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Biomedical subjects

A A Scott

Publications and source records attributed to A A Scott.

At least 19 recordsLinked to original sources
PubMed2000

Psychosocial predictors of satisfaction among orthognathic surgery patients.

This study assessed the usefulness of selected psychosocial tests and demographic measures in identifying satisfied versus dissatisfied patients who received orthognathic surgery. Data were collected prior to placement of orthodontic appliances, 1 to 2 weeks presurgery, and at 1 week, 8 weeks, 6 months, 12 months and and 2 years postsurgery. The Revised Symptom Checklist-90 (SCL-90-R) scales, the Eysenck Personality Inventory (EPI), the Sickness Impact Profile (SIP), and the Oral Health Status Questionnaire (OHSQ) were used as independent variables. Indicators from the Post-Surgical Patient Satisfaction Questionnaire (PSPSQ), which assesses patient satisfaction regarding psychosocial issues, oral functioning, and esthetics, served as a postsurgical dependent measure of patient satisfaction. Thirty-one male and 86 female subjects participated in the multisite randomized trial comparing rigid and wire fixation. Patient age was significantly correlated with patient satisfaction from 8 weeks postsurgery through 2 years postsurgery. Older patients appear to report greater postsurgical satisfaction in comparison to younger patients. The postsurgical OHSQ (esthetics subscale) and postsurgical PSPSQ (satisfaction) were significantly related at 8 weeks, 6 months, 12 months, and 2 years postsurgery. Additionally, PSPSQ (satisfaction) and postsurgical OHSQ (general oral health scale) were correlated at 12 months. The EPI, SIP, and SCL-90-R were not significantly associated with postsurgical satisfaction when assessing the entire study sample. Postsurgical qualitative data from the PSPSQ indicated that 50% of the patients reported positive outcomes in oral functioning. Sixty-five percent reported esthetic improvements, and 37% reported neurosensory loss.

Adult↗
PubMed1999

Cutaneous Waldenstrom macroglobulinemia in transformation.

Waldenstrom macroglobulinemia is a low-grade B-cell lymphoproliferative disorder of the elderly with characteristic monoclonal IgM-producing neoplastic infiltrates of the bone marrow, lymph node, and spleen. Cutaneous manifestations are usually nonspecific such as purpura, ulcers, and urticarial lesions. These lesions are caused by hyperviscosity of the blood, immune complex-mediated vascular damage, paraprotein deposition, and amyloid deposition. Specific skin lesions occur rarely and generally consist of translucent, flesh-colored papules composed of monoclonal IgM deposits. Rarely, there may be violaceous lesions composed of low-grade lymphoplasmacytic infiltrates characteristic of Waldenstrom macroglobulinemia. Both cutaneous manifestations of the disease, as well as disease transformation to high-grade, large cell lymphoma are rare. We report two very unusual cases of Waldenstrom macroglobulinemia with documented skin disease that demonstrated transformation to high-grade lymphoma. Both patients were elderly men with long-standing Waldenstrom macroglobulinemia involving the bone marrow, who subsequently developed skin involvement by the disease. Waldenstrom macroglobulinemia can rarely manifest as cutaneous disease, sometimes as a high-grade transformation of low-grade Waldenstrom macroglobulinemia elsewhere. Distinction of cases of transformed Waldenstrom macroglobulinemia from de novo cutaneous large cell lymphoma may be important, because the two entities are likely biologically different.

Aged↗
PubMed1999

Psychosocial predictors of high-risk patients undergoing orthognathic surgery.

The purpose of this analysis was to identify a set of predictor variables that are prospectively related to postsurgical outcomes. Specifically, psychosocial characteristics were sought to predict postsurgical outcomes. The 5 Revised Symptom Checklist-90 (SCL-90-R) scales, the neuroticism score of the Eysenck Personality Inventory (EPI), the psychosocial domain score from the Sickness Impact Profile (SIP), and 4 scales from the Oral Health Status Questionnaire (OHSQ) were used as the predictors. A total of 31 male and 86 female subjects participated in this multicenter randomized trial, which compared rigid and wire fixation. Data were collected prior to placement of orthodontic appliances, 1 to 2 weeks presurgery, and at 1 week, 8 weeks, 6 months, and 2 years after surgery. Baseline oral health was used as an indicator of postsurgical oral health functioning. A path analytic model of influences on presurgical oral health was estimated (R2 = 0.43). The results suggest that presurgical screening of demographic characteristics (age, sex, and ethnicity), oral health (the OHSQ), quality of life issues (SIP), and personality features (SCL-90-R), accounts for 23% to 39% of the variance in postsurgical oral health outcomes. The path analysis conducted suggests that a patient's age, ethnicity, gender, and elevated scores on the EPI have indirect effects on postsurgical health. As determined by a 2-stage least squares regression model, 3 variables--the patient's presurgical oral health (per the OHSQ), pre- and postsurgical Global Severity Index (GSI) score from the SCL-90-R, and the psychosocial scale score from the SIP--were found to have a statistically significant impact on postsurgical outcomes. Additionally, the GSI, SIP, and OHSQ are reliable measures in predicting oral health outcomes.

Adult↗
PubMed1995

Clinical and molecular characterization of a rare syndrome of acute promyelocytic leukemia associated with translocation (11;17).

Analysis of a variant translocation t(11;17) in a case of acute promyelocytic leukemia (APL) led to discovery of a novel zinc finger gene, PLZF, fused to the retinoic acid receptor-alpha (RAR alpha) gene. We reviewed the clinical and molecular features of five additional patients with t(11;17)-associated APL. The clinical course of three patients was characterized by early death and three experienced disseminated intravascular coagulation. Morphologically all of the patients fell in a unusual morphologic spectrum of APL, with features intermediate between M2 and M3 AML. All six patients had PLZF-RAR alpha gene fusion as detected by reverse transcription/polymerase chain reaction assay, Southern blotting, or pulsed-field gel electrophoresis. Five of the six patients failed to achieve complete remission after initial chemotherapy or differentiation therapy with all-trans retinoic acid (ATRA). A sixth patient responded to initial chemotherapy, but on relapse failed to respond to ATRA. When tested in vitro, cultured cells from three of the patients failed to differentiate in response to ATRA. APL associated with t(11;17) and fusion of the PLZF and RAR alpha genes is a discrete clinico-pathologic syndrome with a distinctly worse prognosis than t(15;17) APL.

Adult↗
PubMed1995

Hantaviruses: clinical, microbiologic, and epidemiologic aspects.

Hantaviruses comprise a genus of the family Bunyaviridae. Bunyaviruses are enveloped viruses with a negative-sense, tripartite RNA genome. Hantaviruses are etiologic agents for two acute and severe illnesses of man, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Each hantavirus is primarily associated with a single rodent host species or genus, and is transmitted to man through accidental inhalation or ingestion of virus-contaminated rodent excreta. The distribution of hantaviruses is worldwide. HFRS is caused by infection with Hantaan, Seoul, Dobrava/Belgrade, and Puumala hantaviruses, all of which are enzootic in murid rodents of Old World origin. HPS is caused by any of several hantavirus species associated with indigenous New World rodents of the subfamily Sigmodontinae, family Muridae. HFRS and HPS have numerous common epidemiologic, clinical, and laboratory characteristics. Common features include fever, myalgia, thrombocytopenia, neutrophilia, and a profound capillary leak syndrome associated with hypotension, decreased cardiac output, and shock. Worldwide, HPS is much less common than HFRS but is associated with a higher mortality rate. Recovery from hantavirus disease is generally complete, although chronic renal insufficiency may be a rare sequel of HFRS.

Animals↗
PubMed1994

HLA-DR-, CD33+, CD56+, CD16- myeloid/natural killer cell acute leukemia: a previously unrecognized form of acute leukemia potentially misdiagnosed as French-American-British acute myeloid leukemia-M3.

We have identified and characterized a previously unrecognized form of acute leukemia that shares features of both myeloid and natural killer (NK) cells. From a consecutive series of 350 cases of adult de novo acute myeloid leukemia (AML), we identified 20 cases (6%) with a unique immunophenotype: CD33+, CD56+, CD11a+, CD13lo, CD15lo, CD34+/-, HLA-DR-, CD16-. Multicolor flow cytometric assays confirmed the coexpression of myeloid (CD33, CD13, CD15) and NK cell-associated (CD56) antigens in each case, whereas reverse transcription polymerase chain reaction (RT-PCR) assays confirmed the identity of CD56 (neural cell adhesion molecule) in leukemic blasts. Although two cases expressed CD4, no case expressed CD2, CD3, or CD8 and no case showed clonal rearrangement of genes encoding the T-cell receptor (TCR beta, gamma, delta). Leukemic blasts in the majority of cases shared unique morphologic features (deeply invaginated nuclear membranes, scant cytoplasm with fine azurophilic granularity, and finely granular Sudan black B and myeloperoxidase cytochemical reactivity) that were remarkably similar to those of acute promyelocytic leukemia (APL); particularly the microgranular variant (FAB AML-M3v). However, all 20 cases lacked the t(15;17) and 17 cases tested lacked the promyelocytic/retinoic acid receptor alpha (RAR alpha) fusion transcript in RT-PCR assays; 12 cases had 46,XX or 46,XY karyotypes, whereas 2 cases had abnormalities of chromosome 17q: 1 with del(17)(q25) and the other with t(11;17)(q23;q21) and the promyelocytic leukemia zinc finger/RAR alpha fusion transcript. All cases tested (6/20), including the case with t(11;17), failed to differentiate in vitro in response to all-trans retinoic acid (ATRA), suggesting that these cases may account for some APLs that have not shown a clinical response to ATRA. Four of 6 cases tested showed functional NK cell-mediated cytotoxicity, suggesting a relationship between these unique CD33+, CD56+, CD16- acute leukemias and normal CD56+, CD16- NK precursor cells. Using a combination of panning and multiparameter flow cytometric sorting, we identified a normal CD56+, CD33+, CD16- counterpart cell at a frequency of 1% to 2% in the peripheral blood of healthy individuals. Our studies suggest that this form of acute leukemia may arise from transformation of a precursor cell common to both the myeloid and NK cell lineages; thus we propose the designation myeloid/NK acute leukemia. Recognition of this new leukemic entity will be important in distinguishing these ATRA-nonresponsive cases from ATRA-responsive true APL.

Acute Disease↗
PubMed1989

Neonatal renal failure: a complication of maternal antihypertensive therapy.

Persistent anuria was diagnosed in a neonate born to a mother whose pregnancy was complicated by severe hypertension and systemic lupus erythematosus. Severe maternal hypertension necessitated the use of a battery of antihypertensive medications that included enalapril, an angiotensin converting enzyme inhibitor. The role of enalapril in neonatal renal failure is discussed.

Acute Kidney Injury↗
PubMed1989

Aggressive bladder carcinoma in an adolescent. Report of a case with immunohistochemical, cytogenetic, and flow cytometric characterization.

Malignant bladder neoplasms of urothelial origin are rare among children; fewer than 125 cases have been reported. Typically, these tumors are single papillary lesions of low grade and stage that have an excellent prognosis following surgical excision. A grade III transitional cell carcinoma of the bladder occurred in a 14-year-old boy who had no urinary tract malformation, carcinogenic exposure, or family history of cancer. Immunohistochemical stains of the tumor were positive for cytokeratin and high-molecular-weight keratin. The tumor tissue failed to stain with an antibody to the patient's blood group [anti-ABO(H)] but was positive for the Thomsen-Frieden-reich antigen. Flow cytometry of the tumor cells demonstrated a diploid or near-diploid DNA content. A karyo-type of the tumor showed a modal chromosome number of 46 with one reciprocal translocation between chromosomes 17 and 22 and a nonreciprocal translocation between chromosomes 18 and 22. The tumor was unique because of its highly aggressive nature and its diploid chromosome number. This case represents the first indepth characterization of a transitional cell carcinoma in a pediatric patient by flow cytometry and cytogenetics, as well as a variety of immunohistochemical studies including ABO(H) blood group and Thomsen-Freidenreich antigens.

Adolescent↗
PubMed1988

Detection of cytomegalovirus in shell vial cultures by using a DNA probe and early nuclear antigen monoclonal antibody.

An in situ biotinylated DNA probe assay was evaluated as an adjunct to anti-cytomegalovirus early nuclear antigen indirect immunofluorescence and cytopathic effect on cytomegalovirus-infected monolayers in shell vial cultures. Viral infection was detected by early nuclear antigen indirect immunofluorescence at 24 h and by DNA probe assay and shell vial cytopathic effect at 5 days.

Antibodies, Monoclonal↗
PubMed1981

Thrombosis in the upper extremity: use of Doppler ultrasound for diagnosis.

A case of subclavian vein thrombosis which was not detected clinically is described. Doppler ultrasound was used to ascertain the diagnosis. The technique of examination with the Doppler method for upper limb thrombi is described. It is expected that this technique will be as valuable for detection of thrombosis in the upper extremities as it has been shown to be in lower extremities. This is important because the incidence of deep vein thrombosis has increased with the frequent use of indwelling central venous catheters and because of increased awareness of the possibility and dangerous sequelae of the thrombosis, Early detection of thrombus by this non-invasive method, with removal of the catheters and prompt heparin therapy can preserve the integrity of the venous conduits and avert emboli. This is particularly relevant for anaesthetists in critical units.

Aged↗
PubMed1980

Mechanical ventilation during laryngeal surgery: an evaluation of the Carden tube.

The effectiveness and safety of the Carden tube-oxygen injector system for ventilation was studied in 18 high-risk patients with obstructive airways disease during microlaryngeal surgery. Blood gas studies during operation demonstrated a mean Pao2 of 65.6 kPa (493 torr) and a mean PaCO2 of 4.5 kPa (34 torr) during mechanical ventilation. No serious complications were noted during operation. Fifty per cent of the patients had postoperative hypercapnia and in two the trachea was re-intubated. Airway maintenance and ventilation are discussed in detail and it is concluded that the Carden tube-oxygen injector system is a safe and convenient method for ventilating the lungs of patients with pulmonary disease who require microlaryngeal surgery.

Adult↗
PubMed1980

Tests for hemostasis and their relevance to venous thrombosis.

The authors have tried to determine which patients were at risk of venous thrombosis. They chose 10 tests for hemostasis that might be of value in predicting those patients who were at risk. The tests were used in two groups of patients: one group in a respiratory intensive care unit and another group of patients about to undergo a major spinal operation. The tests were those for measuring: platelet count, prothrombin time, activated partial thromboplastin time, platelet thromboplastic activity (platelet factor 3), plasma clotting time, and concentrations of fibrinogen, plasminogen, antithrombin-III, alpha-1-antitrypsin and platelet fibrin degradation products (FDP). A diagnosis of thrombosis was made by three techniques: radioactive fibrinogen accumulation in the developing thrombus, impedance plethysmograhpy and ascending venography. The only test for hemostasis that discriminated between patients with and without thrombosis was the level of circulatory FDP. Several of the tests showed pronounced changes within the normal range following development of thrombosis and even before its detection. Therefore, none of the tests was truly predictive. A detailed discussion of the performance and interpretation of impedance plethysmography is presented.

Adult↗
PubMed1979

Aorta-coronary bypass in a patient with sickle cell trait.

A triple aorto-coronary bypass was performed in a patient with sickle cell trait. Partial exchange transfusion with normal packed erythrocytes was used in preparation of the patient for extracorporeal circulation, hypothermia and cardioplegic arrest.

Anemia, Sickle Cell↗
PubMed1979

Thrombosis and free fatty acids in patients subjected to total hip arthroplasty.

The plasma concentrations of free fatty acids were estimated at intervals before, during and after total hip arthroplasty in seven patients. Each patient underwent examination for deep vein thrombosis with iodine-125 leg scanning, impedance plethysmography and contrast venography. Substantially higher concentrations of free fatty acids were found in the plasma of patients shown to have thrombosis than in those without thrombosis.

Aged↗