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Biomedical subjects

R Akhtar

Publications and source records attributed to R Akhtar.

At least 19 recordsLinked to original sources

Low levels of p53 are associated with resistance to tetrachlorodibenzo-p-dioxin toxicity in DBA/2 mice.

We show here that DBA/2 strain mice have a complex mutation/polymorphism in the promoter region of the Trp53 locus (the mouse p53 locus). This region has previously been shown to be essential for p53 expression. We further show that the DBA/2 mutation is associated with approximately fourfold lower p53 levels in thymocytes treated with the DNA-damaging agent etoposide in-vitro, and with relative resistance of these thymocytes to apoptosis induced by the DNA-damaging agent etoposide compared with C57BL/6 mice. When part of the promoter containing this mutation was inserted into a plasmid containing a luciferase reporter gene but lacking eukaryote promoter sequences and transfected into MCF-7 human breast cell line cells, the mean luciferase activity was slightly less with the DBA/2 than with the C57BL/6 promoter-reporter construct (p < 0.01). We found that DBA/2xC57BL/6 F2 hybrid mice with the DBA/2 genotype at the Trp53 locus were relatively resistant to tetrachlorodibenzo-p-dioxin toxicity, and this resistance was additive with resistance associated with the Ahr locus. DBA/2 mice are long-lived and do not have particularly high levels of cancer, suggesting either that they carry other compensatory tumour resistance alleles (such as Ahr(d)), or that, while there may be a p53 protein dosage effect for acute toxicity, lower than normal levels of p53 may still be sufficient to protect against cancer. In evolutionary terms, it may be better to maintain low levels of p53 in order to avoid death from acute toxicity, even at the expense of a higher incidence of cancer in later life.

Animals↗

Bilateral Ebstein-like anomaly with atrial septal defect.

We report an unusual congenital cardiac anomaly consisting of a downward displacement of all leaflets of both atrio-ventricular valves. In addition to these changes, an atrial septal defect of the secundum type was noted. In light of the extreme rarity of this interesting anomaly complex, we reviewed the literature and compare the morphologic features of the present case with classic Ebstein's anomaly.

Ebstein Anomaly↗

Cardiac tumors: clinical experience and surgical results in 74 patients.

A series of 75 cardiac tumors in 74 patients were operated on at La Pitie Hospital between 1972 and 1989. There were 73 primary and 2 metastatic tumors. Among the benign neoplasms, 58 were myxomas; seven of the nine malignant tumors were primary heart tumors. The mean age of the patients was 48 years (range, 9 to 75 years); 46 patients were female and 28 male. Fifty-seven percent of the patients had congestive heart failure, 13% had chest pain, 17% had neurological symptoms, and only 1 patient was totally asymptomatic. The cardiac tumors were incidental findings in 3 patients. Complete resection was carried out in 66 benign lesions and only four of the malignant tumors. All patients survived operation, although 4 died in the early postoperative period. Long-term results were excellent in patients with benign lesions, and no recurrences were found. In patients with malignant tumors, surgical procedures were only palliative and aimed at prolonging life; hence, prognosis remained unchanged.

Adolescent↗

Procarbazine carcinogenicity in methotrexate-treated or lipotrope-deficient male rats.

Procarbazine hydrochloride (PCZ), a chemotherapeutic agent used extensively to treat Hodgkins disease and other tumors, induces leukemia, lymphoma, mammary gland and other solid tumors in rodents and non-human primates and is strongly implicated as a leukemogen in humans. Lipotrope (choline and methionine) deficiency is a powerful potentiator of chemical carcinogenesis in liver and, under some conditions, in other tissues in rodents. Methotrexate (MTX), another commonly used chemotherapeutic agent, interferes with one-carbon metabolism and limits availability of lipotropes. Studies of PCZ carcinogenesis in lipotrope-deficient or MTX-treated male rats are reported, showing that both deficiency and MTX increased PCZ carcinogenicity in the mammary gland. In addition, PCZ was found to induce abnormalities of hepatic choline metabolism. Weanling male Sprague-Dawley rats were fed control (C) or lipotrope-deficient (D) diet. After 3 weeks, C and D rats were given PCZ, MTX, the two drugs together or 0.9% saline by i.p. injection. Doses were 0.2 or 0.5 mg MTX/kg or 25 mg PCZ/kg, given 2 or 3 days per week for 5 or 14 weeks. After 5 weeks of drug treatment livers were assayed for choline, phosphatidylcholine, phosphocholine (PCho), glycerophosphocholine and betaine. PCZ perturbed choline metabolism, increasing hepatic choline and PCho in deficient or MTX-treated rats and, to a smaller extent, in rats fed control diet. MTX markedly enhanced the effect of PCZ on choline metabolism. PCZ-induced mammary tumor incidence was increased 50-70% by lipotrope deficiency or by MTX. In PCZ-treated rats, cumulative probability of bearing a mammary tumor was significantly increased by lipotrope deficiency (P = 0.05), and was increased similarly but not significantly by MTX (P = 0.1). Cumulative tumor numbers per group in PCZ-treated rats were significantly greater in both deficient and MTX-treated rats compared to rats fed control diet (P less than 0.005). Incidences of leukemia, lymphoma and Zymbal's gland tumors induced by PCZ were not significantly altered by diet or MTX.

Animals↗

Medical audit by peer review and competitive self-appraisal as tools for promoting efficiency: a case study in Lahore, Pakistan.

A pilot maternal and child health and family planning service project in urban and rural areas of Lahore, Pakistan, was evaluated after 4 years (1984-1988). In this time the birth rate declined from 41.0 to 19.2, infant mortality from 119.0 to 70.2, and maternal mortality from 560 to 220 per 100,000 live births. Success was attributed to medical audit of services through peer review of performance.

Adolescent↗

[Left thoracotomy: an alternative to median sternotomy in coronary bypass in cases of pericardial adhesions].

Coronary bypass on the circumflex artery network was performed by left thoracotomy in 5 patients. All presented with pericardial adhesions due to coronary artery surgery (n = 4) or to mediastinal irradiation (n = 1). The left thoracotomy route provides excellent exposure of the lateral aspect of the heart and may be an advantageous alternative to sternotomy when pericardial adhesions are present.

Coronary Disease↗

Effect of maintenance oral theophylline on dipyridamole-thallium-201 myocardial imaging using SPECT and dipyridamole-induced hemodynamic changes.

To evaluate the effect of maintenance oral theophylline therapy on the diagnostic efficacy of dipyridamole-thallium-201 single photon emission computed tomography (SPECT) imaging for coronary artery disease, dipyridamole-thallium-201 SPECT imaging was performed in eight men with documented coronary artery disease before initiation of theophylline treatment and repeated while these patients were receiving therapeutic doses of oral theophylline. Before theophylline treatment, intravenous dipyridamole caused a significant increase in heart rate, decrease in blood pressure, angina in seven of eight patients, and ST segment depression in four of eight patients. While they were being treated with theophylline, none of the patients had angina or ST segment depression, and there were no hemodynamic changes with intravenous dipyridamole. Before theophylline treatment, dipyridamole-thallium-201 SPECT imaging showed reversible perfusion defects in myocardial segments supplied by stenotic coronary arteries. With theophylline treatment, dipyridamole-thallium-201 SPECT showed total absence of reversible perfusion defects. Treatment with theophylline markedly reduced the diagnostic accuracy of dipyridamole-thallium-201 imaging for coronary artery disease.

Administration, Oral↗

Caudal view. Aid in testicular scanning.

A false-positive scan for testicular torsion can be obtained in a scrotal scan when either a hernia or hydrocele overlies the testicle. The case of a patient in whom a false-positive scan was avoided by the use of a caudal view is reported.

Adult↗

The spatial distribution of health resources within countries and communities: examples from India and Zambia.

"Between one country and another, one province and another and even one locality and another there will always exist a certain inequality in the conditions of life, which it will be possible to reduce to a minimum but never entirely remove", Friedrich Engels, 1875, Quoted from D. M. Smith's Where the Grass is Greener; Geographical Perspectives on Inequality. London, 1979. And it is true that there are wide disparities in the availability of welfare facilities including health at international, national, regional and inter-regional levels. At the same time such disparities are increasing over time. In terms of spatial distribution, not only the developing world but even developed countries such as the U.S.A. and the United Kingdom, face problems resulting from wide imbalances in the provision of welfare facilities. In this paper, an attempt has been made to study inequalities in the distribution of health facilities in India and Zambia.

Delivery of Health Care↗

Dual infections of Culex tritaeniorhynchus with West Nile virus and Nosema algerae.

Culex tritaeniorhynchus females infected with the microsporidian Nosema algerae, and uninfected control females were compared for susceptibility to infection with West Nile (WN) virus and for the ability to transmit virus. When fed on a high titered dose fo virus, 95% of the control females became infected, whereas only 65% of the N. algerae-infected females were infected with WN virus. However, at two lower viral doses, no differences in susceptibility were observed. No significant differences in transmission ability were found between the N. algerae-infected and control females when tested at 10, 14, and 21 days after infection with WN virus. Also, in mosquitoes dually infected with N. algerae and WN virus, neither agent affected the ability of the other to replicate.

Animals↗