Implications of p53 over-expression in the outcome with radiation in head and neck cancers.

BACKGROUND: Abnormalities in the p53 tumor suppressor gene and in the expression of its protein are commonly seen in several tumors. The prognostic implication of these p53 abnormalities was studied in 55 patients with advanced head and neck cancers. PURPOSE: To identify p53 as a prognostic factor in assessment of response and survival outcome to radiotherapy in head and neck malignancies. MATERIALS AND METHODS: This prospective study was carried out from April 1998 to December 1999. Fifty five patients with proven squamous cell carcinoma of the head and neck region were treated by radiotherapy (RT) (n=34) with or without chemotherapy (CT) (n=21). A dose of 70 Gy/35#/7 weeks was given with or without concurrent administration of weekly cisplatin (35 mg/m2). Paraffin sections obtained at the time of diagnosis, were examined immunohistochemically for p53 overexpression with monoclonal antibody DO-7 (DAKO). The scoring of p53 positive cells was carried out by a trained pathologist. Selected areas of p53 positive cells were viewed under high power field for quantitative assessment of the p53 over expression. A minimum of 1000 cells were counted and the labeling index (LI) was calculated in terms of percentage of p53 positive cells over the total number of cells counted. A 10% nuclear reactivity exhibiting chromogen positivity cutoff point was established. OBSERVATIONS: The data was analyzed as of January 2006. Median follow-up of all the patients was eight months (1-95 months). The median age of this study group was 58 years and of the 55 patients, 48 were males. Positive expression of p53 gene protein was documented by immunohistochemistry in 24 (44%) patients. Over expression of p53 was not associated with T or N stage, site of disease, radiation response or survival outcomes (P=0.143). Stage was the only independent prognostic variable, both for the response to treatment (radiation) and survival (P=0.01). CONCLUSIONS: Over expression of p53 protein, when detected immunohistochemically, does not predict for radiation response in these tumors.

Relevance of Weil-Felix test in diagnosis of scrub typhus in India.

OBJECTIVE: To study the relationship of Weil-Felix test and microimmunofluorescence test. METHODS: Sera of 21 patients with clinical diagnosis of scrub typhus were subjected to Weil-Felix and Microimmunofluorescence tests. RESULTS: On Weil-Felix test, 13 (62%) sera showed titers 1: > or = 40-320. 7 patients showed titers 1: > or = 320, 3 showed titers 1 : 160, 2 showed titers 1 : 80 and 1 patients showed titers 1 : 40, to Proteus OXK antigen. All 21 sera showed significant titers to O. tsutsugamushi on microimmunofluorescence. CONCLUSION: Weil-Felix test is not a very sensitive test in diagnosis of scrub typhus but due to of lack of availability of definitive tests in India it canbe a useful tool when used and interpreted in the correct clinical context.

Non-Ulcer dyspepsia relation with environmental factors - A study in Sub Himalayas, India.

Non ulcer dyspepsia is a common gastrointestinal problem, the etiopathogenesis of which is not well established. This study was planned to see the effect of environmental factors like smoking, tea, alcohol, and NSAIDs consumption with non-ulcer dyspepsia. This study was conducted in the department of Gastroenterology, Medicine and Radiology of I.G. Medical College, Shimla, India. Three hundred patients of non-ulcer dyspepsia were included in the study. Each case was matched with community control of same age and sex. A detailed history of smoking, tea, alcohol, and NSAIDs consumption was taken from the patients and controls. Consumption of tea as an environmental factor was found to be statistically significant in non-ulcer dyspepsia patients as compared to controls using multivariate regression. In the present study, environmental factors like smoking, alcohol, NSAIDs consumption did not show positive co-relation with non-ulcer dyspepsia.

Neurocysticercosis presenting with psychosis.

Cysticercosis consists of infection with the small bladder-like larvae of the pork tapeworm Taenia solium. The life cycle of parasite is maintained between man and pig infected with cysticerci. Epilepsy is the most common presentation of neurocysticercosis; focal signs, headache, involuntary movements and global mental deterioration are other symptoms. Psychosis is a rare presentation and may be seen in up to 5% of patients. We present a 25 years old male, who had been under treatment from psychiatry OPD for psychosis for one year, developed generalized tonic-clonic seizures. CT scan of brain revealed multiple calcified and hypodense lesions with surrounding oedema. Histopathological examination of subcutaneous nodule confirmed the diagnosis of neurocysticercosis.

Clinical and bacteriological profile of community acquired pneumonia in Shimla, Himachal Pradesh.

BACKGROUND: Community acquired pneumonia (CAP) is a common clinical problem. The present study was designed to evaluate the clinical and bacteriological profile of CAP in Shimla. METHODS: Seventy patients with community acquired pneumonia were enrolled in this study. In all the patients blood culture, sputum culture, pleural fluid culture (if available) and serological studies for the detection of Mycoplasma pneumoniae specific IgM antibodies by enzyme linked immunosorbent assay (ELISA) were done. RESULTS: Of the 70 patients, 53 (75.6%) had an identifiable atiology with 12 patients having evidence of mixed infection. No organisms could be isolated in 17 patients inspite of using serological methods for Mycoplasma pneumoniae, invasive procedures like bronchoscopic aspirations in addition to the conventional methods like sputum culture, blood culture and pleural fluid culture. The most frequent pathogen was Streptococcus pneumoniae (n = 19; 35.8%) followed by Klebsiella pneumoniae (n = 12; 22%), Staphylococcus aureus in (n=9; 17%), Mycoplasma pneumoniae (n = 8; 15%), Escherichia Coli (n = 6; 11%), beta-haemolytic streptococci (n = 4; 7.5%) and other Gram-negative bacilli (n = 5, 9%). CONCLUSION: Age smoking and under lying co-morbid conditions specially chronic obstructive pulmonary disease (COPD) were significantly associated with the development of CAP (p < 0.01).

Glioneuronal migration and development disorders: histological and immunohistochemical study with a comment on evolution.

Glioneuronal migration disorders of the brain evolve primarily due to aberration in neuronal migration, maturation and programming in the development of various topographic zones in the brain, following pathological alterations in glial and neuronal interactions. These are broadly referred as cortical dysplastic conditions. While these dysplastic conditions involving cerebral cortex present as drug resistant seizure disorder, those involving cerebellum present as mass lesions or slowly progressing vertigo. We report 17 cases, representing the histological spectrum of dysplastic, glioneuronal migration disorders which include, hemimegalencephaly (1), tuberous sclerosis (4), Sturge Weber Syndrome with focal dysplasia (1), Dysembryoplastic neuroepithelial tumor (7) and Lhermitte Ductos disease of cerebellum (2). The dysplastic neurons in varied stages of maturation showed neuronal cytoskeletal pathology similar to that in neuro degenerative diseases, especially when associated with cytomegaly. Similarly, cells exhibiting dual expression of glial and neuronal markers were noted in the cerebral dysplastic lesions. The dysplastic glial elements probably form the subependymal giant cell astrocytomas. Dysplastic neuronal elements form the nidus for DNT. When localized, surgical resection ameliorate the symptoms in many of these condition. Study of these conditions provide better insight into glioneuronal interaction and maturation of the brain.

Neural network prediction of 3(10)-helices in proteins.

Secondary structure prediction from the primary sequence of a protein is fundamental to understanding its structure and folding properties. Although several prediction methodologies are in vogue, their performances are far from being completely satisfactory. Among these, non-linear neural networks have been shown to be relatively effective, especially for predicting beta-turns, where dominant interactions are local, arising from four sequence-contiguous residues. Most 3(10)-helices in proteins are also short, comprising of three sequence-contiguous residues and two capping residues. In order to understand the extent of local interactions in these 3(10)-helices, we have applied a neural network model with varying window size to predict 3(10)-helices in proteins. We found the prediction accuracy of 3(10)-helices (approximately 14%), as judged by the Matthew's Correlation Coefficient, to be less than that of beta-turns (approximately 20%). The optimal window size for the prediction of 3(10)-helices was about 9 residues. The significance and implications of these results in understanding the occurrence of 3(10)-helices and preferences of amino acid residues in 3(10)-helices are discussed.

Seasonal behaviour of healed duodenal ulcer.

Incidence of peptic ulcer is more in people living at higher altitude and similarly relapse of healed duodenal ulcer is more in winter season. Seasonal behaviour of healed duodenal ulcer with or without maintenance therapy with H2 blockers was studied among subjects residing around Shimla (approximate altitude 7000 feet above mean sea level). Sixty-four subjects of endoscopically healed duodenal ulcer were alternatively advised placebo (32 subjects) and ranitidine 150 mg (32 subjects) at bed time as maintenance therapy for period of one year. Subjects were reviewed endoscopically and evaluated for H pylori by rapid urease test, every months or earlier if symptomatic. Relapse rate was analysed among 60 subjects at the end of one year. Cumulative relapse rate was found 60% in ranitidine group and 100% in placebo group. In ranitidine group percentage of relapse to number of endoscopic examinations was 21.4% throughout the year, but in placebo group during winter and spring season relapse was 87.5% of endoscopic examination whereas 57.2% during summer and fall season. Incidence of duodenal ulcer relapse without maintenance therapy was more in winter and spring season (October to March) as compared to summer and fall (April to September), whereas intermittent seasonal treatment is efficacious in prevention of duodenal ulcer relapse and also improves cost benefit ratio of ulcer treatment.