Dysregulated leukemia inhibitory factor and its receptor regulated signal transducers and activators of transcription 3 pathway: a possible cause for repeated implantation failure in women with dormant genital tuberculosis?

OBJECTIVE: To investigate the influence of dormant Mycobacterium tuberculosis on the expression of various endometrial receptivity markers and leukemia inhibitory factor (LIF)-signal transducers and activators of transcription 3 (STAT3) signaling pathway. Expression of endometrial receptivity markers and LIF-STAT3 signaling in in vitro decidualized human endometrial stromal cells (hESC) treated with 65 kDa mycobacterial heat shock protein (HSP65) is also explored. DESIGN: A prospective study. SETTING: Tertiary care hospital and reproductive health research unit. PATIENT(S): Endometrial tissue samples were collected from 38 women who tested positive for Mycobacterium tuberculosis and 30 normal women with proven fertility undergoing sterilization. In vitro decidualization of hESC was performed. INTERVENTION(S): Endometrial biopsies collected from all women during implantation window and treatment of hESC with HSP65. MAIN OUTCOME MEASURE(S): Measurement of various endometrial receptivity markers including αvß3 integrin, E-cadherin, MECA-79, mucin-1, and pinopodes and LIF/LIFR-STAT3 signaling molecules expressed in the endometrium of women with dormant genital tuberculosis (GTB) during implantation window and measured also in HSP65-treated hESC. RESULT(S): Significantly reduced levels of endometrial receptivity markers LIF, LIFR, and pSTAT3 were observed in endometrium of women with dormant GTB as compared with controls. A similar trend was observed under in vitro conditions with decreased level of phosphorylated STAT3 in HSP65-treated hESC. However, no change in the expression of endometrial receptivity markers under in vitro conditions was observed. CONCLUSION(S): Our findings suggest that endometrium of women with dormant GTB is associated with poor receptivity, as evidenced by reduced receptivity markers and aberrant LIF-STAT3 signaling. In vitro treatment of hESC with HSP65 also confirms compromised endometrial decidualization.

Diagnostic accuracy in retinoblastoma.

This study was done to ascertain the accuracy of diagnosis and possible risk of misdiagnosis in suspected retinoblastoma cases by different pre-operative diagnostic procedures like fundoscopy, ultrasonography, computerised tomography, and aqueous cytology study. Twenty-four eyes excised with diagnosis of suspected retinoblastoma were included in the study. Final diagnosis was reached by histopathological examination of excised eyes and compared with pre-operative diagnosis by different diagnostic procedures and accuracy of each procedure was calculated. Twenty-two cases were finally diagnosed as retinoblastoma and 2 cases (8.33%) as other than retinoblastoma. Computerised tomography and aqueous humour cytology were two most specific (100%) tests. Computerised tomography was the most sensitive (95.4%) test. Aqueous cytology was poorly sensitive (9.09%). Both ultrasonography and fundoscopy demonstrated sensitivity over 90% but with low specificity (50%). When test results of fundoscopy and ultrasonography were combined, specificity of this combination was 100% and sensitivity was 95.4%, which match exactly the values of computerised tomography. Combination of fundoscopy and ultrasonography has accuracy as high as that of computerised tomography. In patients with clear media this combination can be used as an effective alternative to computerised tomography to reach a diagnosis with comparable accuracy.

Relative incidence of different thalassaemias and haemoglobinopathies in South Bengal.

Thalassaemia is a common congenital abnormality throughout the world and beta-thalassaemia and HbE abnormality are two common haemoglobin disorders in West Bengal of India. There is inadequate study of these disorders in and around Calcutta, which is the most populated area in West Bengal. The present study showed 74.85% normal chromatogram on high performance liquid chromatography; 9.16% showed symptomatic patients of which commonest was E beta-thalassaemia followed by beta-thalassaemia. Asymptomatic patients with abnormal haemoglobin was found in 15.99% of which beta-thalassaemia minor was the commonest. Other studies in and around Calcutta also showed similar results. Studies involving population of 24 Paraganas of West Bengal showed less percentage of carrier state than the present study. This signifies the increased awareness of the urban and semi-urban population than the rural population regarding these congenital diseases. Only screening procedure can prevent spread of these diseases amongst general population.

A cross-sectional study on aqueous humour lactate dehydrogenase level in retinoblastoma.

Lactate dehydrogenase enzyme is a non-specific marker found raised in different body fluids in various pathological conditions. This cross-sectional study was done in a medical college of Kolkata, India to find out lactate dehydrogenase level of aqueous humour in retinoblastoma cases. Aqueous humour lactate dehydrogenase level from 21 histology proved retinoblastoma cases and 21 controls was estimated and compared. Range of lactate dehydrogenase levels in retinoblastoma cases were 863-4819 IU/l; mean being 3396.9 IU/l; and in controls range was 48-146 IU/l; mean being 90.6 IU/l; 76.19% of retinoblastoma cases had value over 3000 IU/l. None of the controls had value above 150 IU/l. The difference between lactate dehydrogenase values of cases and controls was significant (p<0.001).

Chondroid lipoma--a case report.

Chondroid lipoma is a rare fatty tumor of soft tissues, especially in limbs and limb girdles. Though it is clinically benign, the main importance lies in its histological similarity with myxoid liposarcoma and chondrosarcoma, which have poorer prognosis. In our study, classical histological pattern of chondroid lipoma was confirmed on H&E and PAS stains with low mitotic count.

An observational study on retinoblastoma cases attending a medical college in Calcutta.

Excision of the eyeball was done in 23 cases with diagnosis of retinoblastoma in a medical college of Calcutta. Of them, 21 cases were histologically proved to be retinoblastoma. A clinicopathological study of these 21 cases was done. Retinoblastoma patients were between 5.5 and 71 months of age, 57.1% were females, in 90.4% cases there was unilateral involvement and left eye was affected in 68.4% patients. All the patients had negative family history. Majority of the patients (85.7%) presented with leucocoria. Multiple presenting features were present in 5 patients. Aqueous humour cytology revealed malignant cells in 9.5% patients. Imprint cytology of cut end of optic nerve stump was negative for malignant cells in all the cases. Histopathological study revealed presence of Flexner-Wintersteiner rosettes in 23.8%, pseudorosettes in 28.6%, anterior chamber involvement in 38%, choroid invasion in 42.8%, optic nerve involvement in 28.6%, necrosis in 28.6% and calcification in 9.5% cases. After one year of follow-up, none developed any metastasis except one patient who had developed intracranial metastasis.