Marrow Histomorphology and Clinical Staging of Chronic Lymphocytic Leukemia-A Rare Disease in India: Experience with 26 Cases

Chronic Lymphocytic Leukemia is a relatively uncommon hemopoietic malignancy in the Indian subcontinent. We have made an attempt to correlate the morphology of the marrow with staging and clinical course of the disease in 26 cases. Four out of 6 cases in Stage A showed a nodular/interstitial marrow pattern, while 18 out of 20 cases of stage B and C demonstrated a mixed/diffuse involvement of marrow. Cases showing a nodular/interstitial pattern had a relatively benign clinical course even without chemotherapy, while patients with diffuse/mixed marrow pattern required chemotherapy. Trephine histological pattern was found to be a good prognosticator and was useful in segregating cases requiring chemotherapy from those which do not.     

Nuclear Magnetic Resonance and Infrared Spectroscopic Analysis of Nedocromil Hydrates

Purpose. Nedocromil sodium (NS), which is used in the treatment ofreversible obstructive airway diseases, such as asthma, has been foundto exist in the following solid phases: the heptahemihydrate, thetrihydrate, a monohydrate, an amorphous phase, which contains variableamounts of water, and a recently discovered methanol + water (MW)solvate. Our aim was to apply ¹³C solid-state nuclear magneticresonance (NMR) spectroscopy and solid-state Fourier transform infrared(FTIR) spectroscopy to the study of specific interactions in the varioussolid forms of NS. Methods. The ¹³ solid-state NMR and FTIR spectra of the varioussolid forms of NS were obtained and were related to the crystalstructures of NS, the conformations of the nedocromil anion, and theinteractions of the water molecules in these crystals. Results. The ¹³C solid-state NMR spectrum is sensitive to theconformation of the nedocromil anion, while the solid-state FTIR spectrumis sensitive to interactions of water molecules in the solid state. In NSmonohydrate, for which the crystal structure has not yet been solved,and in the amorphous phase, the information about the conformationsof the nedocromil anion and the interactions of the water moleculesare deduced from the ¹³C solid-state NMR spectra and solid-state FTIRspectra, respectively. Conclusions. ¹³C solid-state NMR spectroscopy and solid-state FTIRspectroscopy are shown to be powerful complementary tools forprobing the chemical environment of molecules in the solid state,specifically the conformation of the nedocromil anion and the interactions ofwater-molecules, respectively.     

FAS expression inversely correlates with PTEN level in prostate cancer and a PI 3-kinase inhibitor synergizes with FAS siRNA to induce apoptosis

Fatty acid synthase (FAS), a key enzyme of the fatty acid biosynthetic pathway, has been shown to be overexpressed in various types of human cancer and is, therefore, considered to be an attractive target for anticancer therapy. However, the exact mechanism of overexpression of the FAS gene in tumor cells is not well understood. In this report, we demonstrate that the expression of the tumor suppressor gene PTEN has a significant inverse correlation with FAS expression in the case of prostate cancer in the clinical setting, and inhibition of the PTEN gene leads to the overexpression of FAS in vitro. We also found that the combination of the expression status of these two genes is a better prognostic marker than either gene alone. Furthermore, our results indicate that the specific inhibition of FAS gene by siRNA leads to apoptosis of prostate tumor cells, and inhibition of PI 3-kinase pathway synergizes with FAS siRNA to enhance tumor cell death. These results provide a strong rationale for exploring the therapeutic use of an inhibitor of the PTEN signaling pathway in conjunction with the FAS siRNA to inhibit prostate tumor growth.     

Biology versus environment in low birth weight children

OBJECTIVE: To explore the contribution of biologic risk factors versus socio-demographic and environmental risk factors in cognitive development of children with birth weight less than 2000 g, at the age of 12 years. DESIGN: Prospective cohort study. SETTING: Infants discharged from a NICU of a referral hospital, with birth weight less than 2000 g between 1987-89 and followed up in the High Risk Clinic. METHODS: The children were assessed at the age of 12 years, with the Weschlers Intelligence Scale for IQ and by Wide Range Achievement Test for mathematics skills. Mothers education, fathers education, socio-economic status, family structure, spaciousness of the house, the locality in which the child lived and the type of school the child attended, were all recorded. A stimulation score was determined at 6 and 12 months and 3 years. Family environment score was used at 12 years. RESULTS: The cohort consisted of 180 children, with 90 controls. The mean IQ of the study group was 89.5 +- 16.9, which was significantly lower than that of controls (97.2 +- 14.1) (P lessthan 0.05). The mathematical skills of the study group were significantly poorer (P lessthan 0.05) than that of controls. A multiple linear regression analysis was done using IQ as the dependent variable and all risk factors at birth, stimulation scores and socio-environmental factors as independent variables. Mothers education was the most important factor contributing to the total IQ, a variance of 25.2percent of the total variance 44.2 PERCENT. Fathers education emerged as an important factor for mathematics skills. School was the next important factor for IQ as well as academics. Controlling for all other background factors, birth weight was the only biologic factor of significance, and this had a very small contribution. CONCLUSION: Parental education and the type of school attended by the child were the most important factors influencing cognitive development. The only biologic factor of importance was birth weight, but this too had a very small contribution.     

Cataract surgery in sympathetic ophthalmia

PURPOSE: To analyze the results of cataract surgery in patients with sympathetic ophthalmia. SETTING: Sankara Nethralaya, Medical Research Foundation, Chennai, India. METHODS: This study comprised 66 patients (132 eyes) with sympathetic ophthalmia seen at the uveitis referral clinic between January 1990 and July 2001; 42 eyes (31.8%) had cataract. Cataract surgery was performed in 17 sympathizing eyes and 1 exciting eye (17 patients). The records of these 18 eyes were retrospectively analyzed. Three eyes had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, 6 eyes had ECCE without IOL implantation, and 9 eyes had phacoemulsification with IOL implantation. The mean follow-up was 28.7 months (range 3 to 60 months). RESULTS: The causes of sympathetic ophthalmia were penetrating trauma (n = 8 eyes), ocular surgery (n = 6), perforated corneal ulcer (n = 2), and cyclocryotherapy (n = 1). The most common cataract type, present in 7 eyes (38.8%), was mixed (posterior subcapsular and posterior polar). Visual acuity improved after surgery in 13 eyes (72.2%). The main factors impairing visual recovery were submacular scar and optic atrophy, which were sequelae of the sympathetic ophthalmia. Posterior capsule opacification was noted in 14 eyes (77.7%); it was visually significant in 6 eyes. There was no significant difference in postoperative inflammation or disease reactivation between the 3 types of surgery. CONCLUSIONS: Cataract extraction in cases of sympathetic ophthalmia can be safely and successfully performed with vigilant preoperative and postoperative control of inflammation, careful surgical planning, and meticulous surgical technique. The final visual outcome, however, depends on the posterior segment complications of the disease.