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Biomedical subjects

K M Scott

Publications and source records attributed to K M Scott.

At least 19 recordsLinked to original sources
PubMed2001

The health of lone mothers in New Zealand.

AIMS: To compare the sociodemographic characteristics and the mental and physical health status of lone and couple mothers, and to explore possible contributing factors to any differential health status identified. METHODS: Data from the 1996/97 New Zealand Health Survey were analysed. Lone and couple mothers were compared according to sociodemographic factors, health risk behaviours and three medical conditions. Their self-reported health was measured and compared using the SF-36 questionnaire. Multivariate analyses were performed to explore the possible contributing factors to any health disadvantage identified. RESULTS: Lone mothers (n=721) were more likely to be Maori, to have lower family incomes, lower educational qualifications and to live in more deprived areas. There were no significant differences between lone and couple mothers in their prevalence of probable asthma and diagnosed diabetes mellitus, or in their self-reported physical health status after adjustment for socioeconomic variables. However, lone mothers had higher rates of ever having been on medication for hypertension (OR=2.3; 1.2-4.1), and significantly worse self-reported mental health which persisted after adjustment for differences in socioeconomic and other factors. CONCLUSIONS: These findings suggest that lone mothers are a vulnerable group and special consideration should be given to them if inequalities in health are to be addressed.

Asthma↗
PubMed2001

Coccidioidomycosis in adolescents with lupus nephritis.

Coccidioidomycosis, a fungal infection endemic in the southwestern United States, can cause life-threatening infections in immunosuppressed patients. We report the contrasting cases of two adolescents with lupus nephritis, treated with intravenous pulse cyclophosphamide and daily oral corticosteroids, who developed pulmonary coccidioidomycosis. One patient developed a fatal form of fulminant disseminated coccidioidomycosis, while the other patient developed a solitary pulmonary Coccidioides immitis abscess which was responsive to intravenous liposomal amphotericin and fluconazole therapy. Because serologies and initial X-ray studies can be negative, definitive diagnostic studies including bronchoaveolar lavage and needle aspiration should be performed when there is clinical suspicion of coccidioidomycosis in an immunocompromised patient. Immunosuppressed patients with coccidioidomycosis should receive early intravenous amphotericin therapy and may benefit from long-term suppressive antifungal therapy to prevent relapse.

Abscess↗
PubMed2001

Telepathology overview: from concept to implementation.

Telepathology is the practice of pathology at a distance by using video imaging and telecommunications. Significant progress has been made in telepathology. To date, 12 classes of telepathology systems have been engineered. Rapid and ultrarapid virtual slide processors may further expand the range of telepathology applications. Next-generation digital imaging light microscopes, such as miniaturized microscope arrays (MMA), may make virtual slide processing a routine laboratory tool. Diagnostic accuracy of telepathology is comparable with that of conventional light microscopy for most diagnoses. Current telepathology applications include intraoperative frozen sections services, routine surgical pathology services, second opinions, and subspecialty consultations. Three telepathology practice models are discussed: the subspecialty practice (SSP) model; the case triage practice (CTP) model; and the virtual group practice (VGP) model. Human factors influence performance with telepathology. Experience with 500 telepathology cases from multiple organs significantly reduces the video viewing time per case (P < .01). Many technology innovations can be represented as S-curves. After long incubation periods, technology use and/or efficiency may accelerate. Telepathology appears to be following an S-curve for a technical innovation.

Diffusion of Innovation↗
PubMed2000

Diagnostic frozen prostate sextant biopsies: an approach for preserving protein and RNA for additional studies.

BACKGROUND: Primary prostate cancer represents 29% of newly diagnosed visceral cancers in men. Despite this common occurrence, relatively little is known about the pathogenesis of this malignancy. High-grade prostatic intraepithelial neoplasia (HGPIN) is generally accepted as a precursor to invasive prostate carcinoma. There is a lack of adequate animal models, and the available cell culture lines are limited. Tissue from prostate needle core biopsies that have been frozen can provide adequate material for both diagnosis and research. METHODS: Transrectal sextant needle biopsies were snap-frozen, serially sectioned and alternately stained with hematoxylin-eosin or reacted with a basal cell-specific antibody. Two pathologists examined all of the sections, which were scored for the presence or absence of carcinoma and HGPIN. Portions of the remaining tissue were used for studies of protein expression and gene expression. RESULTS: The incidence of carcinoma was 39%, comparable to the mean percent positive cases reported using conventional fixation and paraffin embedding. The incidence of HGPIN was 33%, higher than previously reported. CONCLUSIONS: Prostate carcinoma can be accurately diagnosed using frozen material. The observed high frequency of HGPIN is attributed to the instability of nuclear structure in the frozen material of the atypical nuclei, resulting in inflated grading of PIN lesions. Sufficient material remained in the frozen blocks for additional studies of protein and gene expression.

Aged↗
PubMed2000

Cochlear implantation: minimal hair removal technique.

This prospective study was undertaken to evaluate the safety and patient acceptance of minimal hair removal during cochlear implantation. Forty-six consecutive patients (17 adults, 29 children; age range 13 months to 84 years) received cochlear implantation with a minimal hair removal technique. A questionnaire was used to evaluate acceptance and value of this technique among the first 15 patients and parents. Postoperative examinations were completed 1 and 4 weeks after implantation. Patients were monitored for complications, which included 3 cases of transient seroma, 2 cases of transient dysequilibrium, 2 individual electrode failures, and 1 facial nerve stimulation. Importantly, no wound infections were documented. Use of a small shave technique did not increase surgical risk. This technique has proved to be cosmetically and psychologically more desirable for the patients and their families than complete hair removal in the operative field.

Adolescent↗
PubMed2000

A challenge to the cross-cultural validity of the SF-36 health survey: factor structure in Maori, Pacific and New Zealand European ethnic groups.

This paper reports on a principal component factor analysis of the SF-36 health status questionnaire in the three major ethnic groups in New Zealand (New Zealand Europeans, Maori and Pacific). The SF-36 is hypothesised to have a two-dimensional structure with distinct (weakly correlated) mental and physical health components, and support for this structural model has generally been found cross-nationally. However, in Maori and Pacific models of health mental and physical dimensions are not generally seen as separable, or independently functioning. This raises the possibility that the questionnaire's hypothesised structural model would not be supported among Maori and Pacific ethnic groups. This study evaluated that possibility. The results of the analysis showed a similar factor structure among New Zealand Europeans, and younger Maori (<45 years) to that reported by Ware et al. for Western European countries. Among Pacific people and older Maori (45 years and over), however, the factor structure did not clearly differentiate physical and mental health components. Implications are discussed both specific to the SF-36 (and in particular the use of principal component summary scores), and more generally for the cross-cultural validity of self-reported health status measures.

Activities of Daily Living↗
PubMed2000

A moment in time: selected results from the 1996-1997 New Zealand health survey.

This article presents key results from the 1996-1997 New Zealand Health Survey, the second of two nationally representative surveys on the health status and health service utilization of New Zealanders. This survey involved a face-to-face interview with 7,862 adults and 1,019 children carried out during the period of a year. The survey had an adult response rate of 73.8%. Using the results of this survey, this article highlights some of the major public health issues facing New Zealanders. These issues include smoking, physical inactivity, alcohol use, asthma, and diabetes. The results presented here show that significant disparities exist between particular demographic and socioeconomic groups in New Zealand in relation to both health risk factors and specific chronic diseases. The policy implications of the results are discussed in relation to existing public health strategies and future initiatives.

Alcohol Drinking↗
PubMed1999

SF-36 health survey reliability, validity and norms for New Zealand.

OBJECTIVE: To assess the acceptability, reliability and validity of the SF-36 health survey in the New Zealand population and provide key population norms. METHOD: The SF-36 questionnaire was part of the 1996/97 New Zealand health survey, a cross-sectional, nationally representative survey of 7,862 adults (15 years and over). RESULTS: Overall, in the New Zealand population the questionnaire performed as well as or better than in other national surveys, but there was variability in data completeness across subgroups, and responses were skewed towards the healthy end of the scales. Males scored higher than females on almost all scales; increasing age was associated with decreasing scores (with the exception of the mental health scale); and New Zealand Europeans tended to report better health than the other ethnic groups. CONCLUSIONS: Satisfactory psychometric performance was demonstrated for the SF-36 in the New Zealand population, but researchers need to find ways of increasing data completeness in population groups shown here to have lower completion rates. The questionnaire may be better at discriminating patient rather than population subgroups. The SF-36 normative data confirm in kind, if not in degree, population subgroup disparities in health status observed using objective measures. IMPLICATIONS: Overall, the SF-36 questionnaire appears to be a valid and reliable measure of health-related quality of life for the New Zealand population. However, this paper highlights issues for researchers using the SF-36, such as the skewed nature of responses obstained in a population sample.

Adolescent↗
PubMed1998

Autologous transplantation of mobilized peripheral blood CD34+ cells selected by immunomagnetic procedures in patients with multiple myeloma.

In the use of autologous PBPC transplantation in patients with multiple myeloma, contamination of PBPC with myeloma cells is commonly observed. Enrichment for CD34+ cells has been employed as a method of reducing this contamination. In this study the reduction of myeloma cells in PBPC was accomplished by the positive selection of CD34+ cells using immunomagnetic bead separation (Isolex 300 system). PBPC were mobilized from 18 patients using cyclophosphamide (4.5 g/m2) and G-CSF (10 microg/kg/day). A median of two leukaphereses and one selection was performed per patient. The median number of mononuclear cells processed was 3.50 x 10(10) with a recovery of 1.11 x 10(8) cells after selection. The median recovery of CD34+ cells was 48% (range 17-78) and purity was 90% (29-99). The median log depletion of CD19+ cells was 3.0. IgH rearrangement, assessed by PCR, was undetectable in 13 of 24 evaluable CD34+ enriched products. Patients received 200 mg/m2 of melphalan followed by the infusion of a median of 2.91 x 10(6)/kg CD34+ cells (1.00-16.30). The median time to absolute neutrophil count >0.5 x 10(9)/l was 11 days, and sustained platelet recovery of >20 x 10(9)/l was 14 days. We conclude that immunomagnetic-based enrichment of CD34+ cells results in a marked reduction in myeloma cells without affecting engraftment kinetics.

Adult↗
PubMed1998

Loss-of-function mutations in the LIM-homeodomain gene, LMX1B, in nail-patella syndrome.

Nail-patella syndrome (NPS) is an inherited developmental disorder most commonly involving maldevelopment of the fingernails, kneecaps and elbow joints. NPS exhibits wide variation in phenotypic expression within and among families with respect to these features. Other skeletal abnormalities such as hip dislocation and club foot have also been reported in some individuals with NPS. There is an association between NPS and renal disease, and between NPS and open-angle glaucoma (OAG), but it is not known whether mutations in a single gene cause the observed skeletal, renal and ophthalmic abnormalities. Recently, LMX1B , a transcription factor of the LIM-homeodomain type with homologs that are important for limb development in vertebrates, was mapped to the same general location as NPS at 9q34. We sequenced a large segment of LMX1B from the genomic DNA of probands from four families with NPS and OAG, and identified four mutations: two stop codons, a deletion causing a frameshift and a missense mutation in a functionally important residue. The presence of these putative loss-of-function mutations in the DNA of individuals with NPS indicates that haploinsufficiency of LMX1B underlies this disorder. These findings help to explain the high degree of variability in the NPS phenotype, and suggest that the skeletal defects in NPS are a result of the diminished dorsoventral patterning activity of LMX1B protein during limb development. The results further suggest that the NPS and OAG phenotypes in the families studied result from mutations in a single gene, LMX1B.

Adolescent↗
PubMed1997

Band 1p36 abnormalities and t(1;17) in ovarian carcinoma.

In a series of 128 karyotyped ovarian carcinomas, 42% of cases with chromosome 1 clonal structural abnormalities had breaks at band 1p36 (usually involving translocations of unknown material). Fluorescent in situ hybridization (FISH) studies using combinations of 1 centromere and 1p36.3-specific probes (16 cases) or 1 centromeric and 17 whole-chromosome paint probes (11 cases with 1p+) revealed a trend toward deletion of 1pter relative to 1 centromere (63%); intratumor heterogeneity; and the origin of 1p+ in 3/11 cases (27%) from chromosome 17 [t(1;17)(p36;?)]. The frequency of this specific breakpoint and its involvement in recurrent translocations suggest that these regions are loci for genes important in the pathogenesis of a subset of sporadic ovarian carcinomas.

Adenocarcinoma↗
PubMed1995

Disruption of conserved rhodopsin disulfide bond by Cys187Tyr mutation causes early and severe autosomal dominant retinitis pigmentosa.

PURPOSE: To determine the molecular basis of an early and severe form of autosomal dominant retinitis pigmentosa and to characterize the associated phenotype. METHODS: Visual function evaluation included electrophysiologic and psychophysical testing. Molecular genetic analysis included determining the DNA sequence of sections of the rhodopsin gene amplified by polymerase chain reaction and screening for changes single-nucleotide by allele-specific oligonucleotide hybridization. RESULTS: Affected family members are heterozygous for a unique Cys187Tyr rhodopsin mutation which disrupts a highly conserved disulfide bond essential to normal rhodopsin function. The retinitis pigmentosa (RP) phenotype includes early and severe retinal dysfunction. The full-field electroretinogram showed only negligible remaining rod and cone responses by 22 years of age. Visual fields were constricted severely by early middle-age years. Macular dysfunction caused reduced visual acuity in early adult years, and macular atrophy was present in older age. The severity of phenotype generally correlated with age, with the exception of an affected 44-year-old patient who had better visual acuity, fields, electroretinogram, and dark-adapted thresholds than did three younger affected relatives, ranging in age from 22 to 38 years. CONCLUSION: An early onset, blinding form of autosomal dominant RP results from a rhodopsin Cys187Tyr mutation that eliminates a residue necessary for the formation of a highly conserved disulfide bond essential to normal rhodopsin function. The fact that one family member is significantly less affected than his younger relatives suggests that genetic or environmental factors can modulate the phenotype.

Adolescent↗
PubMed1995

Malignant fibrous histiocytoma of the larynx: case report and literature review.

Malignant fibrous histiocytoma of the larynx is a very rare neoplasm. This article reports the case of a subglottic malignant fibrous histiocytoma in a 38-year-old male treated by wide excision and radiotherapy. A literature search reveals this to be the 22nd case reported. Clinicopathologic features are discussed. The treatment of choice is wide surgical excision with consideration of adjunctive chemotherapy. Radiation therapy is probably of little benefit.

Adult↗
PubMed1990

Rises in antibody to human herpesvirus 6 detected by enzyme immunoassay in transplant recipients with primary cytomegalovirus infection.

Immunoglobulin G to human herpesvirus 6 (HHV-6) and cytomegalovirus (CMV) in sera from solid organ recipients was measured by an enzyme-linked immunoassay (ELISA) before and after transplant. The HHV-6 ELISA was developed from glycine extracts of HHV-6-infected and uninfected HSB-2 cells. At a serum dilution of 1:500, 80 (91%) of 88 recipients were seropositive for HHV-6 before transplant, while only 14 (16%) were seropositive for CMV. Posttransplant HHV-6 serologic rises were observed in 38 (43%) recipients; rises in 25 of these recipients were associated with primary CMV infection. Titration of sera revealed much higher HHV-6 titer rises among those with primary CMV infection than among those with CMV reactivation or with no CMV infection. Elevated HHV-6 antibody titers persisted for up to 2 years after primary CMV infection. No correlation was noted between CMV and HHV-6 antibody titers in individual serum samples.

Antibodies, Viral↗
PubMed1988

Latex agglutination and enzyme-linked immunosorbent assays for cytomegalovirus serologic screening of transplant donors and recipients.

The effectiveness of three serologic assays (two enzyme-linked immunosorbent assays [ELISAs] and latex agglutination) for cytomegalovirus (CMV) serologic matching of donors and recipients was assessed over a 2-year period in a major organ transplant program. Sera with equivocal test results were investigated by repeat testing of serum samples and additional specimens from the individuals involved and monitoring of CMV infection in recipients. An in-house ELISA identified all CMV-infective donors as seropositive. Of 63 ELISA-positive donors, 5 were negative by latex agglutination; recipients from 3 of these donors developed primary CMV infection posttransplant. The in-house ELISA and a commercial ELISA (Abbott enzyme immunoassay; Abbott Laboratories, North Chicago, Ill.) had a 93% concordance of results; follow-up testing indicated that the Abbott assay was sensitive but had a false-positive rate of about 11%. One recipient with a false-positive result developed symptomatic primary CMV infection after receiving a seropositive organ. Thus, performance characteristics of currently used screening assays affect recipient outcome.

Antibodies, Viral↗
PubMed1988

Rapid quantitation of cytomegalovirus and assay of neutralizing antibody by using monoclonal antibody to the major immediate-early viral protein.

An overnight assay, based on staining cytomegalovirus-infected cells with monoclonal antibody to the 72,000-molecular-weight major immediate-early viral protein, was compared with a conventional 14-day plaque assay for quantitation of cell-free stocks of cytomegalovirus laboratory strain AD-169 and 20 other clinical strains. Viral titers were quantitatively similar when determined by either method, but centrifugation of monolayers during inoculation enhanced viral infectivity an average of 4.1-fold. When used for scoring neutralizing antibody assays, monoclonal antibody staining yielded titers within one dilution of 14-day plaque-reduction assays in 54 of 56 titrations. Of 21 cytomegalovirus strains, 2 were not recognized by the monoclonal antibody used. Assay with monoclonal antibody offers a rapid and accurate alternative to plaque assays for quantitation or neutralization of cytomegalovirus.

Antibodies, Monoclonal↗