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Biomedical subjects

A McLay

Publications and source records attributed to A McLay.

17 recordsLinked to original sources

A microsatellite linkage map for Atlantic salmon (Salmo salar).

A linkage map of the Atlantic salmon is described here consisting of 15 linkage groups containing 50 microsatellite loci with a 14 additional unlinked markers (including three allozymes). The map shows the largest sex-specific recombination rate differences so far found in any vertebrate species (3.92:1 female:male). Homologies with previous linkage mapping studies of Atlantic salmon and rainbow trout are described. An in silico search of the Genbank database carried out using the microsatellites used in the mapping process identified significant matches between the flanking regions of the microsatellite SS11 and the calcium-binding mitochondrial carrier protein, 'Aralar1'.

Animals↗

Progressive IgA nephropathy: the role of hypertension.

A retrospective study of 67 patients with IgA nephropathy carried out at the Glasgow Royal Infirmary revealed an overall 10-year actuarial renal survival of 77.4%. At the time of presentation, 27 patients (40.3%) were hypertensive and 40 (59.7%) were normotensive. As expected, the survival was worse in the hypertensive group. However, when the effect of control of blood pressure was assessed, a significantly worse survival was found in those whose hypertension was inadequately controlled, compared to those whose hypertension was well controlled, in whom survival was not significantly different from that of the normotensive group. The differences in survival could not be explained by increased patient age nor by longer duration of disease. Good control of hypertension may prevent progression to end-stage renal failure in IgA nephropathy.

Actuarial Analysis↗

Polyarteritis presenting with thrombocytosis and central retinal vein thrombosis.

We report a case of polyarteritis in a 54 year old woman who presented with marked thrombocytosis and acute blindness in one eye secondary to central retinal vein thrombosis. She also developed bilateral pulmonary infiltrates and renal failure. The diagnosis was confirmed by histological changes in the renal biopsy. Treatment with immunosuppressives, plasma exchange and antiplatelet drugs led to rapid clinical improvement and recovery of renal function and prevented further thromboembolic episodes. Plasma exchange and antiplatelet drugs should be considered in polyarteritis group of systemic vasculitis especially in the presence of thromboembolic complications or thrombocytosis.

Female↗

Polyarteritis nodosa and monocytic leukaemia.

A 67 year old man presented with a polyarteritis nodosa-like syndrome with renal, pulmonary joint and neurological involvement during the 'preleukaemic' stage of monocytic leukaemia. The association between these two conditions is discussed.

Aged↗

The natural history of membranous nephropathy in the West of Scotland.

Membranous nephropathy was diagnosed in 54 patients between January 1975 and June 1983 in the Royal Infirmary, Glasgow. It was the commonest cause of the nephrotic syndrome and, with IgA nephropathy, the commonest primary glomerular disease. A cause was found in 10 patients. The last seven patients diagnosed were enrolled in the MRC trial. The natural history of the remaining 37 patients with idiopathic membranous nephropathy was studied. After an average observation period of 64 months, 50 per cent had stable renal function with or without proteinuria and 50 per cent had progressive renal failure or had died of other causes (five patients). Of the factors examined only heavy proteinuria and hypertension were significantly more common in patients who developed progressive renal failure. No patient who entered remission relapsed. Vascular complications were an important cause of morbidity and mortality. Incidence of events of arterial occlusion was significantly higher in these patients compared with patients with IgA nephropathy. Treatment of patients with membranous nephropathy should, therefore, be judged not only by its efficacy in preventing progressive renal failure, but also by its effect on vascular disease and by its toxicity.

Adolescent↗

Collagenous colitis: possible response to sulfasalazine and local steroid therapy.

A patient with rheumatoid arthritis and collagenous colitis apparently responding to sulfasalazine and prednisolone enemas is reported. It is suggested that this form of therapy should be considered in patients with this rare disorder not only as a short-term measure but also, in the case of sulfasalazine, as long-term treatment in patients with chronic symptoms.

Administration, Oral↗

Plasma exchange in the treatment of mesangiocapillary glomerulonephritis.

9 patients with primary glomerulopathies and slowly progressive renal failure were treated by regular plasma exchanges without immunosuppressive drug therapy. All 3 patients with the subendothelial type of mesangiocapillary glomerulonephritis (MCGN-I) had no progression of their renal failure while undergoing plasma exchanges. The creatinine rose when treatment was stopped and fell again in 2 patients who restarted plasma exchange. 2 patients with hypocomplementaemia and dense deposit disease (MCGN-II) and all 3 patients with idiopathic membranous nephropathy (IMN) did not benefit. 1 patient with normo-complementaemic MCGN-II had some improvement in renal function which lasted 18 months. Proteinuria fell or was unchanged during the 1st month of plasma exchange in the 4 who improved and increased in the 5 who did not. The response to plasma exchanges could not be attributed to removal of circulatory complexes or changes in reticulo-endothelial function. Regular 2.8-litre plasma exchanges using 4.3% immunoalbumin proved to be safe for periods up to 44 months. Regular plasma exchange appears to prevent progression to renal failure in patients with MCGN-I.

Adolescent↗

Polyarteritis group of systemic vasculitis--new diagnostic criteria.

We have used new diagnostic criteria to define patients with the polyarteritis nodosa (PAN) group of vasculitis. These were the combination of a necrotising glomerulitis without diffuse deposits of immunoglobulins or complement components in a patient presenting with systemic disease and multi-organ involvement. Twenty-two patients who fulfilled these criteria presented to our unit between 1975 and 1982. The diagnosis of PAN was confirmed by traditional histological criteria in eight. We anticipate that the use of these criteria will lead to earlier diagnosis and thereby improve the management of this potentially lethal disorder.

Adult↗

Phenylbutazone-induced systemic vasculitis with crescentic glomerulonephritis.

Two patients had phenylbutazone-induced systemic vasculitis syndrome. Both presented with acute oliguric renal failure, and renal biopsies showed severe crescentic glomerulonephritis with marked interstitial inflammatory cell infiltration. Withdrawal of phenylbutazone and treatment with immunosuppressives and plasma exchange led to recovery of renal function in one case.

Acute Kidney Injury↗

Clostridium difficile-associated colitis in uremic patients.

Five uremic patients managed in a renal unit developed Clostridium difficile-associated colitis. Four cases occurred in a cluster at about the same time. All patients had previously received or were on antibiotic therapy at the onset of diarrhea and one patient was also on oral steroid therapy. Cefotaxime, a third generation cephalosporin was involved in all five cases. All patients had severe diseases with explosive diarrhea and systemic toxicity. The diagnosis was confirmed in all cases by culture of C. difficile and demonstration of high titers of C. difficile cytotoxin in the stool. Histology from rectal biopsy in one patient showed classical pseudomembranous colitis. Response to treatment with vancomycin was generally good though one patient had two relapses. Uremic patients have impaired immune response and intestinal motility and are predisposed to C. difficile infection. Cross-infection can occur and the isolation of affected patients seems prudent.

Adult↗

Recovery in malignant hypertension presenting as acute renal failure.

Malignant hypertension may present occasionally with acute renal failure. Seven patients with this syndrome were admitted to the Renal Unit of the Royal Infirmary, Glasgow, between 1977 and 1981 giving an estimated incidence of one per million of the population per year. All the patients smoked and all had features of microangiopathic haemolytic anaemia. Renal biopsies showed arterial subintimal changes with relative sparing of glomeruli in each case. Good control of blood pressure led to significant recovery of renal function in five of the seven patients after 10-44 days of peritoneal dialysis. Renal function improved progressively over the first year and the improvement has been sustained for an average of 24 months (range 15-62 months). Mean serum creatinine when last measured was 248 mumol/l (range 125-350 mumol/l). These results confirm previous reports of recovery of renal function in patients presenting with acute renal failure and malignant hypertension. The proportion of patients who improve may be higher than has been generally recognised, and recovery may last several years. The pathogenesis of the renal failure is discussed.

Acute Kidney Injury↗

Post-irradiation sarcoma of the lower lip.

This report records the occurrence of an irradiation induced fibrosarcoma of the lower lip which appears to be the first case documented in this site. The problems associated with the histopathological diagnosis of such lesions are discussed and the value of electronmicroscopical examination of spindle cell sarcomas stressed.

Aged↗

Changes in the glomerular capillary wall induced by lymphocyte products and serum of nephrotic patients.

This study demonstrated that a soluble factor derived from patients with nephrotic syndrome caused changes consistent with the development of proteinuria when infused into the renal artery of a rat. The supernatants of cultures of stimulated lymphocytes of patients with the nephrotic syndrome containing autologous sera were infused into the renal arteries of rats and caused patchy spreading of the foot processes of epithelial cells and reduction of charge of the glomerular basement membrane of rat kidneys. The equivalent supernatants from normal subjects did not produce these changes.

Animals↗