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Biomedical subjects

S Mohammed

Publications and source records attributed to S Mohammed.

At least 37 records · Page 2Linked to original sources

Mutations and alternative splicing of the BRCA1 gene in UK breast/ovarian cancer families.

BRCA1 is a tumour suppressor gene located on chromosome band 17q21. It is estimated that mutations in the BRCA1 gene account for approximately 45% of the breast cancer families and almost all of the breast/ovarian cancer families. We have used single strand conformation polymorphism analysis, direct sequencing, allele specific oligonucleotide hybridisation, and reverse transcription polymerase chain reaction (RT-PCR) to look for mutations in the BRCA1 gene in 49 breast or breast/ovarian cancer families. Five distinct mutations, three novel and two previously observed, were detected in seven families. Each novel mutation was identified in one family: 3896delT in exon 11, a splicing mutation in the intron 9-exon 10 junction, and an inferred regulatory mutation. The 185delAG in exon 2 was found in three families sharing the same haplotype, but this haplotype is different from that shared by the Ashkenazi Jewish families, suggesting that the 185delAG in our families may have arisen independently. Another previously reported mutation, the 3875del4 in exon 11, was identified in one family. Of the 49 families examined, linkage analyses for both the BRCA1 and the BRCA2 regions were performed on 33 families, and mutations in the BRCA1 gene were identified in all but one family that have a lod score above 0.8 for BRCA1. All of the mutations cause either a truncated BRCA1, or loss of a BRCA1 transcript, thus are likely to be functionally disruptive. In addition, we found that alternative splicing is a common phenomenon in the processing of the BRCA1 gene. Seven variant BRCA1 transcripts were identified by RT-PCR; all but one maintained the BRCA1 open reading frame. We believe that alternative splicing may play a significant role in modulating the physiological function of BRCA1.

Alternative Splicing↗

A precursor of the nitric oxide donor SIN-1 modulates the stress protein heme oxygenase-1 in rat liver.

In this study the effect of increased nitric oxide (NO) production on the expression of rat liver heme oxygenase-1, an inducible stress protein responsible for the catalysis of heme to biliverdin and carbon monoxide, was investigated. Rats were injected intraperitoneally with molsidomine (SIN-10), a long acting drug that is enzymatically converted in the liver to yield the active NO-releasing agent 3-morpholinosydnonimine (SIN-1). Administration of SIN-10 resulted in a significant time- and dose-dependent increase in plasma levels of nitrite/nitrate, an index of NO release. A time course of heme oxygenase-1 mRNA levels in liver showed a gradual increase in the expression of the gene encoding for this protein, which was maximal at 4 hours and returned to normal levels by 6 hours after SIN-10 treatment. Heme oxygenase activity also increased by 50% at 4 hours and was maximal 12 hours after SIN-10 administration (63% increase over baseline). These results indicate a possible role for locally generated NO in the modulation of hepatic stress response in vivo suggesting that NO mediates cell adaptation to stress by activation of endogenous defensive mechanisms.

Animals↗

Palliation of malignant tracheo-oesophageal fistula using covered metal stents.

Nine patients presenting with malignant tracheo-oesophageal fistula have been treated by placing covered oesophageal stents (seven Wallstent, two Gianturco) within the oesophageal lumen over a twelve month period. Five patients had oesophageal carcinoma, two bronchial carcinoma, one metastatic renal cell carcinoma, one developed malignant change within a longstanding tuberculous tracheo-oesophageal fistula. Initial closure of the fistula was successful in six cases. Three failed due to technical problems (one with a Wallstent and both cases with the Gianturco stents). There were no immediate complications and normal diet resumed within 24 h in the six successful cases. One patient was aware of the physical presence of the stent (for a high fistula), the remainder of the stents were well tolerated. Covered metal stents offer a minimally invasive, effective form of palliation in certain patients with malignant tracheo-oesophageal fistulae. Accurate positioning using fluoroscopic guidance is essential in gaining optimal stent position.

Aged↗

Sex differences in the features of coronary artery disease of patients undergoing coronary angiography.

OBJECTIVE: To examine sex differences in the features of coronary artery disease (CAD) of patients who have undergone coronary angiography. DESIGN: Retrospective study which reviewed clinical and angiographic results from eligible patients who underwent coronary angiography under one cardiologist during a consecutive period. SETTING: Tertiary referral women's health centre. PATIENTS: 515 patients (167 women, 348 men) who underwent coronary angiography for suspected CAD, excluding those with previously known primary valvular disease, valvular replacement, congenital heart disease, nonischemic cardiomyopathy, history of cocaine-induced myocardial ischemia or infarction, and those who had previously undergone coronary angiography, coronary artery bypass graft or percutaneous transluminal coronary angioplasty. MAIN RESULTS: Overall, females and males presented at similar ages and with similar prevalences of smoking, diabetes, hypertension, and family histories of premature CAD, albeit women were less likely than men to have a prior history of myocardial infarction. The observed age difference between females and males with coronary disease was less than expected (3.3 +/- 2.3 years, 95% confidence limits). At angiography, women were three times more likely than men to have normal coronary arteries. Yet, in patients found to have coronary disease, there was no sex difference in either the severity or the distribution of the disease. Women were twice as likely as men to have normal left ventricular function on catheterization. However, when all cases of normal angiograms were excluded, multivariate logistic regression analysis showed that, after controlling for other important confounding factors, females were as likely as males to have significant CAD and left ventricular dysfunction on angiography. CONCLUSIONS: Women can develop serious ischemic heart disease that is similar to that in men and at a relatively younger age than previously described. The vulnerability to ischemic heart disease in nonelderly women needs to be emphasized.

Aged↗

Carcinoma of the cervix causing massive intracardiac embolus.

A patient with squamous cell carcinoma of the cervix with cardiac metastases causing a massive right ventricular and right atrial tumor embolus is presented. The patient presented with right heart failure due to the right ventricular outflow tract obstruction. The electrocardiogram showed low QRS voltage. Echocardiogram showed the right atrial and ventricular mass. The patient expired 3 days later. Involvement of the heart by metastatic carcinoma of the cervix is rare. The different modes of metastatic involvement of the heart by carcinoma of the cervix are discussed.

Carcinoma, Squamous Cell↗

Supracondylar fractures of the distal humerus in children.

An audit of 32 displaced supracondylar fractures of the humerus in children treated at the Glasgow Royal Infirmary between June 1990 and September 1992 was carried out. Six fractures were classified as Grade 2 (one cortex intact) and 26 were Grade 3 (no cortical contact). All grade 2 fractures were treated non-operatively with good results. Relatively poor results were obtained when displaced fractures were treated non-operatively with manipulation and plaster immobilization. Seven patients underwent manipulation and percutaneous pinning but two developed a cubitus varus deformity. Open reduction and internal fixation with two K-wires gave the best results with no deformity in ten patients. We therefore conclude that this is the optimal method of treatment in a hospital which deals with relatively few completely displaced fractures, with the cosmetic appearance of the scar being minimized by a medial approach.

Adolescent↗

A possible screening test for inherited p53-related defects based on the apoptotic response of peripheral blood lymphocytes to DNA damage.

The cellular response, in terms of cell cycle arrest(s) and apoptosis, to radiation-induced DNA damage was studied. Experiments were performed on both mitogen-stimulated and resting peripheral blood lymphocytes (PBLs) from normal and cancer-prone (C-P) individuals. The C-P individuals comprised three patients carrying germline p53 mutations and three members of two families apparently without such mutations, but with an inherited defect which results in p53 deregulation as shown by high levels of stabilised p53 protein in normal tissues. Interestingly, mitogen-stimulated PBL, from both normal and C-P individuals failed to demonstrate a G1 arrest after gamma radiation. However, a clear difference was seen in the apoptotic response to DNA damage, of PBL from normal and C-P individuals; PBLs from C-P individuals with inherited p53-related defects had a reduced apoptotic response (P = 0.0003). There was a wide margin of separation, with no overlap between the two groups, supporting the possibility of using this altered apoptotic response as a screening test. This simple and rapid procedure could be used to identify those individuals in a C-P family who carry germline p53-related defects. The method appears to detect both individuals with p53 mutations and those apparently without mutations but with other p53-related defects.

Adult↗

Cefotetan-induced hemolytic anemia causing severe hypophosphatemia.

Phosphorus is a major component of proteins, phospholipids, and nucleotides. The increased uptake of phosphorus by cells during erythropoiesis can result in severe hypophosphatemia. A case of severe hypophosphatemia due to accelerated erythropoiesis in response to Cefotetan-induced hemolytic anemia is described. The hypophosphatemia seen during hemolysis may be the result, rather than the cause, of the hemolysis.

Anemia, Hemolytic↗

The potential of health sector non-governmental organizations: policy options.

Non-governmental organizations (NGOs) have increasingly been promoted as alternative health care providers to the state, furthering the same goals but less hampered by government inefficiencies and resource constraints. However, the reality of NGO health care provision is more complex. Not only is the distinction between government and NGO providers sometimes difficult to determine because of their operational integration, but NGOs may also suffer from resource constraionts and management inefficiencies similar to those of government providers. Some registered NGOs operate as for-profit providers in practice. Policy development must reflect the strengths and weaknesses of NGOs in particular settings and should be built on NGO advantages over government in terms of resource mobilization, efficiency and/or quality. Policy development will always require a strong government presence in co-ordinating and regulating health care provision, and an NGO sector responsive to the policy goals of government.

Delivery of Health Care↗

Cowden syndrome and Lhermitte-Duclos disease in a family: a single genetic syndrome with pleiotropy?

Cowden syndrome is an autosomal dominant condition of multiple hamartomas. Patients with this phakomatosis have an increased risk of breast cancer and thyroid tumours. Lhermitte-Duclos disease is usually a sporadic condition of cerebellar ganglion cell hypertrophy, ataxia, mental retardation, and self-limited seizure disorder. We describe a three generation family with Cowden syndrome and Lhermitte-Duclos disease. Karyotyping performed on the peripheral lymphocytes of the proband and her affected mother showed a 46,XX complement. Single strand conformational polymorphism analysis failed to show any germline p53 mutations as a cause of the syndrome in this family.

Adult↗

p53 protein detected by immunohistochemical staining is not always mutant.

The expression of the tumour suppressor gene p53 was analyzed in a variety of human solid tumours by immunohistochemistry and direct DNA sequencing. Positive nuclear staining using a panel of anti-p53 antibodies was used to select tumours for further genetic analysis. Using PCR amplification followed by immobilization onto magnetic beads and direct sequencing, we sequenced exons 5-9 of the p53 gene from 9 melanomas, 8 nasopharyngeal carcinomas, 16 sporadic breast carcinomas and 11 patients from familial breast cancer families. No sequence alterations of the p53 gene were detected in either the melanoma or nasopharyngeal tumours and only 19% of the primary breast carcinomas showed a variant band indicative of a mutation. Our results indicate firstly that p53 mutations are not generally involved in the tumour types studied and secondly the data emphasize the disparity encountered when attempting to correlate p53 immunohistochemical positivity with mutations within the p53 gene.

Breast Neoplasms↗

Serum calcium, parathyroid hormone, and vitamin D status in children and young adults with sickle cell disease.

The concentrations of serum calcium, parathyroid hormone (PTH), 25 Hydroxyvitamin D (25OHD), and 1,25 Dihydroxyvitamin D (1,25(OH)2D) were determined in 99 Saudi patients with sickle cell disease and in 104 matching healthy controls. Serum calcium and 25OHD were significantly lower in the patients, with 14% and 12% of them had serum calcium and 25OHD concentrations, respectively, below the normal range. PTH was significantly higher in the patients, with 31% having values above the normal range. There was no significant difference between patients and controls in regard to 1,25(OH)2D. There was a significant inverse correlation of 25OHD with PTH and a direct correlation of PTH with 1,25(OH)2D. Dietary intake of calcium and vitamin D was adequate in both patients and controls. The results indicate that sickle cell patients have hypocalcaemic tendency associated with supranormal PTH, and imply impaired intestinal absorption of calcium and vitamin D leading to a disturbed calcium metabolism which might contribute to the skeletal changes seen in sickle cell disease.

Adolescent↗

Use of polymerase chain reaction to demonstrate cytomegalovirus DNA in CSF of patients with human immunodeficiency virus infection.

We used the polymerase chain reaction (PCR) to demonstrate cytomegalovirus (CMV) DNA in the CSF of a patient with the CMV radiculomyelopathy syndrome. To investigate the significance of this finding, we also performed PCR for CMV on CSF samples from 30 patients with human immunodeficiency virus (HIV) infection and neurologic disease, four patients with solid organ transplants including three with active CMV infection, and 10 patients with no clinical suspicion of HIV or CMV infection. There was CMV DNA only in patients with HIV, and it was present more often in patients with evidence of spinal cord dysfunction. Our results suggest that PCR may be useful in the rapid diagnosis of CMV infection of the CNS in patients with HIV and that the radiculomyelopathy syndrome may represent only part of a spectrum of CMV-induced spinal cord dysfunction in these patients.

Adult↗

Bone changes in sickle cell anaemia.

Analysis of available radiographs of the skeletal system in 50 patients suffering from sickle cell anaemia in the Assir Region (South Western height and valley) of the Kingdom of Saudi Arabia taken over a three year period showed a wide spectrum of bone changes. Both infarctions and medullary hyperplasia were common, producing the usual previously reported changes. Spinal changes, mostly osteoporosis and vertebral end plate depression were more prominent in the younger age group. Avascular necrosis of femoral head was common and occurred earlier than in previous reports in the literature. Humeral head and radial head necrosis were also recorded. The overall findings agree with recent reports from both the Eastern and Western regions of the Kingdom that bone changes in SCA are common and could be more severe than in other countries. Complications such as osteomyelitis and fractures were not common.

Adolescent↗

Evaluation of a 10 percent carbamide peroxide gel vital bleaching agent.

A clinical study determined the whitening effect of a 10 percent carbamide peroxide gel on the teeth of 10 subjects. Histological evaluation of the effect of this agent on human tooth pulps and hamster cheek pouch tissues was also undertaken. The gel provided a modest, but unpredictable, whitening of discoloured teeth. A localised mild to moderate inflammatory response was found in some of the pulps of teeth that had been bleached. No soft-tissue changes were observed in the hamster cheek pouches.

Adolescent↗

Abnormal expression of wild type p53 protein in normal cells of a cancer family patient.

Mutations in the p53 gene are the commonest specific genetic change in human cancer. In normal tissues, p53 protein is present in such low quantities that it is not readily detectable by immunochemical techniques. However, in many tumour cells large amounts of p53 protein accumulate and can be seen by simple immunohistochemical staining; this is generally attributed to the accumulation of stabilised, mutant protein. We have found a mother and daughter, who both have a history of breast cancer, who show strong immunohistochemical staining of p53 in most of their normal epithelial and mesenchymal cells. Their family has a history of multiple cancers developing at an early age. Detailed protein analysis and gene sequencing of material obtained from cultured cells, grown from a skin biopsy taken from the daughter, suggest that her cells contained large quantities of normal (unmutated) p53. We suggest that this phenotype defines a new inherited cancer susceptibility syndrome that is distinct from the germ-line mutations in p53 found in some Li-Fraumeni families. This new syndrome affects p53 tumour suppressor function through an indirect mechanism that stabilises normal p53. It remains to be established whether this mechanism also contributes to the accumulation of p53 in sporadic cancers.

Adult↗

Male and female salivary testosterone concentrations before and after sexual activity.

Salivary testosterone concentrations were measured in male and female members of four heterosexual couples on a total of 11 evenings before and after sexual intercourse and 11 evenings on which there was no intercourse. Testosterone increased across the evening when there was intercourse and decreased when there was none. The pattern was the same for males and females. Early evening measured did not differ on the two kinds of days, suggesting that sexual activity affects testosterone more than initial testosterone affects sexual activity.

Adult↗