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Biomedical subjects

A S Hanissian

Publications and source records attributed to A S Hanissian.

At least 19 recordsLinked to original sources

Cystic fibrosis mutations in white and black Americans: an approach to identification of unknown mutations with implications for cystic fibrosis screening.

OBJECTIVE: We sought to define the frequency of common cystic fibrosis mutations in white and black American probands from our geographic region. STUDY DESIGN: Mutation analysis was performed for delta F508, G551D, G542X, R553X, S549N, an d N1303K. For probands with undetermined mutations single-stranded conformational polymorphism analysis was performed. RESULTS: Among 40 white subjects with cystic fibrosis 26 (65%) were homozygous for delta F508, 10 (25%) were heterozygous for delta F508 and another unknown mutation, and two were homozygous for unknown mutations. Among 10 black probands one was homozygous for delta F508, seven (70%) were heterozygous for delta F508 and another unknown mutation, and one was homozygous for unknown mutations. Single-stranded conformational polymorphism analysis for selected exons was performed for 11 probands with unknown mutations. One mutation was detected in a white proband. Sequencing of this exon showed the mutation to be Q493X. CONCLUSIONS: Thirty percent of white subjects and 80% of black subjects carried unknown mutations. In one family single-stranded conformational polymorphism was informative in identifying an undetermined cystic fibrosis mutation.

Black People

Gold: hepatotoxic and cholestatic reactions.

Gold hepatotoxicity is an uncommon but significant clinical problem. Hepatitis was first manifested one day to four weeks after the last dose of gold at a cumulative range of 35 to 2900 mg. An interesting dichotomy was noted between cholestatic and hepatotoxic reactions. Hepatotoxic reactions were associated with other clinical signs of hypersensitivity, thus facilitating differential diagnosis from viral hepatitis. Sudden clinical improvement in a patient receiving gold should stimulate evaluation for a hepatotoxic reaction.

Adult

Hypercalciuria in children with juvenile rheumatoid arthritis: association with hematuria.

After discovering juvenile rheumatoid arthritis (JRA), hematuria, and urolithiasis associated with hypercalciuria in two children, urinary calcium excretion was examined in 38 patients with JRA. Fasting urine calcium/creatinine (mg/mg) (UCa/UCr) ratios were increased (greater than 0.21) in 12 patients, who had a mean UCa/UCr ratio of 0.34 +/- 0.14, compared with 0.09 +/- 0.06 in 26 normocalciuric patients with JRA. Increased UCa/UCr ratios were found more frequently in patients with systemic JRA (P less than 0.05); however, no relationship between UCa/UCr ratios and either functional classification or drug therapy was observed. Four children with increased urine calcium to creatinine ratios were examined more extensively. Twenty-four-hour urine calcium excretion ranged from 4.0 to 7.2 mg/kg/24 hours. An orally administered calcium loading test demonstrated fasting hypercalciuria after dietary calcium restriction in these four patients. Serum calcium, bicarbonate, phosphorus, and parathyroid hormone values were normal. Hematuria was found in six of 12 hypercalciuric patients with JRA but in only three of 26 normocalciuric patients (P less than 0.016). We conclude that urinary calcium excretion is frequently increased in patients with JRA and that hypercalciuria may be related to the pathogenesis of hematuria in some of them.

Arthritis, Juvenile

Treatment of status asthmaticus in children with high doses and conventional doses of methylprednisolone.

Twenty-one children who were admitted to the hospital with status asthmaticus were assigned randomly to one of two groups. Children in group A received methylprednisolone sodium succinate intravenously, 30 mg/sq m every six hours (conventional dose), and those in group B received methylprednisolone sodium succinate intravenously 300 mg/sq m every six hours, until they were no longer wheezing, or for a maximum of four days. There were no significant differences in the outcome between the two groups. We conclude that there is no extra advantage in giving massive doses of corticosteroids over conventional doses in the treatment of severe asthma attacks.

Adolescent

Abnormal collagen in ataxia telangiectasia.

Ataxia telangiectasia has been associated with varying clinical and laboratory abnormalities of the cutaneous, immune, neurological, and endocrine systems. Recently, a primary defect in tissue differentiation has been proposed as a probable cause of the disease. The presence of biochemically abnormal collagen in the skin of two siblings with the disease may further support this hypothesis.

Amino Acids

Impaired cell-mediated immunity in systemic lupus erythematosus (SLE). A controlled study of 23 untreated patients.

Cell-mediated immunity was evaluated in 23 patients with systemic lupus erythematosus (SLE) prior to therapy and in 23 control subjects. The patients with SLE who had moderate to severe disease activity had significantly fewer positive delayed skin tests to streptokinase-streptodornase (SK-SD) and Candida than the control subjects, and a higher frequency of anergy than either the control subjects or the patients with mild SLE. Significant impairment of lymphocyte transformation to all common antigens tested was found in patients with SLE as compared to both normal subjects and control subjects with disease. Phytohemagglutinin response was reduced in patients with SLE as compared to normal subjects but not to the control subjects with disease. Lymphocyte transformation responses to SK-SD and Candida were also significantly lower in patients with moderate to severe SLE as compared to patients with mildly active SLE. Primary immune response to keyhole limpet hemocyanin (KLH) was impaired in patients with SLE as measured by lymphocyte transformation and total KLH antibody, but not 2-mercaptoethanol resistant antibody. The data indicate defective T-cell function in SLE, and suggest that the impairment relates in part to disease activity.

Adolescent