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Biomedical subjects

C J Bell

Publications and source records attributed to C J Bell.

At least 19 recordsLinked to original sources

The neurobiology of social phobia.

Although Social Phobia has been recognised for centuries in comparison with other anxiety disorders, relatively little work has been done to understand its neural basis. The present review attempts to redress this balance by giving an overview of the current state of knowledge in this disorder. By putting together data from the treatment responses to specific agents, the effects of chemical challenges which have been used in other anxiety disorders and by reviewing data on central and peripheral neurotransmitter and endochrine abnormalities, it is possible to begin to generate some potentially testable theories of aetiology and mechanisms. Finally, we review the potential use of neuroimaging techniques to better detail the brain circuits and possibly neurotransmitters involved in social phobia, showing some of our preliminary work using (15)O water blood flow PET activation studies to determine the brain circuits in which metabolism is changed during the experience of social anxiety.

Brain

Prolonged colonic epithelial hyporesponsiveness after colitis: role of inducible nitric oxide synthase.

Colonic epithelial secretion is an important host defense mechanism. We examined whether a bout of colitis would produce long-lasting changes in epithelial function that persisted after resolution of mucosal inflammation. Colitis was induced in rats with intracolonic trinitrobenzenesulfonic acid. Six weeks later, colonic damage and inducible nitric oxide synthase (iNOS) mRNA expression and activity were measured. Segments of distal colon were mounted in Ussing chambers for measurement of permeability and responsiveness to secretory stimuli. Basal electrolyte transport parameters and permeability were not different from untreated controls. Despite normal macroscopic and histological appearance, secretory responses to electrical field stimulation (EFS), isobutylmethylxanthine (IBMX), and carbachol were significantly depressed (by 60-70%) relative to controls. iNOS mRNA expression and enzyme activity were significantly elevated. Dexamethasone reversed epithelial hyporesponsiveness and significantly reduced iNOS mRNA expression. A selective iNOS inhibitor normalized the secretory responses to EFS and IBMX but not to carbachol. These data suggest that ongoing synthesis of nitric oxide by iNOS contributes to chronic suppression of epithelial secretory function after episodes of colitis.

Animals

Decreased brain GABA(A)-benzodiazepine receptor binding in panic disorder: preliminary results from a quantitative PET study.

BACKGROUND: Positron emission tomography (PET) allows the measurement of benzodiazepine-gamma-aminobutyric acidA (GABA(A)) receptor kinetics. We employed flumazenil radiolabeled with carbon 11, a radioligand that labels the benzodiazepine site on the GABA(A) receptor, and fully quantitative, high-sensitivity PET to test the hypothesis that central benzodiazepine site binding is decreased in medication-free patients with panic disorder. METHODS: We compared 7 patients with panic disorder who had been off medication for at least 6 months and who had never abused alcohol with 8 healthy controls. The resulting parametric voxel-by-voxel maps were analyzed by voxel-based and region of interest-based methods using both parametric and nonparametric statistics. RESULTS: The major finding was that there is a global reduction in benzodiazepine site binding throughout the brain in patients with panic disorder compared with controls. There were sex differences in the 2 samples, but a separate analysis excluding women led to the same conclusions. In addition, the loci with the largest regional decrease in binding (right orbitofrontal cortex and right insula) were areas thought to be essential in the central mediation of anxiety. CONCLUSION: These results must be considered preliminary but are congruous with previous clinical psychopharmacologic evidence of involvement of the benzodiazepine-GABA(A) receptor and demonstrate that decreased flumazenil binding at this site may underlie panic disorder.

Adult

Effect of oxidation on delamination of ultrahigh-molecular-weight polyethylene tibial components.

Whether oxidation of ultrahigh-molecular-weight polyethylene (UHMWPE) causes delamination of the plastic in total knee arthroplasties (TKAs) was investigated. Examination of retrieved TKAs has shown that oxidation of UHMWPE can be caused by postirradiation damage leading to a subsurface band or, to a lesser extent, by mechanical forces during use leading to surface oxidation. Delamination cracks propagated through the subsurface oxidized band. In wear tests, delamination occurred in artificially aged UHMWPE where only subsurface oxidized bands had formed. Increased surface wear predominated where oxidation was associated with the surface of the plastic. Similarly, in tensile and fatigue tests of oxidized UHMWPE, there was a significant reduction in the ultimate tensile strength and in the fatigue resistance of specimens that had developed a subsurface band. Oxidation increased fatigue crack growth rate. It was observed that UHMWPE from different manufacturers varied in its resistance to oxidation. This study demonstrates that the effect of oxidation, which results in the development of a subsurface white band, combined with high subsurface shear forces observed in TKAs, is to enhance delamination wear.

Humans

Serotonin and panic.

BACKGROUND: Tricyclic (TCA) and monoamine oxidase inhibitor (MAOI) antidepressants are effective in the treatment of panic disorder. Two selective serotonin reuptake inhibitors (SSRIs) have also been licensed in the UK for this indication and studies with three other SSRIs have recently been completed. These provide further evidence for the role of serotonin in panic. METHOD: Review of clinical, animal and laboratory studies. RESULTS: SSRIs have been shown to be effective in the treatment of panic disorder. The reported rates of improvement of 60-70% of patients taking SSRIs are similar to those seen with TCAs and greater than placebo. Other serotonergic agents do not appear to be effective. Animal work and human studies including measures of 5-HT in plasma, cerebrospinal fluid and platelets, challenge paradigms and tryptophan depletion show that the relationship between 5-HT and anxiety is complex. CONCLUSION: Clinical trials have shown that of all the serotonergic agents only the SSRIs are effective in panic disorder. They are as beneficial as the TCAs and seem to be better tolerated which may be particularly significant in view of the chronic nature of the condition. Serotonin plays a role in panic disorder and serotonergic dysfunction, however the results and evidence do not fit one theory alone. It is also likely that different brain regions and 5-HT receptors are involved in specific ways.

Animals

Radioimmunoassay for monitoring zidovudine in dried blood spot specimens.

We modified and evaluated a RIA for serum and used the modified RIA to measure zidovudine in dried blood spot specimens (DBSs) routinely collected for newborn screening and tested anonymously for maternally acquired HIV antibodies in the national HIV Seroprevalence Survey Among Childbearing Women. DBS calibration and quality-control materials were used to adapt the serum assay to the DBS matrix. The assay had a limit of detection of 24 micrograms/L serum and was used to measure zidovudine from both whole DBSs and the eluate remaining after HIV antibody screening. We initiated a pilot study to investigate the assay's performance and assess its potential to determine the implementation of the US Public Health Service recommendations that HIV-infected pregnant women and newborns receive zidovudine treatment to reduce the risk of perinatal HIV transmission.

Adult

Brain mechanisms of social anxiety disorder.

The neurobiology of social anxiety disorder is poorly understood, although preliminary research has suggested several possible biological abnormalities. Challenge studies have demonstrated that subjects with social anxiety disorder have a sensitivity to carbon dioxide, cholecystokinin, and caffeine somewhere between that of panic disorder patients and normal controls. Serotonergic pathways may play a role in social anxiety disorder, as shown by the clinical effectiveness of selective serotonin reuptake inhibitors, plus fenfluramine and m-chlorophenylpiperazine challenge studies. Dopaminergic function and striatal dopamine uptake appear to be reduced in social anxiety disorder. There is also evidence for cardiovascular and adrenergic abnormalities. Recently, positron emission tomography has begun to identify brain regions that appear to be uniquely activated in this condition. These results offer the promise of an understanding of the brain mechanisms of social anxiety disorder, but much further research is needed to fully elucidate the neurobiological cause(s) that exist.

Animals

Molecular studies of an ependymoma-associated constitutional t(1;22)(p22;q11.2).

We previously described a patient with a de novo constitutional translocation, t(1;22)(p22;q11.2), who developed a malignant ependymoma at age 5, and we proposed that the translocation predisposed the child to the development of the tumor. As a step toward isolation of a putative cancer gene, we have characterized the breakpoints of the (1;22) translocation at the molecular level. The chromosome 22 breakpoint has been narrowed to a region between ARVCF and D22S264. The chromosome 1 breakpoint has been mapped onto a doubly-linked Whitehead YAC contig by PCR analysis of the STS contents of the patient's derivative chromosomes isolated in somatic cell hybrids. Loss-of-heterozygosity (LOH) studies of the patient's ependymoma and of sporadic ependymomas showed no evidence of consistent loss in the breakpoint regions, suggesting that activation of an oncogene, rather than inactivation of a tumor suppressor gene, is the more likely molecular mechanism involved in this case. The gene for Edg-1, a neurally expressed, seven-segment transmembrane receptor, maps to the region of the chromosome 1 breakpoint but does not appear to be interrupted by the translocation. Molecular characterization of the breakpoint regions reported here represents an important step in the identification of the gene(s) affected by this translocation.

Animals

Regional localization of over 300 loci on human chromosome 22 using a somatic cell hybrid mapping panel.

A somatic cell hybrid panel, consisting of 25 cell lines, has been developed to localize loci subregionally on chromosome 22. Over 300 markers in the form of STSs or hybridization probes have been assigned to one of 24 unique regions or "bins" using this panel. This ordered collection of markers will aid in the assembly of physical maps and contigs of chromosome 22 and assist in positional cloning of disease loci mapped to chromosome 22.

Animals

Narrowing the critical region for a rhabdoid tumor locus in 22q11.

Rhabdoid tumor is a rare malignant neoplasm of childhood that may occur in various locations, including the central nervous system and the kidney. Previous cytogenetic studies of primary rhabdoid tumors have demonstrated monosomy or deletion of chromosome 22 and have implicated the presence of a rhabdoid tumor suppressor gene that maps to 22q. We have employed fluorescence in situ hybridization to narrow the region for this locus in four rhabdoid tumor cell lines with translocations or deletions involving chromosome segment 22q11. The completion of a cosmid and yeast artificial chromosome contig spanning the immunoglobulin lambda gene locus to BCR has allowed us to map a critical region for a rhabdoid tumor gene to a 500 kb span of chromosome segment 22q11.

Chromosome Mapping

Serotonin reuptake inhibitor withdrawal.

We studied reported withdrawal symptoms in a retrospective chart review of 352 patients treated in an outpatient clinic with the nonselective serotonin reuptake inhibitor clomipramine or with one of the selective serotonin reuptake inhibitors (SSRIs), fluoxetine, fluvoxamine, paroxetine, or sertraline. In 171 patients who were supervised during medication tapering and discontinuation, the most common symptoms were dizziness, lethargy, paresthesia, nausea, vivid dreams, irritability, and lowered mood. When patients with at least one qualitatively new symptom were defined as cases, these symptoms occurred significantly more frequently in patients who had been treated either with one of the shorter half-life SSRIs, fluvoxamine or paroxetine (17.2%), or with clomipramine (30.8%), than in patients taking one of the SSRIs with longer half-life metabolites, sertraline or fluoxetine (1.5%). The rate was not significantly different between the different shorter half-life treatments. Cases treated with fluvoxamine or paroxetine had received a significantly longer period of treatment (median 28 weeks) than noncases (16 weeks), but there were no significant associations with age or with diagnostic grouping. There was a trend toward an association with male sex. The majority of cases occurred despite slowly tapered withdrawal. Symptoms persisted for up to 21 days (mean = 11.8 days) after onset. These symptoms were relieved within 24 hours by restarting the medication, but were not relieved by benzodiazepines or by moclobemide. A role has been suggested for serotonin in coordinating sensory and autonomic function with motor activity. We suggest that this may lead to useful hypotheses about the pathophysiology of withdrawal symptoms from serotonin reuptake inhibitors.

1-Naphthylamine

Long-range mapping and construction of a YAC contig within the cat eye syndrome critical region.

Cat eye syndrome (CES) is typically associated with a supernumerary bisatellited marker chromosome derived from human chromosome 22pter to 22q11.2. The region of 22q duplicated in the typical CES marker chromosome extends between the centromere and locus D22S36. We have constructed a long-range restriction map of this region using pulsed-field gel electrophoresis and probes to 10 loci (11 probes). The map covers -3.6 Mb. We have also used 15 loci to construct a yeast artificial chromosome contig, which encompasses about half of the region critical to the production of the CES phenotype (centromere to D22S57). Thus, the CES critical region has been mapped and a substantial portion of it cloned in preparation for the isolation of genes in this region.

Abnormalities, Multiple

Butyrate enema therapy stimulates mucosal repair in experimental colitis in the rat.

BACKGROUND: The short chain fatty acid (SCFA) butyrate provides energy for colonocytes, stimulates colonic fluid and electrolyte absorption and is recognised as an effective treatment for multiple types of colitis. AIM: To examine the impact of butyrate enema therapy on the clinical course, severity of inflammation, and SCFA stimulated Na+ absorption in a chronic experimental colitis. METHODS: Distal colitis was induced in rats with a trinitrobenzenesulphonic acid (TNBS) enema. Five days after induction, rats were divided into groups to receive: no treatment, saline enemas, or 100 mM Na-butyrate enemas daily. On day 24, colonic damage score and tissue myeloperoxidase (MPO) activity were evaluated. Colon was mounted in Ussing chambers and Na+ transport and electrical activities were measured during a basal period and after stimulation with 25 mM butyrate. RESULTS: In the untreated and the saline enema treated TNBS groups, diarrhoea and extensive colonic damage were seen, associated with increased tissue MPO activities and absent butyrate stimulated Na+ absorption. In contrast, in the butyrate enema treated TNBS group, diarrhoea ceased, colonic damage score improved, and tissue MPO activity as well as butyrate stimulated Na+ absorption recovered to control values. CONCLUSION: Butyrate enema therapy stimulated colonic repair, as evidenced by clinical recovery, decreased inflammation, and restoration of SCFA stimulated electrolyte absorption.

Animals

Integration of physical, breakpoint and genetic maps of chromosome 22. Localization of 587 yeast artificial chromosomes with 238 mapped markers.

Detailed physical maps of the human genome are important resources for the identification and isolation of disease genes and for studying the structure and function of the genome. We used data from STS content mapping of YACs and natural and induced chromosomal breakpoints to anchor contigs of overlapping yeast artificial chromosome (YAC) clones spanning extensive regions of human chromosome 22. The STSs were assigned to specific regions (bins) on the chromosome using cell lines from a somatic hybrid mapping panel defining a maximum of 25 intervals. YAC libraries were screened by PCR amplification of hierarchical pools of yeast DNA with 238 markers, and a total of 587 YAC clones were identified. These YACs were assembled into contigs based upon their shared STS content using a simulated annealing algorithm. Fifteen contigs, containing between 2 and 74 STSs were assembled, and ordered along the chromosome based upon the cytogenetic breakpoint, meiotic and PFG maps. Additional singleton YACs were assigned to unique chromosomal bins. These ordered YAC contigs will be useful for identifying disease genes and chromosomal breakpoints by positional cloning and will provide the foundation for higher resolution physical maps for large scale sequencing of the chromosome.

Chromosome Mapping

Adaptation of rat gastric mucosa to aspirin requires mucosal contact.

Adaptation of the gastric mucosa to repeated administration of aspirin is a well-documented phenomenon, but the underlying mechanism is not fully understood. In this study, we tested the hypothesis that adaptation of the rat stomach to chronic aspirin administration required contact between the aspirin and the gastric mucosa. Rats were orally treated twice daily with either aspirin (100 mg/kg) or the vehicle. After various periods of treatment (< or = 20 days), the rats were given a higher dose of aspirin (250 mg/kg po), and the extent of gastric damage was assessed 3 h later. Rats receiving chronic aspirin demonstrated the development, in a time-dependent manner, of resistance to the damaging effects of aspirin. Chronic aspirin administration also significantly decreased the susceptibility of the rat stomach to damage induced by indomethacin or naproxen. The adaptation phenomenon was associated with a parallel increase in inflammatory infiltration of the mucosa, as measured by tissue myeloperoxidase activity and histology. Prostaglandin synthesis was markedly suppressed (> 80%) in all rats treated with aspirin. Gastric mucosal ornithine decarboxylase activity was not affected by chronic aspirin administration. If aspirin was administered subcutaneously or intrajejunally for 20 days, neither adaptation nor inflammation of the gastric mucosa was observed. These studies demonstrate that the rat stomach adapts to chronic oral administration of aspirin, but not to aspirin administration via other routes. Adaptation of the gastric mucosa occurred in parallel to infiltration of granulocytes. Whether these two phenomena are mechanistically or causally linked is not yet clear.

Adaptation, Physiological

Disruption of colonic electrolyte transport in experimental colitis.

The time course of disturbances of distal colonic electrolyte transport during experimental colitis in rats was compared with changes in the severity of inflammation and epithelial disruption. Colitis was induced by intracolonic administration of trinitrobenzenesulfonic acid (TNBS). At time points from 1 day to 8 wk thereafter, Na+ and Cl- transport was studied under short-circuited conditions in Ussing chambers, three indexes of tissue inflammation were measured, and histology was performed. Net absorption of Na+ and Cl- was abolished at 1 and 4 days after induction of colitis, but recovered to control levels by 1 wk. All unidirectional electrolyte fluxes were elevated at 1 day and fell significantly, generally to control levels, by 4 days. The indexes of inflammation, tissue myeloperoxidase, and synthetic capacities for prostaglandin E2 and leukotriene B4 were all significantly elevated from 1 day to 2 wk post-TNBS. At 1 and 4 days, there was widespread epithelial necrosis, and reepithelialization was consistently seen by 2 wk. In additional studies, 2 wk post-TNBS, the short-circuit current response to 3-isobutyl-1-methylxanthine was reduced compared with controls. These data suggest that abolition of electrolyte absorption early in this experimental colitis was largely attributable to epithelial damage. Despite demonstrable tissue inflammation 2 wk post-TNBS, basal electrolyte transport was not impaired, while the colitic epithelium was hyporesponsive to a Cl- secretagogue. The data also suggest that gross barrier function was restored prior to reepithelialization.

Animals