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COLLIER A, PATRICK AW, HEPBURN DA, et al., 1990, LEUKOCYTE MOBILIZATION AND RELEASE OF NEUTROPHIL ELASTASE FOLLOWING ACUTE INSULIN-INDUCED HYPOGLYCEMIA IN NORMAL HUMANS, DIABETIC MEDICINE, Vol: 7, Pages: 506-509, ISSN: 0742-3071
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- Citations: 33
Bell D, McNichol MW, Riordan JF, et al., 1990, Noninvasive mechanical ventilation for acute respiratory-failure, British Medical Journal, Vol: 300, Pages: 944-944, ISSN: 0959-8138
Bell D, Jackson M, Nicoll JJ, et al., 1990, Inflammatory response, neutrophil activation, and free radical production after acute myocardial infarction: effect of thrombolytic treatment, Br Heart J, Vol: 63, Pages: 82-87, ISSN: 0007-0769
Activated neutrophils releasing proteolytic enzymes and oxygen free radicals have been implicated in extending myocardial injury after myocardial infarction. Neutrophil elastase was used as a marker of neutrophil activation and the non-peroxide diene conjugate of linoleic acid was used as an indicator of free radical activity in 32 patients after acute myocardial infarction; 17 were treated by intravenous thrombolysis. Patients with acute myocardial infarction had higher plasma concentrations of neutrophil elastase and the non-peroxide diene conjugated isomer of linoleic acid than normal volunteers or patients with stable ischaemic heart disease. Patients treated by thrombolysis had an early peak of neutrophil elastase at eight hours while those who had not been treated by thrombolysis showed a later peak 40 hours after infarction. The plasma concentration of non-peroxide conjugated diene of linoleic acid was highest 16 hours after the infarction irrespective of treatment by thrombolysis. Quantitative imaging with single photon emission tomography showed decreased uptake of indium-111 labelled neutrophils in the infarcted myocardium (as judged from technetium-99m pyrophosphate) in those who had received thrombolysis, suggesting a decreased inflammatory response. The results indicate increased neutrophil activation and free radical production after myocardial infarction; they also suggest that thrombolysis does not amplify the inflammatory response and may indeed suppress it.
Howie AF, Bell D, Hayes PC, et al., 1990, Glutathione S-transferase isoenzymes in human bronchoalveolar lavage: a possible early marker for the detection of lung cancer, Carcinogenesis, Vol: 11, Pages: 295-300, ISSN: 0143-3334
The levels of glutathione S-transferase (GST) isoenzymes, GST pi, B1, B2 and mu were measured, by radioimmunoassay, in human bronchoalveolar lavage fluid from a series of patients presenting with neoplastic (n = 12) and non-neoplastic lung diseases (n = 10). Lavage fluid was obtained from the suspected abnormal area of lung and a presumed normal area of lung at the time of bronchoscopy. Concentrations of GST B1 and GST B2 were found to be significantly raised (P less than 0.02) in the lavage fluid obtained from the suspected abnormal areas of lung compared with the presumed normal area of lung, in patients later diagnosed as having cancer of the bronchus. The findings of the radioimmunoassay, of greater levels of GST B1 and B2 than GST pi in lavage fluid, were confirmed by a one-step purification of GST from lung lavage, using affinity chromatography, followed by their identification using SDS-polyacrylamide gel. We conclude that measurement of GST B1 or GST B2 in lung lavage fluid could be a useful aid in the diagnosis of lung malignancy.
Jackson MH, Millar AM, Dawes J, et al., 1989, Neutrophil activation during cell separation procedures, Nucl Med Commun, Vol: 10, Pages: 901-904, ISSN: 0143-3636
Leucocytes labelled with 111In or 99Tcm are used as diagnostic agents for detecting sites of infection by scintigraphy. Before radiolabelling is performed, leucocytes are isolated from whole blood. The effect of isolation procedures on neutrophil activation has been studied by measuring the neutrophil elastase produced during incubation of whole blood with three erythrocyte sedimentation agents (dextran 70, hydroxyethyl starch and methylcellulose) and two density gradient media (Percoll and Mono-Poly Resolving Medium). Neutrophil elastase was measured using a standard radioimmunoassay. At 21 degrees C, dextran caused no elastase release while hydroxyethyl starch and methylcellulose induced significant release (p = 0.01 and p less than 0.01 resp.). All three agents caused significant elastase release at 37 degrees C. When whole blood was incubated with Percoll and Mono-Poly Resolving Medium, no release of neutrophil elastase was observed. These results show that neither density gradient medium induces neutrophil activation but that certain erythrocyte sedimentation agents do. Of the three sedimentation agents investigated, dextran is the agent of choice if neutrophil activation is to be minimized.
Collier A, Bell D, Clarke BF, 1989, Diene conjugates and microangiopathy - Reply, Diabetic Medicine, Vol: 6, Pages: 458-459, ISSN: 0742-3071
Muir AL, Bell D, 1989, The role of the neutrophil in acute myocardial infarction, Health Bull (Edinb), Vol: 47, Pages: 207-214, ISSN: 0374-8014
Bell D, Collier DA, 1989, Transfer factor for carbon monoxide in patients with diabetes with and without microangiopathy, Thorax, Vol: 44, ISSN: 0040-6376
Collier A, Patrick AW, Bell D, et al., 1989, Relationship of skin thickness to duration of diabetes, glycemic control, and diabetic complications in male IDDM patients, Diabetes Care, Vol: 12, Pages: 309-312, ISSN: 0149-5992
Skin thickness is primarily determined by collagen content and is increased in insulin-dependent diabetes mellitus (IDDM). We measured skin thickness in 66 IDDM patients aged 24-38 yr and investigated whether it correlated with long-term glycemic control and the presence of certain diabetic complications. With univariate analysis, skin thickness was increased and significantly related to duration of diabetes (P less than .001), previous glycemic control (P less than .001), retinopathy (P less than .001), cheiroarthropathy (P less than .001), and vibration-perception threshold (P less than .05). There was a negative correlation between forced expiratory volume at 1 s (P less than .05) and vital capacity (P less than .05) with duration of diabetes. Neither skin thickness nor ankle arteriomedial wall calcification correlated with abnormal autonomic function tests. When corrected for duration of diabetes, there was a weak correlation between skin thickness and glycemic control (P less than .05) but no correlation with retinopathy, cheiroarthropathy, and vibration-perception threshold. This study confirms that there are widespread connective tissue changes in diabetes mellitus, although the biochemistry needs further elucidation.
Bell D, Millar AM, Grayshan R, et al., 1989, New developments in the field of acute myocardial-infarction imaging - Reply, British Journal of Radiology, Vol: 62, Pages: 294-295, ISSN: 0007-1285
Collier A, Jackson M, Bell D, et al., 1989, Neutrophil activation detected by increased neutrophil elastase activity in type 1 (insulin-dependent) diabetes mellitus, Diabetes Res, Vol: 10, Pages: 135-138, ISSN: 0265-5985
Neutrophils have been implicated in the development of vascular disease, and increased plasma neutrophil elastase indicates increased neutrophil activation. The aim of this study was to determine whether neutrophil elastase levels, measured by radioimmunoassay, are altered in diabetes. One hundred Type 1 (insulin-dependent) diabetic patients and 35 comparably-aged control subjects were studied. There was no difference in the total white cell count, but the diabetic group had a higher neutrophil count (p less than 0.05). Plasma neutrophil elastase (p less than 0.001) and total neutrophil elastase (p less than 0.02) were increased in the diabetic group. The total neutrophil elastase levels reflected the neutrophil count, but plasma neutrophil elastase was independent of the number of neutrophils. The increased plasma neutrophil elastase level was not related to age, duration of diabetes, plasma glucose or HbA1. The results suggest an association between diabetes and neutrophil activation which may play a role in the development of vascular disease.
Collier A, Jackson M, Dawkes RM, et al., 1988, Reduced free radical activity detected by decreased diene conjugates in insulin-dependent diabetic patients, Diabetic Medicine, Vol: 5, Pages: 747-749, ISSN: 0742-3071
Free radicals are unstable chemical species which react with and oxidize adjacent molecules, particularly polyunsaturated lipids. The diene-conjugated non-peroxide isomer of linoleic acid (PL-9,11-LA') has been identified as the main diene-conjugated compound in plasma, and is a probable marker of free radical activity. The aim of the current study was to determine whether the level of PL-9,11-LA', measured by HPLC, is altered in insulin-dependent diabetes, and to investigate whether any abnormality demonstrated correlated with microvascular disease in the form of retinopathy. There was no difference in the concentrations of linoleic acid between the diabetic and control groups (422(129) vs 402(81) (SD) mumol l-1). However, the concentration of PL-9,11-LA' was significantly reduced in the diabetic group compared with control group (15.6(6.7) vs 19.3(3.9) mumol l-1, p less than 0.01), with the molar ratio of PL-9,11-LA':linoleic acid x 100 similarly reduced (3.8(1.3) vs 5.0(1.6)%, p less than 0.005). This study does not support the concept that free radicals play a significant role in the development of diabetic vascular disease.
Muir AJ, Bell D, Jackson M, et al., 1988, The use of 111In-labelled autologous neutrophils in imaging myocardial infarction, Nucl Med Commun, Vol: 9, Pages: 707-711, ISSN: 0143-3636
Turnbull LW, Bell D, Nicoll JJ, et al., 1988, Myocardial infarct sizing by magnetic-resonance imaging and TC-99M pyrophosphate, British Journal of Radiology, Vol: 61, Pages: 779-780, ISSN: 0007-1285
Bell D, Millar AM, Grayshan R, et al., 1988, Radiopharmaceuticals for myocardial infarct imaging: a clinical comparison of 99Tcm-pyrophosphate and 99Tcm-dimethylaminomethylene diphosphonate, Br J Radiol, Vol: 61, Pages: 646-648, ISSN: 0007-1285
Bell D, Collier A, Nicoll JJ, et al., 1988, Reduced venous compliance and increased transcapillary escape of protein in insulin-dependent diabetic patients, Diabet Med, Vol: 5, Pages: 454-458, ISSN: 0742-3071
Lower limb venous compliance and transcapillary escape rate of transferrin were measured in eight normotensive, insulin-dependent male diabetic patients and eight control subjects using a dual isotope technique. Technetium-99m labelled autologous erythrocytes were used to measure venous compliance and to correct for local changes in blood volume, whilst Indium-113m labelled transferrin was used to measure transcapillary escape of protein. The diabetic patients were found to have reduced venous compliance 1.5 (0.7 to 3.4) x 10(-2) mmHg-1 compared with controls 3.2 (2.4 to 4.1) x 10(-2) mmHg-1 (p less than 0.01). The diabetic patients were also found to have greater transcapillary escape of transferrin -2.7 (-1.5 to -5.3) x 10(-3), compared with control subjects -5.2 (-4.1 to -8.1) x 10(-3) (p less than 0.02) in response to increasing hydrostatic pressure. These results show reduced venous compliance in patients with a mean duration of diabetes of 15 years and with only at most, early complications of diabetes, and confirm previous observations showing increased transcapillary escape of protein.
BELL D, COLLIER A, MATTHEWS DM, et al., 1988, ARE REDUCED LUNG-VOLUMES IN IDDM DUE TO DEFECT IN CONNECTIVE-TISSUE, DIABETES, Vol: 37, Pages: 829-831, ISSN: 0012-1797
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- Citations: 51
Bell D, Jackson M, Dawkes R, et al., 1988, Changes in neutrophil activation and free-radical activity after thrombolysis for myocardial-infarction in man, British Heart Journal, Vol: 59, Pages: 616-616, ISSN: 0007-0769
Bell D, Jackson M, Dawkes RM, et al., 1988, Free-radical production and neutrophil elastase in myocardial injury, British Heart Journal, Vol: 59, Pages: 103-103, ISSN: 0007-0769
Bell D, Kirby TP, Nicoll JJ, et al., 1988, Regional distribution of ventilation in chronic obstructive lung disease and the effect of salbutamol, Respiration, Vol: 54, Pages: 179-189, ISSN: 0025-7931
Regional distribution of ventilation was assessed in 5 normal volunteers, and 19 patients with symptomatic chronic obstructive lung disease (COAD) using the technique of gated lung ventilation imaging with 127Xe. The results of this technique were compared with the more conventional assessment of regional ventilation by analysis of 127Xe wash-out curves. Both techniques demonstrate loss of the normal gravitational distribution of ventilation in patients with severe COAD which is significantly reduced from normals in upper, middle and lower zones of each lung, being most marked in the lower zones (p less than 0.01). Gated lung imaging also shows a significant reduction of regional ventilation in patients with mild to moderate COAD compared to normals but only in the lower zones (p less than 0.05). Gated lung imaging provides a better quantitative method of assessing regional lung function than wash-out analysis and confirms loss of the normal gravitational distribution of ventilation in patients with obstructive lung disease and relates this to severity of disease. The distribution of ventilation was also assessed in 6 patients with severe COAD before and after placebo or salbutamol. There was a significant improvement of the distribution of ventilation to the lung bases after salbutamol (p less than 0.05).
Bell D, Nicoll J, Jackson M, et al., 1988, Altered lung vascular permeability during intermittent haemodialysis, Nephrol Dial Transplant, Vol: 3, Pages: 426-431, ISSN: 0931-0509
Hypoxia is known to develop during intermittent haemodialysis. To investigate if increased pulmonary capillary permeability to protein contributes to this phenomenon, a dual-isotope technique using Indium-labelled transferrin and Technetium-labelled red blood cells was used. Lung vascular permeability was measured in eight patients with dialysis-dependent chronic renal failure immediately before and during intermittent haemodialysis with cuprophane membranes. As a group there was a significant increase in lung vascular permeability during the early stages of haemodialysis, compared to predialysis values (P less than 0.05) and this increase occurred during the period when the patients were leucopenic and maximally hypoxic. During the haemodialysis period, but not the predialysis period, the permeability index was also significantly increased compared to a group of eight controls (P less than 0.05). These results suggest that increased vascular permeability may contribute to dialysis-induced hypoxia and that this may relate to neutrophil activation within the pulmonary vascular bed.
Bell D, Jackson M, Muir AL, et al., 1987, Acute smoking increases plasma complexed human neutrophil elastase in man, Scottish Medical Journal, Vol: 32, Pages: 154-154, ISSN: 0036-9330
Bell D, Robertson CE, Muir AL, 1987, Carbonated drinks, thiamine deficiency and right ventricular failure, Scott Med J, Vol: 32, Pages: 137-138, ISSN: 0036-9330
A 69 year old male presented with clinical features of right ventricular failure. A dilated poorly contracting right ventricle was confirmed by echocardiography and radionuclide ventriculography, with subsequent improvement following thiamine replacement. Wet beriberi is a result of thiamine deficiency and is uncommon in Europe and North America except in association with chronic alcohol abuse. We report a patient with beriberi presenting unusually with severe right-sided cardiac failure, with documented impairment of right ventricular function, which improved with thiamine replacement. His dietary intake of thiamine was low because of excess intake of carbonated drinks and carbohydrates.
Wathen CG, Bell D, Harrison DJ, et al., 1987, Serum human neutrophil elastase is increased in patients with active Wegener's granulomatosis, Thorax, Vol: 42, Pages: 750-750, ISSN: 0040-6376
Bell D, Jackson M, Millar AM, et al., 1987, Altered lung vascular-permeability during the early stages of intermittent hemodialysis, Thorax, Vol: 42, Pages: 721-721, ISSN: 0040-6376
Bell D, Jackson M, Macrae C, et al., 1987, Neutrophil elastase is a marker of neutrophil activation in acute myocardial-infarction, Thrombosis and Haemostasis, Vol: 58, Pages: 65-65, ISSN: 0340-6245
Collier A, Jackson M, Bell D, et al., 1987, Increased neutrophil elastase activity in type-1 (insulin-dependent) diabetic-patients, Diabetologia, Vol: 30, Pages: A509-A509, ISSN: 0012-186X
Matthews DM, Wathen CG, Bell D, et al., 1987, The use of captopril and captopril plus frusemide as antihypertensive agents in non-insulin dependent diabetes, J Hum Hypertens, Vol: 1, Pages: 19-23, ISSN: 0950-9240
After all previous antihypertensive treatment had been stopped, blood pressure and glucose tolerance were measured in 16 hypertensive non-insulin treated diabetics before and again six weeks after treatment with captopril, an angiotensin-converting enzyme inhibitor. Supine blood pressure fell from 184 +/- 4.1/103 +/- 2.6 to 165 +/- 5.2/88 +/- 2.1 mmHg (P less than 0.001) and erect from 179 +/- 5.2/102 +/- 3.2 to 158 +/- 5.6/87 +/- 2.6 mmHg (P less than 0.005). The area under the oral glucose tolerance curve fell from 2313.6 +/- 154 to 2192.8 +/- 146 mmol/min/l (P less than 0.02). There was no change in plasma insulin, total glycosylated haemoglobin or fructosamine. Four patients who failed to show lowering of supine diastolic pressure below 95 mmHg were additionally given oral frusemide with further improvement in blood pressure and no alteration in carbohydrate intolerance. It was concluded that captopril alone is usually an effective antihypertensive agent in non-insulin dependent diabetes with the addition of frusemide benefiting resistant cases. Glucose intolerance did not worsen with either captopril alone or captopril plus frusemide.
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