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Biomedical subjects

R S Scott

Publications and source records attributed to R S Scott.

At least 109 records · Page 6Linked to original sources
PubMed1983

Utilisation of health services by diabetic patients. 1: The district nursing service.

In 1981 the district nursing service in Christchurch was making 590 home visits, on a weekly basis, to 73 patients for the purposes of drawing up and injecting insulin. This was 13.9% of their total workload. Through a programme of education many were able to manage the injection technique totally. In other cases the provision of pre-loaded syringes permitted less frequent attendance by the district nurse. At survey, one year later, the patient numbers visited had fallen to 46, and the number of weekly visits had been reduced by half. These results show the benefits of research programmes, aimed at evaluation of health delivery, with a view to improving their efficiency and reducing their cost.

Aged↗
PubMed1983

Hyperthermia in combination with radiotherapy: a review of five years experience in the treatment of superficial tumors.

Facilities for regional tumor hyperthermia has been in use at RPMI since 1976, and have been routinely used to treat patients according to protocol since 1977. Hyperthermia delivery has been exclusively by microwave using 434 MHz, 915 MHz and 2450 MHz. Greatest success at reaching tumor temperatures of 43-44 degrees C with minimal skin heating was obtained using 915 MHz. The majority of the patients were treated with this frequency. Approximately 125 patients have been treated and 70 have achieved completion of therapy and follow-up. Follow-up has been at least one month and several patients have been followed for one to two years. Initially, for entry into the hyperthermia protocol, patients were required to have three or more lesions. One lesion on each patient was treated with 800 rad fractions repeated three times on a 72 hour schedule. The second lesion was treated with 700 rad fractions and the third with 500 rad plus hyperthermia on the same schedule. Twelve patients with multiple melanoma lesions completed this study. One of 12 patients showed no response to the combination of hyperthermia plus radiotherapy, while four showed no response to radiotherapy alone. Of eight patients who survived three months, all lesions treated by hyperthermia plus radiotherapy responded completely, while only five lesions treated by radiotherapy alone so responded. In a second study, 58 patients with superficial tumors were treated by a protocol where hyperthermia was added to optimal conventional radiotherapy. Of the total, 43 patients had complete tumor response at follow-up varying from one month to 18 months. A subgroup of 24 of these patients had two lesions, one of which was treated with hyperthermia in addition to radiotherapy while the other served as control, receiving radiotherapy only. Nineteen lesions demonstrated complete response to hyperthermia plus radiotherapy, while only 14 of the controls had complete response. None of the lesions treated with hyperthermia responded less well than those treated by radiotherapy alone. Morbidity, as measured by skin reaction, was rarely increased in the heated field.

Adenocarcinoma↗
PubMed1983

Insulin secretory capacity in newly diagnosed non-insulin dependent diabetics.

Plasma insulin was measured fasting and after iv glucose in fifteen newly diagnosed non-grossly obese non-insulin dependent diabetics. Two-thirds had normal fasting insulin (less than 13 mU/L) and all had sub-normal responses to iv glucose. There was no significant correlation between fasting or stimulated insulin concentrations and body weight. Six subjects with totally "flat" response to iv glucose were tested after a standard 4MJ meal and after 75 g oral glucose. They now showed normal profiles of later phase insulin release to the meal test or oral glucose and a significant increase in early phase insulin concentration, but this response was still blunted when compared with control subjects. We conclude that for non-grossly obese NIDDs (1) insulin deficiency is a common and important disorder and (2) there may be a loss of beta cell sensitivity to blood glucose with retention of sensitivity to gut mediated factors.

Adult↗
PubMed1982

The specificity of inhibin bioassay using cultured pituitary cells.

It has been established that the inhibition of the cellular content of FSH in cultured pituitary cells can be used as a sensitive and precise bioassay for inhibin. During studies on the inhibin content of human plasma, FSH suppression was noted to occur together with LH suppression. Further studies revealed that where combined FSH and LH suppression occurred, cytological changes in the pituitary cells suggestive of toxicity were found, indicating non-specific effects of these substances. Charcoal treatment or gel filtration of seminal plasma removed or separated the toxic substances from the inhibin activity, the latter characterized by FSH suppression parallel to the standard preparation, no LH suppression and no light-microscopic changes in pituitary cells. It is recommended that careful evaluation of all inhibin bioassay systems should be undertaken to detect substances producing non-specific effects and additional guidelines for the assessment of specificity are suggested.

Animals↗
PubMed1981

Home monitoring of blood glucose in diabetic pregnancy.

A study of home monitoring of blood glucose in diabetic pregnancy was made by a retrospective analysis of medical records of women who attended Christchurch Women's Hospital from 1976 to 1980. Of 20 previously-diagnosed insulin-dependent diabetics eight had used home blood glucose meters during pregnancy. The meter users spent on average 23.9 fewer days in hospital and attended on average 4.2 more antenatal clinics. Otherwise management and outcome were equivalent. We conclude that home monitoring of blood glucose is an effective and safe means of minimising hositalisation in diabetic pregnancy without compromising outcome.

Apgar Score↗
PubMed1981

Self-monitoring of blood glucose: an evaluation of the BM test glycemie 20-800 system.

Concentrations of whole blood glucose were measured using two different glucose oxidase impregnated test-strips. The recordings obtained by one observer with Dextrostix were compared with those recorded by an independent observer using BM Test Glycemie 20-800 strips. Dextrostix need a reflectance meter (Ames-Eyetone or Hypocount) for accurate quantitation whereas the BM Test Glycemie 20-800 strips can be read by eye alone. These two semi-quantitative methods for self-monitoring of blood glucose gave similar results over the range 2.2 to 22.0 mmol glucose per litre. The BM Test Glycemie 20-800 strips however are technically easier to use than the Dextrostix in that there is less error if the operator fails to comply exactly with instructions regarding exposure time to the drop of blood. They furthermore eliminate the need for a reflectance meter.

Blood Glucose↗
PubMed1981

An inverse relationship exists between seminal plasma inhibin and serum follicle-stimulating hormone in man.

Inhibin concentrations were measured in 109 seminal plasma samples obtained from 32 normal subjects, 51 infertile patients with either azoospermia or oligospermia, and 20 patients 2-8 months post vasectomy. The infertile group included 14 azoospermic patients with raised peripheral plasma FSH levels (6.8-30.2 IU/liter) and 17 azoospermic patients in whom FSH levels were normal. Only 6 of the 20 patients with oligospermia had raised FSH levels. Seminal plasma inhibin was measured in individual samples using a quantitative in vitro rat anterior pituitary cell culture bioassay in which FSH cell anterior pituitary cell culture bioassay in which FSH cell content was measured after 72 h of incubation with the inhibin-containing material. Biopotencies were determined using combined multiple parallel line assays with reference to an inhibin standard with a potency of 1 U/mg. The concentrations of inhibin in normal seminal plasma were 31.4 +/- 3.0 U/ml, which contrasted with the low levels found in azoospermic patients with high plasma FSH levels. Of these, seven had undetectable inhibin levels (less than 2.5 U/ml) and seven had values ranging from 4.2-8.5 U/ml. These concentrations were significantly lower than those in azoospermic patients, in whom FSH was not raised (18.9 +/- 2.2 U/ml). Seminal plasma inhibin levels post vasectomy were 16.9 +/- 2.3 U/ml and were not significantly different from those measured in azoospermic-normal FSH patients. Peripheral plasma FSH levels were expressed as a function of seminal plasma inhibin concentrations (r = -0.736; P less than 0.001; excluding those patients with vasal obstruction). These findings show that inhibin-like activity in seminal plasma is reduced in infertile men with raised peripheral plasma FSH levels, and that a reciprocal inverse relationship exists between serum FSH and seminal plasma inhibin concentrations.

Follicle Stimulating Hormone↗
PubMed1980

Inhibin is absent from azoospermic semen of infertile men.

There is ample evidence that the secretion of follicle stimulating hormone (FSH) by the pituitary gland is regulated by a nonsteroidal hormone of gonadal origin, termed inhibin. In several species, testicular extracts, gonadal lymph and seminal plasma have been shown to contain proteins which inhibit FSH release; lack of suitable assays for inhibin has, however, prevented clear definition of its physiological significance. Men whose tests show the histological changes of germinal cell failure usually have raised FSH levels in the blood, but may have normal levels of luteinizing hormone (LH) and testosterone. Such patients would thus be predicted to show reduced inhibin production. To test this, we have measured the FSH inhibitory activity of seminal plasma from azoospermic subjects with raised plasma FSH levels. We report here our confirmation of diminished inhibin levels in seminal plasma of these patients, thus providing convincing support for its physiological role as a modulator of FSH production in man.

Follicle Stimulating Hormone↗
PubMed1980

Free insulin, C-peptide and glucagon profiles in insulin dependent diabetes mellitus.

Glucose and hormone profiles, including plasma levels of glucagon, GH, total insulin, free immunoreactive and biologically active insulin were determined by hourly sampling in two groups of insulin dependent diabetics. The five patients in Group I were recently diagnosed and still had residual beta-cell function. The other six in Group II had disease of longer duration, had developed insulin antibodies, and were non-secretors of C-peptide. All patients were studied while receiving their usual maintenance doses of Semilente monocomponent insulin (Novo). Daily insulin requirements were 25.6 +/- 4 U in Group I and 52.2 +/- 7 U in Group II. The glucose profiles were similar in the periprandial periods but over the whole 24-hour period control was more unstable in the patients of Group II and during the period 2400-0200 h plasma glucose fell to low levels (minimum plasma glucose 1.5-3.0 mmol/l). Free insulin levels rose to peak levels over a similar time course but then fell more slowly in the Group II subjects. These patients had higher free, biologically active insulin and lower glucagon levels which were coincident in time with the early morning hypoglycaemia. These observations suggest that raised free insulin levels in the setting of an impaired counter-regulatory glucagon response are one of the factors contributing to glucose instability in long-standing diabetics.

Adolescent↗
PubMed1980

A simple and rapid in vitro bioassay for inhibin.

This report describes a quantitative bioassay for inhibin which can be used to monitor purification and establish the physiological role of this hormone in spermatogenesis and folliculogenesis. Anterior pituitary cells from adult male Sprague-Dawley rats were dispersed and precultured for 18 h before the addition of inhibin-containing materials to the culture medium. After a further 72 h in culture, the medium was removed by aaspiration, and the cells were lysed releasing their intracellular hormone into RIA buffer. Cell content of FSH was reduced in inhibin-containing preparations, but without changes in LH, GH, and PRL concentrations. The inhibin dose-response curve, based on the inhibition of FSH in 15 experiments using an ovine testicular lymph preparation as a standard, had indices of precision between -0.032 and -0.098, and Finney's g ranged from 0.003--0.025. The interassay variability ranged from 15.0--16.9%. The assay had a practical capacity of 300--400 wells, which permitted the measurement of dose-response curves of 15 or more unknowns with quadruplicate wells per dose. The potency of unknown preparations was calculated with reference to the inhibin standard, which had a designated potency of 1 U/mg. Preparations showing nonparallelism were excluded. This assay presented advantages over those described previously, since it showed specificity of response to FSH and accommodated a large number of samples without loss of precision or reproducibility. It is therefore suitable for measurement of the inhibin-like activity in some biological fluids.

Animals↗
PubMed1979

A clinical study of the effects of galvanic vaginal muscle stimulation in urinary stress incontinence and sexual dysfunction.

A preliminary study was designed to test the effect of pelvic for pelvic floor stimulation using the Vagette, a galvanic device, on the symptoms of urinary stress incontinence and pelvic relaxation. A significant improvement in pelvic muscle strength was observed as measured by the Kegel meter. This effect was seen within a short period of treatment. It is suggested from the study that the Vagette may be used for short-term therapeutic trial for urinary stress incontinence and pelvic relaxation before surgery is considered.

Electric Stimulation Therapy↗
PubMed1979

Intermittent Cushing's disease with spontaneous remission.

A patient with well documented Cushing's syndrome, associated with excessive secretion of ACTH, was studied over a 20 month period. During this time there were three episodes of spontaneous biochemical remission and except for a 7 day period of exacerbation the patient has had normal cortisol production for the last 15 months. During this recent prolonged remission period, repeat pituitary function testing demonstrated persistent abnormalities of the hypothalamic pituitary axis, in that ACTH failed to respond to a hypoglycaemic stimulus. However in all other respects adrenal function was normal with preservation of diurnal rhythmicity of cortisol and ACTH, and intact dexamethasone suppressability of cortisol. The additional unusual features of normal GH and TSH responses to stimulation, during either remission or exacerbation, suggest a subtle and localized hypothalamic defect in this case.

Adrenocorticotropic Hormone↗
PubMed1978

Plasma ACTH and cortisol profiles in Addisonian patients receiving conventional substitution therapy.

Plasma ACTH and cortisol profiles were studied over 24 h in five Addisonian patients maintained in good health by conventional gluco- and mineralocorticoid treatment. Patients received their usual treatment (15--30 mg cortisol daily) in divided doses at 08.00 and 16.00 hours. Plasma cortisol concentrations differed from those of control subjects in being higher from 08.00 hours-noon and 17.00-18.00 hours and were unmeasurable (less than 20 nmol/l) during the period of active cortisol secretion (03.00-08.00 hours) observed in normal subjects. Peak plasma ACTH levels (618- greater than 1600 ng/l) occurred at 08.00-09.00 hours in the Addisonian patients and were much greater than those seen in control subjects (60-220 ng/l). Despite this, plasma ACTH fell promptly within 3 h of the morning dose to less than 100 ng/l and levels were indistinguishable from those seen in normal subjects over the period 12.00-02.00 hours. These results show that there are substantial differences between treated Addisonian and control subjects in respect of plasma cortisol and ACTH concentrations. The findings may lead to a better understanding of ACTH-cortisol relationships in disease states, including congenital adrenal hyperplasia where control of excessive ACTH secretion is clinically desirable.

Addison Disease↗