Risk scoring for predicting mucositis in Indian patients with esophageal carcinoma receiving concurrent chemoradiotherapy.

PURPOSE: Mucositis is a common and troublesome adverse effect of concurrent chemoradiotherapy, often causing treatment interruption and compromising treatment outcome. We sought to identify predictors of mucositis in southern Indian patients treated for gastroesophageal carcinoma. METHODS: Patients (N = 90) receiving cisplatin 40 mg/m(2) and concurrent local radiotherapy at 40 to 50 Gy for esophageal carcinoma were retrospectively assessed for predictors of mucositis. Hypothesized risk factors were age, presence of comorbid conditions, low white blood cell (WBC) count, nutritional status (assessed by serum albumin level), continuing tobacco use, elevated erythrocyte sedimentation rate (ESR) as a measure of acute inflammation, World Health Organization (WHO) performance status, and disease stage. Receiver operating characteristic (ROC) curves were drawn to identify cut-off values for risk factors, and a risk scoring model was developed. RESULTS: On the basis of cutoff values on ROC analysis, a risk score of 1 was assigned for each risk factor as follows: age > 50 years, ESR > 3 times upper limit of normal, albumin < 3.3 g/dL, WBC < 2.5 x10(9)/L, WHO performance status > 2, and > stage III disease, with use of tobacco and presence of any comorbid condition also each being assigned a score of 1. For individual patients, a score of < 3 was associated with a 25% risk of grade 3 or 4 mucositis, whereas a score of >/= 6 was associated with 80% risk. CONCLUSION: The scoring system is accurate in predicting the development of mucositis in southern Indian patients receiving concurrent chemoradiotherapy for esophageal carcinoma.

Assessment of luteinizing hormone receptor function in an endometrial cancer cell line, Ishikawa cells in response to human chorionic gonadotrophin (hCG).

Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) play an important role in the development and maintenance of male and female gonads. Both these hormones act through the same specific receptor LH/hCG receptor (LHR). Recent studies have shown the existence of functional LHR in several non-gonadal tissues. The aim of this study was to confirm the functional existence of LHR in an endometrial adenocarcinoma cell line, Ishikawa cells, which has been used since long as an in vitro uterine endometrium model. Reverse transcriptase-polymerase chain reaction (RT-PCR) data showed the stable expression of LHR in this cell line. However, the receptor failed to activate the PKA pathway in response to hCG, which is the most conventional mode of LH/hCG action in target tissues. When tested for other pathways, hCG failed to activate them either. Nested RT-PCR confirmed the existence of full-length LHR and this was further supported by Western blot. This study demonstrated that although Ishikawa cells do possess a full-length LHR, which was confirmed by RT-PCR, nested RT-PCR, Western blot and DNA sequencing, it failed to activate the conventional LH-mediated downstream signaling. Based on these data we hypothesize that in Ishikawa cells LH/hCG does not utilize its conventional receptor. Whether it acts through some other receptor is a question, which can be answered through future research.

Bacteriological study of pyogenic meningitis with special reference to latex agglutination.

Bacterial meningitis is an important and frequent devastating disease. The present study was carried out to determine the prevalence of pyogenic meningitis in our hospital in children and to find out the sensitivity of Gram stain, CRP and latex agglutination tests for the diagnosis of pyogenic meningitis from CSF sample. Out of 150 CSF samples studied, 40 were diagnosed as pyogenic meningitis. H. influenzae was the commonest organism (22.5%), followed by Streptococcus pneumoniae 15%, Staphylococcus aureus--10%, Acinetobacter species and coagulase negative Stapylococci 7.5% each, E-coli 5%, and a case each of Klebsiella species, Group B streptococci, Proteus, Pseudomonas and Enterococci. The sensitivity of Gram stain and Latex agglutination test was 90% and that of CRP test was 62.5%. As most of the cases included in our study were treated earlier, the culture positivity was only 62.5%. Hence, Gram stain and/or latex agglutination tests, if done properly are most rapid and reliable tests for the diagnosis of pyogenic meningitis.