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Biomedical subjects

D MacLeod

Publications and source records attributed to D MacLeod.

30 records · Page 2Linked to original sources

Nicorandil and cardiovascular performance in patients with coronary artery disease.

To establish the cardiovascular profile of nicorandil in patients with coronary artery disease, we recently conducted three studies at our institution. In two groups of patients undergoing cardiac catheterization, the effects of 20 mg nicorandil sublingually (s.l.) on, first, left ventricular hemodynamics (n = 10) and, second, coronary vasodilatation (n = 11) were investigated. In the first group, despite a significant decrease of 12% in left ventricular systolic pressure, heart rate did not increase significantly after nicorandil. Both left ventricular end-diastolic pressure (-43%) and the time constant of early isovolumic relaxation (-11%) decreased, whereas peak Vce and Vmax increased (+19%) (all significantly). In the second group, as mean aortic pressure decreased (-13%, p < 0.05), coronary sinus blood flow did not change significantly, and calculated coronary vascular resistance tended to decrease (-10%). Myocardial oxygen consumption decreased significantly by 14%. Quantitative coronary angiography confirmed a significant increase in the mean diameter of nonstenotic coronary artery segments (+ 14%, n = 43) and, importantly, in mean obstruction diameter of stenotic segments (+ 14%, n = 7) after s.l. nicorandil. In a third continuing study, the effects of intracoronary (i.c.) nicorandil (6 micrograms/kg) and isosorbide dinitrate (2 mg) on the epicardial coronary arteries were investigated in 10 patients undergoing coronary angioplasty. In nonstenotic coronary artery segments, mean coronary diameter increased significantly after either nicorandil (+ 12%) or isosorbide dinitrate (+ 17%). In stenotic segments, however, where the increase in obstruction diameter (+ 20%) after i.c. nicorandil was significant, the 8% increase of isosorbide dinitrate was not.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Sublingual↗

A nuclear protein that binds preferentially to methylated DNA in vitro may play a role in the inaccessibility of methylated CpGs in mammalian nuclei.

The effects of DNA methylation on gene expression and chromatin structure suggest the existence of a mechanism in the nucleus capable of distinguishing methylated and non-methylated sequences. We report the finding of a nuclear protein in several vertebrate tissues and cell lines that binds preferentially to methylated DNA in vitro. Its lack of sequence-specific requirements makes it potentially capable of binding to any methylated sequence in mammalian nuclei. An in vivo counterpart of these results is that methylated CpGs are inaccessible to nucleases within nuclei. In contrast, non-methylated CpG sites, located mainly at CpG islands, and restriction sites not containing this dinucleotide, are relatively accessible. The possibility that DNA methylation acts through binding to specific proteins that could alter chromatin structure is discussed.

Animals↗

Ventricular septal defect after myocardial infarction: assessment by cross sectional echocardiography with pulsed wave Doppler scanning.

Eight patients who developed a ventricular septal defect after myocardial infarction were assessed by cross sectional echocardiography and pulsed wave Doppler scanning. Cross sectional echocardiography visualised the defect in four patients and gave an accurate assessment of global and regional left ventricular function in all eight. In all patients pulsed wave Doppler scanning detected turbulent flow at the apex of the right ventricle or adjacent to a wall motion abnormality affecting the interventricular septum. Pulsed wave Doppler detected coexisting mitral regurgitation in one patient and tricuspid regurgitation in another two. In all patients a left to right shunt was confirmed by oximetry and the location of the defect was identified by angiography or at operation or necropsy. Cross sectional echocardiography in combination with pulsed wave Doppler scanning is useful in the rapid bedside evaluation of patients with ventricular septal defect after myocardial infarction.

Aged↗

Felodipine as a replacement for minoxidil in the treatment of severe hypertension.

The new calcium antagonist felodipine has been compared with minoxidil in the management of severe hypertension in a group of 17 men. Satisfactory control of blood pressure was achieved in all patients with a combination of beta blocker, loop diuretic and minoxidil after inadequate control on a standard regimen of beta blocker, thiazide and vasodilator. The optimal dose of felodipine was titrated after a placebo phase. In a double blind crossover trial blood pressure on felodipine (150/88 +/- 19/8 mmHg, SD) was the same as on minoxidil (148/87 +/- 23/11 mmHg, NS) and the postural difference was similar (NS) on both drug regimens. Body weight was lower on the felodipine regimen (P less than 0.01), as was supine heart rate (P less than 0.05). There was a small rise in plasma liver enzymes on felodipine therapy (P less than 0.01). Felodipine was well tolerated and may be useful in the management of severe hypertension.

Aged↗

Felodipine can replace minoxidil in the treatment of refractory hypertension.

In a group of 15 men with severe hypertension in a double-blind crossover trial, the new calcium antagonist felodipine has been shown to lower blood pressure as effectively as minoxidil when used in combination with a beta-blocker and a loop diuretic. Felodipine was well tolerated and may have a role in the management of severe hypertension.

Aged↗

Exogenous fungal endophthalmitis caused by Paecilomyces.

A 17-year-old white boy developed a fulminating corneal infection and endophthalmitis in his left eye after trauma. He was treated with antibiotics and corticosteroids for one week prior to diagnosis. A saprophytic fungus, Paecilomyces viridis, was cultured from corneal scrapings and was demonstrated in the vitreous cavity by histopathologic examination.

Adolescent↗

A clinico-pathological study of 79 bronchoscopies in HIV-positive patients.

We investigated lung pathology in 61 HIV-positive patients who underwent 79 bronchoscopies. There were 27 cases of pneumocystis carinii pneumonia (PCP), 22 cases of pyogenic pulmonary infection and six cases of mycobacterial infection. Eleven cases of non-specific interstitial pneumonitis were found and 10 intravenous drug abusers had birefringent pulmonary talc granulomata in biopsy specimens. Women and intravenous drug abusers had higher rates of pyogenic pulmonary infection than men and other risk groups respectively. When compared with a previous survey from the same hospital using the same methodology the present study showed a change in the risk groups with 50% more intravenous drug abusers, 42% more haemophiliacs and 45% fewer patients with sexually transmitted infection. However, apparent changes in the spectrum of diseases encountered were not significant.

Adolescent↗