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Biomedical subjects

M A Scott

Publications and source records attributed to M A Scott.

At least 19 recordsLinked to original sources
PubMed1996

Detection of chromosome 20q deletions in bone marrow metaphases but not peripheral blood granulocytes in patients with myeloproliferative disorders or myelodysplastic syndromes.

Myeloproliferative disorders and myelodysplastic syndromes arise in multipotent progenitors and may be associated with chromosomal deletions that can be detected in peripheral blood granulocytes. We present here seven patients with myeloproliferative disorders or myelodysplastic syndromes in whom a deletion of the long arm of chromosome 20 was detectable by G-banding and/or fluorescence in situ hybridization in most or all bone marrow metaphases. However, in each case, microsatellite polymerase chain reaction (PCR) using 15 primer pairs spanning the common deleted region on 20q showed that the deletion was absent from most peripheral blood granulocytes. The human androgen receptor clonality assay was used to show that the vast majority of peripheral blood granulocytes were clonal in all four female patients. This represents the first demonstration that the 20q deletion can arise as a second event in patients with pre-existing clonal granulopoiesis. Microsatellite PCR analysis of whole bone marrow from two patients was consistent with cytogenetic studies, a result that suggests that cytogenetic analysis was not merely selecting for a minor subclone of cells carrying the deletion. Furthermore, in one patient, the deletion was present in both erythroid and granulocyte/monocyte colonies. This implies that the absence of the deletion in most peripheral blood granulocytes did not reflect lineage restriction of the progenitors carrying the deletion but may instead result from other selective influences such as preferential retention/destruction within the bone marrow of granulocytes carrying the deletion.

Aged↗
PubMed1996

Value of videostroboscopic parameters in differentiating true vocal fold cysts from polyps.

Differentiating between benign true vocal fold (TVF) cysts, polyps, and nodules on the basis of their gross appearance would be advantageous in determining the need for surgical therapy. A retrospective study of 32 patients covering 31 months was done to assess the ability to differentiate these lesions on the basis of stroboscopic parameters. Stroboscopic examinations were evaluated for symmetry, amplitude, periodicity, mucosal wave, and closure. Preoperative diagnoses were validated with operative and histologic confirmation. Mucosal wave was absent or diminished in 100% of TVF cysts and present or increased in 80% of TVF polyps (P < .05). Thirty-one percent of original histopathologic diagnoses were modified after pertinent clinical information was provided to the pathologist. Therefore, stroboscopic evaluation of mucosal wave is helpful in preoperative differentiation of TVF cysts and polyps, and providing clinical information to the pathologist is critical for useful histologic information.

Adult↗
PubMed1996

Immunohistochemical characterization of benign laryngeal lesions.

It has been proposed that laryngeal nodules and polyps represent injury to the basement membrane zone of the vocal fold. Repeated trauma from shearing forces produced by excessive or abusive phonation leads to basement membrane zone disruption and thickening. This thickening, along with poorly understood vascular changes, creates the characteristic clinical appearance of the vocal nodule or polyp. As such, to better understand vocal fold nodules it is imperative to characterize the extracellular matrix in this area of injury. Secondary to the small size and relatively acellular nature of these lesions, hematoxylin and eosin (H & E) preparations of histologic material are unsatisfying. A previous study examined this area with immunohistochemical techniques to better characterize its contents. The report, however, contained little information with regard to the clinical appearance of the lesions prior to excision. Therefore, we were prompted to review histologic material from 31 patients who underwent microsurgical excision of 41 benign lesions, vocal nodules (4), polyps (19), polypoid corditis (4), and cysts (14) with immunohistochemical techniques to characterize the patterns of fibronectin and collagen type IV within these lesions. Normal human vocal folds were stained for control. All material was correlated with the H & E preparations and the clinical diagnosis. Collagen type IV and fibronectin appeared present in relatively abnormal patterns in the areas adjacent to the lesion. This study validates earlier results. In addition, correlation with clinical data allows association of immunohistochemical staining patterns with clinical diagnosis.

Adolescent↗
PubMed1995

Plastic-adherent progenitor cells in mobilized peripheral blood progenitor cell collections.

The use of peripheral blood progenitor cells (PBPC) to reconstitute hematopoiesis after high-dose chemoradiotherapy is now commonplace in the treatment of malignancies. Attempts to characterize these cells have concentrated primarily on their phenotype and their content of clonogenic colony-forming cells (CFC). We have used a plastic-adherent delta (P delta) assay system to evaluate the quantity and quality of more primitive cells in addition to the conventional measurements of CFC and CD34-positive cells. The leukapheresis products from 20 patients mobilized using cyclophosphamide (Cy) and granulocyte colony-stimulating factor (G-CSF) were examined for progenitor cell content. The mean number of mononuclear cells (MNC), colony-forming units-granulocyte/macrophage (CFU-GM), and CD34-positive cells from two leukaphereses per patients were 7.9 x 10(8)/kg, 47.3 x 10(4)/kg, and 10.5 x 10(6)/kg, respectively. The mean number of P delta progenitors was 9.3 x 10(4)/kg. Limiting dilution analyses showed the frequency of P delta progenitors in PBPC to be between 1 and 5.3 per 10(5) MNC and that each P delta progenitor has the proliferative capability to generate an overall mean of 4.5 CFU-GM. Of the 20 patients, 16 underwent autografting with PBPC alone. Fifteen patients engrafted neutrophils and platelets within 16 days. One patient had delayed engraftment associated with inadequate etoposide clearance. Statistical analysis showed a strong correlation between numbers of CFU-GM and CD34 positivity. The numbers of plastic-adherent P delta progenitor cells did not correlate with CFU-GM or CD34-positive cells. We conclude that the plastic-adherent P delta progenitor cell assay is capable of measuring primitive hematopoietic cells and that it may be useful for the investigation of primitive progenitors in PBPC harvests.

Antigens, CD34↗
PubMed1995

Rhodococcus equi--an increasingly recognized opportunistic pathogen. Report of 12 cases and review of 65 cases in the literature.

Rhodococcus equi, a gram-positive, weakly acid-fast coccobacillus, initially isolated from horses, is becoming increasingly recognized as an important pathogen for immunosuppressed human hosts since the first human case was reported in 1967. A review of the English medical literature yielded 53 cases. During the last 11 years, the microbiology laboratories of the authors isolated the organism from 12 patients. Of the total 65 cases, 60 occurred in immunosuppressed patients with HIV infection, malignant neoplasms, or chronic immunosuppressive therapy. The lung is the most common primary site of infection. Typically, the lesion is densely infiltrated by histiocytes with multiple microabscesses. Intracellular gram-positive coccobacilli are easily demonstrated. R equi grows well on routine non-selective media at 35 degrees C. Previously, many cases may have been missed because the organism resembles oropharyngeal commensal diphtheroids. Clinical information with gram and Kinyoun strains on fresh isolates is helpful in recognizing the possibility of R equi infection.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Probability of progenitor renewal (PPR) and production of clonogenic progeny (CFU-GM) by primitive adherent progenitor cells in adult human bone marrow and umbilical cord blood.

Human haemopoietic tissues contain primitive plastic-adherent progenitor cells (P delta cells) that can be detected by measurement of their granulocyte-macrophage colony-forming cell (CFU-GM) progeny. Limiting dilution analysis and Poisson statistics are necessary for determining the frequency of P delta cells because each of them produces several CFU-GM. Limiting dilution also permits measurement of the abilities of individual P delta progenitors to produce CFU-GM. Here we report that the frequencies of P delta progenitors in cord blood and adult marrow are similar (5.6 and 7.8/10(5) mononuclear cells respectively) and individual cord blood P delta progenitors produce fewer CFU-GM than adult P delta progenitors. To test the possibility that the lower production of differentiated progeny by cord blood cells was the result of a higher rate of self-renewal, we devised a two-stage limiting dilution assay relying on the relative production of CFU-GM after two consecutive weeks of incubation. The probability of progenitor renewal (PPR) was derived from the number of wells (progenitors) that produced CFU-GM on both occasions compared with the number that produced CFU-GM on the first occasion only. The total number of CFU-GM produced on the second occasion compared with the number produced on the first occasion provided an index of the overall change in the size of the P delta cell population. The data indicate that P delta cells in cord blood have a higher PPR (0.59) than those in adult marrow (0.36). Also, the relative numbers of CFU-GM produced in the second and first weeks were greater for cord blood (1.2) than for adult marrow (0.36). Therefore P delta cells in cord blood have a greater capacity for self-maintenance and possibly for expansion than P delta cells in adult marrow.

Adult↗
PubMed1995

Peripheral blood progenitor cell harvesting in multiple myeloma and malignant lymphoma.

Peripheral blood progenitor cells are being used increasingly as part of the treatment protocol for a variety of haematological malignancies. The most appropriate mobilisation therapy and the optimum collection procedures have yet to be fully elucidated. 28 patients with myeloma (9), NHL (11) and HD (8) underwent PBSC mobilisation and harvesting between November 1992 and October 1993. Two protocols were used; the myeloma group received high-dose cyclophosphamide, 7 g/m2 + G-CSF and were leucapheresed on 5 consecutive days during the recovery period using the Haemonetics V50 and the lymphoma group a lower dose of cyclophosphamide, 3 g/m2 + G-CSF followed by leucapheresis on 2 or 3 occasions using a Cobe Spectra. Median time to achieve a WBC of 1 x 10(9)/l during the recovery phase, was 14 days (11-16) and 10 days (9-15) respectively. Median numbers of MNC and CFU-GM collected for the myeloma group were 5.9 x 10(8)/kg (2.5-13.5) and 69.4 x 10(4)/kg (9.9-268.1) and for the lymphoma group. 5.1 x 10(8)/kg (1.2-11.1) and 35.4 x 10(4)/kg (1.2-129.7). Three patients with lymphoma had a low yield of CFU-GM, two of which did not proceed to autograft. The third patient failed to engraft and died despite receiving bone marrow backup. For the remaining 25 patients, median time to neuts > 0.5 x 10(9)/l and platelets > 50 x 10(9)/l was 9 (8-13) and 11 (9-23) days for the myeloma group and 12 (9-15) and 13 (9-180) days for the lymphomas. We found a strong correlation between CD34+ cells and CFU-GM from the last 9 patients. There is a correlation between CFU-GM infused and speed of engraftment. All patients who received > 10 x 10(4) CFU-GM/kg showed a rapid engraftment for neutrophils and platelets. In all cases, when > 4 x 10(8)/kg MNC were harvested, > 10 x 10(4) CFU-GM/kg were obtained. Sufficient cells for a rapid engraftment can be obtained from 2 leucaphereses in the majority of patients. The recovering peripheral blood WBC provides a good indicator of when to harvest. The target value of CFU-GM can be predicted by the number of cells harvested and by the number of CD34 positive cells in the leucapheresis product.

Aged↗
PubMed1995

Peripheral blood stem cell transplantation after high-dose therapy in patients with malignant lymphoma: a retrospective comparison with autologous bone marrow transplantation.

We report the results of peripheral blood progenitor cell (PBPC) harvesting in 22 patients with lymphoma who underwent leucapheresis after cells were mobilised using 3 g/m2 cyclophosphamide and G-CSF. In 19 patients, the total CFU-GM collected was greater than 7.5 x 10(4)/kg. These patients underwent successful autologous PBPC transplantation. This group of patients was compared to a historical group of 24 patients with lymphoma who underwent ABMT with the same conditioning chemotherapy. The time to engraftment of neutrophils to 0.5 x 10(9)/l was significantly reduced (median 11 days vs 19 days, P < 0.0001) and consequently in-patient stay was reduced (median 21 days vs 28 days, P < 0.001). Blood product support (median 3 vs 4 units blood, P = 0.02; median 15 vs 40 units platelets, P = 0.005) and use of TPN (median 0 days vs 8 days, P < 0.001) were reduced. We estimate a saving of approximately pounds 2370 per patient using PBPC for autologous transplantation compared to bone marrow progenitor cells. This saving is significant (P < 0.001).

Adult↗
PubMed1995

Comparative treatment of mares susceptible to chronic uterine infection.

Four intrauterine treatment strategies were evaluated for effectiveness in mares that were confirmed to be susceptible to chronic uterine infection. Pretreatment samples were obtained at detection of estrus, and a genital strain of Streptococcus zooepidemicus was infused into the uterus when a preovulatory (> 35 mm) follicle was detected. At 12 hours after inoculation, mares were assigned to 1 of 4 selected treatment groups: autologous plasma, 100 ml (n = 5); potassium penicillin, 5 million U in 100 ml of phosphate-buffered saline solution (PBSS; n = 5); 10 mg of prostaglandin F2 alpha in 100 ml of PBSS (n = 5)' and large-volume lavage with normal saline solution (1,000 ml increments). A fifth group, treated with vehicle alone (100 ml of PBSS), served as a negative control (n = 7). All treatments were administered into the uterus. To assess the effectiveness of the treatment, samples for culture and cytologic examination were collected at 96 hours after bacterial inoculation. An effect of treatment was observed on the number of uterine neutrophils (P = 0.02) and growth of S zooepidemicus (P < 0.01). Intrauterine treatment with potassium penicillin, prostaglandin F2 alpha, and large-volume uterine lavage significantly reduced the growth of S zooepidemicus (P < 0.01) as well as the number of neutrophils (P < 0.02). Autologous plasma reduced the number of neutrophils (P < 0.05), but not growth of S zooepidemicus. There was significant correlation between the number of uterine neutrophils and growth of S zooepidemicus for each treatment group (r = 0.57; P < 0.05).

Analysis of Variance↗
PubMed1994

Modulation of calcitonin gene-related peptide release from dorsal thoraco-lumbar spinal cord slices by 5-HT3 receptors.

The release of endogenous calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) from slices of dorsal and ventral thoraco-lumbar spinal cord was examined using a fixed volume incubation technique and radioimmunoassay. Incubation with potassium (25-100 mM) produced a dose-related increase in basal CGRP-LI in the supernatant of dorsal slices which was calcium dependent and release was also evoked by incubation with capsaicin (10 microM). Pre-incubation with the 5-HT3 agonist 2-methyl-5-hydroxytryptamine (10(-5) M) attenuated potassium-induced release from dorsal spinal cord slices, which was prevented by additional pre-incubation with the 5-HT3 antagonist ondansetron (10(-8) M). In contrast, the low level of CGRP-LI released from ventral spinal cord slices was not significantly enhanced by incubation with either potassium or capsaicin.

Calcitonin Gene-Related Peptide↗
PubMed1994

Liquid storage of peripheral blood progenitor cells for transplantation.

Peripheral blood progenitor cells (PBPC) were mobilised by recombinant human G-CSF (rhG-CSF) and cyclophosphamide, harvested by apheresis from 9 patients with NHL and stored at 4 degrees C without further manipulation. They were then reinfused after high-dose chemotherapy. We monitored the change in colony-forming units-granulocyte, macrophage (CFU-GM) proliferation as well as plasma glucose, lactate and pH levels over the period of the study. In an attempt to maintain CFU-GM numbers, rhG-CSF was added to storage bags at collection and 48 h later. Our observations suggest that cell viability is well maintained and that CFU-GM numbers rise over the first 48 h of storage before falling rapidly. Metabolic changes cause a fall in the pH and glucose levels with a reciprocal rise in plasma lactate. The addition of rhG-CSF at a concentration of 10 ng/ml to cells in storage showed no detectable benefit. Following storage for 96 h, 77% (SEM +/- 8%) of the initial CFU-GM remained.

Blood Component Removal↗