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Biomedical subjects

N Ali

Publications and source records attributed to N Ali.

At least 37 records · Page 2Linked to original sources

Magnetic properties of iron nitride-silica nanocomposite materials prepared by high-energy ball milling.

Powder mixtures of (FexN)y and (SiO2)1-y, with x between 3 and 4 and y equal to 0.2 or 0.6, were ball-milled for 4, 8, 16, 32, and 64 h. X-ray diffraction, thermal analysis, and magnetization measurements allowed an investigation of structural and magnetic properties to be carried out. The samples consist of nanostructured Fe3N and Fe4N particles in a SiO2 matrix. As the milling time increases, the Fe4N phase is eliminated from the particles in favor of Fe3N. Coercive fields as high as 270 and 84 Oe are obtained for (FexN)0.2(SiO2)0.8 at 5 and 300 K, respectively. This higher coercive field, upon cooling, indicates the presence of small superparamagnetic particles. The coercive field also increases with milling time, which is due to the reduced particle size and induced stain. The saturation magnetization decreases with increased milling time as a consequence of an increase in the superparamagnetic fraction and increased strain. Hard and soft magnetic properties are observed for y = 0.2 and y = 0.6 samples, respectively.

Alloys↗

Radioimmunoscintigraphy with Tc-99m-labelled SM3 in differentiating malignant from benign adnexal masses.

OBJECTIVE: Ultrasound scanning, serum CA125 and menopausal status have previously been combined in a risk of malignancy index for the differential diagnosis of adnexal masses. Although this approach has greater accuracy than either individual tests or clinical assessment, it has a significant false positive and false negative rate. Efforts have been directed at refining differential diagnosis and this study assessed the role of radioimmunoscintigraphy using the stripped mucin 3 (SM3) antibody that has a 17-fold greater uptake in malignant than benign ovarian tumours in vitro. DESIGN: Prospective study of patients with a pelvic mass using radioimmunoscintigraphy. SETTING: Department of Nuclear Medicine of St Bartholomew's Hospital in collaboration with Cancer Network. POPULATION: A total of 93 patients with pelvic masses were recruited for this study of which 32 had ovarian cancer and 61 had benign lesions. METHODS: Radioimmunoscintigraphy was performed with Tc-99m-labelled SM3 (600 MBq), anterior and posterior pelvis imaged at 10 minutes and at 4 and 24 hours and evaluated with change detection analysis and probability mapping. MAIN OUTCOME MEASURES: Sensitivity and specificity of radioimmunoscintigraphy for ovarian cancer. RESULTS: Radioimmunoscintigraphy had a sensitivity for ovarian cancer of 84% (27 true positive and 5 false negatives) and a specificity of 87% (53 true negatives and 8 false positives) giving a negative predictive value of 91%. CONCLUSION: These results suggest that radioimmunoscintigraphy could be used to reduce the number of false positive findings in a strategy to refine differential diagnosis of the pelvic mass.

Adnexa Uteri↗

Diagnostic strategies in CADASIL.

BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited autosomal dominant condition characterized by migraine, recurrent stroke, and dementia. It results from mutations in the notch3 gene but mutations may occur at multiple sites making molecular diagnosis time consuming. It has been suggested that the presence of granular osmiophilic material (GOM) on skin biopsy and involvement of the anterior temporal lobe and external capsule on MRI may help in diagnosis. METHODS: The authors identified 83 potential index cases from the British population and screened exons 2 to 23 of notch3. MRI scans were scored using a modified Scheltens scale. Skin biopsy was performed in a subgroup. RESULTS: Fifteen different point mutations were identified in 48 families, 73% of which were in exon 4, 8% in exon 3, and 6% in each of exons 5 and 6. Moderate or severe involvement of the anterior temporal pole on MRI had a sensitivity of 89% and specificity of 86% for diagnosis of CADASIL, whereas external capsule involvement had a high sensitivity of 93% but a low specificity of 45%. Skin biopsy, performed in 18 cases, had a sensitivity of 45% and specificity of 100%. CONCLUSIONS: The spectrum of mutations in this study can be used to plan appropriate screening protocols; a suggested protocol is to screen exon 4, and proceed to exons 3, 5, and 6 where indicated. GOM on skin biopsy is diagnostic but can be negative. Anterior temporal pole involvement on MRI is a useful diagnostic marker.

Adult↗

Atrial natriuretic peptide gene G664A polymorphism and the risk of ischemic cerebrovascular disease.

The atrial natriuretic peptide (ANP) gene may underlie stroke susceptibility and sensitivity to cerebral ischemia in an animal model of stroke. The authors investigate its role in humans by genotyping a polymorphism (G664A) in 436 patients with ischemic cerebrovascular disease and 295 community control subjects. The frequency of this variant was similar in both groups and across the different stroke subtypes. The ANP gene G664A polymorphism is therefore unlikely to be an important risk factor for ischemic stroke in this population.

Aged↗

Theoretical study of Mn K-edge in La1-xCaxMnO3.

Effects of (i) local magnetic ordering, (ii) lattice distortions, and (iii) Mn 3d - O 2p hybridization on the shape of Mn K- edge XANES spectra of La1-xCa(x)MnO3 have been evaluated numerically and compared with available experimental data. We calculated the spin-polarized Mn K-edge spectra. An energy splitting between spin-up and spin-down XANES of 0.5-1.1 eV contributes to the broadening of the total XANES below T(N)(T(C)). To simulate lattice polaronic distortions across a MI transition the Mn K-edge spectra were calculated twice: assuming R-3c (R=1.96 A) and Pbnm (R1=1.91, R2=1.97, and R1=2.16 A) symmetries. Results could qualitatively reproduce the observed energy "shift" across the transition. A pre-edge peak at E approximately 6542 eV and feature B3 at approximately 6 eV above the main peak were found to be related to the Mn 3d - O 2p hybridization. The feature B3 should be assigned to a shake-up transition. The calculated K-edge spectrum was obtained as a convolution product of the single-electron XANES and the spectrum of many-body excitations in the Mn-O electronic states in the presence of the 1s core-hole.

Journal Article↗

Mechanical or bioprosthetic valves in the elderly: a 20-year comparison.

BACKGROUND: Our objective was to compare long-term results of mechanical and bioprosthetic valve replacement in patients older than 70 years. METHODS: Patients older than 70 years who had either a St. Jude Medical (SJM) mechanical prosthesis or any bioprosthesis (BP) implanted between January 1977 and December 1997 were identified. Alive patients were interviewed by telephone during a closing interval of 130 days. RESULTS: Complete follow-up was achieved with a total follow-up of 2,264 patient years. A total of 547 patients had 448 aortic valve replacements (199 SJM and 249 BP) and 99 had mitral valve replacements (76 SJM and 23 BP). A further 30 patients had double valve replacement. One hundred ninety of the 577 patients (33%) had coronary artery bypass grafting in addition to the valve replacement. Survival analysis showed no advantage for either mechanical or bioprosthetic valves. There was also no difference in thromboembolic rates, paravalvular leaks, structural dysfunction, and endocarditis rates. However, patients with mechanical valves had a significantly greater risk of major (p < 0.0001) and minor bleeding (p = 0.002) events. CONCLUSIONS: Bioprosthetic valves do not offer a survival advantage over mechanical valves among the elderly. However, anticoagulant-related mortality and morbidity is statistically higher for patients with mechanical valves.

Aged↗

Allozyme polymorphism and variability in permethrin tolerance in British populations of the parthenogenetic stored product pest Liposcelis bostrychophila (Liposcelididae, Psocoptera).

Variability in allozyme patterns is demonstrated among 111 British populations of Liposcelis bostrychophila (Badonnel), an obligatory parthenogenetic liposcelid species that is a common domestic pest in the United Kingdom. In addition four tropical strains and a laboratory culture were included in the analysis. Permethrin toxicity was measured in a subset of the populations.Using cellulose acetate paper electrophoresis, 16 of 34 enzymes tested were found in the liposcelid material and, of these, four were polymorphic. A total of 47 distinct morphs were recognised. This enzyme variation appears to be random with respect to geography throughout the country.Permethrin tolerance was highly variable among populations. A significant relationship was demonstrated between the mean LC(50) for permethrin and latitude such that there appears to be higher levels of tolerance in southern, than in northern, Britain.No link could be established between the allozyme polymorphisms, particularly in the esterases, and permethrin tolerance.

Journal Article↗

Estrogen receptor beta expression in invasive breast cancer.

The aim of this work was to determine the extent of estrogen receptor beta (ER-beta) expression in invasive breast cancer (BrCA) and whether ER-beta expression is correlated with response to adjuvant hormonal therapy with tamoxifen (AHTT). Immunohistochemical staining (IHC) for estrogen receptor alpha (ER-alpha) and ER-beta was performed on sections of formalin-fixed and paraffin-embedded tissue from 47 unselected invasive breast carcinomas (BrCA). IHC for ER-beta was also performed on sections of BrCA from 118 women who were treated with mastectomy and AHTT. Survival analysis was performed using the Kaplan-Meier method and the log-rank test. Of the 47 unselected BrCA, 17 (36%) were negative for ER-alpha and of these, 8 (47% of ER-alpha negative cases and 17% of all 47 patients) were ER-beta positive. Five of the 8 ER-alpha negative and ER-beta positive cases were positive for ER biochemically. There was no correlation between ER-beta positivity and overall survival in the unselected group. By contrast, in the group of women treated with AHTT, expression of ER-beta in more than 10% of cancer cells was associated with better survival (P = .0077), even in women with node-negative BrCA (P = .0069). In conclusion, our results show that a significant number of women with BrCA are positive for ER-beta only, and may be determined to be ER-negative when currently available IHC is used. ER-beta status is a significant predictor of response to AHTT in women with BrCA. Larger studies with multivariate analysis are needed to confirm these findings.

Blotting, Western↗

Ultrasound features of osteosarcoma of the mandible--a first report.

Ultrasound imaging is becoming widely used in the head and neck region as a first-line investigation to assess soft tissue swellings. Clinicians should be aware of the potential of diagnostic ultrasound to identify important signs of malignant disease involving bone. Involvement of the mandible by osteosarcoma is uncommon. A young adult patient presented with facial swelling and an apparently infected lower third molar extraction socket. Subtle signs were missed on dental radiographs. Diagnostic ultrasound investigation was pivotal in identifying sinister signs: namely, soft tissue mass associated with bone thinning, erosion, expansion, and the "sunray" appearance of the buccal cortex, which were suggestive of osteosarcoma. These findings enabled priority to be given to subsequent investigations using other modalities. We present a first report of the ultrasound features of osteosarcoma of the mandible and consider this to be a useful modality in an initial investigation.

Adult↗

The effectiveness of patient referral in Pakistan.

In Pakistan, despite an elaborate network of over 5000 basic health units and rural health centres, supported by higher-level facilities, primary health care activities have not brought about expected improvements in health status, especially of rural population groups. A poorly functioning referral system may be partly to blame. System analysis of patient referral was conducted in a district of Punjab province (Attock) for the purpose of identifying major shortcomings, if any, in this domain. Respondents from 225 households were interviewed. Of the households experiencing serious illnesses less than half were taken to a nearest first-level care facility (FLCF). Major reasons included dissatisfaction with quality of care offered, non-availability of physician, and patients being too ill to be taken to the FLCF. The FLCF utilization rate was less than 0.6 patient visits/person/year. The mean number of patients referred per FLCF during the previous 3 months was 6.5 +/- 5.0. Only 15% of patients were referred on the prescribed referral form. None of the higher-level facilities provided feedback to FLCFS: Records of higher-level facilities revealed lack of information on either patient referrals or feedback. There were no surgical or emergency obstetric services available at any of the first-level referral facilities. Seventy-five percent of the patients attending the first-level referral facilities and 44% of the patients attending higher-level facilities had a problem of a primary nature that could well have been managed at the FLCF. As a result of the study findings, eight principal criteria were identified that need to be satisfied before a referral system may be considered functional.

Catchment Area, Health↗

Increased common carotid intima-media thickness in UK African Caribbeans and its relation to chronic inflammation and vascular candidate gene polymorphisms.

BACKGROUND AND PURPOSE: Individuals of African Caribbean descent who live in the United Kingdom have an increased risk of stroke. The reasons for this are not fully understood, but differences in genetic predispositions or other novel stroke risk factors could play a role. US blacks have been reported to have increased common carotid artery wall thickness, or intima-media thickness (IMT), measured by ultrasound. We measured carotid IMT in UK African Caribbeans compared with UK whites and determined whether different distributions of polymorphisms in potential candidate vascular genes or differences in measures of chronic inflammation or infection could account for any difference. METHODS: In a population study, common carotid artery IMT was measured in 202 white men and 89 African Caribbean men. The distribution of polymorphisms in ACE, paraoxonase 1, paraoxonase 2, and methylenetetrahydrofolate reductase genes was determined. Serum C-reactive protein and Helicobacter pylori seropositivity were determined. RESULTS: Carotid IMT was increased in African Caribbeans even after controlling for cardiovascular risk factors, including homocysteine and social class: beta=0.113, 95% CI 0.036 to 0.189, P=0.004. There was a significant interaction with smoking and mean IMT (P=0.022), and the difference in both measures of IMT between ethnic groups was largely limited to individuals who had never smoked. There were significant ethnic differences in the distributions of 3 of the 4 candidate genes studied (ACE, paraoxonase 1, and methylenetetrahydrofolate reductase). H pylori seropositivity was increased in African Caribbeans (78.7% versus 53% in UK whites). However, neither the genetic polymorphisms nor H pylori seropositivity was related to IMT, and ethnic differences in their distribution did not account for the increased IMT seen in African Caribbeans. CONCLUSIONS: Carotid IMT is increased in UK African Caribbeans even after controlling for conventional risk factors. There are highly significant ethnic differences in the distribution of many potential cerebrovascular candidate genes. Although those we examined did not explain the ethnic differences in IMT, other genetic predispositions or environmental exposures could account for these differences.

Adult↗

Leishmanicidal activity of stearylamine-bearing liposomes in vitro.

Liposomes consisting of stearylamine (SA) and egg yolk phosphatidylcholine (PC) were studied for their cytotoxic activity against freshly transformed promastigotes and intracellular amastigotes of Leishmania donovani, the causative agent of visceral leishmaniasis. More than 99% of the parasites of strain AG83 were killed within 60 min by treatment with 22 mol% SA-PC liposomes (132 microg/ml total lipids). This was further confirmed by incubating the liposome-treated promastigotes at 22 C for 96 hr. The killing activity of the liposomes progressively decreased with lowering lipid concentration. However, weak cytotoxic activity was still detected at 6.6 microg/ml lipids. Leishmanicidal activity of the liposomes became stronger with increasing SA content but was reduced with the incorporation of cholesterol in the liposomes. A similar cytotoxic effect was observed on other Indian strains of L. donovani, for example PKDL and DD8, as well as on species such as Leishmania donovani S1, Leishmania donovani infantum, Leishmania tropica, Leishmania amazonensis, and Leishmania mexicana. However, freshly transformed promastigotes appeared to be more susceptible than the ones subcultured. The strong leishmanicidal activity of SA-PC liposomes was also demonstrated toward intracellular L. donovani amastigotes. The SA-bearing vesicles could effectively inhibit the growth and multiplication of the parasites within the macrophages. The cytolytic activity of these liposomes on leishmanial parasites and low toxicity on host macrophages may, thus, find application in the therapy of leishmaniasis.

Amines↗

Coronary care physician 1994-2000 adherence to 1993 National Cholesterol Education Program diet and lipid recommendations.

The 1993 NCEP recommended phase 2 diets and < or = 100 mg/dL LDL goals for all atherosclerotic patients. We reviewed Washington, DC physician 1994-2000 use of these recommendations for coronary care unit (CCU) patients. Questionnaires, chart reviews and interviews of cardiologists, residents and dietitians showed > 80% of CCU physicians ignored NCEP dietary recommendations. NCEP 1 diets were ordered for approximately 80% of patients. NCEP 2, AHA 3 or vegetarian diets were used for < 20%. Statins were reported for approximately 25% of patients in 1994-95 but were on < 20% of charts in 1996-7. This increased to approximately 58% by 2000. NCEP 2 diets lower cholesterol approximately 5%, rarely reaching LDL goals, and < 20% of CHD patients on anti-lipid therapy were at NCEP LDL goals by 1999. With 1-year post-myocardial infarction 34% mortality and 53% readmission rates, we need early and much more aggressive anti-lipid diets and drugs in treating these patients.

Arteriosclerosis↗

Percutaneous transmyocardial laser revascularisation for severe angina: the PACIFIC randomised trial. Potential Class Improvement From Intramyocardial Channels.

BACKGROUND: Percutaneous transmyocardial laser revascularisation (PTMR) is a proposed catheter-based therapy for refractory angina pectoris when bypass surgery or angioplasty is not possible. We undertook a randomised trial to assess the safety and efficacy of this technique. METHODS: 221 patients with reversible ischaemia of Canadian Cardiovascular Society angina class III (61%) or IV (39%) and incomplete response to other therapies were recruited from 13 centres. Patients were randomly assigned PTMR with a holmium:YAG laser plus continued medical treatment (n=110) or continued medical treatment only (n=111). The primary endpoint was the exercise tolerance at 12 months. Analyses were by intention to treat. FINDINGS: 11 patients died and 19 withdrew; 92 PTMR-group and 99 medical-treatment-group patients completed the study. Exercise tolerance at 12 months had increased by a median of 89.0 s (IQR -15 to 183) with PTMR compared with 12.5 s (-67 to 125) with medical treatment only (p=0.008). On masked assessment, angina class was II or lower in 34.1% of PTMR patients compared with 13.0% of those medically treated. All indices of the Seattle angina questionnaire improved more with PTMR than with medical care only. By 12 months there had been eight deaths in the PTMR group and three in the medical treatment group, with similar survival in the two groups. INTERPRETATION: PTMR was associated with increased exercise tolerance time, low morbidity, lower angina scores assessed by masked reviewers, and improved quality of life. Although there is controversy about the mechanism of action, and the contribution of the placebo effect cannot be quantified, this unmasked study suggests that this palliative procedure provides some clinical benefits in the defined population of patients.

Adult↗