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Biomedical subjects

S M Scott

Publications and source records attributed to S M Scott.

At least 91 records · Page 5Linked to original sources

Soft tissue fibrosarcoma. A clinicopathologic study of 132 cases.

Over the last 20 to 30 years, a recognition and general acceptance of the entity of malignant fibrous histiocytoma and monophasic synovial sarcoma has occurred. The introduction of these diagnostic categories among the generic group of spindle cell sarcomas now requires a reevaluation of the more traditional and historic entity of fibrosarcoma and the clinical ramification of this diagnosis. A review of 132 cases of fibrosarcoma using current diagnostic criteria was undertaken to clarify the behavior of fibrosarcoma as diagnosed in current patients. Special attempts were made to correlate histologic grade and Enneking stage in fibrosarcomas in an effort to correlate their predictive value in metastatic rate and survival.

Actuarial Analysis↗

Effects of classical and atypical antipsychotic drugs on isolation-induced aggression in male mice.

A series of classical, atypical and putative antipsychotic drugs were compared for their ability to inhibit isolation-induced intraspecies aggression with affinity for D-2 dopamine receptors and induction of akinesia. The majority of drugs tested significantly inhibited aggressive behavior only after doses that greatly decreased the ability of mice to move. Even though akinesia seemed to account for inhibition of aggression there was no apparent correlation with binding to striatal D-2 receptors.

Aggression↗

"Benign" metastasizing giant cell tumor: evaluation of nuclear DNA patterns by flow cytometry.

Nuclear deoxyribonucleic acid (DNA) ploidy was determined by flow cytometry for nine histologically benign giant cell tumors that developed systemic metastases and for eight tumors that did not metastasize. Specimens from the primary tumor, local recurrences, and pulmonary metastases were evaluated. No feature of the DNA ploidy pattern was identified to distinguish giant cell tumors that metastasized from those that did not. The mean percentage of diploid (G0/G1 peak, 2C) cells was 81% in the metastasizing group and 80% in the nonmetastasizing group. The DNA ploidy pattern of the primary tumors was not different from that of their metastases. No DNA aneuploid patterns were observed among the benign tumors.

Cell Nucleus↗

Immunoreactive human epidermal growth factor concentrations in amniotic fluid, umbilical artery and vein serum, and placenta in full-term and preterm infants.

Immunoreactive human epidermal growth factor (IR-hEGF) was measured in samples taken from 27 full-term and 14 preterm infants. The samples included amniotic fluid, amniotic membranes, fetal and maternal sides of the placenta, and matched umbilical artery and umbilical vein serum. Our results demonstrated the presence of IR-hEGF in the human placenta, amniotic fluid and cord blood during the second half of gestation. The increase in placental tissue, amniotic fluid, and cord blood concentration with progressive gestation suggests a possible functional role for EGF during perinatal development.

Amniotic Fluid↗

Medical compared with surgical management of unstable angina. 5-year mortality and morbidity in the Veterans Administration Study.

We evaluated medical in comparison to surgical plus medical (surgical) treatment of unstable angina using a prospective randomized protocol that stratified patients by clinical presentation and by invasive evaluation of left ventricular (LV) function. Clinical presentations were as follows--type 1: progressive or new onset angina relieved by medication; type 2: prolonged bouts of angina poorly or incompletely relieved by medication. Abnormal LV function was arbitrarily defined as ejection fraction less than 0.50 or LV end-diastolic pressure 16 mm Hg or more. Of 468 patients, 237 were assigned to medical and 231 to surgical therapy. There were 374 type 1 and 94 type 2 patients. LV function was normal in 334 and abnormal in 134 patients. Compared with results at 24 months, this 60-month follow-up study showed important differences in survival for patients with three-vessel disease: 75% for medical and 89% for surgical patients (p less than 0.02). The cumulative 5-year rate of repeat hospitalizations for cardiac reasons was less with surgical patients for either clinical presentation. For type 1, medical patients had a 56% rate, and surgical patients had a 42% rate (p = 0.004). For type 2, medical patients had a 62% rate, and surgical patients had a 43% rate (p = 0.05). Overall mortality did not differ between the two treatments, and this remained true in type 1 versus type 2 patients and in those with normal versus abnormal LV function. However, regression analysis of medical and surgical groups with ejection fraction as a continuous variable showed that mortality of medical patients depended on ejection fraction (p = 0.004), whereas the mortality of surgical patients did not (p = 0.76), and survival in the surgical group was higher in the lowest ejection fraction tercile-73% for medical and 86% for surgical patients, p = 0.03. We conclude that surgery improves survival in patients with three-vessel disease and leads to fewer subsequent hospitalizations for cardiac reasons. An impaired ejection fraction had an adverse impact on survival of medical patients but not on surgical patients, and mortality in surgical patients was improved compared with medical patients in the lowest ejection fraction tercile.

Angina Pectoris↗

Effect of congenital renal disease and neonatal thyroid status on urinary human epidermal growth factor concentrations.

We have previously demonstrated that changes in urinary epidermal growth factor/creatinine ratios relate to gestational age and gender. It is unclear what controls this developmental pattern although chronic renal disease and thyroid aberrations have significant effects on epidermal growth factor and creatinine excretion in childhood and in adults. Therefore, we chose to explore the effects of these disease states on epidermal growth factor excretion during the perinatal time period. We collected urine samples from 8 infants with congenital renal disease and 45 infants with low T4 and normal TSH values who 'failed' the newborn screen. In addition, 2 infants with hypothyroidism and 2 infants with neonatal Grave's disease had urine samples examined. Values were compared with the epidermal growth factor and creatinine excretion from 190 infants. We demonstrated that epidermal growth factor excretion increased earlier in gestation than does creatinine excretion. In infants with renal disease or hypothyroidism, epidermal growth factor excretion was decreased while hyperthyroidism enhanced excretion. Epidermal growth factor excretion increased with relief of an obstruction but still remained low and creatinine excretion was unchanged. We confirm that in preterm infants as in childhood there are similar effects of thyroid and renal diseases on epidermal growth factor excretion.

Congenital Hypothyroidism↗

Reversal of neuroleptic-induced catalepsy by novel aryl-piperazine anxiolytic drugs.

The novel anxiolytic drug, buspirone, reverses catalepsy induced by haloperidol. A series of aryl-piperazine analogues of buspirone and other 5-hydroxytryptaminergic agonists were tested for their ability to reverse haloperidol induced catalepsy. Those drugs with strong affinity for 5-hydroxytryptamine1a receptors were able to reverse catalepsy. Drugs with affinity for other 5-HT receptors or weak affinity were ineffective. However, inhibition of postsynaptic 5-HT receptors neither inhibited nor potentiated reversal of catalepsy and leaves open the question as to the site or mechanism for this effect.

Animals↗

The forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee.

Posteroanterior weight-bearing radiographs, made with the knee in 45 degrees of flexion, were compared with conventional radiographs for fifty-five patients who had surgical treatment for a lesion causing pain in one knee. Narrowing of the cartilage space of two millimeters or more was defined as indicative of major degeneration (grade III or IV). Comparison of the intraoperatively observed degeneration with the narrowing that was seen on the radiographs revealed that the posteroanterior weight-bearing radiographs that were made with the knee in 45 degrees of flexion were more accurate (p less than 0.01), more specific (no false-positives) (p less than 0.01), and more sensitive (fewer false-negatives) than the conventional extension weight-bearing anteroposterior radiographs.

Adult↗

Veterans Administration Cooperative Study for treatment of patients with unstable angina. Results in patients with abnormal left ventricular function.

In a prospective randomized trial, 468 patients with unstable angina pectoris who were stratified according to clinical presentation (Type I or Type II angina) and left ventricular function (normal or abnormal) were assigned to medical or surgical treatment groups. Left ventricular function was defined as abnormal if the ejection fraction was less than 0.50, or if the end-diastolic pressure was 16 mm Hg or greater. Left ventricular function was abnormal in 134 patients, 66 of whom were assigned to surgical and 68 to medical treatment groups. The cumulative 3-year mortality for surgical patients was 6.1% and for medical patients, 17.6% (p = 0.039). This 3-year figure represents a 65% reduction in mortality with surgery. Survival was significantly better for surgical patients whose ejection fractions ranged from 0.30 to 0.49 (p = 0.05). Survival of patients whose ejection fractions were greater than 0.69 was better with medical treatment (p = 0.049). Thus, surgery appears to be the treatment of choice for patients with unstable angina pectoris and abnormal left ventricular function.

Aged↗

Comparison of medical and surgical treatment for unstable angina pectoris. Results of a Veterans Administration Cooperative Study.

We conducted a multicenter, randomized, prospective study comparing medical therapy alone with coronary-artery bypass surgery plus medical therapy in 468 men with unstable angina pectoris. Patients were entered in the study from June 1, 1976, to June 30, 1982. Among those assigned to surgery who received bypass grafts, operative mortality was 4.1 percent. Arteriography performed after one year of follow-up revealed that 74.8 percent of the grafts studied were patent. The cumulative rate of crossover from medical to surgical therapy after two years was 34 percent; the operative mortality among patients crossed over was 10.3 percent. Nonfatal myocardial infarction occurred in 11.7 percent of the patients treated surgically and 12.2 percent of those treated medically (no significant difference). Most of the nonfatal myocardial infarctions in the surgical group occurred in the perioperative period. Overall, the two-year survival rate computed by life-table analysis did not differ between the two groups. However, the curves reflecting mortality as a function of left ventricular ejection fraction were significantly different (P = 0.03); surgery was associated with a significantly reduced mortality among patients with lower ejection fractions. We conclude that patients with unstable angina pectoris have a similar outcome after two years whether they receive medical therapy alone or coronary bypass surgery plus medical therapy. However, patients with reduced left ventricular ejection fractions may have a better two-year survival rate after coronary bypass surgery.

Adrenergic beta-Antagonists↗

Effects of gepirone, an aryl-piperazine anxiolytic drug, on aggressive behavior and brain monoaminergic neurotransmission.

Gepirone (BMY 13805), a buspirone analog, was used to determine the antianxiety mechanism of the arylpiperazine class of drugs. Because of the weak effects of these drugs on conflict behavior, isolation-induced aggressive mice were used as the antianxiety model. Gepirone, like buspirone, potently inhibited attacks against group housed intruder mice (ED50 = 4.5 mg/kg i.p.) without causing sedation or ataxia. Inhibition of aggression was potentiated by co-administration of 0.25 mg/kg methiothepin or 2.5 mg/kg methysergide. Gepirone had variable effects on dopamine metabolism and reduced 5-hydroxytryptamine (5HT) metabolism about one third after a dose of 2.5 mg/kg. In contrast to buspirone, which markedly increased dopaminergic impulse flow, gepirone inhibited the firing of most cells recorded from the substantia nigra zona compacta in doses of 2.3-10 mg/kg i.v. and the effects were reversible by administration of haloperidol. The common metabolite of buspirone and gepirone, 1-(2-pyrimidinyl)-piperazine, caused increased firing rates only. Gepirone potently inhibited serotonergic impulse flow recorded from the dorsal raphe nucleus (88.3% after 0.04 mg/kg) and this effect was partially reversed by serotonergic antagonists. Both buspirone and gepirone displaced [3H]-5HT from the 5HT1a binding site in the hippocampus with IC50 values of 10 and 58 nM, respectively. Non-alkyl substituted aryl-piperazines displaced [3H]-5HT from both 5HT1a and 5HT1b binding sites. Thus, although gepirone may be a weak postsynaptic 5HT agonist, its primary effect is to decrease 5HT neurotransmission. In support of this conclusion was the observed potentiation of antiaggressive effects by blocking 5HT receptors wit small doses of methiothepin or methysergide, which would exacerbate the decreased release of 5HT caused by gepirone. These results are in harmony with reports that decreased serotonergic activity has anxiolytic-like effects in animal models of anxiety.

Aggression↗

Technetium-99m imaging of bone trauma: reduced sensitivity caused by hydrocortisone in rabbits.

This study evaluates the effect of hydrocortisone on the sensitivity of 99mTc-scintigraphy for the detection of bone trauma in three groups of rabbits: a control group that received no hydrocortisone, a low-dose group that received 0.8 mg/kg/day, and a high-dose group that received 20 mg/kg/day. Scintigrams of the tibial diaphyses were obtained at 48 hr, 1 week, 2 weeks, and 3 weeks after surgical creation of a simulated fracture (a 1.5-mm hole in the cortex). The mean sensitivity for detecting fractures in control animals was 95% at 48 hr and 100% at all other times. Mean sensitivity for rabbits given the high dose of hydrocortisone was 41% at 48 hr. Mean sensitivity for the low-dose group was 75% at 48 hr, but this was not significantly different from the control group. Sensitivity in both groups treated with hydrocortisone improved with time. At 3 weeks, the mean was 93% in the low-dose group and 83% in the high-dose group. These data suggest that 99mTc scintigraphy may be less sensitive in detecting bone trauma in patients on glucocorticoid therapy than in patients in the general population.

Animals↗

Clinical, hemodynamic, and angiographic predictors of operative mortality in patients undergoing single valve replacement. Veterans Administration Cooperative Study on Valvular Heart Disease.

Preoperative characteristics of 964 patients in the Veterans Administration Cooperative Study on Valvular Heart Disease undergoing single valve replacement were examined to determine predictors of operative mortality. The operative mortality rate was 8.3% in 661 patients having isolated aortic valve disease and 7.5% in 239 patients having isolated mitral valve disease, but 12.5% in 64 patients with multivalve disease undergoing single valve replacement. For the aortic valve replacement subgroup, three-vessel coronary artery disease, left ventricular systolic pressure, prior cardiac operation, body surface area, and cardiac index were related to operative mortality. In the mitral valve replacement group, there was a strong association of operative mortality with advanced age, exertional dizziness, reduced cardiac index, left ventricular contraction grade, ST segment depression on the resting electrocardiogram, and pleural effusion. The risk of operative death for an individual patient undergoing aortic or mitral valve replacement may be estimated with the use of independent risk factors.

Adult↗

Arthroscopic meniscal repair evaluated with repeat arthroscopy.

Arthroscopic meniscal repair is a technically feasible approach to the treatment of meniscal tears in young active individuals. To evaluate this premise, we repaired 29 minisci in 27 patients and then arthroscoped their knees 3 months later. Repairs were limited to displaceable longitudinal tears. In 16 patients ligaments were intact. Eleven patients were anterior cruciate ligament deficient, six of whom underwent concomitant ACL reconstructions. In two patients, bicompartmental tears were encountered. Under arthroscopic control, using curved cannulae, horizontal mattress sutures of absorbable monofilament were placed across the tear, out through the capsule, and tied over the fascia, deep to the skin. No arthrotomies were performed, and all portions of the menisci could be reached with this method. Twenty-four of 29 repairs healed completely; 5 healed partially (30 to 50% healing). Four of the five failed repairs occurred in unstable anterior cruciate ligament deficient knees.

Adolescent↗

Effect of thyroid hormone and sex status on epidermal growth factor concentrations in the submandibular gland of a congenitally hypothyroid mouse model.

Studies were performed to explore the role of thyroid hormone and sex status on epidermal growth factor concentrations in the submandibular gland of a congenitally hypothyroid mouse model designated hyt/hyt. The animals were studied at 20, 30 and 40 days of postnatal age. The euthyroid animals were homozygous or heterozygous for the hypothyroid gene. The homozygous euthyroid animals displayed a pattern of submandibular gland epidermal growth factor concentrations similar to those previously described in other mouse species and showed the expected sex differences. The hypothyroid animals had measurable but very low submandibular gland epidermal growth factor concentrations without sexual dimorphism. Serum thyroxine concentrations in the heterozygotes were comparable to those in the homozygous euthyroid animals, yet the animals had a delayed increase in epidermal growth factor concentrations combined with a later expression of female-male differences. The timing of the sex differences in submandibular gland epidermal growth factor concentrations followed a pattern similar to that seen for the timing of the first litter in these three genetically distinct groups. This infers the timing of the onset of puberty and suggests a role of androgens in the changes seen in epidermal growth factor concentrations. We conclude that thyroid hormone and sex status in this mouse model influence the pattern and concentrations of submandibular gland epidermal growth factor concentrations.

Animals↗