Effect of Pluchea lanceolata bioactives in LPS-induced neuroinflammation in C6 rat glial cells

Neuroinflammation plays a significant role in various chronic and acute pathological conditions of the central nervous system. In the Indian system of medicine, Pluchea lanceolata is used to treat the neurological disorders. We investigated the effect of major pentacyclic triterpene and its naturally occurring acetate derivative isolated from P. lanceolata on lipopolysaccharide (LPS)-stimulated neuroinflammatory condition associated to inflammatory cytokine production in rat astrocytoma cell line (C6). The log concentration dependence of Pluchea bioactive taraxasterol (Tx) significantly (p?<?0.05) attenuates the release of pro-inflammatory cytokines, such as TNF-α, IFN-γ, and IL-6, while its in situ produced acetyl derivative, i.e., taraxasterol acetate (TxAc), did not inhibit the LPS-induced IL-6 production at lower concentration (p?>?0.05). Surflex-Dock molecular modeling study was performed to simulate the binding capacity of compounds into the active site of the TNF-α (2AZ5), tumor protein P53 (2VUK), and NF-kappa-B (1RAM). The differential inhibition of cytokines by Tx and TxAc was further confirmed by high docking scores showing the high affinity to target proteins. Findings of the study demonstrated the comparatively greater role of Pluchea triterpene than its in situ produced acetate derivate in neuroinflammation-associated disorders.     

Results of radiotherapy with, or without, salvage surgery versus combined surgery and radiotherapy in advanced carcinoma of the hypopharynx

There is considerable controversy surrounding the optimum treatment of advanced hypopharyngeal cancers. Curative radiotherapy with surgical salvage in reserve is an accepted protocol as is also a combined treatment of surgery and radiotherapy. The present study is a retrospective analysis of the survival results of 195 cases treated in a single centre. The combined surgery and radiotherapy group comprised a greater number of pyriform fossa and post-cricoid tumours whereas, the curative radiotherapy group had a higher proportion of posterior pharyngeal wall tumours. Actuarial two-year disease-free survival rates were significantly better with combined treatment when results of stage III and IV lesions (164 patients) of all sites are taken together, as compared to those obtained with curative radiotherapy without salvage (p = 0.000) or radiotherapy with surgical salvage for residual/recurrent tumours (p = 0.0021).     

Sentinel lymph node biopsy,axillary dissection and breast cancer: radiation oncologist's viewpoint

Sentinel lymph node (SLN) identification and biopsy in breast cancer have been carried out successfully since the early 1990s. In early-stage breast cancer, the negative predictive value of a SLN biopsy is as high as 93%-100%. With a negative SLN, no axillary treatment would be required and the breast can be treated by tangential radiation fields. Currently, for a patient with a positive SLN, axillary dissection is recommended. Axillary irradiation can replace surgery with a low risk of recurrence (< 7%). The modern practice of radiotherapy, delivering a dose of 50 Gy to the axilla, has a low rate of late morbidity. Hence, it is now time to plan clinical trials comparing axillary irradiation with axillary dissection in SLN-positive, early-stage breast cancer. These approaches to the axilla, guided by the status of the SLN can reduce arm problems in women with breast cancer and improve their quality of life. Just as the treatment of the primary breast tumour has changed from Halstedian mastectomy to conservation surgery combined with breast irradiation, SLN biopsy may allow a move away from surgical axillary clearance and the associated morbidity in the future.     

Adenocarcinoma esophagus with choroid metastasis.

Metastases to the eye are rare and those from carcinoma esophagus are very rare, with only one report in the English literature. We report a 46-year-old man with adenocarcinoma of esophagus who developed isolated choroid metastasis after definitive treatment of the primary tumor.     

Prophylactic beclomethasone spray to the skin during postoperative radiotherapy of carcinoma breast: a prospective randomized study

BACKGROUND AND AIMS: Radiation induced wet desquamation of skin in carcinoma breast patients is a painful condition. In this study topical beclomethasone dipropionate spray was used as prophylaxis with the purpose of reducing risk of the wet desquamation of skin in irradiated field. MATERIALS AND METHODS: Sixty patients of carcinoma breast were planned for postoperative loco regional radiotherapy (50 Gy in 25 fraction over five weeks) were prospectively randomized into two groups (1) steroid group-patients were advised to use beclomethasone dipropionate spray in irradiated axilla from day one of radiotherapy, (2) control group-patients were not allowed to use any topical agent in irradiated area. Radiation induced skin reaction was noted in terms of erythema, dry desquamation and wet desquamation weekly till end of prescribed 50 Gy dose of the radiation therapy. STATISTICAL METHOD: Chi-square test was used to see the statistical significance of the difference in wet desquamation between two arms of the study. Chi-square value and P-value was calculated for the difference of wet desquamation in two study arms. RESULT: In steroid group 4/30 (13.33%) patients developed wet desquamation of the axillary skin at the end of the radiotherapy. For the control group, this figure was 11/30 (36.66%). The difference in wet desquamation of the axillary skin in the two groups was statistically significant (P-value = 0.0369). CONCLUSION: Topical steroid (beclomethasone dipropionate spray) for skin during radiotherapy significantly reduces the risk of wet desquamation of the skin.     

A case of Hodgkin's disease presenting with recurrent laryngeal nerve palsy and tracheoesophageal fistula

Malignancy is the most common cause of tracheoesophageal fistulas. The malignancies commonly implicated in the development of tracheoesophageal fistulas are primary bronchial or esophageal carcinomas. Hodgkins disease rarely leads to such a fistula. We report a case of Hodgkin's disease with a tracheoesophageal fistula as well as a left recurrent nerve palsy at presentation. This presentation has no precedent in literature. The patient was treated with systemic chemotherapy and involved field radiotherapy. On follow up 1 year after the completion of treatment, he was clinically and radiologically disease free.