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Biomedical subjects

J McGill

Publications and source records attributed to J McGill.

At least 19 recordsLinked to original sources

A controlled clinical trial of angiotensin-converting enzyme inhibition in type I diabetic nephropathy: study design and patient characteristics. The Collaborative Study Group.

A placebo-controlled, double-blind clinical trial has been initiated to determine whether angiotensin-converting enzyme inhibitor (ACEI) therapy with captopril (25 mg three times daily) slows the progressive loss of renal function in patients with type 1 diabetes mellitus. Entry criteria include; (1) ages 18 to 50 yr; (2) onset of insulin-dependent diabetes before the age of 30 yr, insulin dependent for at least 7 yr; (3) 24-h urine protein excretion > 500 mg, plus: (a) diabetic retinopathy or (b) if no retinopathy, a renal biopsy diagnosis of diabetic nephropathy; (4) serum creatinine (SCr) < 2.5 mg/dL; (5) informed consent. Patients follow strict medical management protocols. Systemic blood pressure is controlled to predefined goals (< 140-90 mm Hg). The primary outcome of the Study is a doubling of the patients' entry SCr to at least 2 mg/dL confirmed by a > 50% decrease in GFR by radioactive iothalamate clearance technique. Baseline characteristics of the cohort at entry into the Study are (mean +/- SD): male/female, 52%/48%; age, 35 +/- 8 yr; duration of diabetes, 21 +/- 7 yr; duration of proteinuria, 2.8 +/- 3.3 yr; duration of retinopathy, 4.5 +/- 4.1 yr; 50% of cohort presented with hypertension, duration, 4 +/- 4.7 yr; blood pressure, 139/86 +/- 19/12; SCr, 1.35 +/- 0.44 mg/dL; GFR 78 +/- 32 mL/min; BUN, 24 +/- 11 mg/dL; proteinuria, 3.1 +/- 3.3 g/day; cholesterol, 236 +/- 50 mg/dL; total glycosylated hemoglobin, 11.1 +/- 2.1%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Preclinical leads for innovative uses for etoposide.

Amplification of oncogenes in human tumors has been associated with a poor prognosis. Microscopically visible amplified oncogenes can be located either within chromosomes in homogeneously staining regions, or in an extrachromosomal compartment in double minutes (DMs). The DMs are composed of submicroscopic circular DNA (episomes), which have multimerized to form the microscopically visible DMs. When amplified oncogenes are located in an extrachromosomal location, they are vulnerable to loss from the cell. In this study we have found that the topoisomerase II inhibitor etoposide, in concentrations easily achievable clinically, causes a significant decrease in the number of DM-containing amplified oncogenes in three different human tumor cell lines. The elimination of amplified oncogenes from the cell could be accompanied by less aggressive tumor behavior.

DNA, Circular

A single major gene controls most of the difference in susceptibility to streptozotocin-induced diabetes between C57BL/6J and C3H/HeJ mice.

To assess genetic factors determining sensitivity to streptozotocin-induced diabetes in inbred strains of mice, a genetic analysis of streptozotocin-sensitive C57BL/6J and streptozotocin-resistant C3H/HeJ mice was performed. One week after a single dose of streptozotocin (200 mg/kg body weight), differences in plasma glucose concentration were marked between male mice of the C57BL/6J and C3H/HeJ strains (p less than 0.001). To determine the number of genes responsible for the difference, F1 male progeny of a cross between parental strains were produced, and found to be streptozotocin resistant like C3H/HeJ parents. F1 mice were, therefore, backcrossed with streptozotocin-sensitive C57BL/6J mice (Backcross: F1 female female X C57BL/6J male male). The plasma glucoses of backcrossed male mice (n = 41) following streptozotocin treatment appeared to segregate into two populations, half like the C57BL/6J parent, and half like the F1 parent. Statistical analysis of the data revealed that the data fit a model with two distributions better than one with a single distribution, suggesting a single major gene responsible for the difference in streptozotocin susceptibility. This hypothesis was also supported by the observation that streptozotocin sensitivity in 12 recombinant inbred strains of C57BL/6J and C3H/HeJ mice appeared to segregate into two classes. Resistance to streptozotocin induced diabetes in F1 mice suggested that the expression of this gene is recessive, although X-chromosome linked inheritance could not be excluded. Efforts to map the streptozotocin-sensitivity gene revealed lack of right linkage to several loci including the H-2 locus.(ABSTRACT TRUNCATED AT 250 WORDS)

Alleles

Anterior tucking of the iris caused by posterior chamber lenses with polypropylene loops.

One hundred ten eyes that had extracapsular cataract extraction with posterior chamber lens implantation were examined gonioscopically to ascertain the frequency of anteriorly displaced polypropylene loops "tucking" into the posterior iris surface. The association with iris transillumination defects and the development of postoperative uveitis, hyphema, and raised intraocular pressure were also recorded. Sixty-six eyes (60%) had one or two anteriorly tucked loops; 28 of them (25%) had some associated iris transillumination defect related to the implant. Twenty eyes (18%) developed persistent postoperative uveitis; 15 of them had anteriorly tucked loops. Two eyes had postoperative hyphema and in both these eyes the loops were anteriorly tucked. The means of recognizing and preventing potential complications are discussed.

Follow-Up Studies

The enigma of herpes stromal disease.

Herpes stromal disease is due to direct damage as a result of viral replication, virally induced immune mechanisms, or a combination of the two. Viral replication may have a major initiating role in the production of herpes simplex and herpes zoster induced stromal disease, and steroids may initially be harmful in their treatment. On topical antiviral drugs alone, in patients who never previously had had topical steroids, 14 of 15 cases of herpes simplex induced disciform keratitis responded favourably in an average of 44 days of treatment. This compared with one out of 14 responding if steroids had previously been used, 13 of 14 requiring topical steroids and an average 112 days' treatment. In herpes zoster stromal disease cases 78% had epithelial involvement, 54 of 57 responded to topical antivirals alone without the use of steroids, 2% recurred, and treatment averaged a total of 62 days. If steroids were used alone or in combination with antivirals, there was a 50% recurrence rate and 200 day total treatment duration.

Acyclovir

Leigh's disease.

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Brain Diseases, Metabolic

Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy.

A prospective randomised trial to compare radiotherapy and cryotherapy in the treatment of basal-cell carcinomas was carried out in 93 patients. Two years after treatment, 4% of tumours treated with radiotherapy and 39% of those treated with cryotherapy had recurred. It is concluded that cryotherapy does not offer a satisfactory alternative to radiotherapy in the treatment of basal-cell carcinomas.

Aged

Colorectal cancer in a nuclear family. Familial or hereditary?

Because of the high incidence of colorectal cancer, familial aggregations of this disease are common. Differentiation between etiologies contributing to familial clustering (which may have resulted either from common environmental exposure or from mere chance) and primary genetic factors may prove vexing to the physician. This report deals with the myriad problems encountered when attempting to make such etiologic distinctions in order to provide appropriate surveillance and management, based upon tumor spectrum and natural history, for patients at increased cancer risk.

Aged

Viral keratitis.

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Adenoviridae Infections

Herpes zoster ocular infection.

A retrospective analysis of 171 patients with herpes zoster ocular infection has been carried out to determine the effect of treatment with either topical acyclovir, topical steroids, or a combination of both. Acyclovir was superior to steroids and to the combination. Treatment with topical acyclovir was on average 54 days compared with 200 days with steroids, and recurrences were 6% with acyclovir compared with 50% with steroids.

Acyclovir

Visual field defects.

The detection and analysis of visual field defects allows the practitioner to examine some functions of the central nervous system at the bedside. Cerebrovascular accidents and temporal lobe tumours can be diagnosed easily, as can pituitary lesions.

Brain Diseases