Biomedical subjects

C MacNeill

Publications and source records attributed to C MacNeill.

11 recordsLinked to original sources

PubMed2001

Recurrent vulvovaginal candidiasis.

Widespread use of over-the-counter antifungal medications has contributed to a large increase in the number of women who experience more than three episodes of candida vulvovaginitis per year. These women are particularly prone to chronic vulvovaginal pain syndromes; as such, the value of aggressive therapy based on detailed diagnosis extends well beyond immediate symptom relief. Diagnosis is complicated by the fact that a larger proportion of cases of are due to non-albicans species, which are not readily identifiable at office evaluation, and points to the value of fungal culture in such cases. Although most Candida albicans are sensitive to azole antifungals, non-albicans species are more often resistant, necessitating alternative therapies. In many cases therapy aimed at suppression of recurrence must extend 6 months. Ongoing studies may identify host factors that facilitate recurrence, and thus provide the basis for individually targeted therapy.

Administration, Intravaginal↗

PubMed2000

Modular regulation of cGATA-5 gene expression in the developing heart and gut.

The evolutionarily conserved GATA-5 transcription factor is an early and persistent marker of heart and gut development in diverse vertebrate species. To search for control regions that might regulate the chicken GATA-5 (cGATA-5) gene, we assayed a set of cGATA-5/lacZ constructs in transgenic mice and found evidence for two functionally conserved control regions that regulate different facets of cGATA-5 gene expression. The more distal control region is activated in embryonic endoderm at the head-fold stage, whereas the other control region contains a regulatory module that is activated in a restricted region of endoderm following closure of the gut tube. Remarkably, the latter control region also contains a complex regulatory module that is activated in the cardiac crescent at the head-fold stage and subsequently functions in several mesodermal components of the developing heart, including the outer (epicardial) layer. We discuss these results in terms of possible contributions of epicardial-derived cells to the formation of heart valves, conduction tissue, and compact myocardium. These transgenes thus reveal, and provide a means to further analyze, transcriptional programs for several facets of heart morphogenesis and gut development.

Animals↗

PubMed1997

Transcripts for functionally distinct isoforms of chicken GATA-5 are differentially expressed from alternative first exons.

Our analysis of cDNA and genomic clones unexpectedly revealed that the chicken gata-5 gene is differentially expressed from alternative first exons. Moreover, we show that the respective transcripts are differentially processed to yield mRNAs for two distinct isoforms of GATA-5. The major isoform, which we described previously, has two CXNCX17CNXC zinc fingers typical of a vertebrate GATA factor. The minor isoform, on the other hand, has only one such zinc finger. We show that this novel isoform localizes within the nuclei of transfected cells and can bind to a consensus GATA site. This truncated isoform of GATA-5 is compromised in its ability to transactivate a simple target gene, however, and thus is functionally distinct from the major isoform of GATA-5.

Amino Acid Sequence↗

PubMed1994

GATA-4/5/6, a subfamily of three transcription factors transcribed in developing heart and gut.

We describe experiments which show that: 1) two previously identified members of the GATA family of transcription factors (both of which were originally called GATA-4) correspond to chicken cDNAs for two distinct factors (which we now refer to as cGATA-4 and cGATA-5); 2) another new member of this family corresponds to a third factor designated cGATA-6; 3) each of these mRNAs displays a differential expression pattern. The cGATA-5 gene is initially transcribed in the cardiac crescent prior to formation of the primordial heart tube. Following formation of the primitive heart, cGATA-5 transcripts are evident in both endocardium and myocardium as well as in other lateral plate derivatives. The cGATA-5 gene is also transcribed in the primitive embryonic gut and in late stage embryos is sequentially up-regulated in distinct segments of gastrointestinal epithelia as they undergo terminal differentiation. These studies thus provide novel insights into tissue-specific regulation by GATA-5, as well as into possibly overlapping regulatory functions for these three family members.

Animals↗

PubMed1994

Impaired motor memory for a pursuit rotor task following Stage 2 sleep loss in college students.

It has recently been reported that selective REM sleep deprivation (REMD) in college students results in memory impairment of the application of a set of rules in a logic task, but not recall of a paired associate task. The present experiments were designed to examine the effects of Total Sleep Deprivation (TSD) and (REMD) following acquisition of a pure motor task, the pursuit rotor. In Experiment 1, subjects (N = 90) were exposed to TSD for one of several nights following training. Results showed that TSD on the same night as training resulted in poorer performance on retest one week later. In Experiment 2, subjects (N = 42) were exposed to various kinds of sleep deprivation on the night of task acquisition. One group was subjected to REMD. Other groups included a non-REM awakening control group (NREMA), a TSD group, a normally rested Control group and a group allowed the first 4 h of sleep in the night before being subjected to TSD (LH - TSD) for the rest of the night. Results showed the REMD and Control groups to have excellent memory for this task while the TSD and LH - TSD subjects had significantly poorer memory for the task. The NREMA group showed a slight, but not significant deficit. It was concluded that Stage 2 sleep, rather than REM sleep was the important stage of sleep for efficient memory processing of the pursuit rotor task.

Journal Article↗

PubMed1992

Detection and patterns of treatment failure in 300 consecutive cases of "early" endometrial cancer after primary surgery.

From November 1977 to July 1987, 300 consecutive patients with endometrial carcinoma clinically confined to the uterine corpus underwent primary surgery consisting of at least abdominal hysterectomy and adnexectomy. Patients with aggressive disease characteristics received postoperative radiotherapy. Forty-seven patients (16%) demonstrated recurrent disease from 2 to 125 (median of 12.8) months after surgery. Forty-seven percent of the recurrences were detected within the first year following surgery and 70% by 2 years after hysterectomy. Of the 47 recurrences, 29 were at distant sites, 16 were within the pelvis, and 2 consisted of both local and distant recurrences. Patients treated with pelvic radiotherapy after hysterectomy were more likely to experience distant, rather than local recurrences. Only 7 of the 148 patients (5%) treated with postoperative radiotherapy recurred in the pelvis. Approximately half of the recurrences were detected in asymptomatic individuals; physical examination and chest X-ray were the most useful means to detect disease in patients without symptoms. The combination of history, physical examination, pap smear, and chest X ray detected all of the recurrences. Actuarial survivals at 12, 24, and 36 months after recurrence were 42, 24, and 17%, respectively. The site of recurrence, time interval of surgery to recurrence, and use of postoperative pelvic radiotherapy were statistically related to patient prognosis. The identification of patients at risk of recurrence and more effective adjuvant therapy need to be developed in order to decrease the frequency of recurrence. In order to substantially improve the survival of patients with recurrent disease, more sensitive methods of detection, as well as more effective salvage therapy, will be required.

Combined Modality Therapy↗

PubMed1991

Analysis of prognostic factors and survival in patients with ovarian cancer treated with second-line hexamethylmelamine (altretamine).

Hexamethylmelamine (altretamine, HMM) 260 mg/m2/day p.o. for 14 days followed by a 14-day drug-free interval was administered to 52 outpatients with advanced ovarian cancer who had previously been treated with chemotherapy. Prior to HMM, 92% (48/52) of these patients had received cisplatin and cyclophosphamide with or without doxorubicin. Two more patients received other cisplatin-based regimens. At the completion of HMM therapy, 15% (8/52) displayed no evidence of disease (NED). Of these eight patients, five are still alive 32 to 82 months after altretamine therapy (median follow-up of 46 months). At 41 months, one patient died of intercurrent illness with no clinical evidence of recurrence; the other two patients died of their disease at 21 and 31 months following HMM therapy. The median survival of the total group was 11 months: nine months for patients who did not respond to altretamine and 46+ months for patients with NED after altretamine (p less than 0.05). Intermittent oral administration of single-agent altretamine was well tolerated: eight patients reported moderate gastrointestinal symptoms, and only one patient reported severe gastrointestinal symptoms. Moderate neurologic toxicity was reported by five patients. No WBC fell below 2000 mm3 and platelet counts fell below 100,000 mm3 in only three patients; no patient experienced severe hematologic toxicity. In this series of patients, the overall response (15%) was comparable to or better than those reported for more toxic chemotherapeutic regimens. On the basis of these data and those reported by other investigators, HMM warrants consideration as a reasonable option in the management of recurrent or persistent ovarian cancer.

Altretamine↗

PubMed1991

Abdominal instillation of high-molecular-weight dextran or lactated Ringer's solution after laparoscopic surgery. A randomized comparison of the effect on weight change.

Abdominal fluid retention after the instillation of lactated Ringer's solution into the abdomen after operative laparoscopy was evaluated by comparing the serial weights of patients receiving lactated Ringer's after surgery to those of patients treated with the abdominal instillation of high-molecular-weight dextran and to those of negative controls. Twenty-four patients were randomized to receive either lactated Ringer's or high-molecular-weight dextran after operative laparoscopy. Patients undergoing only diagnostic laparoscopy served as negative controls. Patients receiving either lactated Ringer's or high-molecular-weight dextran had increased weights as compared to the negative controls for at least 36 hours (P less than .5), although the weight gain in the treatment groups did not differ statistically significantly. The weight gain remained significantly greater than in the negative controls on postoperative days 3 and 4 in patients treated with dextran. Since the "flotation" effect of dextran in preventing pelvic adhesions is likely to be most pronounced in the immediate postoperative period, the findings suggest the need for a reinterpretation of adhesion prevention studies in which the use of dextran was compared to that of lactated Ringer's solution or to saline as a negative control.

Dextrans↗

PubMed1990

Hexamethylmelamine as a single second-line agent in ovarian cancer.

Fifty-two patients with advanced ovarian cancer were treated with single-agent hexamethylmelamine (HMM), 260 mg/m2 po per day for 14 days followed by 14 days off drug. All patients had been previously treated with chemotherapy. Of these patients, 92% (48/52) received cisplatin and cyclophosphamide +/- doxorubicin prior to hexamethylmelamine. Two additional patients received other cisplatin-based regimens. Fifteen percent (8/52) were found to have no evidence of disease (NED) at the completion of treatment with HMM. Five of these patients are alive at 12 to 65 months (median follow-up of 32 months); one patient died at 41 months of an intercurrent illness with no clinical evidence of recurrence; two patients died of recurrent tumor at 21 and 31 months. The median survival of the series of 52 patients is 11 months: 9 months for patients who did not respond versus 41 months for patients with NED post-HMM (P less than 0.05). The regimen was well tolerated: moderate gastrointestinal toxicity was reported by 8 patients; only one patient reported severe gastrointestinal toxicity. Moderate neurologic toxicity (primarily sensory) was reported by 5 patients, 3 patients experienced white counts less than 2000 or platelet counts less than 100,000, and no patient sustained severe hematologic toxicity. This moderate-dose intermittent regimen was associated with moderate toxicity and was well accepted by patients. The overall response is comparable to or higher than that reported for more toxic chemotherapy regimes. Based on these data and those recently reported by other authors, hexamethylmelamine should be considered in the treatment of recurrent ovarian cancer.

Adult↗

PubMed1988

Regional cerebral glucose utilization transiently increases during mild hypoxia.

Regional cerebral glucose utilization (rCMRglu) was studied during mild hypoxic hypoxia in awake free-ranging rats. Rats were prepared with chronic arterial and venous catheters and placed in individual chambers for 4 days to recover from surgery before the experiments. The catheters were accessible by passing them through the top of the chambers. Hypoxia was induced by filling the chambers with a gas mixture consisting of 11% O2 in a balance of N2. Regional CMRglu and physiological parameters were measured in normoxic controls and in rats that had been hypoxic for 2 and 17 min before beginning the measurements. Regional CMRglu was measured in 17 brain regions using [6-14C]glucose. PaO2 decreased from 88 mm Hg in the controls to approximately 40 mm Hg during hypoxia. In the early stages of hypoxia (2-12 min), rCMRglu increased approximately 10-25% above the control rates. In later stages of hypoxia (17-27 min), rCMRglu was not different from that in the normoxic controls. The increase in rCMRglu in the early hypoxia was not blocked by propranolol (1.4 mg/kg), indicating that beta-adrenergic receptors were not involved with the increase in rCMRglu. It was concluded that mild hypoxia is associated with an increased rate of cerebral glucose utilization; however, the increase is transitory, with glucose utilization returning to control rates before 17 min.

Animals↗

PubMed1986

Regional cerebral glucose utilization during insulin-induced hypoglycemia in unanesthetized rats.

Regional cerebral glucose utilization (rCMRgl) was studied during insulin-induced hypoglycemia in unanesthetized rats. Rats were surgically prepared using halothane and nitrous oxide anesthesia and allowed 5 h to recover from the anesthesia before rCMRgl was measured. The rCMRgl was measured using [6-14C]glucose in a normoglycemic control group and two hypoglycemic groups, A (30 min after insulin injection) and B (2 h after insulin injection). The mean plasma glucose level was 7.03 mumol/ml in the normoglycemic group, 1.96 mumol/ml in hypoglycemic group A, and 1.40 mumol/ml in hypoglycemic group B. The rCMRgl in hypoglycemic group A decreased 8-18% in 17 brain regions measured; five changes were statistically significant. The rCMRgl in hypoglycemic group B decreased significantly in all but one of the brain regions measured; the decrease ranged from 15% in the pyramidal tract to 36% in the motor and auditory cortices. The rCMRgl in every brain region decreased when the plasma glucose level fell below 1.5-2.5 mumol/ml. No brain region could maintain rCMRgl at plasma glucose concentrations lower than predicted by regional glucose influx described in previous studies. Glucose utilization in all brain regions appears to be limited by the influx of glucose.

Animals↗