Curcumin and its analogues: Potential anticancer agents

This review chronicles the exploration of the curcumin in terms of development of analogues for the anticancer activity over the last century. Curcumin is a natural phytochemical obtained from dried root and rhizome of Turmeric (Curcuma Longa). It has been shown to interfere with multiple cell signaling pathways, including apoptosis (activation of caspases and downregulation of antiapoptotic gene products), proliferation (HER‐2, EGFR, and AP‐1), angiogenesis (VEGF), and inflammation (NF‐κB, TNF, IL‐6, IL‐1, COX‐2, and 5‐LOX). In the last decade it has been much explored and various synthetic analogues have been prepared and evaluated for various pharmacological activities. Most of the analogues have shown very good anticancer activity in various models and various cell lines. However, some analogues have also shown antioxidant, anti‐HIV, antimutagenic, antiangiogenic, antimalarial, antitubercular, antiandrogenic, COX inhibitory activities. Few analogues have shown very potent results and may be considered as clinical candidates for the development of future anticancer agent. This review contains 728 curcumin analogues and covers the literature from 1815 to mid 2009 and 93 references are cited. © 2009 Wiley Periodicals, Inc. Med Res Rev, 30, No. 5, 818–860, 2010     

Accidental unilateral and incomplete strangulation injury in a patient while traveling on a bicycle

Chunni (a piece of cloth worn around the neck by many Indian women) is a well recognized accidental ligature around the neck. We report a rare case of accidental strangulation with chunni where the patient was pillion rider on bicycle; in spite of very common of use of bicycle to best our knowledge this kind of injury has not been reported previously.     

The benefits of adjuvant radiation therapy after therapeutic lymphadenectomy for clinically advanced,high‐risk,lymph node‐metastatic melanoma

BACKGROUND:

The objective of this study was to evaluate the impact of adjuvant radiation therapy (RT) on regional recurrence and survival after therapeutic lymphadenectomy (TL) for clinically advanced, lymph node‐metastatic melanoma.

METHODS:

Six hundred fifteen patients who had clinically advanced, regional lymph node‐metastatic disease underwent TL. All patients were appropriate potential candidates for adjuvant RT (enlarged or multiple positive lymph nodes, extracapsular extension) because of a high risk for regional recurrence regardless of whether or not they received RT. Patient‐related, tumor‐related, and treatment‐related variables that were associated with recurrence, survival, and treatment‐related morbidity with and without RT were analyzed.

RESULTS:

The median follow‐up was 5 years. The actuarial 5‐year regional lymph node basin control rate was 81%. On multivariate analysis, the number of positive lymph nodes, the number of lymph nodes removed, and the use of adjuvant RT were associated with improved regional control. Treatment‐related morbidity, particularly lymphedema, was increased with the use of adjuvant RT and an inguinal site of lymph node metastases. At last follow‐up, 268 patients were alive with actuarial 5‐year distant metastasis‐free survival (DMFS) and disease‐specific survival (DSS) rates of 40% and 48%, respectively. On multivariate analysis, DMFS and DSS both were influenced by the number of positive lymph nodes and the number of lymph nodes removed. In addition, DSS was influenced by primary tumor thickness and the receipt of adjuvant RT.

CONCLUSIONS:

Adjuvant RT was associated with improved regional lymph node basin control compared with TL alone in patients with high‐risk, clinically advanced, lymph node‐metastatic melanoma. Although it is a regional therapy, adjuvant RT also may have an impact on DSS. Cancer 2009. © 2009 American Cancer Society.     

Primary endocrine therapy in locally advanced breast cancers--the Nottingham experience

Introduction There are trials comparing different neoadjuvant chemotherapy regimens for locally advanced primary breast cancer (LAPC). Few studies have evaluated alternative therapeutic approaches towards LAPC. A previous trial from our institute in LAPC patients unselected for oestrogen receptor (ER) status, comparing primary endocrine therapy versus multimodal treatment, showed no difference in breast cancer related deaths or overall survival. We report our experience of primary endocrine therapy in ER+ LAPC. Methods Between 1988 and 2007, 195 ER+, non-inflammatory LAPC patients were treated with primary endocrine agents in our institute, due to patient choice, being unfit for chemotherapy, or recruitment into the above mentioned trial. All patients had disease assessable by UICC criteria. Results Median age was 69 years. The median follow-up was 61 months. 154 patients (79%) received endocrine treatment alone. 185 patients (95%) derived clinical benefit (complete response/ partial response/ stable disease) for ≥6 months from primary endocrine therapy. Overall 5-year survival was 76% and 5-year breast cancer specific survival was 86%. Conclusion In selected group of ER+ LAPC patients, primary endocrine treatment achieves excellent survival outcome and is a viable alternative to other modalities of treatment.     

Advances in pharmacological strategies for the prevention of cataract development

Cataractous-opacification of the lens is one of the leading causes of blindness in India. The situation can be managed by surgical removal of the cataractous lens. Various pharmacological strategies have been proposed for the prevention and treatment of cataract. Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients. This review deals with the various mechanisms, and possible pharmacological interventions for the prevention of cataract. The article also reviews research on potential anticataractous agents, including aldose reductase inhibitors, glutathione boosters, antiglycating agents, vitamins and various drugs from indigenous sources.     

Histological study of routine tonsillectomy specimen

Introduction

Palatine and nasopharyngeal tonsils are lymphatic flesh clusters of tissue of the respiratory and digestive tract’s epithelium. There is not much literature pertaining to the histological assessment of resected tonsils though anecdotal case reports of choristoma, squamous cell cysts of the tonsil have been reported which mimicked chronic tonsillitis. Tonsils also are an important site for head and neck cancer in adults.

Aim & objective

To study the histological features of routine tonsillectomy specimens and to study for the presence of choristomatic tissue or any other benign pathology as a cause of chronic tonsillitis.

Patients & methods

Fifty consecutive tonsillectomy specimens, which were received in the department of Pathology, Gandhi Medical College, were evaluated with regards to clinical information. Among 50 patients, a slight predominance of men (56 %) over women (44 %) was observed.

Conclusion

The mesenchymal tissue consisted mainly of epithelium and lymphoid tissue with cartilage in a single case and fat in three cases. The role of imaging techniques, in assessing the need for early surgical intervention in cases with chronic tonsillitis, can be determined by assessing the micropathology of tonsillectomy specimens and is an arena for further research. We discussed the role of FDG-PET scan in the assessment of the same.     

Chondroid chordoma of petrous temporal bone with extensive recurrence and pulmonary metastases

Chondroid chordoma is a variant of chordoma; it may rarely involve the petrous temporal bone and has a high propensity for recurrence. Chordoma rarely metastasizes but it is, nevertheless, associated with a poor outcome. We report a rare case of chondroid chordoma with extensive recurrence and pulmonary metastases.     

MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy

BACKGROUND: This study investigated the role of magnetic resonance imaging (MRI) in evaluation of pathologically complete response and residual tumors in patients who were receiving neoadjuvant chemotherapy (NAC) for both positive and negative HER-2 breast cancer. METHODS: Fifty-one individuals, comprised of 25 HER-2 positive and 26 HER-2 negative patients, were included in the study. Serial MRI studies were acquired before, during, and after NAC. On the basis of the final MRI, response was determined to be a clinically complete response ([CCR], no enhancement), probable CCR (residual enhancement equal to or less than that of glandular tissue), or residual tumor. All patients received surgery. Pathological outcomes were categorized as 1) no residual cancer, 2) no residual invasive cancer but ductal carcinoma in situ (DCIS) present, or 3) residual invasive cancer. The pathologically complete response (pCR) was defined as no invasive cancer. RESULTS: Complete clinical response as seen through MRI, including CCR and probable CCR, was identified in 35 (35 of 51, 69%) patients. MRI correctly diagnosed pCR in 26 (26 of 35, 74%) patients, including 18 of 19 (95%) patients in the HER-2 positive group and 8 of 16 (50%) patients in the HER-2 negative group (P < .005). The accuracy of MRI in identifying pCR varied according to the chemotherapy agent that was administered. MRI was more accurate in identifying pCR in patients who were receiving trastuzumab and less accurate in patients receiving bevacizumab. The high false-negative rate found in HER-2 negative patients was associated with residual disease that presented as scattered cells or small foci. In cases with residual bulk tumor, the lesion size, determined by MRI, correlated highly with that found in histopathological measurements (r = 0.93). CONCLUSIONS: MRI may predict pCR with high accuracy in HER-2 positive patients, but it has a high false-negative rate in HER-2 negative patients, particularly in patients who are receiving antiangiogenic agents. Results indicate that the chemotherapy agent should be taken into consideration when using MRI to interpret therapeutic outcomes. More studies are needed to establish the role of MRI in managing, especially surgical planning, patients who are receiving NAC.