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Biomedical subjects

M Scott

Publications and source records attributed to M Scott.

At least 37 records · Page 2Linked to original sources
PubMed2001

Treatment delays for patients with acute myocardial infarction within the Coromandel region of New Zealand.

AIM: To assess treatment delays incurred by Coromandel patients requiring thrombolytic therapy for acute myocardial infarction at Thames Hospital. METHODS: A chart search was undertaken at Thames Hospital to identify all patients admitted from July 1993 to July 1998 with a diagnosis of acute myocardial infarction who were treated with thrombolytic therapy. Times of pain onset, general practitioner (GP) assessment, transportation, hospital arrival and thrombolytic administration were noted. Additional information, when required, was obtained from the patient's GP or the St Johns Ambulance service. RESULTS: 153 patients were thrombolysed at Thames Hospital over this period, mean age 65.1 years, 36.6% in heart failure. The mean time from pain onset to GP contact was 157.2 minutes and varied from 63.2 minutes in Coromandel Township to 272.5 minutes in Pauanui. Delays from GP contact to thrombolysis were longer for patients living in outlying areas versus Thames and its environs, 169.4 +/- 45.9 versus 125.2 +/- 50.4 minutes (mean +/-SD) respectively, p<0.001. This contributed to a total delay from pain onset to thrombolysis of 316.7 +/- 145.8 minutes for patients in outlying areas versus 269.1 +/- 185.8 minutes for local patients (p=0.014). CONCLUSIONS: Delays in providing thrombolytic therapy for acute infarct patients reflect not only transport times but also delays in seeking initial medical assessment and hospital triage times. Transport times become particularly significant for those outside of Thames and its environs. Only with improved patient education and local delivery of thrombolytic therapy will these delays be adequately addressed.

Aged↗
PubMed2001

Monitoring pudendal nerve function during labor.

BACKGROUND: To determine methodology and feasibility of pudendal nerve monitoring during labor and delivery. METHODS: With Institutional Review Board approval, 13 low-risk, singleton pregnant women were recruited. The latency and amplitude of the perineal branch of the pudendal nerve compound muscle action potential were recorded during the second stage of labor and after delivery. With the first two patients, a wire electrode was used to stimulate the pudendal nerve continuously at the ischial spine. For the remaining 11 patients, a St. Mark's electrode was used to stimulate transvaginally. Aurethral ring electrode on a 14 French foley catheter monitored the response from the urethral sphincter. All patients received prophylactic antibiotics. EXPERIENCE: Twelve patients delivered vaginally, and one by cesarean. In two patients, continuous wire stimulation showed a gradual decrease in amplitude. Changes were minimal over 15-minute intervals. Wire electrode placement was technically difficult and dislodged easily. With the remaining 11 patients, all had data available for interpretation, and of the 85 potential perineal branch of the pudendal nerve compound muscle action potentials, 53 were obtained. No patients developed cystitis. CONCLUSION: Intrapartum assessment of pudendal nerve function is feasible. Continuous wire stimulation is technically more difficult and does not provide additional information beyond that available from intermittent stimulation.

Action Potentials↗
PubMed2001

Extra copies of chromosomes 7, 8, 12, 19, and 21 are recurrent in adamantinoma.

Adamantinoma of long bones is a rare neoplasm predominantly involving the tibia. Cytogenetic studies of adamantinoma are few. Cytogenetic or molecular cytogenetic analysis of four adamantinomas, and a review of eleven cases in the literature reveals extra copies of chromosomes 7, 8, 12, 19, and 21 as recurrent in this neoplasm. Adamantinoma may be confused with a variety of primary and metastatic epithelial and mesenchymal neoplasms. Observation of these aneuploidies may be useful in establishing the diagnosis of adamantinoma.

Adolescent↗
PubMed2001

Carotid artery ectasia coexistent with primary open angle glaucoma.

A 60-year-old smoker presented with high intraocular pressure in the right eye with a right afferent pupil defect and visual field suggestive of primary open angle glaucoma in the right eye only, when an examination 2 years earlier had revealed no hint of ocular pathology. Radiological investigations demonstrated prominent ectasia of the internal carotid arteries extending into the proximal middle cerebral arteries. The changes in the carotids extended throughout the cavernous sinus regions, encroached on the under surface of the optic chiasm and were closely related to the internal aspects of both optic canals. In primary open angle glaucoma management, neural imaging is not normally recommended; however, neural imaging investigations should be considered if the presentation is not typical of a chronic bilateral optic neuropathy

Carotid Artery Diseases↗
PubMed2001

Oestrogen receptor status determines oncological benefits of laparoscopic oophorectomy.

A meta-analysis of over 3000 patients in 1992 demonstrated that ovarian ablation in women less than 50 years of age produces a highly significant reduction in both disease recurrence and mortality. Laparoscopic ovarian ablation has been offered to premenopausal women at the University College Hospital in Galway for 12 years. A review of 136 cases with follow-up and examination of disease-free survival and mortality is presented. The influence of oestrogen receptor status on response and long-term outcome is examined. Premenopausal women over the age of 40 years were offered bilateral laparoscopic oophorectomy. This procedure was well tolerated with no serious morbidity. A significant difference in disease-free survival and reduction in mortality was observed in the oestrogen receptor positive group when compared with women with oestrogen receptor negative disease. No significant difference in disease-free survival or mortality was observed between the oestrogen receptor negative group and a comparable control group. These results have influenced our patient selection for this adjuvant treatment. A controlled prospective trial is now necessary to examine the role of laparoscopic oophorectomy in oestrogen receptor negative, premenopausal women with breast cancer.

Journal Article↗
PubMed2001

SNP genotyping by multiplexed solid-phase amplification and fluorescent minisequencing.

The emerging role of single-nucleotide polymorphisms (SNPs) in clinical association and pharmacogenetic studies has created a need for high-throughput genotyping technologies. We describe a novel method for multiplexed genotyping of SNPs that employs PCR amplification on microspheres. Oligonucleotide PCR primers were designed for each polymorphic locus such that one of the primers contained a recognition site for BbvI (a type IIS restriction enzyme), followed by 11 nucleotides of locus-specific sequence, which reside immediately upstream of the polymorphic site. Following amplification, this configuration allows for any SNP to be exposed by BbvI digestion and interrogated via primer extension, four-color minisequencing. Primers containing 5' acrylamide groups were attached covalently to the solid support through copolymerization into acrylamide beads. Highly multiplexed solid-phase amplification using human genomic DNA was demonstrated with 57 beads in a single reaction. Multiplexed amplification and minisequencing reactions using bead sets representing eight polymorphic loci were carried out with genomic DNA from eight individuals. Sixty-three of 64 genotypes were accurately determined by this method when compared to genotypes determined by restriction-enzyme digestion of PCR products. This method provides an accurate, robust approach toward multiplexed genotyping that may facilitate the use of SNPs in such diverse applications as pharmacogenetics and genome-wide association studies for complex genetic diseases.

DNA↗
PubMed2001

A protease-resistant 61-residue prion peptide causes neurodegeneration in transgenic mice.

An abridged prion protein (PrP) molecule of 106 amino acids, designated PrP106, is capable of forming infectious miniprions in transgenic mice (S. Supattapone, P. Bosque, T. Muramoto, H. Wille, C. Aagaard, D. Peretz, H.-O. B. Nguyen, C. Heinrich, M. Torchia, J. Safar, F. E. Cohen, S. J. DeArmond, S. B. Prusiner, and M. Scott, Cell 96:869-878, 1999). We removed additional sequences from PrP106 and identified a 61-residue peptide, designated PrP61, that spontaneously adopted a protease-resistant conformation in neuroblastoma cells. Synthetic PrP61 bearing a carboxy-terminal lipid moiety polymerized into protease-resistant, beta-sheet-enriched amyloid fibrils at a physiological salt concentration. Transgenic mice expressing low levels of PrP61 died spontaneously with ataxia. Neuropathological examination revealed accumulation of protease-resistant PrP61 within neuronal dendrites and cell bodies, apparently causing apoptosis. PrP61 may be a useful model for deciphering the mechanism by which PrP molecules acquire protease resistance and become neurotoxic.

Animals↗
PubMed2001

UV-induced binding of ING1 to PCNA regulates the induction of apoptosis.

Previous studies have shown that UV-induced binding of p21(WAF1) to PCNA through the PCNA-interacting protein (PIP) domain in p21(WAF1) promotes a switch from DNA replication to DNA repair by altering the PCNA protein complex. Here we show that the p33(ING1b) isoform of the ING1 candidate tumour suppressor contains a PIP domain. UV rapidly induces p33(ING1b) to bind PCNA competitively through this domain, a motif also found in DNA ligase, the DNA repair-associated FEN1 and XPG exo/endonucleases, and DNA methyltransferase. Interaction of p33(ING1b) with PCNA occurs between a significant proportion of ING1 and PCNA, increases more than tenfold in response to UV and is specifically inhibited by overexpression of p21(WAF1), but not by p16(MTS1), which has no PIP sequence. In contrast to wild-type p33(ING1b), ING1 PIP mutants that do not bind PCNA do not induce apoptosis, but protect cells from UV-induced apoptosis, suggesting a role for this PCNA-p33(ING1b) interaction in eliminating UV-damaged cells through programmed cell death. These data indicate that ING1 competitively binds PCNA through a site used by growth regulatory and DNA damage proteins, and may contribute to regulating the switch from DNA replication to DNA repair by altering the composition of the PCNA protein complex.

Apoptosis↗
PubMed2000

Theory of Frequency-Dependent Polarization of General Planar Electrodes with Zeta Potentials of Arbitrary Magnitude in Ionic Media.

Electrode polarization effects have long aggravated the efforts of low frequency analysis, particularly those investigations carried out on biological material or in highly conductive media. Beginning from elementary equations of electrostatics and hydrodynamics, a comprehensive model is devised to account for the screening of a general planar electrode by an ionic double layer. The surface geometry of the planar electrode is left unspecified to include any type of micromachined array. Building on the previous work by DeLacey and White (1982, J. Chem. Soc. Faraday Trans. 2 78, 457) using a variational theorem, we extend their numerical results with compact analytic solutions, analogous to the Debye-Hückel potential for dc systems, but applicable now to dynamic ac experiments. The variational approach generates functions that are not restricted by perturbation expansions or numerical convergence, representing optimal approximations to the exact solutions. Copyright 2000 Academic Press.

Journal Article↗
PubMed2000

Theory of Frequency-Dependent Polarization of General Planar Electrodes with Zeta Potentials of Arbitrary Magnitude in Ionic Media.

The expressions obtained in the previous paper for electrode polarization are applied to a homogeneous planar electrode and a planar array of electrodes used in the generation of nonuniform fields. The effective far field experienced outside the double layer is computed for both electrodes, and sample spectra are provided. The effective far field expression contains the electrode impedance and the effects of concentration polarization due to the static double layer on the electrode generated by the zeta potential. The effective far field results are compact and contain simple integrals that can be evaluated numerically. Copyright 2000 Academic Press.

Journal Article↗
PubMed2000

Development of a pharmacy residency program in home care.

A residency training program developed by a college of pharmacy in conjunction with a home care company is described. The 12-month program is based on the ASHP Residency Learning System and the goal statements and educational objectives of ASHP's accreditation standard for pharmacy practice residency training with emphasis in home care. Establishing the program involved identifying goals, objectives, and learning experiences consistent with the expected outcomes. Specific objectives for meeting goals in four categories--practice foundation skills, direct patient care, drug information and drug policy development, and practice management--were linked to expected program outcomes. Learning experiences that would lead to achievement of the program objectives and outcomes were selected and organized into one- to eight-week rotations (e.g., in acute care, care of pediatric patients, pain management, nutrition, patient education and counseling, and administration and practice management). Throughout the program, residents gain experience in pharmaceutical services and research. Skills in care planning and monitoring are emphasized, as is practicing pharmaceutical care in an interdisciplinary environment. Residents who have completed the program have found employment immediately as pharmacy managers of home infusion centers. Pharmacy residency training in home care provides the experience needed to function as a competent clinician and manager who can identify and solve problems to improve patient care.

Education, Pharmacy↗