence) respectively. A total of 54 recommendations were identified, with 12 key recommendations suggested frequently by the CPGs.

CONCLUSION

The AGREE II instrument identified strengths and weaknesses of the CPGs, but failed to assess clinical implications and feasibility of the guidelines. Further research is needed to improve clinical relevance of CPGs in the identification and management of frailty. The feasibility in implementing these guidelines with regards to cost-effectiveness of frailty screening warrants further investigation.

Chitosan overlaid Fe3O4/rGO nanocomposite for targeted drug delivery, imaging, and biomedical applications

A hybrid and straightforward nanosystem that can be used simultaneously for cancer-targeted fluorescence imaging and targeted drug delivery in vitro was reported in this study. A chitosan (CS) polymer coated with reduced graphene oxide (rGO) and implanted with Fe3O4 nanoparticles was fabricated. The fundamental physicochemical properties were confirmed via FT-IR, XRD, FE-SEM, HR-TEM, XPS, and VSM analysis. The in vivo toxicity study in zebrafish showed that the nanocomposite was not toxic. The in vitro drug loading amount was 0.448 mg/mL-1 for doxorubicin, an anticancer therapeutic, in the rGO/Fe3O4/CS nanocomposite. Furthermore, the pH-regulated release was observed using folic acid. Cellular uptake and multimodal imaging revealed the benefit of the folic acid-conjugated nanocomposite as a drug carrier, which remarkably improves the doxorubicin accumulation inside the cancer cells over-express folate receptors. The rGO/Fe3O4/CS nanocomposite showed enhanced antibiofilm and antioxidant properties compared to other materials. This study's outcomes support the use of the nanocomposite in targeted chemotherapy and the potential applications in the polymer, cosmetic, biomedical, and food industries.

Bioconversion of Calophyllum inophyllum oilcake for intensification of rhamnolipid and polyhydroxyalkanoates co-production by Enterobacter aerogenes

The biologically derived products are highly valued due to their biodegradability, low toxicity, and renewability. However, most production processes are exorbitant due to high raw material cost and the downstream processing required for product recovery and purification. Therefore, the present study utilized the low-cost lignocellulosic biomass, Calophyllum inophyllum oilcake for the simultaneous production of PHA and rhamnolipid by a facultative anaerobe Enterobacter aerogenes. Both the products are produced during the stationary phase and constitute β- hydroxyalkanoic acids, which makes it feasible for the co-production through a single fermentation process. From the batch fermentation studies, it was revealed that the under optimum condition rhamnolipid and PHA yield are 5.81 g/L and 4.2 g/L: 5%(v/v) of inoculum size, pH of 6.5, C:N ratio of 5:1 and urea are found to be the best nitrogen source for the fermentation process. Characterization studies for extracted PHA and RL was done using- FTIR, NMR and TGA analysis.

Production of biodiesel by enzymatic transesterification of waste sardine oil and evaluation of its engine performance

Waste sardine oil, a byproduct of fish industry, was employed as a low cost feedstock for biodiesel production. It has relatively high free fatty acid (FFA) content (32 mg KOH/g of oil). Lipase enzyme immobilized on activated carbon was used as the catalyst for the transesterification reaction. Process variables viz. reaction temperature, water content and oil to methanol molar ratio were optimized. Optimum methanol to oil molar ratio, water content and temperature were found to be 9:1, 10 v/v% and 30 °C respectively. Reusability of immobilized lipase was studied and it was found after 5 cycles of reuse there was about 13% drop in FAME yield. Engine performance of the produced biodiesel was studied in a Variable Compression Engine and the results confirm that waste sardine oil is a potential alternate and low-cost feedstock for biodiesel production.

Green synthesis of gold nanoparticles using a cheap Sphaeranthus indicus extract: Impact on plant cells and the aquatic crustacean Artemia nauplii

The impact of green-fabricated gold nanoparticles on plant cells and non-target aquatic species is scarcely studied. In this research, we reported an environment friendly technique for the synthesis of gold nanoparticles (Au NPs) using the Sphaeranthus indicus leaf extract. The formation of the metal NPs was characterized by UV-Visible and FT-IR spectroscopy, XRD, SEM and TEM analyses. The UV-Visible spectra of Au NPs showed a surface plasmon resonance peak at 531nm. FT-IR analysis indicated functional bio-molecules associated with Au NPs formation. The crystalline nature of Au nanoparticles was confirmed by their XRD diffraction pattern. TEM revealed the spherical shape with a mean particle size of 25nm. Au NPs was tested at 0, 1, 3, 5, 7 and 10% doses in mitotic cell division assays, pollen germination experiments, and in vivo toxicity trials against the aquatic crustacean Artemia nauplii. Au NPs did not show any toxic effects on plant cells and aquatic invertebrates. Notably, Au NPs promoted mitotic cell division in Allium cepa root tip cells and germination of Gloriosa superba pollen grains. Au NPs showed no mortality on A. nauplii, all the tested animals showed 100% survivability. Therefore, these Au NPs have potential applications in the development of pollen germination media and plant tissue culture.

Guazuma ulmifolia bark-synthesized Ag, Au and Ag/Au alloy nanoparticles: Photocatalytic potential, DNA/protein interactions, anticancer activity and toxicity against 14 species of microbial pathogens

In the present study, we focused on a quick and green method to fabricate Ag, Au and Ag/Au alloy nanoparticles (NPs) using the bark extract of Guazuma ulmifolia L. Green synthesized metal NPs were characterized using different techniques, including UV-Vis spectroscopy, FT-IR, XRD, AFM and HR-TEM analyses. The production of Ag, Au and Ag/Au alloy NPs was observed monitoring color change from colorless to brown, followed by pink and dark brown, as confirmed by UV-Vis spectroscopy characteristic peaks at 436, 522 and 510nm, respectively. TEM shed light on the spherical shapes of NPs with size ranges of 10-15, 20-25 and 10-20nm. Biosynthesized NPs showed good catalytic activity reducing two organic dyes, 4-nitrophenol (4-NP) and Congo red (CR). UV-vis spectroscopy, fluorescence, circular dichroism spectroscopy and viscosity analyses were used to investigate the NP binding with calf thymus DNA. The binding constant of NPs with DNA calculated in UV-Vis absorption studies were 1.18×10⁴, 1.83×10⁴ and 2.91×10⁴M^-1, respectively, indicating that NPs were able to bind DNA with variable binding affinity: Ag/Au alloy NPs>Ag NPs>Au NPs. Ag/Au alloy NPs also showed binding activity to bovine serum albumin (BSA) over the other NPs. Ag and Ag/Au alloy NPs exhibited good antimicrobial activity on 14 species of microbial pathogens. In addition, the cytotoxic effects of Ag/Au alloy NPs were studied on human cervical cancer cells (HeLa) using MTT assay. Overall, our work showed the promising potential of bark-synthesized Ag and Ag/Au alloy NPs as cheap sources to develop novel and safer photocatalytic, antimicrobial and anticancer agents.

Plant pathogenic fungus F. solani mediated biosynthesis of nanoceria: antibacterial and antibiofilm activity

The present study reports the synthesis of CeO₂ nanoparticles using Fusarium solani. The biosynthesized CeO₂ nanoparticles were subjected to different characterization techniques and also showed potential antibacterial and antibiofilm activities.

Synthesis of cerium oxide nanoparticles using Gloriosa superba L. leaf extract and their structural, optical and antibacterial properties

CeO2 nanoparticles (NPs) were green synthesized using Gloriosa superba L. leaf extract. The synthesized nanoparticles retained the cubic structure, which was confirmed by X-ray diffraction studies. The oxidation states of the elements (C (1s), O (1s) and Ce (3d)) were confirmed by XPS studies. TEM images showed that the NPs possessed spherical shape and particle size of 5nm. The Ce-O stretching bands were observed at 451cm(-1) and 457cm(-1) from the FT-IR and Raman spectra respectively. The band gap of the CeO2 NPs was estimated as 3.78eV from the UV-visible spectrum. From the photoluminescence measurements, the broad emission composed of eight different bands were found. The antibacterial studies performed against a set of bacterial strains showed that Gram positive (G+) bacteria were relatively more susceptible to the NPs than Gram negative (G-) bacteria. The toxicological behavior of CeO2 NPs was found due to the synthesized NPs with uneven ridges and oxygen defects in CeO2 NPs.

Ammonium dichromate poisoning: A rare cause of acute kidney injury

Ammonium dichromate is an inorganic compound frequently used in screen and color printing. Being a strong oxidizing agent, it causes oxygen free radical injury resulting in organ failure. We report a 25-year-old female who presented with acute kidney injury after consumption of ammonium dichromate. She was managed successfully with hemodialysis and supportive measures. This case is reported to highlight the toxicity of ammonium dichromate.

Biohydrogen and polyhydroxyalkanoate co-production by Enterobacter aerogenes and Rhodobacter sphaeroides from Calophyllum inophyllum oil cake

The feasibility of coupled biohydrogen and polyhydroxyalkanoate production by Enterobacter aerogenes and Rhodobacter sphaeroides using Calophyllum inophyllum oil cake was studied under dark and photo fermentation conditions. The utilization of a non-edible acidic oil cake (C. inophyllum), and exploitation of a modified minimal salt media led to reduction in the cost of media. Cost of fermentation is reduced by implementation of alternate dark-photo fermentative periods and through the use of a co-culture consisting of a dark fermentative (E. aerogenes) and a photo fermentative (R. sphaeroides) bacterium. The biohydrogen and polyhydroxyalkanoate produced were 7.95 L H2/L media and 10.73 g/L media, respectively, under alternate dark and photo fermentation and were 3.23 L H2/L media and 5.6g/L media, respectively under complete dark fermentation. The characteristics of the oil cake and alternate dark (16 h) and photo (8h) fermentative conditions were found to be supportive in producing high biohydrogen and polyhydroxyalkanoate (PHA) yield.

ROCK1 & 2 perform overlapping and unique roles in angiogenesis and angiosarcoma tumor progression

The serine/threonine protein kinase paralogs ROCK1 & 2 have been implicated as essential modulators of angiogenesis; however their paralog-specific roles in endothelial function are unknown. shRNA knockdown of ROCK1 or 2 in endothelial cells resulted in a significant disruption of in vitro capillary network formation, cell polarization, and cell migration compared to cells harboring non-targeting control shRNA plasmids. Knockdowns led to alterations in cytoskeletal dynamics due to ROCK1 & 2-mediated reductions in actin isoform expression, and ROCK2-specific reduction in myosin phosphatase and cofilin phosphorylation. Knockdowns enhanced cell survival and led to ROCK1 & 2-mediated reduction in caspase 6 and 9 cleavage, and a ROCK2-specific reduction in caspase 3 cleavage. Microarray analysis of ROCK knockdown lines revealed overlapping and unique control of global transcription by the paralogs, and a reduction in the transcriptional regulation of just under 50% of VEGF responsive genes. Finally, paralog knockdown in xenograft angiosarcoma tumors resulted in a significant reduction in tumor formation. Our data reveals that ROCK1 & 2 exhibit overlapping and unique roles in normal and dysfunctional endothelial cells, that alterations in cytoskeletal dynamics are capable of overriding mitogen activated transcription, and that therapeutic targeting of ROCK signaling may have profound impacts for targeting angiogenesis.

Abstract P5-03-09: Ovarian Hormones Promote Mammary Carcinogenesis by Altering Growth Factor Receptor Signaling

Study of carcinogenesis in rat models plays an important role in understanding the nature of neoplastic transformation. Identification of biological, cellular and molecular alterations involved in the carcinogen induced preneoplastic transformation has vital importance in mammary cancer development. Copenhagen rats are resistant to the carcinogen, N-methyl-N-nitrosourea (MNU) induced mammary carcinogenesis. Our previous studies indicate that MNU induced preneoplastic lesions were promoted to mammary cancer by the hormones estrogen and progesterone. The purpose of this study is to delineate the molecular mechanisms of hormonal promotion of mammary carcinogenesis. Seven week old female Copenhagen rats were administered a single dose of 50 mg/kg body weight MNU intraperitoneally. Four weeks post carcinogen administration, rats were divided into 4 groups, 1) Control, 2) rats treated with 30 mg estradiol, 3) rats treated with 30 mg progesterone, 4) rats treated with 30 mg estradiol plus 30 mg of progesterone. Two weeks after the implantation rats were killed and mammary glands were excised and used for further experiments. Quantitative RT-PCR experiments showed up-regulation of growth factor receptors such as Igf-1r, Egfr and growth factor signaling members Grb2, Pi3k and Ras mRNA expression. Immuno histochemical studies showed strong staining to growth factor receptors and western blotting studies showed increased protein levels of growth factor receptors such as IGF-1R and EGFR and active form of proliferative signaling molecules Akt and SAPK/JNK were up-regulated in combination of estradiol and progesterone treated rats. Phosphorylated p38 was reduced in the combination of hormones treated rat preneoplastic lesions when compared to control. Combination of ovarian hormones treatment provided enhanced growth factor signaling environment and promoted the mammary lesions through activation of SAPK/JNK and growth factor signaling pathways.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-03-09.

Abstract P1-08-02: Short-Term Pregnancy Levels of Estradiol Delays Mammary Tumor Development by Altering PI3K/AKT Pathway in Her2/neu Mice

Approximately 20-30% of all breast cancers overexpress the human epithelial growth factor receptor 2 (Her2). Breast cancers that overexpress Her2 have been associated with a more aggressive phenotype and decreased survival. Currently, the FDA has only approved trastuzumab, a recombinant monoclonal antibody against the Her2 receptor, for treatment of Her2- overexpressing breast cancer. Even though trastuzumab has been effective, many breast cancers do not respond to treatment or they eventually progress to a resistant state. Hence, several research investigations are underway to identify therapies besides trastuzumab that could be used for the treatment of Her2-positive breast cancer. It has been earlier demonstrated that uniparous Her2/neu transgenic mice developed smaller mammary tumors and these tumors had significantly decreased metastatic potential. Also, we had earlier demonstrated that short-term treatment with pregnancy levels of estradiol was very effective in delaying tumor progression and decreasing tumor burden. In this present investigation, we have attempted to understand the molecular mechanisms underlying this anti-tumor effect of short-term pregnancy levels of estradiol treatment against Her2/neu driven mammary carcinogenesis. Seven week old activated Her2/neu (murine-mammary-tumor virus (MMTV)-c-neu) FVB transgenic mice were treated for 3 weeks with 100mg of estradiol in silastic capsules. We have shown that this dose of estradiol treatment mimics pregnancy levels of the hormone in circulation. Control animals received empty silastic capsules for the same duration. Mice were palpated once every week for nine months to monitor the development of mammary cancer. Histopathological examination was performed to confirm the carcinomatous nature of the palpable tumors. A group (n=3) of mice were terminated from control and estradiol treated groups immediately after three weeks of treatment, and also, at 6 and 12 weeks post withdrawal of the treatment. Mammary tumor and normal mammary tissue were excised, snap-frozen in liquid nitrogen and stored at −80°C. Protein and total RNA were extracted from these tissues. Pathway focused microarray analysis was done on the PI3K/AKT pathway. Results demonstrate that, in parous and estrogen treated mice, proteins and genes involved in tumor-suppression (Mtcp1,Rbl2,Srf and Ywhah) and immune response (Cd14,Tlr4) were upregulated; which have been shown to play a role in reducing tumors by induction of apoptosis. This trend in gene expression alteration is present in both normal and mammary tumor tissue in the estradiol treated and parous groups and demonstrates that short-term pregnancy levels estrogen is altering the PI3K/AKT pathway; which correlates with our previous findings that short-term estradiol treatment is effective in tumor delay.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-08-02.

Abstract P5-03-06: Progesterone Activates MAPK Pathway in Estrogen Induced Mammary Carcinogenesis

In women, breast cancer is the most prevailing endocrine-related malignancy. Epidemiological and experimental studies argue that estrogens are central to its etiology. Estrogen-induced carcinogenesis in ACI rats is highly relevant as a model for human breast cancer. These estrogen-induced cancers exhibit aneuploidy, as do invasive ductal mammary carcinomas in women. It has been demonstrated that ovary intact ACI rats given estrogen induced high incidence of mammary cancers while ovariectomized rats given the same dose of estrogen for the same length of time did not induce mammary cancers. Recently, we demonstrated that ovariectomized ACI rats given estrogen plus progesterone had a high incidence of mammary cancer. In this context, it is essential to understand the possible role of progesterone, if any, as the other main ovarian hormone in mammary carcinogenesis. Our goal was to determine the role of progesterone in mammary cancer development by using carcinogenesis induced solely by hormones in ACI rats. To achieve our goal, we designed the following experiment. Ovary intact and ovariectomized rats were used in this study. The groups (n=30) tested were as follows: 1) ovary intact control (no hormone treatment); 2) ovary intact rats given 30 mg estradiol; 3) ovary intact rats given 30 mg estradiol plus 30 mg mifepristone; 4) ovary intact rats given 30 mg progesterone; 5) ovariectomized control (no hormone treatment); 6) ovariectomized rats given 30 mg estrogen; and 7) ovariectomized rats given 30 mg estradiol plus 30 mg progesterone. Mammary glands were surgically excised and snap frozen in liquid nitrogen and stored at -80°C from a subset (n=4) of intact animals after four weeks of treatment and ovariectomized rats after twelve weeks of treatment. In rest of the animals mammary carcinogenesis was followed for nine months. As expected, estradiol induced mammary cancers in ovary intact rats and not in ovariectomized rats. Addition of progesterone to ovariectomized rats treated with estradiol induced high incidence of mammary cancer. Mifepristone treatment inhibited mammary carcinogenesis in ovary intact rats receiving estradiol. Pathway focused microarray analysis of mammary glands from the rats of different groups and treatment indicated alterations in apoptosis, MAPK and PI3K pathways. Estrogen plus progesterone treatment down regulated apoptotic genes such as Apaf1, Bad, Bax, Bid, Casp9 and up regulated Mapk3, Grb10, Itgb1, PrKca, Prkcz and Map4k1, Map2k1ip1, Mapk8ip2, Mapkapk5 in PI3K and MAPK pathways respectively when compared with estrogen alone treatment. We have observed differences both at transcriptional and translational levels. Our results clearly demonstrate the significance of progesterone in mammary carcinogenesis.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-03-06.

Abstract P1-08-01: Short-Term Exposure to Pregnancy Levels of Estrogen Alters Key Molecular Pathways Involved in Breast Cancer Development

Breast cancer is the most common cancer in women worldwide and attempts at prevention of breast cancer are important areas of clinical and experimental investigations. Interestingly, a full-term pregnancy before the age of twenty is the only natural phenomenon known that can drastically reduce the risk of breast cancer in women. The universal protective effect of early pregnancy is clearly a major consideration in devising breast cancer prevention strategies. Rats that have been exposed to carcinogens before or after undergoing a full-term pregnancy are protected from mammary carcinogenesis. Hormonal prevention strategies have used exogenous hormonal treatment to mimic the protective effect of early full-term pregnancy against breast cancer. We have demonstrated that short-term treatment with pregnancy levels of estradiol with or without progesterone is highly effective in conferring protection against mammary carcinogenesis in rats. In order to understand the molecular mechanism of the protective effect of short-term pregnancy levels of estradiol treatment we have performed pathway focused microarrays. Nine week old female Lewis rats were divided into three groups, each consisting of 15 rats and receiving one of the following treatments: (i) control, (ii)10 microgram estradiol (non-protective dose), and (iii) 200 microgram estradiol (protective dose). Each treatment was given in the form of silastic capsule and continued for the length of gestation (3 weeks) in rats. At the end of the treatment, the silastic capsule was removed. The rats were then terminated, 8 and 16 weeks after removal of the hormone treatment. Mammary glands were removed, immediately snap frozen in liquid nitrogen and stored at −80°C. Total RNA and protein were extracted and used for gene and protein expression analyses. Our data indicate that several proteins and genes which are involved in apoptosis, DNA repair and growth inhibition (Bax, Bclaf1, Cidea, Fas, Tnfsf10) are upregulated in the mammary glands of rats that received pregnancy levels of estradiol treatment compared to the rats that received non-pregnancy levels of estradiol treatment and untreated controls. By contrast, there were consistent decreasing levels of proteins and genes involved in growth regulation, angiogenesis, anti-apoptosis and cell cycle regulation (Dad1 Faim, Naip2, Xiap) in the mammary glands of pregnancy level estradiol treated rats when compared to the non pregnancy level estradiol treated rats and untreated controls. These alterations were similar at both the time points after withdrawal of treatments indicating that these changes are constitutive. In conclusion, short-term treatment with pregnancy levels of estradiol resulted in persistent down-regulation of growth promotion, cell cycle, anti-apoptosis, angiogenesis and oncogenesis. On the other hand, the same protective treatment persistently enhanced growth inhibition, apoptosis and DNA repair. The data obtained could be helpful to understand the mechanisms involved in short-term pregnancy level estradiol-induced protection and will also facilitate the identification of biomarkers associated with protection.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-08-01.

An innovative method of reconstruction of large skeletal chest wall defects

The reconstruction of large skeletal defects of the chest wall is considered complex and difficult. A simple technique for this repair, using polymethylmethacrylate ribs that are prefabricated in a prosthodontic laboratory using heat cure polymer, is presented. These ribs are used as bone substitutes while reconstructing the chest wall defect. The prefabricated polymethylmethacrylate ribs have been used to reconstruct the large chest wall defects after resection of chest wall tumors in three patients. There was risk of severe paradoxical movement of the chest wall without the skeletal defect reconstruction. In all of the cases, there was no need for postoperative mechanical ventilation and there was no paradoxical movement. Cosmetically, it was highly satisfactory. In one patient, the stainless steel wire caused a sinus after 1 year of reconstruction, requiring removal of the wire and the rib, but it did not compromise the stability of the chest wall. We conclude that reconstruction of large chest wall defects with prefabricated polymethylmethacrylate ribs is simple, cost-effective, and easy to plan and execute.

An inexpensive self fabricated pressure clip for the ear lobe

Pressure therapy is an integral part of keloid treatment. There are certain areas of the body which are prone to keloid formation but are not amenable to pressure therapy. The ear lobe is one such area. A simple, self fabricated and inexpensive pressure clip has been used for applying postoperative pressure to the ear lobe. This is fabricated with cold-cure poly methyl methacrylate and orthodontic wire. This has been used in 41 ear lobe keloids in 26 patients along with postexcisional triamcinolone acetonide therapy, 5 ear lobe reconstructions and 2 cases of ear lobe clefts over a period of 8 years. Although these clips are not very aesthetic, still the acceptability is very high as the patients were well motivated. A total of 27 ear lobes in 18 patients of ear lobe keloids have undergone ear boring after 6-18 months of pressure therapy. The only complication noticed is in the form of pressure ulcer due to continuous pressure in two patients at the beginning of our experience with these clips. These healed well after temporarily stopping the use of the clip.