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Biomedical subjects

M Ahmed

Publications and source records attributed to M Ahmed.

At least 181 records · Page 10Linked to original sources
PubMed1996

Papillary thyroid cancer in Saudi Arabia. Clinical, pathologic, and management characteristics.

During a 3-year period, 233 patients with papillary thyroid cancer were seen at King Faisal Specialist Hospital (KFSH) (79% were female; 94% were national subjects). Pathology revealed 88% pure papillary carcinoma and 12% mixed papillary and follicular carcinoma, 7% microfocus, 18% well encapsulated, 24% capsular invasion, and 51% soft tissue invasion. Thirty percent of patients who had initial surgery not done at KFSH compared with 93% of patients who had initial surgery done at KFSH had an I-123 24-hour uptake < 5%. One hundred seventeen patients required completion thyroidectomy at KFSH for significant residual thyroid tissue, 56% of those had residual papillary carcinoma. The amenability of papillary thyroid cancer for cure necessitates the optimization of management at the national level. In Saudi Arabia, papillary thyroid cancer presented in an advanced stage, especially in males as manifested by the large primary tumor size, advance pathologic staging, and distant metastases at the time of presentation. Findings at second surgery, showed significant residual disease.

Adult↗
PubMed1996

Murine humoral immune response against recombinant structural proteins of hepatitis C virus distinct from those of patients.

We examined the humoral immune response to recombinant structural proteins of hepatitis C virus (HCV) such as C, E1 and E2 in immunized mice. Mice showed high induction of antibodies against these three structural proteins. Conformational and/or linear epitopes of these regions showed high responses in mice. Comparison with patients revealed higher anti-E1 and anti-E2 responses in mice and 15 immunoreactive peptides which are unique to mice, especially 11 peptides from the E2 region. The hydrophilic regions of these proteins were found to be the most immunogenic. Therefore, the murine immune system against recombinant E1 and E2 glycoproteins was distinct from those of patients in natural infection, and may be a target to find protective activity against HCV infection.

Animals↗
PubMed1996

Cognitive visual dysfunction in a child with cerebral damage.

Visual impairment as a sequel to cortical damage can be associated with complex disorders in cognitive visual function. Such dysfunction can be difficult to diagnose with certainty, particularly in children, owing to the child's problems of awareness and communication. The authors describe the case of a 13-year-old girl whose cerebral damage is apparently accompanied by complex cognitive visual disorders. Though she has a good binocular visual acuity, she cannot see rapidly moving objects. She has difficulties with orientation, recognising faces and cognitive depth perception. Despite an absence of detailed psychometric testing, a clinical diagnostic approach such as that used in this case, based on a CT scan and careful history-taking and observation, may be helpful in planning educational strategies.

Adolescent↗
PubMed1996

The drug-binding activity of the multidrug-responding transcriptional regulator BmrR resides in its C-terminal domain.

Rhodamine and tetraphenylphosphonium, the substrates of the Bacillus subtilis multidrug efflux transporter Bmr, induce the expression of Bmr through direct interaction with its transcriptional activator BmrR. Here we show that the C-terminal domain of BmrR, expressed individually, binds both these compounds and therefore can be used as a model for molecular analysis of the phenomenon of multidrug recognition.

Bacillus subtilis↗
PubMed1996

Islet cell antibodies at diagnosis, but not leanness, relate to a better cardiovascular risk factor profile 5 years after diagnosis of NIDDM.

OBJECTIVE: To evaluate the relationship between islet cell antibodies (ICAs) and the cardiovascular risk profile 5 years after clinical diagnosis of NIDDM. RESEARCH DESIGN AND METHODS: Five years after clinical diagnosis, we evaluated blood pressure (BP) and lipids in 17 NIDDM patients with ICA at diagnosis (age 60 +/- 4 years) and 133 NIDDM patients without ICA at diagnosis (age 61 +/- 1 year). Urinary albumin excretion was evaluated in a subset of 12 NIDDM patients with ICA at diagnosis (age 60 +/- 4 years) and 82 NIDDM patients without ICA at diagnosis (age 61 +/- 1 year). RESULTS: NIDDM patients without ICA showed higher BP (140/86 +/- 2/1 mmHg vs. 128/79 +/- 3/2 mmHg; P < 0.05), total cholesterol (6.10 +/- 0.11 vs. 5.09 +/- 0.29 mmol/l; P < 0.01), LDL-to-HDL ratio (3.85 +/- 0.14 vs. 2.49 +/- 0.18; P < 0.001), and triglycerides (2.58 +/- 0.24 vs. 0.90 +/- 0.06 mmol/l; P < 0.001), lower HDL cholesterol (1.08 +/- 0.03 vs. 1.40 +/- 0.08 mmol/l; P < 0.001), and higher urinary albumin excretion (0.16 +/- 0.06 vs. 0.01 +/- 0.01 g/24 h; P < 0.05) than NIDDM patients with ICA. Among NIDDM patients without ICA, no differences concerning BP or lipids were found between obese and nonobese patients. CONCLUSIONS: ICA at diagnosis of NIDDM is a marker of more favorable cardiovascular risk profile 5 years after clinical diagnosis.

Adult↗
PubMed1996

Isolated porta hepatis metastasis of papillary thyroid cancer.

Metastases from differentiated thyroid cancer are usually seen in the cervical or mediastinal lymph nodes, lung or bone. We report a case of papillary thyroid cancer metastasizing to lymph nodes in the porta hepatis. No other site of metastasis was apparent on neck or abdominal exploration or on iodine whole-body scans. The primary tumor was a multifocal papillary thyroid cancer arising on a background of multinodular goiter. The metastasis was observed on a diagnostic radioiodine scan after surgical resection of the primary tumor despite significant (11%) radioiodine uptake by residual thyroid tissue in the neck and was proven by histologic examination and thyroglobulin immunohistochemistry. Although rare, metastasis to porta hepatis lymph nodes should be considered in the differential diagnosis of abdominal radioiodine uptake in patients with differentiated thyroid cancer.

Adult↗
PubMed1996

Audit of the care of patients with epilepsy in general practice.

BACKGROUND: Previous studies have shown that there is great potential for improving the management of patients with epilepsy. AIM: To identify all patients with epilepsy, to evaluate and audit their care in relation to an annual review, to document seizure frequency and appropriateness of daily therapy to aid compliance and to propose strategies to improve these and other aspects of epileptic care. METHOD: An audit of the care of patients with epilepsy was undertaken in two King's Lynn practices with a combined population of 22,500. Principles for the management of epilepsy were established. From these principles, the following standards were agreed: 75% of patients on treatment for epilepsy should be seen every year, 75% of patients should have their seizure frequency documented, and 75% of patients should take their anti-epileptic drugs no more than twice daily. As a result of the first audit cycle, changes were made in the documentation and advice regarding treatment relating to these standards. RESULTS: The first audit cycle showed that 83% of patients had been seen at least once in the previous year, that documentation of seizure frequency existed for 51% of patients in the past year, and that 63% of patients were taking their treatment no more than twice daily. The evaluation was repeated 22 months later and an overall improvement was demonstrated in the first two results: 95% of patients had been seen in the past year, 93% had had their seizure frequency documented; however, only 66% of patients were taking their treatment twice daily or less. CONCLUSION: Call and recall, and documentation of seizure frequency were improved by this clinical audit. However, alterations in daily therapy appeared difficult for a variety of reasons; for example, therapy might have been initiated by a hospital specialist, and patients in a stable condition might have been apprehensive about changes. In order to improve the care of patients with epilepsy, a primary care team approach is desirable within a structure of good specialist services.

Anticonvulsants↗
PubMed1995

Capsaicin effects on substance P and CGRP in rat adjuvant arthritis.

The effects of capsaicin on the sensory neuropeptides substance P and calcitonin gene-related peptide were analyzed in the ankle joints and dorsal root ganglia (L2-L6) of adult female Lewis rats. The study included 23 normal rats and 23 arthritic rats, all injected subcutaneously with capsaicin (total dose 200 mg/kg bw). Another two groups of animals from a previous study, i.e., 23 normal rats and 23 arthritic rats not given capsaicin served as controls. Adjuvant arthritis was induced by inoculation with heat-killed mycobacteria. The morphological distribution of sensory neuropeptides was assessed by immunohistochemistry and the tissue concentrations were determined by radioimmunoassay. In normal rats, capsaicin significantly reduced the concentrations of substance P and calcitonin gene-related peptide in ankle joints (54 and 36%, respectively) as well as dorsal root ganglia (40 and 54%, respectively). In arthritic rats those pretreated with capsaicin had significantly lower concentrations of substance P and calcitonin gene-related peptide in dorsal root ganglia (19 and 42%, respectively) compared to the arthritic controls. In the ankle joints, however, only the SP concentration was reduced (42%). Notably, this was accompanied by a 40% reduction in inflammatory response as assessed by comparing the ankle joint weights of the experimental groups. In general, there was a good correlation between the neuropeptide concentrations in ipsilateral ankle joints and the corresponding dorsal root ganglia as assessed in individual rats. The present study of adjuvant induced arthritis shows that capsaicin administration reduces the otherwise up-regulated levels of sensory neuropeptides in dorsal root ganglia and ankle joints. However, capsaicin at the dose given can only mitigate, not completely prevent the development of joint inflammation. Nonetheless, the findings suggest that antineuronal therapy targeted against specific neurotransmitters may prove useful in inflammatory joint disease.

Animals↗
PubMed1995

Increased levels of substance P and calcitonin gene-related peptide in rat adjuvant arthritis. A combined immunohistochemical and radioimmunoassay analysis.

OBJECTIVE: To analyze the occurrence of substance P (SP) and calcitonin gene-related peptide (CGRP) in ankle joints and corresponding dorsal root ganglia (L2-L6) of rats with adjuvant arthritis. METHODS: Arthritis was induced by inoculation with heat-killed mycobacteria. The morphologic distribution of SP and CGRP was assessed by immunohistochemical analysis. Tissue concentrations of the neuropeptides were determined by radioimmunoassay. RESULTS: Neuronal CGRP-like immunoreactivity was clearly increased in the synovium and the dorsal root ganglia, whereas the increase in SP-positive structures was less pronounced. The tissue concentrations of SP and CGRP were significantly increased both in ankle joints and in dorsal root ganglia. CONCLUSION: Levels of sensory neuropeptides are increased under conditions of joint inflammation.

Animals↗
PubMed1995

Re-excision operations in nonpalpable breast cancer.

We retrospectively reviewed the records of 317 needle-localization (NL) biopsies performed at the Royal Marsden Hospital during 1989-1992. The malignancy yield in our centre, where there is an emphasis on cooperation with an experienced radiologist and breast pathologist, was 48% (151/317), with benign to malignant biopsy ratio of 1:1:1. Analysis of the histopathological findings of the malignant lesions revealed a 45% (68/51) incidence of positive microscopic margins. Of these 68 patients, 50 had re-excisions, including nine patients who required mastectomy. Twenty-eight of the re-excisions (56%) contained residual tumour, of which five (18%) were invasive carcinoma > 3 mm (size range 1-19 mm) and 13 (46%) were residual DCIS > 1 mm (size range 1-40 mm). Our findings suggest a significant incidence of residual disease associated with positive microscopic margins in NL-detected nonpalpable cancers. Therefore, our current practice of performing a wider re-excision for positive margins is justified. Stereotactic fine-needle aspiration cytology was not performed by the radiologist referring these cases, but it should be performed preoperatively and if the test is positive, definitive treatment in the form of wide local excision or quadrantectomy is carried out in the first instance in order to avoid a second-surgical procedure.

Biopsy, Needle↗