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Biomedical subjects

B D Minty

Publications and source records attributed to B D Minty.

28 records · Page 2Linked to original sources

Pulmonary epithelial permeability is immediately increased after embolisation with oleic acid but not with neutral fat.

Pulmonary fat embolism occurs frequently after trauma but its functional significance is often unclear. To obtain direct evidence of lung damage caused by fat embolism we have measured changes in permeability of the alveolar-capillary interface. A permeability index was derived from the half time clearance from lung to blood (T1/2LB) of 99mTcDTPA introduced into the lung in a 1 ml bolus. Three groups of rabbits were studied. Baseline T1/2LB. did not differ significantly between groups. After intravenous injection of saline placebo in one group and of 300 mg/kg triolein in another group there was no change in permeability index. After intravenous injection of 100 mg/kg oleic acid in the third group there was an immediate change in T1/2LB from a monoexponential baseline 280 +/- 20 min (SEM) to a multiexponential curve which was resolved into two components, one with a T1/2LB of 3.2 +/- 0.6 min (SEM) and the other 39.5 +/- 7.6 min (SEM). Statistically significant changes in alveolar-arterial PO2 difference, dynamic compliance, chest radiography, and postmortem lung water accompanied the changes in T1/2LB in this group. There were no significant changes in these variables in the placebo or triolein group. Histological studies of the lung tissue of these animals using the osmic acid stain for fat showed no fat in the placebo group, extensive fat embolisation which was densely stained in the triolein group and much less densely stained fat in the oleic acid group. Measurement of the permeability of the alveolar-capillary interface provides direct evidence of lung damage after oleic acid embolisation. There were no functional changes in animals with extensive embolisation with triolein.

Animals↗

Rapid improvement in abnormal pulmonary epithelial permeability after stopping cigarettes.

A new, non-invasive method of measuring pulmonary epithelial damage in man was compared with traditional tests of small-airway function. Pulmonary epithelial permeability was expressed as the half-time clearance from the lung into blood of (99m)Tc-diethylene triaminepenta-acetic acid ((99m)Tc-DTPA) deposited predominantly in the alveoli from an inhaled aerosol.Recovery from abnormal pulmonary permeability was recorded after stopping smoking for 21 days in a group of young symptomless cigarette smokers. Before stopping smoking there was a significant correlation between half-time lung clearance of (99m)Tc-DTPA and carboxyhaemoglobin concentration (r=0.69; p <0.05). There was no correlation between carboxyhaemoglobin value and closing volume, the only other abnormal test of airway function. Twenty-four hours after stopping smoking the mean half-time lung clearance of (99m)Tc-DTPA had increased significantly (p <0.001) from a baseline of 15.8 min (SEM 1.3 min) to 25.5 min (SEM 2.5 min). The mean half-time clearance continued to increase to a maximum of 35.5 min (SEM 3.1 min) at seven days, but was significantly less than the reported half-time clearance for non-smokers (59 min, SEM

Adolescent↗

Increased alveolar epithelial permeability in cigarette smokers.

Two indices of alveolar epithelial permeability were derived in man by a non-invasive method. The rate of transfer of 99mTc DTPA (diethylenetriamine penta-acetate) from the lung into the blood was measured and a significantly greater (P less than 0.001) transfer rate was found in symptomless cigarette smokers compared with non-smokers.

Adult↗

Accuracy of an automated blood-gas analyser operated by untrained staff.

Performance of the IL 613 automatic blood-gas analyser has been assessed using a group of 100 "analysts" with no previous training or experience in the use of the instrument. Test material consisted of blood equilibrated to a known PO2 and PCO2 in a tonometer: pH estimations were carried out on thawed aliquots of a large batch of frozen serum which were then equilibrated to a known PCO2. Eighty-six per cent of analyses were within acceptable limits of error. The largest proportion of errors was in the measurement of pH. Satisfactory results were obtained in 98% of the analyses of PO2 and PCO2. Eighty-eight per cent of operators were able to use the analyser after instruction lasting less than 1 min. These results were significantly better than those obtained in a regional survey of 16 blood-gas laboratories, staffed by trained technicians.

Autoanalysis↗

Comparison of active and passive manoeuvres on the pattern of airway closure in man.

The effect of active and passive manoeuvres on closing volume was studied in conscious subjects. There were no significant differences in closing volume in nine of 10 non-smokers. There was a significantly greater closing volume with the passive manoeuvre (airway pressure +3 kPa to --2 kPa) in seven of nine smokers and one non-smoker with evidence of mild obstructive airway disease. The sensitivity of the closing volume to airway pressure could not be reproduced in three non-smokers exposed to a histamine aerosol. In two of three smokers the effect of airway pressure on closing volume was abolished by salbutamol. The results suggest that subjects with irritable airways may show an increase in closing volume with a change in airway pressure.

Adult↗

Regional quality control survey of blood-gas analysis.

We undertook an external quality control survey of blood-gas analysis in 16 laboratories at 13 hospitals. All samples were prepared in the laboratories under investigation by equilibration of blood or serum with gas mixtures of known composition. pH of serum was measured with no significant bias but with an SD of random error 0.026 pH units, which was almost twice the SD of the reference range (0.015). An acceptable random error (half SD of reference range) was not obtained in a longitudinal internal quality control suvey although there were acceptable results for buffer pH in both field and internal surveys. Blood PO2 was measured with no significant bias but with SD of random error 1.38 kPa which reduced to 0.72 kPa by excluding one egregious result. The latter value was just over half of the SD of the reference range (1.2 kPa). PCO2 of blood was also measured without significant bias but with a much smaller SD of random error of 0.28 kPa (by excluding one egregious result), which was again just over half the SD of the reference range (0.51 kPa). Measurements of blood PO2 and PCO2 seem generally acceptable in relation to their respective reference ranges but measurements of pH were unsatisfactory in both internal and external trials.

Blood Gas Analysis↗