Review of ultrasound appearance in inflammatory breast cancer: A pictorial essay

Inflammatory breast cancer (IBC) is a rare malignancy accounting for 1–2% of breast cancers. It has an aggressive clinical presentation and poor prognosis. The sonographic findings in 41 patients with a clinical diagnosis of IBC and biopsy‐proven breast malignancy are presented in this study. The most common finding was the presence of skin thickening (92%). Multiple small anechoic spaces within the dermis, correlating with the presence of dermal lymphatic invasion by tumour emboli on histopathology were noted in approximately one‐third of cases. Other sonographic findings included single or multiple masses, parenchymal oedema, axillary lymphadenopathy, echogenic foci consistent with microcalcifications and increased vascularity.     

Plasma clusterin concentration is associated with longitudinal brain atrophy in mild cognitive impairment

Recent genetic and proteomic studies demonstrate that clusterin/apolipoprotein-J is associated with risk, pathology, and progression of Alzheimer's disease (AD). Our main aim was to examine associations between plasma clusterin concentration and longitudinal changes in brain volume in normal aging and mild cognitive impairment (MCI). A secondary objective was to examine associations between peripheral concentration of clusterin and its concentration in the brain within regions that undergo neuropathological changes in AD. Non-demented individuals (N = 139; mean baseline age 70.5 years) received annual volumetric MRI (912 MRI scans in total) over a mean six-year interval. Sixteen participants (92 MRI scans in total) were diagnosed during the course of the study with amnestic MCI. Clusterin concentration was assayed by ELISA in plasma samples collected within a year of the baseline MRI. Mixed effects regression models investigated whether plasma clusterin concentration was associated with rates of brain atrophy for control and MCI groups and whether these associations differed between groups. In a separate autopsy sample of individuals with AD (N = 17) and healthy controls (N = 4), we examined the association between antemortem clusterin concentration in plasma and postmortem levels in the superior temporal gyrus, hippocampus and cerebellum. The associations of plasma clusterin concentration with rates of change in brain volume were significantly different between MCI and control groups in several volumes including whole brain, ventricular CSF, temporal gray matter as well as parahippocampal, superior temporal and cingulate gyri. Within the MCI but not control group, higher baseline concentration of plasma clusterin was associated with slower rates of brain atrophy in these regions. In the combined autopsy sample of AD and control cases, representing a range of severity in AD pathology, we observed a significant association between clusterin concentration in the plasma and that in the superior temporal gyrus. Our findings suggest that clusterin, a plasma protein with roles in amyloid clearance, complement inhibition and apoptosis, is associated with rate of brain atrophy in MCI. Furthermore, peripheral concentration of clusterin also appears to reflect its concentration within brain regions vulnerable to AD pathology. These findings in combination suggest an influence of this multi-functional protein on early stages of progression in AD pathology.     

Upstream thinking and health promotion planning for older adults at risk of social isolation

wilson d.m., harris a., hollis v. & mohankumar d. (2010) Upstream thinking and health promotion planning for older adults at risk of social isolation. International Journal of Older People Nursing 6 , 282–288
doi: 10.1111/j.1748‐3743.2010.00259.x Aims and objectives. To raise awareness of social isolation, and provide an approach to first conceptualise and then prevent social isolation among older community‐dwelling persons. Background. Older adults comprise a vulnerable population for social isolation and its associated health risks. Design. Literature review. Methods. Canada’s Population Health Promotion Model was chosen as a comprehensive tool to understand and prevent social isolation. Research studies were sought to identify key health determinants and evidence‐based options for preventing social isolation. Results. Around 1 out of 6 older persons are socially isolated and three health determinants are of prime importance: (i) income and social status; (ii) personal health practices and coping skills and (iii) social support networks. Evidence‐based interventions targeted to these health determinants are suggested. Conclusion. Nurses are a key group to advocate for actions needed to prevent social isolation. Implications for practice. Nurses can play a vital role in minimising social isolation through a variety of educational, prevention and political lobbying activities.     

Design and synthesis of resveratrol-based nitrovinylstilbenes as antimitotic agents

A new series of resveratrol analogues was designed, synthesized, and demonstrated to be tubulin polymerization inhibitors. Most of these compounds exhibited antiproliferative activity and inhibited in vitro tubulin polymerization effectively at concentrations of 4.4-68.1 and 17-62 μM, respectively. Flow cytometry studies showed that compounds 7c, 7e, and 7g arrested cells in the G2/M phase of the cell cycle. Immunocytochemistry revealed loss of intact microtubule structure in cells treated with 7c and 7e. Docking of compounds 7c and 7e with tubulin suggested that the A-ring of the compounds occupies the colchicine binding site of tubulin, which coordinates with Cys241, Leu242, Ala250, Val318, Val328, and I378, and that the nitrovinyl side chain forms two hydrogen bonds with the main loop of the β-chain at Asn249 and Ala250.     

Connective tissue growth factor antibody therapy attenuates hyperoxia-induced lung injury in neonatal rats

Despite recent advances in neonatal intensive care and surfactant therapy, bronchopulmonary dysplasia (BPD) continues to be one of the most common long-term pulmonary complications associated with preterm birth. Clinical efforts to prevent and treat BPD have been largely unsuccessful due to its multifactorial nature and poorly understood disease process. Connective tissue growth factor (CTGF) is a matricellular protein that plays an important role in tissue development and remodeling. Previous studies have demonstrated that hyperoxia exposure up-regulates CTGF expression in neonatal rat lungs. Whether CTGF overexpression plays a role in the pathogenesis of BPD, and whether CTGF antagonism has a therapeutic potential for BPD, are unknown. In the present study, we examined CTGF expression in lung autopsy specimens from patients with BPD and control subjects with no BPD. We assessed the effect of a CTGF-neutralizing monoclonal antibody (CTGF Ab) on preventing hyperoxia-induced lung injury in neonatal rats. Our study demonstrates that CTGF expression is increased in BPD lungs. In newborn rats, exposure to 90% oxygen for 14 days resulted in activation of β-catenin signaling, decreased alveolarization and vascular development, and physiological and histological evidence of pulmonary hypertension (PH). However, treatment with CTGF Ab prevented β-catenin signaling activation, improved alveolarization and vascular development, and attenuated PH during hyperoxia. These data indicate that CTGF-β-catenin signaling plays a critical role in the pathogenesis of experimental BPD. CTGF antagonism may offer a novel therapeutic strategy to alleviate BPD and PH in neonates.     

Multimodal biological brain age prediction using magnetic resonance imaging and angiography with the identification of predictive regions

Biological brain age predicted using machine learning models based on high‐resolution imaging data has been suggested as a potential biomarker for neurological and cerebrovascular diseases. In this work, we aimed to develop deep learning models to predict the biological brain age using structural magnetic resonance imaging and angiography datasets from a large database of 2074 adults (21–81 years). Since different imaging modalities can provide complementary information, combining them might allow to identify more complex aging patterns, with angiography data, for instance, showing vascular aging effects complementary to the atrophic brain tissue changes seen in T1‐weighted MRI sequences. We used saliency maps to investigate the contribution of cortical, subcortical, and arterial structures to the prediction. Our results show that combining T1‐weighted and angiography MR data led to a significantly improved brain age prediction accuracy, with a mean absolute error of 3.85 years comparing the predicted and chronological age. The most predictive brain regions included the lateral sulcus, the fourth ventricle, and the amygdala, while the brain arteries contributing the most to the prediction included the basilar artery, the middle cerebral artery M2 segments, and the left posterior cerebral artery. Our study proposes a framework for brain age prediction using multimodal imaging, which gives accurate predictions and allows identifying the most predictive regions for this task, which can serve as a surrogate for the brain regions that are most affected by aging.     

Tunnel-floor entry continuous curvilinear capsulorhexis technique: Rhexis in a controlled and stable anterior chamber always

Continuous circular capsulorhexis (CCC) was demonstrated independently by Thomas Neuhann, Kimiya Shimizu, and Howard Gimbel in the 1980s and it finds mention in the landmark paper by Gimbel and Neuhann. The authors describe a technique of achieving the rhexis in a stable, viscoelastic-filled anterior chamber using the tunnel floor as the entry. This gets covered by the roof of the tunnel postoperatively and, therefore, does not leak. There is no oar-locking or striae even when cystitome goes beyond the edge of the tunnel. As there is no escape of the viscoelastic substance, there is no change in the pressure or shallowing of the anterior chamber. It is a useful technique for beginners. It is of great help in difficult cases like intumescent cataracts, shallow anterior chambers, hyperopes, nanophthalmos, pseudoexfoliation, small non-dilating pupils, intraoperative floppy iris syndrome (IFIS), and phacomorphic glaucoma.