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Biomedical subjects

B W East

Publications and source records attributed to B W East.

At least 19 recordsLinked to original sources
PubMed1991

Body concentration of caesium-137 in patients from Western Isles of Scotland.

OBJECTIVES: To compare caesium-137 concentrations in patients from the Western Isles Health Board, Glasgow area, and other parts of the Scottish mainland, and to investigate the source of 137Cs in patients from the Western Isles. DESIGN: Study of hypertensive patients having electrolyte concentrations measured, including 137Cs. Interview by questionnaire of island subjects about intake of foods likely to contain radiocaesium and the source of these foods. Measurement of 137Cs and 134Cs in food, urine, and vegetation. SETTING: Scottish mainland and Western Isles, 1979-86. All measurements before Chernobyl nuclear accident. PATIENTS: 413 consecutive patients referred to the blood pressure unit for investigation of hypertension. 60 from the Western Isles, including 44 from North Uist; 32 from North Uist participated in the dietary analysis. MAIN OUTCOME MEASURES: Concentration of radiocaesium in the body, urine, food, and vegetation. Islanders' consumption of local produce. RESULTS: Patients from the Western Isles had five times higher body concentrations of 137Cs (median 2.54 (interquartile range 1.25-3.73)) Bq/gK) than did patients from around Glasgow (0.47 (0.26-0.66) Bq/gK) and other parts of the Scottish mainland (0.42 (0.24-0.71) Bq/gK). Islanders often consumed local milk and mutton, but ate local fish rarely. 137Cs and 134Cs were present in coastal (21.6 Bq/kg 137Cs, 0.25 Bq/kg 134Cs) and moorland (135.9, 0.65 Bq/kg) grasses and in islanders' urine (2.01, 0.013 Bq/l). Lower concentrations (0.336, 0.004 Bq/l), were found in the urine of Glasgow controls (p less than 0.001 for both isotopes). CONCLUSIONS: Islanders have excess body 137Cs concentrations, most of which probably comes from local milk and lamb. The radioactivity is not above the recommended safety limit. The presence of 134Cs suggests that nuclear reprocessing is the source of some of the radiocaesium.

Adolescent↗
PubMed1991

Manganese, selenium and other trace elements in spinal cord, liver and bone in motor neurone disease.

Trace element levels were measured by neutron activation analysis in spinal cord, liver and bone of 7 control patients dying of non-neurological disease and 15 patients dying of motor neurone disease (MND). The concentration of selenium was significantly elevated in the cervical cord, liver and bone in the MND group. Although spinal cord manganese levels were increased at both the cervical and thoracic levels, the hepatic concentration was reduced in the MND patients. These findings are discussed in relation to current understanding of the pathogenesis of MND.

Adult↗
PubMed1987

Total body electrolyte composition in patients with heart failure: a comparison with normal subjects and patients with untreated hypertension.

Total body elemental composition was measured in 40 patients with well documented heart failure who were oedema-free on digoxin and diuretics. The results were compared with values for 20 patients with untreated essential hypertension matched for height, weight, age, and sex. Total body potassium alone was also measured in 20 normal subjects also matched for anthropomorphic measurements. Patients with hypertension had a very similar total body potassium content to that of normal subjects, but patients with heart failure had significantly reduced total body potassium. This could not be explained by muscle wasting because total body nitrogen, largely present in muscle tissue, was well maintained. When total body potassium was expressed as a ratio of potassium to nitrogen mass a consistent depletion of potassium was revealed in the group with heart failure. Potassium depletion was poorly related to diuretic dose, severity of heart failure, age, or renal function. Activation of the renin-angiotensin-aldosterone system was, however, related to hypokalaemia and potassium depletion. Such patients also had significantly lower concentrations of serum sodium and blood pressure. Serum potassium was related directly to total body potassium. Despite the absence of clinically apparent oedema total body chlorine was not consistently increased in heart failure, but the calculated extracellular fluid volume remained expanded in the heart failure group. Total body sodium was significantly increased in patients with heart failure, but less than half of this increase could be accounted for by extracellular fluid volume expansion. Potassium depletion in heart failure may account in part for the high frequency of arrhythmias and sudden death in this condition.

Anthropometry↗
PubMed1987

Relation of arrhythmias and electrolyte abnormalities to survival in patients with severe chronic heart failure.

To investigate the determinants of mortality in patients with chronic congestive heart failure, we prospectively evaluated 84 patients with this disorder who underwent detailed biochemical, clinical, and functional tests at the time of initial evaluation and were then followed for 12 to 52 months (mean 31). During this period of follow-up, 58% of the patients died, of whom 71% died suddenly. The most important pretreatment predictor of mortality in these patients was the frequency of ventricular extrasystoles, followed by echocardiographic fractional shortening, a diagnosis of coronary artery disease, and duration of treadmill exercise. The finding of hypokalemia and hyponatremia in these patients at the time of entry into the study was associated with a poor prognosis by univariate analytical methods, but these electrolyte abnormalities did not provide independent prognostic information. The presence of ventricular arrhythmias was related to the severity of left ventricular dysfunction, exercise intolerance, and neurohormonal activation, suggesting that such arrhythmias are multifactorial in origin and may not simply be related to electrolyte abnormalities.

Adult↗
PubMed1986

Body composition of Atlantic salmon (Salmo salar L.) studied by neutron activation analysis.

This paper describes the measurement of whole body Ca, Cl, K, N, Na, O and P in Atlantic salmon parr, adults and kelts by neutron activation analysis (NAA). This technique is based on counting the specific gamma activity in samples which is present naturally or is produced by neutron irradiation. Body composition (fat, mineral, protein and water) are estimated from these data. NAA has advantages over chemical methods with the potential for in vivo measurements. Anthropogenic 137Cs was found in sea-water (SW) salmon but not found in the freshwater (FW) stages (parr and kelts). Presence of this isotope in fish caught in FW indicates recent SW residence.

Aging↗
PubMed1986

Trace elements in the spinal cord and other tissues in motor neuron disease.

Trace elements were estimated in the spinal cord, liver and bone of five patients dying of motor neuron disease and five control subjects dying of non-neurological disease. The content of selenium in cord and liver and the cord manganese level were significantly increased in the motor neuron disease patients. These findings are discussed in terms of the possible aetiology of motor neuron disease.

Aged↗
PubMed1985

A comparison of body protein determination in rats by in vivo neutron activation and carcass analysis.

Total body nitrogen (TBN) was determined in 16 rat carcasses ranging in weight from 55 to 550 g, by non-destructive 14 MeV neutron activation analysis (NAA). The rat carcasses were subsequently analysed for TBN by Kjeldahl digestion, for total body water (TBW) by loss of weight after freeze-drying and for body fat by adiabatic bomb calorimetry after subtraction of protein energy. TBN results by the two methods were in good agreement, the precision by NAA (coefficient of variation = 1.5%) being superior to that by chemical analysis (coefficient of variation = 2.8%). Body fat calculated by difference from a combination of measured TBW and NAA data agreed closely with bomb calorimetry measurements. The use of indirect estimates of TBW to determine fat gave poor results. A group of four growing rats was analysed sequentially by NAA four times in 2 weeks. The maximum total radiation dose received by each animal was less than 50 rem (less than 500 mSv) and no significant differences in growth rate were observed compared with non-irradiated control groups. 14 MeV NAA in vivo can be conducted with sufficient precision to measure 0.14 g TBN changes in growing rats at 2 weeks post-weaning.

Animals↗
PubMed1985

Total body and serum electrolyte composition in heart failure: the effects of captopril.

We compared the long-term effects of captopril and placebo on patients with heart failure in a double blind crossover fashion. Serum and total body electrolytes were measured and the response to 6 week periods of treatment with captopril determined. During the placebo phase of the study, total body potassium was low at 92 +/- 14% of predicted normal (P less than 0.05) and total body sodium was high at 104 + 7% of predicted normal (P less than 0.05). Total body chlorine did not differ from predicted normal (99 + 12%). In those patients with active plasma renin concentrations above the normal range (greater than 50 microU ml-1) total body potassium was even more markedly deplete (85 + 13% of predicted normal). This group was also characterized by lower serum potassium and sodium concentrations and lower blood pressure. Total body potassium increased significantly on captopril, and the rise was greatest in those with the highest plasma renin concentrations during the placebo phase of the study. However, captopril had no significant effect on total body sodium and chlorine or weight indicating that no long-term natriuresis had occurred.

Aged↗
PubMed1985

Effects of enalapril in heart failure: a double blind study of effects on exercise performance, renal function, hormones, and metabolic state.

Several studies have shown symptomatic and haemodynamic improvement after the introduction of angiotensin converting enzyme inhibitors in patients with heart failure treated with diuretics. The concomitant long term effects of the new orally effective long acting angiotensin converting enzyme inhibitor, enalapril, on symptoms, exercise performance, cardiac function, arrhythmias, hormones, electrolytes, body composition, and renal function have been further assessed in a placebo controlled double blind cross over trial with treatment periods of eight weeks. Twenty patients with New York Heart Association functional class II to IV heart failure who were clinically stable on digoxin and diuretic therapy were studied. Apart from the introduction of enalapril, regular treatment was not changed over the study period; no order or period effects were noted. Enalapril treatment significantly improved functional class, symptom score for breathlessness, and exercise tolerance. Systolic blood pressure was significantly lower on enalapril treatment. Echocardiographic assessment indicated a reduction in left ventricular dimensions and an improvement in systolic time intervals. In response to enalapril, the plasma concentration of angiotensin II was reduced and that of active renin rose; plasma concentrations of aldosterone, vasopressin, and noradrenaline fell. There were significant increases in serum potassium and serum magnesium on enalapril. Glomerular filtration rate measured both by isotopic techniques and by creatinine clearance declined on enalapril while serum urea and creatinine rose and effective renal plasma flow increased. Body weight and total body sodium were unchanged indicating that there was no overall diuresis. There was a statistically insignificant rise in total body potassium, though the increase was related directly to pretreatment plasma renin (r = 0.5). On enalapril the improvement in symptoms, exercise performance, fall in plasma noradrenaline, and rise in serum potassium coincided with a decline in the frequency of ventricular extrasystoles recorded during ambulatory monitoring. Adverse effects were few. In patients with heart failure, enalapril had a beneficial effect on symptoms and functional capacity. The decline in glomerular filtration rate on enalapril may not be beneficial in early heart failure.

Angiotensin II↗
PubMed1984

Enalapril in treatment of hypertension with renal artery stenosis. Changes in blood pressure, renin, angiotensin I and II, renal function, and body composition.

The converting enzyme inhibitor enalapril, in single daily doses of 10 to 40 mg, was given to 20 hypertensive patients with renal artery stenosis. The decrease in blood pressure six hours after the first dose of enalapril was significantly related to the pretreatment plasma concentrations of active renin and angiotensin II, and to the concurrent decrease in angiotensin II. Blood pressure decreased further with continued treatment; the long-term decrease was not significantly related to pretreatment plasma renin or angiotensin II levels. At three months, 24 hours after the last dose of enalapril, blood pressure, plasma angiotensin II, and converting enzyme activity remained low, and active renin and angiotensin I high; six hours after dosing, angiotensin II had, however, decreased further. The increase in active renin during long-term treatment was proportionately greater than the increase in angiotensin I; this probably reflects the diminution in renin substrate that occurs with converting enzyme inhibition. Long-term enalapril treatment increased renin secretion by more than 10-fold, and renal venous and peripheral plasma renin concentration by more than 20-fold; however, the mean renal venous renin ratio was not changed. Enalapril caused a reduction in effective renal plasma flow via the affected kidney but a marked and consistent increase on the contralateral side, where renal vascular resistance decreased. The overall increase in effective renal plasma flow was significantly related to the decrease in angiotensin II. Overall glomerular filtration rate was lowered, and serum creatinine and urea increased. Enalapril alone caused a long-term reduction in exchangeable sodium, with slight but distinct increases in serum potassium. In five patients with bilateral renal artery lesions, enalapril given alone for three months did not cause renal function to deteriorate. Enalapril was well tolerated and provided effective long-term control of hypertension; only two of the 20 patients studied required concomitant diuretic treatment.

Administration, Oral↗
PubMed1984

Trace elements in cerebrospinal fluid in motor neurone disease.

Concentrations of sodium, chlorine, potassium, chromium, iron, cobalt, zinc, rubidium, silver, caesium, and selenium in cerebrospinal fluid from 14 control subjects and 20 patients with motor neurone disease were measured by in vitro neutron activation analysis. No statistically significant correlation was found between the concentrations of any two elements other than sodium and chlorine in either the patient or control group (r = 0.9905; p less than 0.001). The mean cobalt concentration was significantly lower in the patients (p = 0.0015). No other statistically significant difference was shown. The relevance of this finding was examined in relation to current concepts of the pathogenesis of motor neurone disease and the role of cobalt in cellular metabolism.

Cobalt↗
PubMed1984

Captopril in heart failure. A double blind controlled trial.

The effect of the converting enzyme inhibitor captopril as long term treatment was investigated in 14 patients with severe congestive heart failure in a double blind trial. Captopril reduced plasma concentrations of angiotensin II and noradrenaline, with a converse increase in active renin concentration. Effective renal plasma flow increased and renal vascular resistance fell; glomerular filtration rate did not change. Serum urea and creatinine concentrations rose. Both serum and total body potassium contents increased; there were no long term changes in serum concentration or total body content of sodium. Exercise tolerance was appreciably improved, and dyspnoea and fatigue lessened. Left ventricular end systolic and end diastolic dimensions were reduced. There was an appreciable reduction in complex ventricular ectopic rhythms. Adverse effects were few: weight gain and fluid retention were evident in five patients when captopril was introduced and two patients initially experienced mild postural dizziness; rashes in two patients did not recur when the drug was reintroduced at a lower dose; there was a significant reduction in white cell count overall, but the lowest individual white cell count was 4000 X 10(6)/l. Captopril thus seemed to be of considerable value in the long term treatment of severe cardiac failure.

Captopril↗