ICMR BULLETIN VOL.19-No.-9-SEPTEMBER-1989.pdf
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ICMR
BULLETIN
Vol.19 No.9
September, 1989
IMMUNOLOGY OF SOLID TUMOURS AND PREMALIGNANT
LESIONS
Cancer has been considered a cellular disease and
therefore most of the research on cancer has been
focussed on trying to uncover the fundamental cause of
the disease at the cellular level1. Cancer may be viewed as
resulting from the development of modified cells that are
capable of cloning in an otherwise hostile environment
because the organism has somehow become incapable of
responding in a proper fashion. The transformation of a
normal cell into a cancer cell leads to a permanent
alteration in cell behaviour, which is maintained and
transmitted to descendent generations of cells through the
chromosome which represent the genetic component of
the cell2. The failure of malignant cells to respond to the
homeostatic control of the host, their ability to invade
surrounding tissues and their frequent propensity for
metastasis has prompted many researchers to look into
the biological behaviour of the malignant cells.
In 1908 Ehrlich3 postulated that cancer cells arise
frequently and they bear membrane changes that could be
recognised as foreign antigens by the host and the cellular
immune responses may be sufficient for cancer cell
rejection in most cases. Later Thomas4 stated that the
development of cell mediated immunity was driven by the
need for immunological surveillance of newly arising
neoplasms. Based on these theories Burnet5 put forward
the immunological surveillance hypothesis which states
that the heterogenecity of histocompatibility antigens and
the associated capacity of the immunological apparatus
of higher vertebrates to distinguish self from nonself is
concerned with the elimination of somatic mutation. The
failure of immune surveillance need not necessarily lead
to overt malignancy.
The primary role of the normally functioning
immune system is to provide defense against malignant
cells which are constantly arising through out the body.
Subsequently it was predicted that immune deficiency
states could give rise to frequent, multiple and diverse
tumours early in life6. This has gained support from
reports of tumours arising in patients "with genetic
disorders associated with immunodeficiency7. It has been
postulated that patients with naturally occurring
immunodeficiencies are prone to malignancy. Malignant
events generally become apparent in early life. It is
generally accepted that there are immunological
derrangements in patients with cancer.
About 4000 new cancer patients are registered every
year at the Regional Cancer Centre, Trivandrum. Of
these, 27 per cent are affected with oral cancer, 14 per cent
with cervical cancer and 7 per cent with breast cancer8.
Eventhough these three cancers constitute about 50 per
cent of the total cancer incidence in Kerala, very little
work has been carried out to evaluate the immunological
derrangements in these patients, as also those with the
Division of Publication & Information, ICMR, New Delhi - 110 029
premalignant lesions. The prevalence of premalignant
lesions, especially of the oral cavity namely oral
leukoplakia and oral submucous fibrosis, are also
reported to be very high in Kerala910.
The failure in immune surveillance has been reported
to be an important factor in the development of cancer5.
Tumour specific antigen (TSA) may be present both on
the surface as well as in the interior of the tumour cells.
The immunological reaction directed against the antigen
on the cell surface is likely to interfere with the growth of
the tumour. Antibodies may bind to the surface and cause
complement components to be fixed which lyse the cell
membrane. Immunologically specific cytotoxic ‘T‘
lymphocytes may bind the surface antigens and destroy
the tumour cells or inhibit the growth. Such antigens are
referred to as transplantation specific tumour antigen
(TSTA). They mimic the histocompatibility antigens that
are responsible for rejection of foreign tissue grafts11
It has been shown that the sites for antigen
recognition on the lymphocytes are blocked by
circulating antigens in tumour bearing animals. However,
reports of such blocking factors in human cancers are
rare12*13. It is well known that if the surface characteristics
of lymphocytes are altered their normal circulation
pattern inside the body will also be changed. Alteration in
the surface characteristics of lymphocytes by any means
such as neuraminidase treatment14 or by antilymphocyte
serum treatment15 will change the distribution pattern of
the lymphocyte.
It has been shown16 that the pre-incubation of the
lymphocytes from tumour bearing animals will increase
the cytotoxic activity of T lymphocytes. This may be due
to the removal of blocking factors (antigens or antibodies
or immune complexes) from the surface of the
lymphocytes. It was hypothesised that if the blocking
factors are present on the surface of lymphocytes, their
homing pattern may also be changed. On this basis a
study was conducted to evaluate the alterations in the
surface characteristics of lymphocytes of patients with
oral cancer17. Chromium labelled lymphocytes from
normal persons and oral cancer patients were injected
into mice and the radioactivity in the liver and spleen of
the animals were measured. A drastic change in the
homing patterns was observed when the patients
lymphocytes were injected. After incubation the
lymphocytes of the patients showed normal homing
pattern. This study17 suggested that the surface
characteristics of lymphocytes in cancer patients are
altered probably due to the presence of blocking factors.
A close association between cellular immune
responses and malignancy has been reported by many
92
workers18 19. The failure in immune surveillance has been
reported to be an important mechanism in the
development of cancer and in tumour progression5^0.
Therefore the assessment of cellular immunity is believed
to be of use in the diagnosis and / or prognosis, as well as in
the treatment of cancer. Enumeration of T lymphocytes
by rosette formation with sheep erythrocytes (E rosettes)
has been used as a method to assess cellular immunity in
normal individuals as well as in cancer patients21. Many
modifications have been suggested to improve the
technique of E rosette formation. A depression in cellular
immunity as assessed by a depression in E rosette forming
cells has been reported in patients with cancer2223.
Because of the differences in the values obtained Weese et
al24 employed a modified method by which two types of
rosette forming cells (RFCs) could be identified and
differentiated. The total rosette forming cells (TRFCs)
included all T cells which form rosettes with sheep red .
blood cells (SRBC) at low temperature on prolonged"
incubation whereas the high affinity rosette forming cells
(HARFCs) form rosettes at 29°Clwith fewer number of
SRBC. This was later supported by Bashford and
Gough25.
The HA RFC were reported to be decreased in
patients with carcinoma of breast, lung, uterine cervix
and hematological neoplasms24*26. Similar studies on
head and neck tumours are scanty. Moreover, no
attempts were made to evaluate the changes in HA RFC
with the progression of the disease. The effect of
treatment on the HARFC level was also not evaluated. In
view of this lacuna a study was undertaken at the
Regional Cancer Centre, Trivandrum, to evaluate the
changes in TRFC and HARFC levels, not only in head
and neck tumours, but also in carcinoma of breast and
uterine cervix as well as in the premalignant lesions27. The
changes in HARFC with progression of disease and the
effect of treatment on the HARFC level were also
investigated. No change was observed in the TRFC levels
in any of the premalignant or malignant lesions.
However, HARFC levels were found to be decreased in
cancer patients and the decrease became more
pronounced with the progression of clinical stages. If the
treatment was effective, the HARFC returned to normal
level, while in patients with residual lesions after the
treatment, the HARFC level remained depressed. In the
case of premalignant lesions, HARFC showed depression
only in patients with oral submucous fibrosis28. These
results were in agreement with previous reports24^5.
Though monoclonal antibodies may be more useful to
characterise the different subsets of T lymphocytes, the
enumeration of HARFC seems to be a very simple,
reliable and less expensive method to assess cellulai
immune response in cancer patients.
Pathological process in the tissues and organs
usually produce tissue damage with concomitant release
of proteins into the circulation. The immunoglobulins
play an important role in the inactivation and
nutralization of the antigens associated with tumours.
Hence the immunoglobulins continue to be a subject of
investigative interest. Serum immunoglobulin levels are
used as parameters to assess the status of humoral
immunity in cancer patients. Eventhough the presence of
cytotoxic antibodies in cancer patients have been
described, the humoral immune system has been
described as being interfering or blocking in nature29#30.
However, cell mediated and humoral responses are
interdependent on each other31.
A rise in serum IgG in patients with uterine cervix
was reported as early as in 1971 by Vasudevan et
which was later supported by others33. The levels of IgG in
oral and breast cancers were reported to be normal34 35,
elevated36 or even decreased37. Vijayakumar and
colleagues38 observed increased levels of serum IgG only
in patients with cervical cancers and not in breast or oral
cancer patients.
Elevated levels of serum IgA have been observed in
oral cancer, breast cancer and cervical cancer patients33-38.
The serum IgA levels were found to increase with
progression of clinical stages; and the levels of clinically
cured patients were within the normal limits. Thus serum
IgA seems to be a good indicatorforthediagnosisand/or
prognosis of these solid tumours.
Serum IgM levels were reported to be elevated in oral
cancer by Khanna et al34. But many workers33*35*39/0
reported normal values for IgM in cancer patients.
Vijayakumar et aln did not find any change in the serum
IgM fraction even in the advanced stages of the disease,
but observed increased levels of serum IgD and IgE in
patients with solid tumours and the values were found to
increase with progression of the clinical stages.
Munzarova et al41 reported decreased level of IgD in
breast cancer and Scully35 reported that IgD level is
unaltered in oral cancer patients. A rise in serum IgE in
oral cancer was reported earlier35/2/3, but the IgE levels in
breast cancer patients were reported to be normal40. That
the rise in IgE may reflect a defect in cellular immunity
has been suggested44.
Analysis of immunoglobulin levels in the sera of
patients with premalignant lesions was also carried
out28*38. Alterations in immunoglobulin levels were
observed only in patients with oral submucous fibrosis.
The tissue immunoglobulin levels were also evaluated in
patients with oral cancer and oral premalignant
lesions45/6. Immunoglobulins were detected in the tissues
from areas of oral submucous fibrosis and oral cancer but
not in oral leukoplakia.
Tumour associated antigens may be released from a
developing tumour into the extracellular environment
and subsequently be found in free form and/or as antigen
antibody complexes or circulating immune complexes
(CICs) in the serum and in other body fluids47. The
detection and clinical significance of CICs in human
neoplasias were reported by many workers48/9. A
progressive rise in CICs with progression of clinical stages
was observed in patients with solid tumours50. An
elevation of CICs in oral cancer35 and breast and
gynaecological tumours were reported5 952. The earlier
studies had not quantitated the immunoglobulin contents
of the CICs and had failed to characterise the antigen.
Eventhough Vijayakumar and colleagues50 could not
characterise the antigen, the antibodies (igs) were
quantitated. It was observed that the level of
immunoglobulins (G and M) were significantly elevated
in the CICs of cancer patients. It seems possible to predict
the effectiveness of treatment from the CICs and its
immunoglobulin contents50. The higher levels of CICs in
oral cancer patients may be due to the increased herpese
simplex virus infection which was reported to be one of
the etiological factors for oral cancer53.
Remani and associates54 detected elevated levels of
CICs in patients with oral submucous fibrosis and oral
cancer. It was stated that the CIC and its antibody content
may help in monitoring the malignant transformation of
oral submucous fibrosis. Earlier Vijayan and co
workers55 had reported that the Jack Fruit lectin staining
pattern may help in predicting the malignant
transformation of premalignant lesions.
Sasidharan and co-workers56 had reported a
decrease in the absolute peripheral lymphocytes and
normal B cell counts in patients with cancer. It was also
shown that there is an impairment in delayed
hypersensitivity in cancer patients especially those with
metastasis. Sasidharan and associates57 had tried to
evaluate tumour directed cellular immune responses in
oral cancer patients by leucocyte migration inhibition
assay. A significant depression in mean migratory index
was observed in oral cancer patients. The depression was
more pronounced in the advanced stages of the disease.
The complement system, which is the essential part
of normal immune responses, is essential for phagocytosis
and lysis of bacteria and viruses58. In many pathological
conditions, such as cancer, some of the components of the
complement system elicit typical primary or secondary
responses. It is reported to be the primary humoral
mediator of antigen antibody reactions59. Many attempts
93
have been made to evaluate the role of complements in
neoplastic diseases. Elevated levels of total complement
activity or complement components were observed in
cancer patients60"62.
In the earlier reports the number of patients studied
were not many and no attempts were made to assess the
changes in complement activity with progression of
tumours. Moreover, the effect of treatment on the
complement system was not evaluated. Vijayakumar et
al63 tried to evaluate the changes in complement activity
in patients with solid tumours, at different clinical stages
as well as before and after treatment63. The total
complement activity and C3 and C4 were found to be
elevated in patients with solid tumours. The rise in the
complement activity was in accordance with the clinical
stage of the disease. Clinical cure reduced the values to
normal levels. In premalignant lesions of breast and
cervix, there were no alterations in the complement
activity. In oral submucous fibrosis the values were found
to be altered64. From this study it can be assumed that the
complement system tries to maintain immunologic
homeostasis by compensating the weakened cellular
immune responses.
Conclusions
From these studies it can be concluded that there is
alteration both in the cellular and humoral immune
responses in patients with solid tumours. The depression
in immunity seems to be progressive with the clinical stage
of the disease. The immunological status of patients
returns to normal level if they respond to treatment. In
case of benign lesions of breast and cervix no significant
alteration in immunity was observed. But in case of oral
premalignant lesions, especially oral submucous fibrosis,
depression in both cellular and humoral immunity was
observed. The assessment of the immunological
parameters seems to be of help in the diagnosis and
prognosis of solid tumours.
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This write-up is based on the Raja Ravi Sher Singh of Kalsia
Memorial Award for Cancer Research (1987) Oration (of ICMR)
delivered by Shri T. Vijayakumar, Regional Cancer Centre,
Trivandrum, at the XV Annual Conference and Symposium of the
Indian Immunology Society, at Siliguri (November 28-30, 1988).
SURVEILLANCE FOR AIDS—AN UPDATE
Clinical and serological surveillance for HIV
infection in India has been further intensified during the
last 6 months.
Till September 15, 1989 a total of 3,71,887 persons
have been screened for HIV antibodies. Of these, 1571
persons have been found to be seropositive (seropositivity
rate 4.2/1,000). Profile of the seropositive individuals
detected is given in Table I.
Table I. Details of seropositive individuals
detected in India
(from October, 1985 to September 15, 1989)
Number of persons screened
Number of persons found seropositive
Seropositivity rate (per 1000)
Rbk group
371887
1571
4.2
Male
Female
Total
The serosurveillance programme provided the
database for formulation of a rational National AIDS
Control Programme. The trained and sensitized
personnel of the surveillance centres will be able to take
care of the increasing need for serodiagnosis, and the
centres would act as nodal training and quality control
centres in their respective states. Thus sentinel
surveillance, diagnostic service provision and manpower
development for future needs can all be achieved within
the existing health infrastructure.
Thirty two AIDS patients have been detected so far.
Twelve of them were foreigners; 14 Indian patients
appeared to have acquired the infection abroad, while 6
seemed to have got the infection in India. Most of the
Indian AIDS patients have probably acquired the
infection through heterosexual promiscuity (Table II).
Table II. AIDS patients detected in India
INDIANS:
Heterosexually promiscous
Homosexuals
Blood donors
Patients on dialysis
Pregnant women
Recipients of blood/blood products
Relatives of AIDS patients
Suspected ARC/AI DS cases
Intravenous drug users
Others
Sub total
FOREIGNERS:
Students
Others
Sub total
Total
332
2
386
2
-
549
44*
26*
70*
951
601
1482
10°
9
54*
35*
19*
620
89*
1571
4
0
7
3
13
8
39
9
23
3
85
881
1
16*
881
2
390
2
7
42
22
31
4
101
•
•Figures are lower than those reported earlier because of reclassification and
elimination of duplicates.
96
'
(till September 15, 1989)
Indian
Foreigners
Total
Probable source of Infection in Indians
Heterosexual promiscuity
Blood transfusion
Blood products infusion
Homosexual contacts
Spouse of AIDS patient
Male
Female
Total
17
9
3
3
20
26
6
32
In India
12
Abroad
4
11
1
0
0
1
1
1
1
-
The Directorate-General of Health Services
(DGHS) has organised a series of workshops to sensitize
clinicians for early detection, and to initiate appropriate
therapy for AIDS patients. These steps might result in
prolonging the survival of AIDS patients in India.
Blood Donor Screening
Screening of high risk blood donors, as a part of the
serosurveillance programme led to the detection of
seropositive donors in the later half of 1987. By the end of
1988, it became obvious that seropositivity rate among
blood donors was progressively rising. The ICMR Expert
Group reviewed these findings and recommended that
blood donor screening for HIV antibodies needs to be
intensified, monitored and expanded in a phased manner.
In response the DGHS, in collaboration with State health
authorities, have drawn up an action plan and initiated
steps to ensure safety of blood and blood products in
India. In the first stage, blood donor screening has been
initiated in four metropolitan cities of India by linking
existing blood banks to selected centres where facilities
for HIV antibody detection are available. It is envisaged
that over the next year there will be a phased expansion of
this programme. In order to ensure that the programme
starts without any delay; ICMR was requested to assist
the DGHS in the initial phase by using the systems and
networks established by ICMR for the HIV
serosurveillance programme in—
(i)
import of ELISA readers and kits and other supplies
for the programme;
(ii) storage and distribution of kits and readers to the
depot and screening centres; and
(iii) training of personnel for the screening centres.
The surveillance/reference centres responded to the
request for screening the sera from blood donations sent
to them for HIV antibody testing. According to the
reports received by 1CM R in the short period of 5 months
from April 1 to August 31, 1989 a total of 1,20,953 sera
from blood donations have been screened and 137) of
them were ELISA reactive.
Evaluation of ELISA Kits
In view of the increasing demand for HIV screening
in India, there is an urgent need to explore feasibility of
bringing down the cost of kits by their indigenous
manufacture. At the request of the Ministry of Health and
Family Welfare and the Department of Biotechnology
(DBT), ICMR initiated an evaluation of immunodiagnostic kits for HIV antibody detection, to select a
suitable kit for indigenous production. Three kits have
been recommended to DBT on the basis of specificity and
sensitivity. It was noted that neither of the visual assays
tested were specific and sensitive enough for Use in
screening centres.
Sentinel Surveillance for HIV Infection
There is an urgent need to initiate sentinel
surveillance for monitoring time trends in prevalence of
HIV infection in order to evolve appropriate intervention
programmes for AIDS control and to study the impact of
these intervention strategies. A proposal for such sentinel
surveillance for HIV infection in general hospitals,
institutions dealing with specific diseases like tuberculosis
and in urban and rural communities has been drawn up
and is expected to be initiated shortly.
ICMR NEWS
* The following meetings of various Scientific
Advisory Groups/Project Review Committees/Expert
Groups of the Council were held during the month:
Meetings of the Scientific Advisory Groups (SAGs):
Meetings of Project Review Committee (PRC)/Expert
Group (EG), held at New Delhi.
PRC on Human Genetics,
Immunology and Allergy.
September 8, 1989
EG on HIV Infection
in India.
September 21, 1989
SAG of the Division of
Epidemiology and Communi
cable Diseases.
September 8-9, 1989
(at New Delhi)
SAG of the Division of
Publication and Information.
September 25, 1989
(at New Delhi)
SAG on Traditional Medi
cine Research.
September 29, 1989
(at Madras)
Dr. S.P. Tripathi, Addl. Director-General, ICMR,
participated in a workshop on AIDS, at Srinagar
(September 1, 1989). He also participated in a Clinical
Update on AIDS, at Bombay (September 16-17, 1989).
SAG of the Division of
Basic Medical Sciences.
September 29, 1989
(at New Delhi)
Dr. H. Srinivasan, Director and Dr. M.D. Gupte,
Deputy Director, Central Jalma Institute for Leprosy,
Participation of ICMR Scientists in Scientific Events:
NITY HEALTH GEL
COMMU
326, V
Main, 1 Block
Koremen C 034
Bangaletet.
India
97
Agra, participated in the Joint IMMLEP/THELEP
Scientific Working Group meeting of WHO, at Geneva
(September 4, 1989). Dr. Srinivasan also participated in
an ad-hoc IMMLEP/THELEP Sub-Committee meeting
on Leprosy Reactions and Nerve Damage, at Geneva
(September 5-6, 1989).
Dr. Suman Mehta, Asstt. Director-General, ICMR,
participated in the meeting of WHO Steering Committee
of the Task Force on Safe Motherhood Research, at
Geneva (September 4-6, 1989). She also participated in
the meeting of WHO Steering Committee on the Task
Force on Safety and Efficacy of Fertility Regulating
Methods,-at Geneva (September 26-29, 1989).
Dr. C.B. Pandya, Senior Research Officer, National
Institute of Occupational Health, Ahmedabad,
participated in the conference on Health of Inner Cities
and Urban Areas, at Cardiff, Wales, U.K. (September 47, 1989).
Dr. Vinodini Reddy, Director, as well as Dr.
Ghafoorunissa, Dr. I.S. Shenolikar and Dr. C. Rukmini,
Asstt. Directors, National Institute of Nutrition (NIN),
Hyderabad, participated in the PORIM International
Palm Oil Development Conference, at Kuala Lumpur
(September 5-9, 1989).
Dr. M.D. Gupte participated in the second WHO
IMMLEP/THELEP meeting on Field Research in
Leprosy, at Geneva (September 5-6, 1989). He also
participated in the 33rd IMMLEP Steering Committee
and the Joint IMMLEP/THELEP meetings, at Geneva
(September 7-8 and 8, 1989 respectively).
Dr. N. Raghuramulu, Dy. Director, NIN,
Hyderabad, participated in the first joint meeting of the
International Conference on Calcium Regulating
Hormones and American Society for Bone and Mineral
Research, at Montreal (September 9-14, 1989).
Dr. N. Pralhad Rao, Dy. Director, NIN, Hyderabad,
has taken .up an ^assignment as a 3 Short-term WHO
Consultant for assisting Government of Iran in preparing
Outline and Formats for National Nutrition Surveys,
and for Training Personnel (September 11-25, 1989).
Dr. Tripathi delivered a guest lecture on Shortcourse Chemotherapy of Tuberculosis at SA ARC
meeting of Expert Groups on Tuberculosis, at Bangalore
(September 18, 1989).
Dr. G.V. Satyavati, Sr. Deputy Director-General.
ICMR, participated in the meeting of the Programme
98
Advisory Committee of DST on Medical Biology, at New
Delhi (September 20-21, 1989).
Dr. Uma Ganguly, Asstt. Director, National
Institute of Cholera & Enteric Diseases (NICED).
Calcutta, participated in 50th Asian Conference on
Diarrhoeal Diseases* at Kathmandu (September 21-23,
1989).
Dr. H. Srinivasan participated in the Asian meeting
on Leprosy, at Kuala Lumpur (September 22-25, 1989).
Dr. A. Roy, Sr. Research Officer, National Institute
of Virology, Pune, participated in the VI Bucher Sympo
sium on Growth Factors: Their Nature and Role in Medi
cine, at Berlin, (September 24-28, 1989).
Dr. S.C. Pal, Director, NICED, Calcutta,
participated in the 18th All Union Congress of
Microbiologists, Epidemiologists and Parasitologists, at
Alma-Ata, USSR (September 26-29, 1989).
Dr. P.K. Rajagopalan, Director, Vector Control
Research Centre. Pondicherry, participated in the WHO
Steering Committee meeting of the Scientific Working
Group on Filariasis, at Geneva (September 26-29, 1989).
Dr. Usha K. Luthra, Addl. Director-General,
ICM R, delivered a talk on Cancer Problems in India and
National Cancer Control Programmes and our
Commitments, at Maulana Azad Medical College, New
Delhi (September 29, 1989).
Science and Technology Exhibitions:
Council’s National Institute of Nutrition,
Hyderabad and Vector Control Research Centre,
Pondicherry, participated in Science & Technology
Demonstration Campaign-cum-Exhibition, organized by
the CSIR, New Delhi, at Ottapalam in Palghat district of
Kerala (September 1-14, 1989).
As part of “Hindi Diwas” celebration, a Science
Exhibition (in Hindi) was organised at the campus of
ICMR Hqrs., in collaboration with the major ICMR
institutes/Centres located in Delhi. This Exhibition
comprized display material (both visual and audio-visual)
on various health problems of national relevance, in
Hindi, for the benefit of laymen. Senior scientists of
ICMR were interviewed by the All India Radio for giving
short messages in Hindi on malaria, filariasis, cancer,
traditional remedies etc.
ICMR AIDED SYMPOSIA/SEMINARS/WORKSHOPS/COURSES/CONFERENCES
Symposium/Seminar/Workshop/
Course/Conference
Date & Place
Contact Address
Symposium on Head Injuries (Surgery).
September 2, 1989;
Baroda
Prof. S.N. Sharma, President, Association of Plastic
Surgeons of India, and Head, Department of Plastic
Surgery, Medical College, Baroda.
Conference on Biotechnology in Biomedicine.
September 9-10, 1989;
Madras
Dr. G.S. Kailash, Institute
of
Madras Medical College Madras.
National Seminar on Newer Challenges in
Medicine.
September 9-10. 1989;
Jabalpur
Dr. B.N. Shrivastava. Professor & Head. Depart
ment of Medicine, and Dean, Government Medical
College, Jabalpur.
Symposium on Early Breast Cancer, and
Workshops on Laser in Cancer Surgery; and
Epidemiology of oral cancer.
September 9-10. 1989;
Indore
Dr. S.K. Shukla, Organizing Secretary, VI National
Cancer Convention, M.G.M. Medical College.
Indore.
Continuing Medical Education in Haemato
logy, and Workshop on Advanced Laboratory
Techniques in Routine Haematology.
September 18-20, 1989;
Chandigarh
Dr. P.L. Wahi, Director, Postgraduate Institute of
Medical Education and Research, Chandigarh.
XV Mid Term Conference of Indian Associa
tion of Paediatric Surgeons.
September 28-30. 1989;
Srinagar
Seminar on New Trends in Methodology for
Social and Population Research.
October 1-3. 1989:
Tirupati
Dr. Mahmooda Khan, Professor & Head, Depart
ment of Surgery, Government Medical College,
Srinagar.
Prof. K. Mahadevan. Department of Population
Studies. S.V. University, Tirupati.
National Workshop on Burns Injuries and
their Sequele.
October 7-8. 1989;
Chandigarh
Dr. C.P. Sawhney, Professor & Head, Department
of Plastic Surgery, Postgraduate Institute of Medi
cal Education and Research, Chandigarh.
XVI Annual Conference of Indian Immuno
logy Society and Symposium on Tropical
Immunology.
October 12-14, 1989;
Sevagram
Dr. B.C. Harinath, Professor & Head, Department
of Biochemistry, Mahatma Gandhi Institute of
Medical Sciences, Sevagram, Wardha.
Symposium on Reproductive Biology and
Fertility Control.
October 12-14. 1989;
Imphal
Dr. B.K. Omar. Professor & Head. Department of
Anatomy, and Secretary. Anatomical Society of
India. Regional Medical College. Imphal.
Symposium on Nurse and MCH Services.
October 13-14, 1989;
Srinagar
Dr. M. Regu, Department of Nursing Education,
Sher-I-Kashmir Institute of Medical Sciences,
Srinagar.
Seminar on Surgery for Base of Skull.
October 13-14, 1989;
New Delhi
Dr. S. Bahadur, Additional Professor, Department
of Otolaryngology, All India Institute of Medical
Sciences, New Delhi.
Symposium on Respiratory Allergy and
Applied Immunology.
October 14-16, 1989;
Hyderabad
Dr. M. Sundaramma. Professor & Chest Physician.
Osmania Medical College and A.P. Chest Hospital,
Hyderabad.
XXII Annual .Convention of the Indian
Dietetic Association.
October 19-20. 1989;
Hyderabad
Dr. Indira Ray, Reader, Home & Social Science
Department, Calcutta University, Calcutta.
Seminar on Acute Respiratory Infections
Among Children in the Context of Primary
Heath Care.
October 20-22, 1989;
Guwahati
Dr. A:C. Patowary, Director, Medical Education of
Assam, and Hony. Professor and Head, Department
of Social and Preventive Medicine, Gauhati Medi
cal College, Guwahati.
Physiology,
99
Symposium/Seminar/ Workshop/
Course/Conference
Contact Address
Date & Place
Brachytherapy Workshop for Cancer Cervix.
November, 1989:
Betul (M.P.)
Dr. Anand Vijay Kumar. Secretary. Paramedical
Section, Christian Medical Association of India,
Smruti Theatre Compound, Nagpur.
National Workshop on Advances in Flexible
Fiberoptic Bronchoscopy.
November 4-5, 1989;
Chandigarh
Dr. S.K. Jindal, Department of Chest Diseases,
Postgraduate Institute of Medical Education and
Research, Chandigarh.
All India Symposium on Biophysics of Cell
Structure and Function.
November 6-8. 1989:
Chandigarh
Dr. P.C. Mangai. Chairman. Department of BioPhysics. Punjab University, Chandigarh.
International Symposium on Levels of Aware
ness and Conscious Experiences.
November 6-9, 1989;
Visakhapatnam
Prof. P.V. Krishna Roa, Director, Institute for Yoga
& Consciousness, Andhra University, Vijayanagram
Palace, Visakhapatnam.
Seminar on Zoonoses.
November 9-10. 1989:
Dibrugarh
Dr. L.P. Datta. Director. Regional Medical Research
Centre (ICMR). P.B. No.105. Dibrugarh.
XVI Biennial Conference of the Indian Asso
ciation of Leprologists.
November 9-12. 1989:
Trichur
Dr. P. Vijay Shanker, Damien Institute,
Ayyappankavu. Trichur.
Seminar on Pathology of Cardiomyopathies.
November 11, 1989:
Bhubaneswar
Professor L.N. Mohapatra. Convenor, Indian Asso
ciation of Pathologists and Microbiologists (Orissa
Chapter) and Director. Regional Medical Research
Centre (ICMR). Bhubaneswar.
Conference on Health Care for the Villagers
and Urban Slums.
November 23-25, 1989;
Calcutta
Dr. Ashok Sahani. Professor & Hony. Executive
Director. Indian Society of Health Administrators.
104 (13/37). Cambridge Road Cross, Ulsoor.
Bangalore.
National Seminar on Squint and Amblyopia.
Novcmer 25-27. 1989:
New Delhi
Dr. Vimla Menon. Dr. Rajendra Prasad Centre for
Ophthalmic Sciences. All India Institute of Medical
Sciences. New Delhi.
All India Symposium on Reproductive Bio
logy and General Endocrinology.
November 26-28, 1989:
Baroda
Prof. P.M. Ambedkar, Department of Zoology.
M.S. University of Baroda. Baroda.
Workshop on Recent Advances in Intensive
Care.
November 26-30. 1989;
New Delhi
Dr. H.K. Kaul, Professor & Head. Department of
Anaesthesiology. All India Institute of Medical
Sciences. New Delhi.
XXXIII All India Obstetric and Gynaecologi
cal Congress.
December 28-30, 1989;
Patna
Dr. J. Mishra. Department of Obstetrics and Gynaecology. Hospital for Women. Patna Medical College
Hospital. Patna.
Seminar on Indian Speech, Language and
Hearing Tests - the proposed IS HA battery.
February 8-9. 1990;
New Delhi
Dr. S.K. Kacker. Professor & Head. Department of
Otorhinolaryngology. All India Institute of Medical
Sciences. New Delhi.
COUNCIL’S TRAINING PROGRAMMES
Virology
Nutrition
At the National Institute of Virology, Pune:
At the National Institute of Nutrition, Hyderabad:
Short-term Course on Detection and Isolation of
Arboviruses Using Mosquito Inoculation and Mos
quito Cell Culture (October, 1989).
100
Annual Certificate Course in Nutrition (Decem
1, 1989 to February 28. 1990).
Occupational Health
Cytology
At the National Institute of Occupational Health,
Ahmedabad:
At the Institute of Cytology and Preventive Oncology,
New Delhi:
Indo-US Workshop on Chemoprevention of the
Uterine Cervical Dysplasia with Nutrient Inter
vention (December, 1989).
Refresher Course for Industrial/ESIS-Medical Offi
cers (October 9-14, 1989).
Training Course on Disaster Management of
Hazarduous Chemicals in Industry for Industrial
Physicians, Chemists, Safety Officers, Hygienists
(November 6-10, 1989).
Laboratory Animal Technology
At the Laboratory Animal Information Service Centre,
National Institute of Nutrition, Hyderabad:
Training Course for Laboratory Animal Super
visors (September 1 to November 30, 1989).
SOME AVAILABLE ICMR PUBLICATIONS
Price
Rs.
Growth & Physical Development of Indian Infants and Children (1972), Reprinted 1989
10.00
Studies on Weaning & Supplementary Foods (1974), Reprinted 1984
6.00
Studies on Pre-School Children (1974), Reprinted 1984
6.00
A Manual of Nutrition (1973), Second Edition 1974, Reprinted 1984
2.50
Low Cost Nutritious Supplements (1972), Second Edition 1975, Reprinted 1977
150
Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for South India
(1959), Third Edition 1977, Reprinted 1984
2.00
Menus for Low Cost Balanced Diets and School Lunch Programmes Suitable for North India
(1959), Third Edition 1977, Reprinted 1984
2 00
Some Common Indian Recipes and their Nutritive Value (1964), Fourth Edition 1977,
Reprinted 1984, by Swaran Pasricha and L.M. Rebello
6.00
Nutrition for Mother & Child (1962), Third Edition 1978, Reprinted 1983, by P.S. Venkatachalam
and L.M. Rebello
5 00
Japanese Encephalitis in India (Revised Edition 1980)
5 00
Some Therapeutic Diets (1969), Fourth Edition 1981, Reprinted 1983, Revised 1988,
by Swaran Pasricha
2 00
Recommended Dietary Intakes for Indians (1981), Reprinted 1984
4 60
Lathyrism: A Preventable Paralysis (Revised Edition 1983)
A Manual of Laboratory Techniques (1983), Edited by N. Raghuramulu, K. Madhavan Nair
and S. Kalyanasundaram
Fruits (1983), by Indira Gopalan and M. Mohan Ram
2.50
Count What You Eat (1989), by Swaran Pasricha
4.50
The Anophelines of India (Revised Edition 1984), by T. Ramachandra Rao
150.00
Depressive Disease (1986), by A. Venkoba Rao
58.00
Medicinal Plants of India, Vol. 2 (1987)
136.00
Unpriced Publications
(for limited distribution)
Collaborative Study on Short-term Sequelae of Induced Abortion (1981)
Proceedings of the Indo-UK Workshop on Leishmaniasis. (1983)
1_
21
A"-4o,"0
(8, LBRAFY I
I
I
--
UMENTATION
) ")
Peoples of India—Some Genetic Aspects (1983)
Management of Acute Diarrhoea (1985)
Plague Conquest and Eradication in India (1987) by S.C. Seal
Laboratory Manual for the Diagnosis of Haemophiloid Disorders (1989),
by Manorama Bhargava and Dinesh Jain
These publications are available on prepayment of cost by cheque or postal order (bank and postal charges will be extra) drawn in favour of the
Director-General, Indian Council of Medical Research, New Delhi. Money Orders are not acceptable. All correspondence in this regard should
be addressed to the Chief, Division of Publication and Information, Indian Council of Medical Research, Post Box No.4508, Ansari Nagar,
New Delhi-110029.
Some available publications of the Institute of Immunohaematology, Bombay
Techniques in Blood Banking, by H.M. Bhatia
Price
Rs.
12.00
Genetic Atlas of the Indian Tribes, by H.M. Bhatia and V.R. Rao
125.00
These publications are available on prepayment of cost by money order or Bank draft, from Director, Institute of
Immunohaematology, 13th floor. New Multistoreyed Complex, KEM Hospital Campus, Parel, Bombay-400012.
RADIOIMMUNOASSAY KITS AVAILABLE
The following RIA Kits (prepared under the Matched Reagents and Quality
Control Programme of Reproductive Hormones of the Indian Council of Medical
Research) are available for distribution to scientists in the country:-
(i) Progesterone
(ii) Estradiol-17B
(iii) Testosterone
Kits contain lyophilized antisera, tracer, standard and dextran coated charcoal
for 100 tube assay.
For further information, Dr. B.N. Saxena, Sr. Deputy Director-General, Indian
Council of Medical Research, Ansari Nagar, New Delhi-110029 may be contacted.
EDITORIAL BOARD
Chairman
Dr. A.S. Paintai
Director-General
Chief, Publications
Dr. G.V. Satyavati
Members
Dr. Usha K. Luthra
Dr. Badri N. Saxena
Dr. S.P. Tripathy
Editor
Dr. N. Medappa
Printed and Published by Shri G.P. Kulshreshth for the Indian Council of Medical Research, New Delhi
at the ICMR Offset Press, New Delhi
R.N. 21813/71
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