Diagnostic Accuracy of MRI in Breast Cancer-A Study of 156 Cases

Background: Background- MRI helps in detection of multicentric and multifocal disease in the same breast as well as in identification of synchronous lesions in contralateral breast. MRI imaging done with dedicated breast coil and thin section imaging of the axilla is an effective tool in determining the axillary lymph node metastasis in newly diagnosed cases of breast cancer. Aims-To study those interpretation criteria of MRI that serve to increase the sensitivity and specificity of identifying non-mass like enhancement, multi centricity and nodal characteristics in breast cancer patients undergoing breast conservation surgery. Methods: Retrospective analysis of 156 patients was conducted in the Department of Radio diagnosis; Max Hospital, New Delhi, from September 2011 to June 2014. Both were correlated for tumor size, multifocality, multicentricity, extension of DCIS, nodal characteristics, extension to nipple and contralateral breast lesions. Results: In our study, detection of NMLE on MRI had a sensitivity of 89% and specificity of 78%. Lymph nodes with cortical thickening had a higher sensitivity (86% vs 65%) but lower specificity (69 % vs 89 %) than fatty hilum. Sensitivity was high for post lumpectomy with positive surgical margins and post NACT patients (100%). Conclusion: MRI has a high sensitivity in detection of breast cancer lesions. The detection of multicentric/ multifocal lesions in the same as well as contralateral breast and non-mass like enhancements is critical in deciding breast conservation surgery.

SVC Obstruction Secondary To Indwelling Central Venous Catheter – A Case Report

SVC obstruction is attributed to intraluminal and extraluminal causes. A 55 year lady, known diabetic was diagnosed with carcinoma left breast. The preoperative PET scan showed FDG avid index lesion with enlarged axillary nodes but none in neck or thorax. In this case, carcinoma breast -associated hyper coaguable state and infection may have promoted thrombus formation rather than the CVAD.

Angiosarcoma – A Case Report

Angiosarcoma is an aggressive malignant tumor of vascular origin. We present a case of secondary angiosarcoma in a 66 year old female patient, who presented with a history of left breast wide local excision with intraoperative brachytherapy.The only chance of curative treatment for secondary angiosarcoma is extensive surgery, preferably with resection of all irradiated tissue.

Seroprevalence of Hepatitis B virus infection among blood donors in Shia Muslims in a population of Lucknow.

Background: The objective of this study was to determine the prevalence and trends in hepatitis B infection among blood donors Shia Muslims attending the blood bank in Era's Lucknow Medical College lucknow. A retrospective study was carried out by reviewing the results of HBsAg among blood donors for the years 2002 to 2012. During this period,11962 blood donors were studied. Conclusion: There is a constant need to improve public awareness programs to lower the incidence of hepatitis B infection in the general population and in Shia Muslims and consequently first time blood donors. Future studies are also required to determine the trends and outcomes of these programs.

Cloning of medicinal plants through tissue culture--a review.

In order to have standardized formulations, the chemical constituents from plants and their parts are required to be uniform both qualitatively and quantitatively. Furthermore, an ever increasing demand of uniform medicinal plants based medicines warrants their mass cloning through plant tissue culture strategy. A good number of medicinal plants have been reported to regenerate in vitro from their various parts, but a critical evaluation of such reports reveals that only a few complete medicinal plants have been regenerated and still fewer have actually been grown in soil, while their micropropagation on a mass scale has rarely been achieved, particularly in those medicinal plants where conventional propagation is inadequate, like, the mass clonal propagation of Dioscorea floribunda leading to its successful field trials. Such facts make it imperative to document the factual position of micropropagation of medicinal plants bringing out the advancements made along with the short falls, in this important area. The present review deals with the futuristic view on the said subject restricted to higher plants.

In vitro control of fasciation in proliferating nucellar embryos of Mangifera indica L. var totapari red small for cloning.

Nucellar tissue contained in ovular halves of young fruits of Mangifera indica L. totapari red small, a dwarfing rootstock, differentiated fasciated embryonal structures in presence of 6-benzylaminopurine [BAP(0.15 mg l(-1))], 6-(gamma-gamma-dimethylallylamino) purine [2iP(0.15 mg l(-1))] and indole-3-acetic acid [(IAA(0.5 mg l(-1))] incorporated in the semisolid medium during 50-60 days. Due to embryonal fasciation, hardly 2-3 well-formed embryos could be obtained per culture of proliferating embryos. Of the 3 ethylene inhibitors [L-alpha-(2-aminoethoxyvinyl)-glycine-HCl (AVG), AgNO3 and salicylic acid (SA)] used, embryonal fasciation and necrosis of intervening tissue was completely controlled by 3-4 subcultures of fasciated mass of embryos under the influence of AVG (0.05 mg l(-1)) in presence of adenine sulphate [AdS (50 mg l(-1))] incorporated in the same medium. Almost synchronized development of isolated embryos, measuring ca 2 cm in length, was observed in a different medium used in liquid stationary state and supplemented, particularly with stress-producing substances [abscisic acid (ABA, 0.01 mg l(-1)); and polyethylene glycol (PEG, 100 mg l(-1))] besides certain other modifications. About 34% convertibility of processed embryos was obtained during a period of 90 days. The plantlets had well-developed roots along with laterals which were longer than leafy shoots. In vitro raised plants survived ex vitro for about 2 months.

Citrus tissue culture employing vegetative explants.

Citrus being a number one fruit of the world due to its high nutritional value, huge production of fruits and fruit products, the citrus industry may be considered a major fruit industry. Though citrus orchard area in India is comparable to USA, the produce is far less, while its export is nil. Biotechnology has played an outstanding role in boosting the citrus industry, e.g., in Spain, which is now the biggest exporter of citrus fruit with the application of micrografting. Amongst the fruit trees, perhaps the maximum tissue culture research has been done in citrus during the past four decades, however, the results of practical value are meagre. The shortfalls in citrus tissue culture research and some advancements made in this direction along with bright prospects are highlighted, restricting the review to vegetative explants only. Whilst utilization of nucellar embryogenesis is limited to rootstocks, the other aspects, like, regeneration and proliferation of shoot meristems measuring 200 microm in length--a global breakthrough--of two commercially important scion species, Citrus aurantifolia and C. sinensis and an important rootstock, C. limonia, improvement of micrografting technique, cloning of the same two scion species as well as some Indian rootstock species, employing nodal stem segments of mature trees, of immense practical value have been elaborated. A rare phenomenon of shift in the morphogenetic pattern of differentiation from shoot bud differentiation to embryoid formation occurred during the long-term culture of stem callus of C. grandis. Stem callus-regenerated plants of C. aurantifolia, C. sinensis and C. grandis showed variation in their ploidy levels and a somaclonal variant of C. sinensis, which produced seedless fruits was isolated. Tailoring of rooting in microshoots to a tap root-like system by changing the inorganic salt composition of the rooting medium, resulting in 100% transplant success, and germplasm preservation through normal growth culture of shoots of C grandis without loss of regeneration capacity during 31 years, observed so far, are some other significant results. Plants of C. aurantifolia and C. sinensis raised from shoot meristem and micrografting were grown in a nethouse and those from nodal stem segments in the field along with the in vitro-raised plants of rootstocks, namely, C. jambhiri, C. karna and C. limonia. All the plants showed normal healthy growth. Significantly enough, the meristem regenerated plants of C. aurantifolia attained the reproductive phase just in 1 year of transplantation to soil similar to those raised from nodal stem segments of mature trees, which also produced normal fruits in the subsequent year while growing under field conditions. Thus, a significant fundamental concept of a maturity factor, carried over through as small a shoot meristem as 200 microm in length to cloned plants has been demonstrated. The concept is of far-reaching significance in citrus industry besides production of pathogen-free orchards.

In vitro high frequency regeneration of plantlets of Vigna mungo and their ex vitro growth.

Of the five explants of V. mungo var. T9 used, the excised shoot tips gave best response with regard to offshoot formation followed by the embryonal axis explants. While a treatment comprising 0.5 mgL(-1) BAP, 0.5 mgL(-1) 2iP and 0.1 mgL(-1) NAA induced differentiation of an average 10 offshoots in shoot tip explants, only 3 offshoots were formed in the explants of embryonal axis in a treatment containing 0.5 mgL(-1) BAP and 0.1 mgL(-1) NAA, found optimum for them. Multiple shoots differentiated when explants with earlier regenerated and growing offshoots were first cultured in a treatment containing 0.1 mgL(-1) BAP, 0.25 mgL(-1) IAA and 5 mgL(-1) CCC and then subcultured in the same treatment but having only 1 mgL(-1) CCC. The isolated shoots rooted in 0.5 mgL(-1) IAA resulted in the formation of complete plantlets of an average height of 15 cm in 20 days. The in vitro-regenerated plants grew normally under field conditions and came to flowering as well.

Effect of fluvoxamine and N-methyl-D-aspartate receptor antagonists on shock-induced depression in mice.

We have earlier demonstrated that NMDA receptor antagonists possess antidepressant effect and also they show a synergism with imipramine. The present study attempts to investigate whether NMDA receptor antagonists also interact with selective serotonin reuptake inhibitors. The study was conducted in albino mice using shock-induced depression model. The mice were placed on a grid floor and shock delivered were of 2 sec duration with a 9 sec interval for 1 h. Twenty four hours later depression was measured by an open field test followed by a forced swimming test. Presentation of inescapable foot shock significantly reduced ambulation (from 159.50 +/- 5.42 to 80.50 +/- 4.61) and rearing (from 22.10 +/- 2.15 to 11.30 +/- 1.32) in the open field arena and increased immobility duration in the forced swimming test (from 82.20 +/- 3.51 to 158.90 +/- 4.61). Pretreatment with fluvoxamine, MK-801, ketamine and the combination of fluvoxamine with either of the NMDA antagonists antagonised shock-induced depression. Haloperidol and ketanserin pretreatment modified the effect of these agents. These findings suggest an interaction of NMDA receptor antagonists with fluvoxamine, and an involvement of brain dopaminergic and tryptaminergic mechanisms in the behavioural suppression observed after inescapable foot shock.

Interaction between N-methyl-D-aspartate receptor antagonists and imipramine in shock-induced depression.

In the past few years, literature has accumulated describing manifestation of seizures following administration of certain antidepressants. Such reports are of particular importance because depression is a frequent psychiatric problem associated with epilepsy. Therefore, in the view of the fact that NMDA receptor antagonists have been reported to reduce behavioural deficits and have been shown to be anticonvulsant, it was considered imperative to study their antidepressant effect using shock-induced depression model in mice. Presentation of inescapable foot shock significantly reduced ambulation and rearing in the open field arena and increased immobility duration in the FST. Pretreatment with imipramine, MK 801 and ketamine significantly prevented the effect of shock. Also, the combination of imipramine with either of the NMDA antagonists antagonised the effect of shock. Haloperidol, prazosin and ketanserin pretreatment modified the effect of these agents. These findings suggest an antidepressant effect of the NMDA receptor antagonists, and a complexity of neurotransmitter mechanisms, which are responsible for the occurrence of behavioural effects in shock-induced depression model.

Tobacco use in Mizoram, India: sociodemographic differences in pattern.

A study on tobacco use was carried out in Aizawl district of Mizoram, India, to assess the prevalence and pattern of tobacco use. An area served by two Sub-health Centers representing town and village population were selected for a household survey. 375 people (age 10 years and above) were interviewed about their habits of taking tobacco. Use of tobacco was high among males (56.6%) and females (45.7%), but the high prevalence of smoking among males (42.3%) and chewing among females (27.9%) indicates the existence of sex differences in tobacco use pattern. Age and occupation had significant association with tobacco use but influence of education was very low and its association was not significant. Mean age for start of tobacco chewing and smoking for males and females varied significantly. However, the mean age of start for adolescent and young age (10-29 years) tobacco users was 17.2 years (SD +/- 2.3). Though there are some limitations to this study, these findings revealed differential patterns of tobacco use which is valuable information for prevention effort.

Plantar acral melanoma--an experience from a regional cancer centre, India.

This is a retrospective analysis of all plantar acral melanomas treated at the Cancer Institute (WIA) Madras between January 1981 and December 1990. Acral melanomas constitute 26% of all melanomas in this population, the sole of the foot being the dominant site (35 of 36 cases). We have found that it is more common in the lower socioeconomic strata, occurs often over weight bearing areas and is usually advanced at presentation. The projected five year survival was 51% while the five year disease free survival was only 22%. Pathological nodal status was found to be the only factor significantly influencing survival in this study. Wide local excision was found to give results equivalent to radical amputation and is strongly recommended since it gives a much better quality of life with a disease that has an overall dismal prognosis.