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Biomedical subjects

R S Scott

Publications and source records attributed to R S Scott.

At least 91 records · Page 5Linked to original sources
PubMed1986

A peer evaluation for measuring team teaching effectiveness.

The peer evaluation tool for team teaching was developed to supply data for the team teaching component of the comprehensive evaluation procedure. The tool is used most effectively when the evaluators are familiar with the criteria, and have had an opportunity to work with and observe a colleague's performance for an extended period of time. It lends itself for use in yearly evaluation of non-tenured faculty and faculty applying for promotion of tenure. The criteria written as performance objectives can also provide direction for one's self-evaluation of teaching performance and serve as a standard for professional growth.

Evaluation Studies as Topic↗
PubMed1985

Utilisation of health services by diabetic persons. III: Audit of hospital admissions and bed occupancy.

The extent and patterns of use of hospital services by diabetic persons in New Zealand are not well documented. The usage of all four major Canterbury hospitals was prospectively studied for the 12 month period 1 January to 31 December 1983. There were 889 admissions by 689 diabetic persons who were either discharged from or died in hospital within the 12 month survey period (F = 373, M = 316). Ages ranged from three to 95 years mean 64.6 yr (SEM 0.7). One hundred and fifty-one patients were hospitalised more than once. At admission, 63.9% of patients were treated with diet or diet plus oral hypoglycaemic agents, 27.6% with insulin and 8.5% were newly diagnosed. The mean hospital stay was 20.1 (1.1 days), but the longest admission stays were by those over 65 years of age. Overall diabetic persons accounted for 4.8% of the total bed occupancy of the four hospitals. During 1983 14.8% percent of the 1200 insulin treated diabetic persons and 10.2% of the estimated 4000 non-insulin treated diabetic persons in the Canterbury Hospital Board area were hospitalised. Conditions associated with or a consequence of diabetes precipitated 57.5% of admissions. The potentially preventible disorders of glycaemic control and infection were factors in 25% and 26.9% of admissions respectively. These data show high risk of hospitalisation amongst diabetic individuals, particularly for those using insulin, but there is scope for prevention of admission or at least for reduction in duration of hospital stay.

Adolescent↗
PubMed1985

Hypoglycemia masquerading as cerebrovascular disease (hypoglycemic hemiplegia).

Hypoglycemia produced hemiplegia with right-sided predilection in 16 patients initially suspected of having suffered a stroke. Fifteen patients had no demonstrable brain disease, and the hemiplegia cleared rapidly once the hypoglycemia was corrected. Invasive investigations such as carotid arteriography are not required in most patients. The features of hypoglycemia hemiplegia suggest that a selective neuronal vulnerability and not underlying focal brain disease is responsible in most cases.

Adult↗
PubMed1985

Insulin secretion from perifused rat pancreatic pseudoislets.

Isolated adult rat pancreatic islets were dispersed into single cells and cultured free-floating for 3 to 4 d, during which time islet cells reaggregated spontaneously into spherical clusters or pseudoislets. The gross morphology of these tissues resembled nondissociated islets. Electron microscopy revealed well-preserved cell ultrastructure and intercellular membrane connections. Immunofluorescent localization of islet cell types showed that A cells tended to be peripherally distributed around a B cell core, with D cells scattered throughout the aggregate mass. The dynamics of insulin release from pseudoislets were evaluated in vitro by perifusion techniques. Pseudoislets exhibited clear biphasic dose-dependent insulin responses to 30 min glucose stimulation over the range 5.5 to 30 mM. Repeated 2-min pulses with 22 mM glucose elicited brief monophasic spikes of insulin release of consistent magnitude. L-Arginine (5 to 20 mM) evoked biphasic insulin release but these responses were not dose-dependent. These data indicate that islet cells reaggregate into structures with close morphologic similarities to intact islets, and that pseudoislet B cells continue to secrete insulin in response to nutrient secretagogues, comparable to that seen with islets in vitro and in situ.

Animals↗
PubMed1985

Adult rat pancreatic islet cells adherent to microcarrier beads: evaluation of function and morphology.

Dispersed adult rat pancreatic islet cells were incubated with Cytodex-3 microcarrier beads for 72 h, during which time single cells adhered firmly to bead surfaces. Electron microscopy revealed well-preserved ultrastructure of attached A, B, and D cells. Perifusion of these cultures showed stable basal insulin release, brisk, biphasic insulin responses to 30-min glucose stimulation, and consistent, monophasic spikes of insulin release in response to repeated, brief pulses of glucose. These results indicate that adult rat islet cells attach to microcarriers and remain viable in culture. This preparation offers advantages for studies of hormone secretory dynamics of differentiated single islet cells, free from cell-to-cell interactions.

Animals↗
PubMed1985

Transient microwave induced neurosensory reactions during superficial hyperthermia treatment.

A pattern of neural anomaly has emerged in 10 of the 200 patients treated with ionizing external beam radiation and 915 MHz microwave induced hyperthermia for superficial malignancies. Patients report various sensations in parts of the body which not only are far removed from the treated area, but also are not generated through pathways in the treated areas. The most common sensation was a numbness and tingling in the ipsilateral arm when the chest was being treated. In each case, the applicator was at least three aperture widths from the axilla; the angle with the axilla was approximately 90 degrees, and the applicator was angled from 90-180 degrees to the affected arm. In each case, the sensation was only appreciated when the microwave energy was present. There was no correlation of sensation with level of power application. The sensation would saturate at power densities far below those used to achieve therapeutic heating. One patient reported such a severe "burning" sensation in the arm at the lowest measurable power from the generator that further treatment was discontinued. Only one patient had a demonstrable motor deficit. These effects were patient specific and repeated from treatment to treatment in at least two-thirds of the treatment sessions. Sensitive patients were sporadically distributed throughout the patient population.

Aged↗
PubMed1985

Standardization of insulin secretion from pancreatic islets: validation of a DNA assay.

The use of islet DNA content to standardize insulin secretion rates from pancreatic islets of different sizes has been studied. Isolated intact islets were sorted into 4 size categories and perifused with 22 mM glucose, collecting effluent in 5 min fractions for insulin RIA. DNA content of perifused islets was measured by fluorometric assay, and insulin secretion expressed as pmoles/ug DNA/unit time. For islets with diameters less than 300 u (1) insulin secretion was proportional to islet size; (2) insulin release per islet and islet DNA content were strongly correlated; (3) when expressed as a function of DNA content, insulin secretion from different sized islets was not significantly different. These relationships did not continue for very large islets (above 300 u) suggesting a limiting islet size for insulin secretion in vitro. The data demonstrates that expression of insulin secretion from pancreatic islets with diameters less than 300 u, as a function of their DNA content standardizes secretion irrespective of islet size and number, and should allow direct comparison of secretory responses between different islet tissue preparations.

Animals↗
PubMed1985

Structure-function relationships in pancreatic islets: support for intraislet modulation of insulin secretion.

Pancreatic islet B cell function was studied in vitro using three structurally different preparations of islet tissues: isolated, intact islets, dispersed islet cells attached singly to microcarrier beads, and reaggregated islet cells. Mechanisms of intercellular communication are eliminated with single cell preparations, whereas in aggregates cell to cell communications are reestablished and a defined microenvironment restored. Perifusion studies measured nonstimulated and glucose- and arginine-stimulated insulin release from the three islet tissues. Insulin secretion rates were expressed as a function of cellular DNA content, permitting direct comparison between tissues. During perifusion with low (2.8 or 5.5 mM) glucose concentrations, secretion rates of single islet cells were up to 6-fold greater (P less than 0.001) than those of intact islets. Perifusion of islet cells with 2.8 mM glucose and 100 or 500 pg glucagon/ml had no effect whereas GH-release-inhibiting factor (330 and 1000 pg/ml) decreased nonstimulated insulin secretion rates by 15% (P less than 0.05). After reaggregation, basal insulin secretion rates were restored toward those of intact islets. Glucose (5.5-30 mM) and L-arginine (5-20 mM) elicited first phase insulin responses from single islet cells that were not significantly different from those observed with intact islets; in contrast, second phase responses of single islets to glucose were approximately 50% those seen with intact islets, and their second phase responses to arginine were absent. Single islet cell first and second phase insulin responses to 5.5 mM glucose were enhanced 2.2-fold (P less than 0.01) and 2.8-fold (P less than 0.05), respectively, in the presence of exogenous glucagon, resulting in secretory profiles characteristic of intact islets. Reaggregation of single islet cells was associated with markedly increased first and second phase insulin responses to both glucose and arginine stimulation. These data show that disruption of the islet microanatomy results in alteration of insulin secretory responses and that these effects can be reversed, in part by exogenous glucagon and GH-release-inhibiting factor, and by reaggregation. Although different mechanisms appear important for nonstimulated, first and second phase insulin release, the findings support a role for both direct intercellular communication and hormonal secretion by islet A and D cells in the modulation of B cell function.

Animals↗
PubMed1985

Exner's Four Square: useful index in appraisal of learning disability?

Rorschach protocols, focusing on Exner's Four Square, were obtained for 14 boys who had been referred for a second opinion following an initial diagnosis as learning disabled. The findings indicated wide diversity, suggesting that a significant proportion of students manifest fundamental problems which are not essentially cognitive in nature. For these students, traditional psychoeducational decisions may be inappropriate and unproductive.

Adolescent↗
PubMed1984

Diabetes mellitus in a Christchurch working population.

Using criteria recommended by the World Health Organisation, prevalence rates for diabetes mellitus have been determined in a Christchurch working population of adults aged 15-65 years. Ninety-three percent of 1047 workers employed by a large industrial group were screened for diabetes mellitus using 75 G oral glucose tolerance tests. Three point one percent of the survey group were diabetic--1.55% were known to have diabetes and a further 1.55% were new cases. In addition, 0.31% were considered to have gestational diabetes mellitus. Blood glucose elevations not diagnostic for diabetes mellitus were present in another 0.93%. By applying the criteria of the National Diabetes Data Group, slightly different prevalence rates were found--3.0% for diabetes mellitus and 1.14% for impaired glucose tolerance.

Adolescent↗
PubMed1984

Treatment of condyloma acuminata with carbon dioxide laser: a prospective study.

The common wart has been a ubiquitous problem throughout recorded history. In recent times, the genital wart has assumed more and more importance. These viral growths cause itching and burning as well as more severe problems. Treatment traditionally has included a large variety of preparations from nature. Subsequently, man-made chemicals were used along with freezing, burning, and surgical excision. Because of the pain, bleeding, scarring, and high recurrence rate with these treatments, a study was instituted in 1978 to evaluate the advantages of the CO2 laser for treatment of this condition. Results have been excellent, far exceeding what we expected. Recurrence rate has been under 2%. The control group had the usual high rate of persistence and recurrence. Recent work pointing to a strong association between human papilloma virus (HPV) and cancer of the female genitals suggests an increasing need for early, vigorous, and more effective treatment of these lesions.

Adult↗
PubMed1984

Local hyperthermia in combination with definitive radiotherapy: increased tumor clearance, reduced recurrence rate in extended follow-up.

Fifty-nine patients with superficial malignancies appropriate for treatment with definitive radiotherapy and technically suitable for application of local microwave hyperthermia were available for at least 6 months follow-up. Thirty-one of these patients presented with two lesions, only one of which was heated, the other serving as internal control. The responses of the lesions which were heated were compared with those receiving only radiation. The heated lesions responded more quickly, reconfirming observations previously made. However, at subsequent 6 months, 1 year, 18 months and 2 years follow-ups, tumor clearance was shown to be significantly more complete as compared with the internal controls. At 6 months follow-up complete response with combined therapy was observed in 27 of 31 lesions (87%) in contrast to complete response in 12 of 31 (39%) lesions treated with radiotherapy alone. At one year combined modality treatment produced complete response in 19 of 19 lesions (100%) while radiotherapy alone yielded complete response in 10 of 19 lesions (53%). At 18 months, 8 of 9 lesions (89%) treated with combined therapy remained controlled, 1 having recurred. Seven of 9 (78%) treated by radiotherapy alone were controlled, 2 having recurred. At 2 years, 6 patients were available for follow-up and 6 of 6 (100%) of lesions treated with combined modality remained controlled. Among those treated by radiotherapy alone, 5 of 6 (83%) remained controlled, while 1 recurred. The rate of tumor recurrence among the heated lesions was significantly lower than was found among the controls. The recurrence rate among the controls was similar to that expected in a similar group of patients treated with definitive radiotherapy. Therefore, in addition to its established capability to shrink tumors, hyperthermia in combination with radiotherapy has been shown to increase the rate of overall tumor clearance and reduce recurrences compared with that obtained from radiotherapy alone.

Adult↗
PubMed1984

Treatment of poorly controlled non-insulin-dependent diabetic patients with Acarbose.

Acarbose, 300 mg/day, was administered over one month in a cross-over trial to 18 hyperglycemic patients aged 41-66 years with non-insulin-dependent diabetes mellitus (NIDDM). All showed "normal" or exaggerated insulin release after a glucose challenge and remained in poor control (random glucose levels greater than or equal to 13 mmol/l) despite involvement in a diabetes intervention programme and prior use of oral hypoglycemic agents. During the one month treatment with Acarbose, fasting glucose and % HbAl concentrations were not different from those observed during placebo therapy. Furthermore, glucose tolerance was unchanged by Acarbose treatment. Glucose concentrations after a 1.6 MJ test meal were reduced by Acarbose from peak values of 17.3 +/- 1.0 to 15.0 +/- 1.1 mmol/l and were associated with lower post-prandial C-peptide (CPR) and insulin responses. Nevertheless, daily insulin production, as assessed by CPR excretion rates and plasma CPR and insulin concentrations, was not reduced by Acarbose. In fact, fasting plasma insulin and CPR levels were significantly higher during Acarbose then placebo therapy. Acarbose (100-400 mg/day) was continued for six months in 12 of these patients. During treatment, post-prandial glucose levels remained lower but monthly MBG values, determined by self-measurement of blood glucose, were unchanged except for small reductions in the 4th and 5th treatment months. % HbAl levels did not change. These data show that Acarbose treatment of a defined group of patients with poorly controlled NIDDM: resulted in small but sustained reductions of post-prandial glucose levels but without improving glucose tolerance, and reduced the circulating concentrations of insulin and CPR postprandially, but overall did not reduce daily production.

Acarbose↗