Pulmonary function after whole lung radiation in pediatric patients with malignant solid tumors

10025

Background: Pediatric malignant solid tumors are increasingly curable; whole lung irradiation (WLI) may be used to treat pulmonary tumor involvement. Few studies have addressed long-term pulmonary function after WLI during childhood. Methods: We conducted a retrospective review of pulmonary function tests (PFTs) in 1 year survivors of pediatric malignant solid tumors treated with WLI. We assessed PFT changes over time and the relationship of abnormal values to clinical parameters (diagnosis, radiation dose, and presence or absence of boost lung irradiation or surgical resection). Results: We evaluated 164 PFTs performed on 49 patients with the diagnoses of Wilms tumor (38), rhabdomyosarcoma (5), Ewing sarcoma (3), synovial sarcoma (2), and thymoma (1). Median age at radiation was 6.3 years (range, 0.5–20.2 years); median WLI dose was 12 Gy (range, 10.5–18 Gy). Seventeen (34.7%) had focal pulmonary boost irradiation and 21 (42.9%) had partial lung resection. Across the entire population, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) declined after irradiation with a median follow-up of 9.3 years. The odds of having a normal FEV1 and FVC decreased by a factor of 0.90 (p = 0.0387) and 0.91 (p = 0.0445), respectively, every year, indicating that the proportion of patients with normal values of FEV1 and FVC decreases over time. FEV1/FVC ratio and forced expiratory flow (FEF25%-75%) remained stable. Abnormal FEV1/FVC and FEF25%-75% were more likely in patients who received boost irradiation than in patients who did not (p = 0.0034 and 0.0233, respectively). Conclusions: Pulmonary function worsened over time in this cohort of childhood cancer survivors treated with WLI. Boost irradiation further impaired pulmonary function. Further studies are planned to assess the clinical consequences of these progressive PFT abnormalities and to identify risk factors associated with clinically significant pulmonary dysfunction after WLI.

No significant financial relationships to disclose.

In vitro effect of fluoroquinolones against Mycobacterium tuberculosis isolates from Agra & Kanpur region of north India

BACKGROUND & OBJECTIVE

Fluoroquinolones (FQs) are important drugs used for treatment of drug resistant tuberculosis and are also now being considered as first line drugs to shorten the duration of treatment of tuberculosis (TB). In order to find out useful FQs for treatment of tuberculosis, the comparative efficacy of five FQs, namely, ofloxacin (OFL), ciprofloxacin (CIP), sparfloxacin (SPX), gatifloxacin (GAT) and levofloxacin (LEVX) was studied against Mycobacterium tuberculosis (MTB) isolates obtained from both treated and untreated patients from Agra and Kanpur regions of north India.

METHODS

A total of 162 MTB isolates [including 110 MTB isolates obtained from untreated patients (Cat-I) and 52 isolates from treated patients (Cat-II)] were tested for their susceptibilities to FQs using standard minimum inhibitory concentration (MIC) method on Löwenstein-Jensen medium.

RESULTS

Keeping in view the therapeutically achievable drug levels, it was found that in Cat-I 97.2 per cent (107/110) isolates were sensitive to GAT, 89 per cent (98/110) to LEVX at 1 microg/ml whereas 92.7 per cent (102/110) isolates were inhibited by OFL at 2 microg/ml and 73.6 per cent (81/110) to SPX at 0.5 microg/ml. Only 63.6 per cent (70/110) isolates were found to be sensitive to CIP at 2 microg/ml which increased to 89 per cent (98/110) at 4 microg/ml (higher than achievable peak serum level). On the other hand, among 52 isolates for Cat-II, 37 (71.2%) were found to be sensitive to GAT and 33 (63.5%) to LEVX at 1 microg/ml concentration, 28 (53.8%) to SPX at 0.5 microg/ml whereas 33 (63.5%) and 24 (46.2%) isolates were found to be sensitive to OFL and CIP at 2 microg/ml, respectively.

INTERPRETATION & CONCLUSION

It appears that GAT has higher activity against MTB isolates followed by OFL, LEVX and SPX whereas CIP showed the lowest activity. GAT was also found to be the most effective FQ against multi-drug resistant (MDR) isolates both from Cat-I and Cat-II patients. Thus, except CIP, other FQs showed potential to be included in the treatment regimens of tuberculosis including MDR-TB.

Study on the response of indigenously developed CaSO4:Dy phosphor-based neutron dosemeter

In the present paper, we report the indigenous development of a neutron-sensitive thermoluminescent dosemeter (TLD) based on CaSO4:Dy Teflon TL disc. The study includes indigenous development of a neutron dosemeter and its response in terms of operational quantity to different energies of neutrons under various irradiation conditions. It was found that the thermal neutron sensitivity of the CaSO4:Dy Teflon neutron disc is about one-third of TLD-600. However, the thermal neutron sensitivity with respect to CaSO4:Dy Teflon gamma disc is about 42 times for in-air irradiation and about 84 times for on-phantom irradiation condition. This newly developed neutron dosemeter can be used as a routine TLD with a slight change in the design of the TLD badge system in the mixed fields of gamma and neutrons of energy up to 500 keV for radiation workers engaged in nuclear fuel cycle operation and other applications.

Isolation and characterization of betaA3-crystallin associated proteinase from alpha-crystallin fraction of human lenses

PURPOSE

The purpose was to characterize the properties of a proteinase activity associated with betaA3-crystallin, which was isolated from the alpha-crystallin fraction of human lenses.

METHODS

An inactive, Arg-bond hydrolyzing proteinase in the alpha-crystallin fraction, which was isolated from the water soluble (WS) protein fraction of 60- to 70-year-old human lenses, was activated by sodium deoxycholate treatment. The activated enzyme was purified by a three-step procedure that included a size-exclusion Agarose A1.5 m chromatography, non-denaturing preparative gel-electrophoresis, and size-exclusion HPLC. The purified proteinase was characterized for the proteinase type, proteolysis of bovine recombinant gammaB-, gammaC-, and gammaD-crystallins, and its presence in three different protein fractions of human lenses (i.e., alpha-crystallin, beta(H)-crystallin, and membrane fractions).

RESULTS

An inactive, Arg-bond hydrolyzing proteinase present in the alpha-crystallin fraction showed activity on treatment with detergents such as sodium deoxycholate, Triton X-100, octyl beta-D-glucopyranoside, and CHAPS (3-[(3-cholamido propyl) dimethylammonio]-1-propanesulfonate). The sodium deoxycholate-activated enzyme was released from the alpha-crystallin fraction since it eluted at a lower molecular weight species than alpha-crystallin during size-exclusion Agarose A1.5 m chromatography. Following a three-step purification procedure, the enzyme showed three species between 22 kDa and 25 kDa during sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis. The three protein bands were identified as betaA3-, betaB1-, and betaB2-crystallin by the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and tandem mass spectrometric (ES-MS/MS) methods. Inhibitor studies revealed that the enzyme was a serine-type proteinase. Among the recombinant betaA3-, betaB1-, or betaB2-crystallins, only the betaA3-crystallin exhibited the proteinase activity following detergent treatment and size-exclusion chromatography. The proteinase also exhibited proteolysis of gammaC- and gammaD- crystallins, and the cleavage of gammaD-crystallin at M(1)-G(2), Q(54)-Y(55), M(70)-G(71), and Q(103)-M(104) bonds. Further, the enzyme was also present in three fractions of human lenses (alpha-crystallin, beta(H)-crystallin, and membrane fractions).

CONCLUSIONS

A serine-type betaA3-crystallin proteinase existed in an inactive state in the alpha-crystallin fraction and was activated by detergents. The enzyme proteolyzed alphaA-, alphaB-, gammaC-, and gammaD-crystallins and was present in three fractions (alpha-crystallin, beta(H)-crystallin, and membrane-fractions) of 60 to 70-year-old human lenses.

Multi-crystallin complexes exist in the water-soluble high molecular weight protein fractions of aging normal and cataractous human lenses

The purpose of the study was to identify non-covalently held complexes that exist in the water-soluble high molecular weight (WS-HMW) protein fractions of normal human lenses of 20-year-old and 60- to 70-year-old, and in the age-matched 60- to 70-year-old cataractous lenses. The WS protein fractions were prepared from five pooled normal lenses of 20-year-old donors or five pooled lenses of 60- to 70-year-old donors or four pooled cataractous lenses (with nuclear opacity) of 60- to 70-year-old donors. Each WS protein fraction was subjected to size-exclusion chromatography using an Agarose A 5m column to recover the void volume WS-HMW protein fraction. A method known as blue-native polyacrylamide gel electrophoresis (BN-PAGE), which allows the isolation of large multi-protein complexes (MPCs) in their native state for further characterization, was used to separate such complexes from individual WS-HMW protein fractions. The protein species that existed as a complex were excised from a gel and trypsin-digested, and the amino acid sequences of the tryptic fragments analyzed by electrospray tandem mass spectrometry (ES-MS/MS). After the second-dimensional sodium dodecyl sulfate-PAGE during BN-PAGE, protein complexes containing a total of 16, 12, and 24 species with M(r) between 10 and 90 kDa were identified in the HMW protein fractions of normal lenses of 20-year-old, 60- to 70-year-old and cataractous lenses of 60- to 70-year-old donors, respectively. Based on the amino acid sequences of tryptic peptides of individual protein species in the complexes by the ES-MS/MS method, the presence of alpha-, beta-, and gamma-crystallin species along with beaded filament proteins (filensin and phakinin) was observed in the 20-year-old normal lenses. The 60- to 70-year-old normal lenses contained filensin and aldehyde dehydrogenase in addition to the above crystallins. Similarly, the age-matched cataractous lenses also contained the above crystallins and aldehyde dehydrogenase but lacked beaded filament proteins. Protein complexes, held mostly via non-covalent bonding, were seen in the WS-HMW proteins of 20-year-old normal, 60- to 70-year-old normal, and 60- to 70-year-old cataractous lenses. The complexes in the normal lenses were made of alpha-, beta-, and gamma-crystallin species, beaded filament proteins (filensin and/or phakinin), and aldehyde dehydrogenase. The complexes in the age-matched cataractous lenses also contained these crystallins, and aldehyde dehydrogenase, but not the beaded filament proteins. Further, the crystallin fragments were greater in number in the cataractous lenses compared to the age-matched normal lenses. During multi-angle light scattering (MALS), the HMW proteins from cataractous lenses exhibited species with lower molecular weight range than age-matched normal lenses. The HMW protein preparations from both normal and cataractous lenses showed spherical structures on electron microscopic analysis.

Isolation of Mycobacterium bovis & M. tuberculosis from cattle of some farms in north India--possible relevance in human health

BACKGROUND & OBJECTIVE

Infection due to Mycobacterium bovis typically occurs in cattle and animals transmit infection to each other. The choice of appropriate clinical specimen is very important for isolation of M. bovis and M. tuberculosis from cattle. The present study reports the isolation of M. tuberculosis and M. bovis from different types of specimens from cattle suspected to be suffering from tuberculosis in certain organized cattle farms in north India.

METHODS

A total of 768 specimens (heparinized or EDTA containing blood (162), fine needle aspirates from prescapular lymph gland (PSLG,160), milk (154), pharyngeal swab (PhS, 98), rectal pinch (RP, 97) and faecal sample (97) from 161 cattle of organized cattle farms in north India suspected to be suffering from tuberculosis were analyzed. After decontamination by modified Petroff's method isolation of M.tuberculosis complex was done on Lowenstein-Jensen medium (with and without pyruvate). The culture isolates were identified as M. tuberculosis and M. bovis on the basis of biochemical tests.

RESULTS

A total of 54 M. tuberculosis complex isolates were obtained, of them 40 were identified as M.bovis and 14 as M. tuberculosis. M.bovis were isolated from 12 of 38 animals in group A (Tuberculin +ve with signs of tuberculosis), 7 of 37 animals in group B (Tuberculin +ve and apparently healthy), 9 of 21 group C animals in (Tuberculin -ve with clinical signs of tuberculosis), 4 of 26 animals in group D (Tuberculin -ve and apparently healthy), 4 of 27 group E animals (having non-mycobacterial infection) and 4 of 12 animals in group F (having clinical signs such as debilitated condition, cough, decreasing milk production, etc). Maximum number of M. bovis (19/40, 47.5%) and M. tuberculosis (5/14, 35.7%) isolates were grown from prescapular lymph gland biopsy (PSLG) followed by blood from which 9/40 (22.5%) M. bovis and 4/14 (28.5%) M. tuberculosis were isolated. M. bovis [6/40(15%)] and M. tuberculosis [4/14(28.5%)] were also isolated from milk. Only 3/40 (7.5%) isolates of M.bovis could be isolated from 97 rectal pinch followed by 98 pharyngeal swab 2/40 (5%) and 97 fecal samples 1/40 (2.5%) while 1/14 (7.1%) M.tuberculosis isolates were obtained from pharyngeal swab.

INTERPRETATION & CONCLUSION

Among the samples analyzed, PSLG was found to be most suitable specimen for isolation of M. tuberculosis complex from cattle and is thus of diagnostic importance. M. bovis in milk indicates the need to investigate the transmission to human in such settings. Isolation of M. bovis and/or M. tuberculosis from apparently healthy cattle indicates sub-clinical infection in the herd. Further, isolation of a significant number of M. tuberculosis from cattle suggests possible human-to-cattle transmission which need to be confirmed by prospective studies including tools like DNA fingerprinting.

Reduction in Drug Prescription using Biofeedback Relaxation in Neurotic and Psychosomatic Disorders

BACKGROUND

There is a paucity of Indian studies on effectiveness of biofeedback in reducing drug prescription in neurotic and stress related disorders.

METHODS

Study sample of generalized anxiety disorders (GAD), mixed anxiety depression, obssessive compulsive disorder (OCD), dissociative disorder and headache were assigned to three groups of 28, 23 and 27 patients respectively. Group 1 were subjected to drug therapy, Group 2 to biofeedback and Group 3 to drugs and biofeedback for 12 weeks. All were followed up at six months and one year.

RESULT

At the end of one year, in Group 1, 60.71 % had mild and 17.86 % had moderate anxiety levels, while 21.43% required no further follow up. In Group 2, 39.13 % showed mild and 43.48 % had moderate anxiety levels, while 17.39 % required no follow up. In Group 3, 22.22% had mild and 11.13% had moderate levels of anxiety, while 66.66% required no further treatment.

CONCLUSIONS

Biofeedback relaxation with pharmacotherapy is useful in select group of neurotic and psychosomatic cases.

Psychiatric Effects of Traumatic Brain Injury

In India 30,000 people die and 1,25,000 become disabled due traumatic brain injury (TBI). The psychiatric sequalae of TBI can be acute and chronic. Chronic sequalae of TBI are usually ignored and may take the form of defects of cognition, memory, perception, language or intelligence. It may also lead to inappropriate aggression, sexual behaviour, personality change, mood changes, neurosis and psychosis. Neuropsychological assessment of TBI can be pharmacological or behavioural. Survivors of TBI are referred to a walking wounded and require to be cared for.

Evaluation of gemcitabine versus cisplatinum as an adjunct to radiotherapy in locally advanced carcinoma uterine cervix

16012

Background: Locally advanced carcinoma cervix patients are treated by a combination of external beam radiation and brachytherapy. Concurrent chemo-radiotherapy has been an active area of investigation in such patients. In this present study, we have compared two chemotherapy drugs- cisplatinum vs gemcitabine along with radiotherapy in loco-regionally advanced carcinoma cervix with the purpose of evaluating loco-regional disease control and tolerability of these combinations. Methods: This study was undertaken on 65 biopsy-proven patients with stage IIb- IIIb carcinoma cervix. All patients were treated with 50 Gy of external beam radiation with 2 Gy per fraction, 5 days a week followed by intra-cavitary radiotherapy (ICRT). Dose of ICRT delivered by high dose rate brachytherapy was 18 Gy by either of the two schedules, viz. 3 fractions of 6 Gy at weekly interval or 2 fractions of 9 Gy each at one week apart. The concurrent chemotherapy was either inj. Cisplatinum 35 mg/m2 IVI weekly (control group), or inj. gemcitabine 150 mg/m2 IVI weekly (Study group). Results: A total of 65 age and stage matched patients were recruited in the two arms of the study. We analyzed sixty patients who completed the above treatment protocol with 32 patients in control group and 28 in study group. Eighty-nine percent patients in study group had complete response (CR) to the above combination treatment vs. 72% CR in control arm (p< 0.05). However, overall response rate (CR+ PR) was similar in both the groups (96% in study group vs. 100% in control group). No patient in both the groups had grade IV skin reaction with only one patient in study group developing grade III skin toxicity. Grade III gastrointestinal (GI) toxicity was higher in study group as compared to controls (14% vs. 3%) with none of the patients experiencing grade IV GI toxicity. No other significant toxicity was encountered in this study. Conclusions: We can conclude that synchronous chemo-radiotherapy using either gemcitabine or cisplatinum as radiation sensitizer is feasible in locally advanced carcinoma cervix with similar overall response rate and acute toxicity profile with a significantly higher complete response rate when gemcitabine is used as a chemotherapeutic drug.

No significant financial relationships to disclose.

Induction of tolerance after establishment of peanut allergy by the food allergy herbal formula-2 is associated with up-regulation of interferon-?

BACKGROUND

Peanut (PN)-anaphylaxis is potentially life threatening. We previously reported that a Chinese herbal medicine preparation, food allergy herbal formula-2 (FAHF-2), prevented peanut allergy (PNA) in mice when administered during sensitization.

OBJECTIVE

To investigate whether FAHF-2 also can prevent anaphylactic reactions when administered to mice with established PNA and, if so, whether protection would persist after cessation of therapy.

METHODS

C3H/HeJ mice sensitized and boosted over 8 weeks with a standard protocol known to establish PN hypersensitivity received seven weeks of FAHF-2 treatment or water as a sham treatment. Mice were subsequently challenged with PN at week 14 (1-day post-therapy) and week 18 (4-week post-therapy) to evaluate the efficacy and persistence of FAHF-2 treatment by assessing anaphylactic scores, core body temperatures and plasma histamine levels. Serum PN-specific antibody levels and cytokine profiles from splenocytes and mesenteric lymph node (MLN) cells were also determined.

RESULTS

All sham-treated mice challenged at weeks 14 and 18 showed anaphylactic symptoms. In contrast, FAHF-2-treated mice showed no sign of anaphylactic reactions. PN-specific IgE levels in FAHF-2-treated mice also were reduced whereas IgG2a levels were increased. Furthermore, MLN cells from FAHF-2-treated mice produced markedly less IL-4 and IL-5, but more IFN-gamma, and contained increased numbers of IFN-gamma-producing CD8+ cells as compared with sham-treated mice.

CONCLUSION

FAHF-2 treatment established PN tolerance in this model, which persisted for at least 4-week post-treatment. This result was associated with modulation of intestinal T helper type 1 cell (Th1) and Th2 cytokine production, and with increased numbers of mesenteric IFN-gamma-producing CD8+ cells.

Comparison of various blood compartments and reporting units for the detection and quantification of Epstein-Barr virus in peripheral blood

Epstein-Barr virus (EBV) infection is associated with a broad spectrum of disease. While quantification of EBV nucleic acid in the peripheral blood has been demonstrated to be useful for diagnosis and patient care, the optimal sample type and reporting format for such testing remain uncertain. Using quantitative real-time PCR (QRT-PCR), we evaluated EBV in whole blood (WB), peripheral blood mononuclear cells (PBMC), and plasma in 249 samples from 122 patients. In WB and PBMC, results were reported both in viral copies/ml and in copies/microg of total DNA. Trendings of quantitative values over time among the different sample types were compared. The sensitivities of QRT-PCR using WB and that using PBMC did not differ significantly (P = 0.33), and both were more sensitive than plasma alone (P < 0.0001). EBV viral load results from WB and PBMC paired sample types also showed a significant correlation (P < 0.05), as did results reported in copies/ml and copies/microg DNA for both WB and PBMC (R2 > 0.93). EBV viral loads detected using WB and PBMC trended very closely for the few patients who had multiple positive samples available for analysis. WB and PBMC show comparable sensitivities and a close quantitative correlation when assayed for EBV by QRT-PCR. The close correlation between copies/ml and copies/microg DNA also suggests that normalization to cell number or genomic DNA in cellular specimens may not be necessary.

Changing Pattern of Alcohol Abuse in the Army before and after AO 3&11/2001

BACKGROUND

The Army Order 3&11/2001 was introduced to curb alcoholism and to weed out habitual alcoholics. Hence a study was carried out in a zonal referral hospital from 01 Jan 2001 to 30 Jun 2003 to assess its effectiveness.

METHODS

The subjects consisted of officers, junior commisioned officers and other ranks who satisfied the International Classification of Diseases (ICD) 10 criteria for alcohol dependence.

RESULT

Out of 1023 consecutive admissions, alcohol dependent cases numbered 245 (23.95%). They were disposed as under: 57/ 245 (23.6%) in S1 (fit for all duties), 67/245 (27.35%) in S2 (fit for duties with few restrictions), 72/245 (29.39%) in S3 (fit for duties with more restrictions), and 32/245 (13.06%) in S5 (unfit for further service.).

CONCLUSION

The data showed that the percentage of cases disposed under fit for all duties had risen four times (23.80 vs 5.86), those invalided out increased by two times (12.70 vs 6.64) and those retained in S2 had reduced (26.46 vs 41.21) after the new policy.

Psychological Well-being of Medical Students

BACKGROUND

Training in medicine is emotionally demanding. Psychological well being of medical students is a matter of concern. There is lack of Indian studies in this area.

METHODS

A total of 105 medical student of one batch were assessed utilizing psychophysiological state inventory, Institute for personality and ability testing (IPAT) anxiety and depression scale, achievement motivation scale, scale for locus of control and 16 PF in three phases at one-year intervals.

RESULT

Majority of the students had average achievement, motivation and adaptability. Anxiety and depression scores fell within normal limits. In personality profile factor 'B', 'M' and 'Q41' had changed significantly. Achievement motivation showed significant decreases and CSS1 and PO1 scores showed significant increase during the years of medical education.

CONCLUSION

The results demonstrate that over satisfaction and relaxed attitude may have poor academic outcome.

Development of an algorithm for TLD badge system for dosimetry in the field of X and gamma radiation in terms of Hp(10)

In view of the introduction of International Commission on Radiation Units and Measurements operational quantities Hp(10) and Hp(0.07), defined for individual monitoring, it became necessary to develop an algorithm that gives direct response of the dosemeter in terms of the operational quantities. Hence, for this purpose and also to improve the accuracy in dose estimation especially in the mixed fields of X ray and gamma, an algorithm was developed based on higher-order polynomial fit of the data points generated from the dose-response of discs under different filter regions of the present TL dosemeter system for known delivered doses. Study on the response of the BARC TL dosemeter system based on CaSO(4):Dy Teflon thermoluminescence dosemeter discs in the mixed fields of X and gamma radiation was carried out to ensure that the accuracies are within the prescribed limits recommended by the international organisations. The prevalent algorithm, based on the ratios of the disc response under various filters regions of the dosemeter to pure photons, was tested for different proportion of two radiations in case of mixed field dosimetry. It was found that the accuracy for few fields is beyond the acceptable limit in case of prevalent algorithm. The new proposed algorithm was also tested in mixed fields of photon fields and to pure photon fields of varied angles. It was found that the response of the dosemeter in mixed fields of photons and its angular response are satisfactory. The new algorithm can be used to record and report the personal dose in terms of Hp(10) as per the international recommendation for the present TL dosemeter.

Truncation of motifs III and IV in human lens betaA3-crystallin destabilizes the structure

The purpose of our study was to determine the effects of specific truncations on the structural properties of human betaA3-crystallin. The following eight deletion mutants of betaA3-crystallin were generated: (i) N-terminal extension (NTE) 21 amino acids (betaA3[21] mutant), (ii) NTE 22 amino acids (betaA3[22] mutant), (iii) NTE (betaA3[N] mutant), (iv) NTE plus motif I (betaA3[N+I] mutant), (v) NTE plus motifs I and II (betaA3[N+I+II] mutant), (vi) NTE plus motifs I and II and connecting peptide (betaA3[N+I+II+CP] mutant), (vii) motifs III and IV (betaA3[III+IV] mutant), and (viii) motif IV (betaA3 [IV] mutant). The DNA sequencing and MALDI-TOF mass spectrometric methods confirmed desired specific deletions, and the purified mutant proteins exhibited a single band during SDS-PAGE analysis. When ANS bound, all the mutant proteins exhibited fluorescence quenching and a red shift, suggesting that the truncations caused changes in the exposed hydrophobic patches. The CD spectra showed that deletion of either NTE or the N-terminal domain (motifs I and II) had a relatively weaker effect on the structural stability than deletion of the C-terminal domain (motifs III and IV). Intrinsic Trp fluorescence spectral studies suggested changes in the microenvironment of the mutant proteins following truncations. HPLC multiangle light scattering analyses showed that truncation led to higher-order aggregation compared to that in the wild-type protein. Equilibrium unfolding and refolding of WT betaA3 with urea were best fit to a three-state model with transition midpoints at 2.2 and 3.1 M urea. However, the two transition midpoints of betaA3[21] and betaA3[22] and betaA3[N] mutants were similar to those of the wild type, suggesting that these truncations had a minimal effect on structural stabilization. Further, the mutant proteins containing the N-terminal domain (i.e., betaA3[III+IV] and betaA3[IV] mutants) exhibited higher transition midpoints compared to the transition midpoints of the mutant protein with the C-terminal domain (i.e., betaA3[N+I+II+CP] mutant). The results suggested that the N-terminal domain is relatively more stable than the C-terminal domain in betaA3-crystallin.

Norms of the Rorschach Test for Indian Subjects

BACKGROUND

The clinical utility of the Rorschach test in Indians is hampered by the absence of reliable normative data. Method : The Rorschach by Dlopfer's method was administrated to 1256 subjects consisting of 300 normal army personnel, 300 normal civilians, 250 schizophrenics, 300 neurotics and 106 patients with organic disorders.

RESULTS

The Rorschach protocols of normal Indian army personnel and normal civilians showed significant differences from one another and also from the western norms. These differences are culturally determined and are not indicative of low intelligence or psychopathology. Patients with schizophrenia, neurosis, head injury and epilepsy show significant differences from the records of normal subjects. The protocols of army schizophrenics show significant deviations from those of normal army personnel and these changes revert to normal with clinical recovery.

CONCLUSION

The Rorschach test is not a culture fee test as claimed earlier. In view of the differences from Western norms, Rorschach protocols of Indians should be interpreted using the norms for Indians. In the case of army personnel the norms for army personnel should be used. While the use of the Rorschach to study the personality patterns of normal individuals and as an aid to clinical diagnosis was strongly supported, the findings of the study indicate that the test can also be employed to assess therapeutic response of patients with schizophrenia.