Correlation of macular thickness and posterior hyaloid change following bevacizumab and triamcinolone in diffuse diabetic macular edema in middle-aged patients
To compare changes in posterior vitreous detachment (PVD) following intravitreal injection of bevacizumab and triamcinolone in diffuse diabetic macular edema in middle-aged type 2 diabetes patients and to correlate this change with change in central macular thickness (CMT).  Fifteen consecutive patients treated by intravitreal bevacizumab (group A) and ten patients treated by intravitreal triamcinolone (group B). Institutional study carried out by retrospective analysis of patient registers including serial optical coherence tomography (OCT) images at baseline, and after 1 and 4 months. A central macular thickness (CMT) and vitreomacular relationship was noted on OCT. PVD was graded on a linear scale (0–4). Change in grade of PVD was correlated with change in CMT at each follow-up. At month 4, the decrease in mean CMT from baseline was 51.2 μ (P = 0.000) and 45 μ (P = 0.022) in group A and group B, respectively, with no significant difference between the two groups (P = 0.874). A change in grades of PVD from baseline to month 4 was significant in both group A (P = 0.001) and group B (P = 0.004) with no significant difference between the two groups (P = 0.906). A significant correlation between change in PVD and reduction of CMT was observed in group A (P = 0.011) but not in group B (P = 0.315). Both bevacizumab and triamcinolone caused a significant reduction in macular thickness and a significant change in grade of PVD. Change in PVD played an influential role in the reduction of macular thickness following bevacizumab.

title: Awareness of diabetic retinopathy among physicians and optometrists in a district of West Bengal.
abstract: A cross sectional study was done to ascertain the current knowledge among physicians and optometrists regarding diabetic retinopathy in a district of West Bengal. We obtained response from 242 physicians and 36 optometrists working in government health units. The questionnaire comprised of three sections covering magnitude of problem, risk factors and management. The responses were analysed and graded. In different sections, knowledge of 74 - 78% physicians and 83 - 86% optometrists was graded as not acceptable. Existing lack of knowledge among physicians and optometrists regarding diabetic retinopathy needs correction.

title: Pulmonary adenocarcinoma is associated with poor long-term survival after surgical resection. Effect of allogeneic blood transfusion.
abstract: The significance of allogeneic blood transfusion in the prognosis of patients with nonsmall lung carcinoma (NSCLC) remains controversial. Reports have suggested that patients with adenocarcinoma have a worse prognosis from cancer than patients with squamous cell carcinoma (SCC), but this evidence is lacking in NSCLC. The objective of the current study was to elucidate the correlation between perioperative allogeneic blood transfusion and the prognosis in patients with adenocarcinoma and SCC.



The study group comprised 329 consecutive patients (172 men and 157 women) with a mean age of 67 years who underwent lung resection between 1996 and 2003 in 1 unit. The clinicopathologic and survival data were compared between 62 patients (42.7%) with adenocarcinoma and 58 patients (48.3%) with SCC who received a perioperative blood transfusion and 83 patients (57.3 %) with adenocarcinoma and 126 patients (61.3%) with SCC who did not.



The overall surgical mortality rate was 3.9% (13 deaths). The median surgical blood loss was 380 mL (range, 125-4500 mL). The mean blood transfusion received was 1.9 U (range, 0-8 U). The overall actuarial 1, 3, and 5-year survival rates in the adenocarcinoma and SCC groups were 82.3%, 49.6%, and 19.4% and 87.9%, 71.7%, and 32.7%, respectively (P = 0.021). Multivariate analysis demonstrated that the factors that appeared to be independent prognostic factors in both groups were T-classification (P < 0.001), lymph node metastasis (P < 0.001), and postoperative complications (P = 0.029). Perioperative blood transfusion was not an independent prognostic indicator in either group.



The current study demonstrated that long-term survival in patients with adenocarcinoma of the lung was significantly worse compared with patients with SCC, but was independent of allogeneic perioperative blood transfusion. The results reaffirmed the importance of tumor invasion and lymph node involvement in the overall poor prognosis of these patients.

title: Chemically induced unfolding of bovine serum albumin by urea and sodium dodecyl sulfate: a spectral study with the polarity-sensitive charge-transfer fluorescent probe (E)-3-(4-methylaminophenyl)acrylic acid methyl ester.
abstract: Sensitivity of the charge-transfer (CT) band of the fluorescence probe (E)-3-(4-methylaminophenyl)acrylic acid methyl ester (MAPAME) towards the polarity of its immediate environment is employed to investigate the binding interaction of the probe with bovine serum albumin (BSA) and uncoiling of BSA by the denaturants urea and sodium dodecyl sulfate micelles. Binding of the probe with BSA produces a blue shift and enhanced intensity of the CT emission band which clearly point toward a decrease in polarity of the immediate environment of MAPAME. This is expected, since binding with BSA moves the probe from a polar water environment to a much less polar, hydrophobic protein interior, where the CT band is expected to be blue-shifted. Higher intensity arises due to fewer non-radiative decay paths available to the probe in the hydrophobic protein environment. Chemically induced unfolding of BSA by urea and sodium dodecyl sulfate is tracked by monitoring the induced spectral changes of the protein-bound probe MAPAME. Red-edge excitation shift or REES, fluorescence resonance energy transfer (FRET) and anisotropy measurements are used to investigate and monitor these binding and unfolding processes.

title: Volatilization of Mercury by Resting Mercury-Resistant Bacterial Cells

abstract: The mercuric ion reduction system encoded by the Hg2+ inducible mer operon confers bacterial resistance to mercuric ion. The mer A gene product which is a FAD-containing enzyme catalyzes the reduction of Hg2+ to volatile elemental mercury with the help of intracellular thiols and NADPH as a cofactor (Schottel 1974; Summers and Silver 1978; Fox and Walsh 1982; Misra 1992). Our earlier studies have shown that growing cells of different mercury-resistant bacteria reduce Hg2+ compounds to Hg(O) (Ray et al. 1989; Pahan et al. 1990a; Gachhui et al. 1989). We have also shown the effect of thiol compounds and flavins on mercury-degrading enzyme activities in mercury-resistant bacteria (Pahan et al. 1990b). Here we report that resting cells of mercury-resistant bacteria survive in a buffer system for several hours, synthesize inducible mercury-degrading enzymes and volatilize mercury from a mercury-containing buffer system. We know of no information regarding studies of mercury-degrading enzymes in resting mercury-resistant bacterial cells.

title: Therapeutic value ofalpha-4 integrin blockade in inflammatory bowel disease:the role of natalizumab
abstract: Lymphocyte infiltration into the intestinal tract in Crohn’s disease is mediated by the interaction between α4 integrin, expressed on lymphocytes, and its ligand mucosal vascular addressin cell-adhesion molecule-1 (MADCAM-1), expressed on the endothelial cells of the microvasculature in inflamed intestinal tract. Natalizumab, a recombinant, humanised monoclonal antibody against α4 integrin was effective in Crohn’s disease in a Phase II, randomised, controlled trial. The highest response rate and remission rates were 71 and 44% at 6 weeks, respectively, after two infusions of 3 mg of natalizumab administered 4 weeks apart. Natalizumab was well-tolerated in this study. The Phase III trial results are awaited.

title: Natalizumab for active Crohn's disease.
abstract: In chronic inflammatory conditions such as Crohn's disease, the migration of leukocytes from the circulation into the parenchyma and their activation within inflammatory sites are mediated in part by alpha4 integrins.



We conducted a double-blind, placebo-controlled trial of the alpha4 integrin-specific humanized monoclonal antibody natalizumab in 248 patients with moderate-to-severe Crohn's disease. Patients were randomly assigned to receive one of four treatments: two infusions of placebo; one infusion of 3 mg of natalizumab per kilogram of body weight, followed by placebo; two infusions of 3 mg of natalizumab per kilogram; or two infusions of 6 mg of natalizumab per kilogram. Infusions were given four weeks apart. Outcomes included changes in scores for the Crohn's Disease Activity Index (higher scores indicate more severe disease), the health-related quality of life, and C-reactive protein levels.



The group given two infusions of 6 mg of natalizumab per kilogram did not have a significantly higher rate of clinical remission (defined by a score of less than 150 on the Crohn's Disease Activity Index) than the placebo group at week 6 (the prospectively defined primary end point in the efficacy analysis). However, both groups that received two infusions of natalizumab had higher remission rates than the placebo group at multiple time points. Natalizumab also produced a significant improvement in response rates (defined by a reduction of at least 70 points in the score on the Crohn's Disease Activity Index). The highest remission rate was 44 percent and the highest response rate was 71 percent (at week 6 in the group given two infusions of 3 mg per kilogram). Overall, the two infusions of 6 mg of natalizumab per kilogram and of 3 mg per kilogram had similar effects. The quality of life improved in all natalizumab groups; C-reactive protein levels improved in groups receiving two infusions of natalizumab. The rates of adverse events were similar in all four groups.



Treatment with the selective adhesion-molecule inhibitor natalizumab increased the rates of clinical remission and response, improved the quality of life and C-reactive protein levels, and was well tolerated in patients with active Crohn's disease.