Search PubMedSearch

Biomedical subjects

G Kobal

Publications and source records attributed to G Kobal.

At least 19 recordsLinked to original sources

Dose-dependent stereoselective activation of the trigeminal sensory system by nicotine in man.

RATIONALE: Nicotine applied to the nasal cavity can evoke 'odorous' sensations in the concentration range near the detection threshold by the activation of the olfactory sensory system and at higher concentrations 'burning' and 'stinging' sensations by the dose-dependent recruitment of C- and Adelta-fibers of the trigeminal sensory system. Neuronal nicotinic acetylcholine receptor (nAchR) subunits are expressed in trigeminal primary afferents and could constitute the receptors involved in nicotine perception. OBJECTIVE: In the present study, we dose-dependently investigated the stereoselective effects of R(+)- and S(-)-nicotine on the trigeminal and olfactory sensory system in man. METHODS: Trigeminal detection thresholds for the 'burning' and 'stinging' sensations and the olfactory detection threshold for the 'odorous' sensation were determined. In order to quantify trigeminal activation, we recorded summated electrical responses from the respiratory nasal mucosa during stimulation with R(+)-and S(-)-nicotine vapor (40, 80, 120, 160 ng/ml; stimulus duration: 250 ms). In addition, subjects rated the intensity of 'odorous', 'burning' and 'stinging' sensations. For chemical stimulation with nicotine enantiomers, a vapor-dilution olfactometer (constant flow rate: 140 ml/s, humidity: 80%, temperature: 37 degrees C, stimulus duration 250 ms) was employed. RESULTS: We found significant stereoselective differences for the trigeminal but not for the olfactory system, i.e. higher summated responses, higher trigeminal intensity estimates, and lower trigeminal detection thresholds for S(-)- compared to R(+)-nicotine. CONCLUSION: Our results clearly demonstrate the different stereoselective activation of the trigeminal sensory system by R(+)-and S(-)-nicotine, indicating the presence of specific stereoselective receptors on trigeminal nociceptive Adelta- and C-fibers.

Adult

Chemosensory event-related potentials to trigeminal stimuli change in relation to the interval between repetitive stimulation of the nasal mucosa.

Event-related potentials (ERPs) to olfactory and trigeminal stimuli have been used commonly to evaluate chemosensory dysfunction. The aim of the present study was to investigate how ERPs could be modified by repetitive stimulations of the intranasal trigeminal nerve using 52% v/v CO2 stimuli for 200 ms periods. Nine subjects were exposed to 6 sessions each during which trains of 16 stimuli were applied. The interval between stimuli was constant for each experiment, but varied between experiments (10, 20, 30, 40, 60, and 90 s). Trigeminal ERPs were obtained from three positions on the skull. Both intensity ratings and ERP amplitudes decreased as the interstimulus interval (ISI) shortened. Specifically, ratings and response amplitudes were most strongly reduced by approximately 30-50% at the shortest ISI used (10 s) and were largest at an ISI of 90 s. The decrease of amplitudes was strongest for the P46 amplitude. Our findings suggest that this may be the result of both habituation and stimulus predictability. We hypothesize that the ISI dependence of chemosensory ERPs may also be a function of an interaction between Adelta and C fibers.

Adult

Visual evoked potentials in migraine patients: alterations depend on pattern spatial frequency.

Visual information is conducted by two parallel pathways (luminance- and contour-processing pathways) which are thought to be differentially affected in migraine and can be investigated by means of pattern-reversal visual evoked potentials (VEPs). Components and habituation of VEPs at four spatial frequencies were compared between 26 migraineurs (13 without aura, MO; 13 with aura, MA) and 28 healthy volunteers. Migraineurs were recorded in the headache-free interval (at least 72 h before and after an attack). Five blocks of 50 responses to chequerboards of 0.5, 1, 2 and 4 cycles per degree (c.p.d.) were sequentially averaged and analysed for latency and amplitude. Differences in VEPs were dependent on spatial frequency. Only when small checks were presented, i.e. at high spatial frequency (2 and 4 c.p.d.), was the latency of N2 significantly prolonged in MA and did it tend to be delayed in MO subjects. Habituation behaviour was not significantly different between groups under the stimulating conditions employed. Prolonged N2 latency might be explained by the lack or attenuation of a contour-specific component N130 in migraineurs, indicating an imbalance of the two visual pathways with relative predominance of the luminance-processing Y system. These results reflect an interictally persisting dysfunction of precortical visual processing which might be relevant in the pathophysiology of migraine.

Adult

Pharmacokinetic modeling of M6G formation after oral administration of morphine in healthy volunteers.

BACKGROUND: Morphine is metabolized to two major metabolites, morphine-3-glucuronide and morphine-6-glucuronide (M6G). Under the conditions of long-term oral morphine administration, the accumulation of M6G may contribute to the analgesic effects, but it may also cause respiratory depression. METHODS: Five healthy male volunteers (ages 25-34 yr) received 90 mg MST (morphine sulfate 5H2O sustained-released tablet, equivalent to 67.8 mg oral morphine). Multiple plasma and urine samples were taken for as long as 14 and 36 h, respectively. Individual pharmacokinetics after intravenous administration of morphine and M6G were available from a previous investigation. A new model that considers the M6G-plasma profile as a sum of the input from the first-pass metabolism of morphine and the input from systemically available morphine was applied to the plasma concentration versus time curves of M6G. The concentrations of M6G at the effect site after long-term morphine administration were simulated. RESULTS: The fraction of morphine absorbed from the gut was 82+/-14%. Of this, 42+/-8% passed through the liver, resulting in an oral bioavailability of morphine of 34+/-9%. Of the total amount of M6G, 71+/-7% was formed during the first-pass metabolism, and 29+/-7% was formed by metabolism of systemic morphine. After 36 h, the amounts of M6G and morphine excreted in the urine were 92+/-17% and 9+/-3%, respectively. Simulation of effect-site concentrations of M6G indicated that after multiple oral dosing of morphine in patients with normal liver and renal function, M6G might reach concentrations two times greater than that of morphine. CONCLUSIONS: M6G may contribute to the analgesic and side effects seen with long-term morphine treatment. The current model of morphine and M6G pharmacokinetics after oral administration of morphine may serve as a pharmacokinetic basis for experiments evaluating the analgesic contribution of M6G with long-term oral dosing of morphine.

Administration, Oral

Olfactory function in acute rhinitis.

This study was performed to investigate the effects of the common cold on olfactory function, which was assessed using chemosensory event-related potentials (CSERP, in response to both olfactory [H2S] and trigeminal [CO2] stimuli) and psychophysical measures (intensity ratings, odor discrimination, butanol threshold); nasal volume was assessed by means of acoustic rhinometry. The investigation was performed in 36 subjects (18 women, 18 men). After onset of the rhinitis (day 0) measurements were performed on days 2, 4, 6 and 35. The cold produced a decrease of the volume of the anterior nasal cavity accompanied by an increase of mucus secretion, an increase of olfactory thresholds, a decrease of intensity ratings and a decrease of N1 CSERP amplitudes to olfactory and trigeminal stimuli. When mucus secretion of the contralateral nasal cavity was controlled with oxymetazoline, N1 amplitudes to olfactory stimuli were still affected by the cold as indicated by the significant increase of amplitudes as subjects recovered; this phenomenenon was not found for responses to trigeminal stimuli. This indicates that the common cold has a small effect on olfactory function which may be independent of nasal congestion.

Acute Disease

Effects of nasal-airway volume and body temperature on intranasal chemosensitivity.

Interrelations between intranasal detection sensitivity for odor (H2S) and pain (CO2), nasal-airway volume (acoustic rhinometry), and body temperature were studied in young, healthy men across the diurnal cycle. The results showed a weak but statistically significant negative correlation between nasal volume and odor threshold and a weak but positive correlation between body temperature and odor threshold.

Adult

Factors affecting pain intensity in a pain model based upon tonic intranasal stimulation in humans.

OBJECTIVE: The present publication describes an inflammatory pain model based on an air-stream introduced in the nasal cavity. The aim of the present study was to investigate the influence of flow, humidity and temperature of the air-stream on the intensity of the evoked pain sensations. METHODS: Six healthy volunteers participated in the study. Pain was produced by a stream of air introduced to the nasal cavity at different flow rates (5, 6 and 81/min), humidity (20 and 80% relative humidity) and temperature (16, 24, and 32 degrees C). The evoked pain was quantified by means of visual analogue scales. RESULTS: The air-stream induced a dull and burning painful sensation. The intensity of pain was found to be related to the air-stream's humidity and temperature. Specifically, a dry air-stream (20% relative humidity) evoked significantly stronger pain than a humidified air-stream (80% relative humidity). Pain was significantly greater at a temperature of 32 degrees C than at 24 degrees and 16 degrees C, while the temperatures of 16 and 24 degrees C did not differ with respect to pain intensity. In contrast, a tendency towards stronger pain produced by a flow of 81 compared to that with 51 could not be statistically justified within the present study. CONCLUSIONS: The non-invasive pain stimulus was found to be easily applicable and the evoked pain sensation could be modified by variation of humidity and temperature of the air-stream.

Adult

Effects of the nasal decongestant oxymetazoline on human olfactory and intranasal trigeminal function in acute rhinitis.

OBJECTIVE: The placebo-controlled, randomized, double-blind study was performed to investigate dose-related effects of oxymetazoline on olfactory function during the course of the spontaneously occurring cold. METHODS: Drug effects were assessed using olfactory/ trigeminal event-related potentials (ERPs) and psychophysical measures (intensity ratings, odor discrimination, butanol threshold); nasal volume was monitored by means of acoustic rhinometry. The investigation was performed in 36 subjects (mean age 24.6 years). The subjects were assigned to treatment groups A, B or C (three groups with 12 subjects each; six women and six men per group). All the subjects received placebo on the left side; on the right side, group A subjects received placebo and group B and C subjects received 0.25 mg x ml(-1) and 0.5 mg x ml(-1) oxymetazoline, respectively. After onset of the rhinitis (day 0) measurements were performed on days 2, 4, 6 and 35. RESULTS: Oxymetazoline clearly produced an increase in nasal volume. However, during the 2-h observation period, effects produced by the two dosages were not significantly different. Despite the increase in nasal volume, oxymetazoline produced only an increase of the overall intensity of H2S stimuli; it had no systematic effect on other measures of olfactory or trigeminal function. In addition, after all the subjects had recovered from the cold, oxymetazoline had no significant main effect on olfactory/trigeminally mediated sensations. CONCLUSIONS: Oxymetazoline appeared to have neither negative nor major positive effects on intranasal chemosensory function. It is hypothesized that oxymetazoline needs to be applied locally to the area of the olfactory cleft in order to significantly improve olfaction during the course of the common cold.

Acute Disease

Pharmacokinetics of morphine-6-glucuronide and its formation from morphine after intravenous administration.

BACKGROUND: Morphine-6-beta-glucuronide is a primary morphine metabolite with potent opioid action. However, its low and slow brain permeability eventually prevents its central opioid effects after short-term intravenous administration. Research is needed to establish whether morphine-6-beta-glucuronide qualifies as an analgesic; this study provides the pharmacokinetic bases for such studies. METHODS: Plasma concentration-time data of morphine-6-beta-glucuronide and morphine obtained from 20 healthy volunteers after short-term intravenous administration of either morphine-6-beta-glucuronide or morphine were described by a biexponential disposition curve. Disposition parameters of morphine-6-beta-glucuronide and morphine were estimated by nonlinear regression, and basic pharmacokinetic parameters (clearance, volume of distribution at steady state, and mean disposition residence time) were derived. A new model of metabolite kinetics was applied, and the disposition parameters of morphine and morphine-6-beta-glucuronide were then used to fit the plasma concentration-time profile of morphine-6-beta-glucuronide formed from morphine. Thereby the fraction of morphine metabolized to morphine-6-beta-glucuronide and the mean transit time of morphine across the site of metabolism were estimated. RESULTS: The extent and time course of morphine-6-beta-glucuronide formation from morphine could be well described by a parametric model, with a fraction of morphine metabolized to morphine-6-beta-glucuronide of 7.55% +/- 1.24% and a mean metabolic transit time for morphine to morphine-6-beta-glucuronide of 0.28 +/- 0.21 hour. The underlying disposition of morphine and morphine-6-beta-glucuronide was characterized by clearance (morphine clearance, 32.7 +/- 6 ml.min-1.kg-1, morphine-6-beta-glucuronide clearance, 2.2 +/- 0.4 ml.min-1.kg-1), volume of distribution at steady state (morphine, 1.8 +/- 0.3 L.hr-1; morphine-6-beta-glucuronide, 0.12 +/- 0.02 L.hr-1), and mean disposition residence time (morphine, 1.8 +/- 0.4 hours; morphine-6-beta-glucuronide, 1.7 +/- 0.4 hours). CONCLUSIONS: The time course of morphine-6-beta-glucuronide formation kinetics was analyzed with use of the information on the disposition kinetics of both morphine and preformed morphine-6-beta-glucuronide, which was obtained by separate data fits. The transformation of morphine to morphine-6-beta-glucuronide could be described by two parameters characterizing the extent and delay of metabolite formation. The results of this study will serve as pharmacokinetic bases of future investigations of morphine-6-beta-glucuronide in human beings.

Adult

Chemosensory event-related potentials change with age.

The study examined age-related changes in the perception of olfactory and trigeminal chemical stimuli using chemosensory event-related potentials (CSERP). Three groups of healthy volunteers, each comprised of 8 men and 8 women, were tested (age ranges 15-34, 35-54, and 55-74 years). Subjects underwent extensive psychological testing focusing on impairments of memory and attention. In addition, odor identification and discrimination ability was evaluated, as well as detection threshold sensitivity for two odorants. Odor discrimination scores exhibited a significant age-related decrease. Significant age-related changes were also observed for CSERP N1P2 and P2 amplitudes, and for the N1 peak latency. The age-related decrease of CSERP amplitudes appeared to follow a different time course for responses to trigeminal and olfactory stimulants.

Adolescent

Relation of olfactory event-related potentials to changes in stimulus concentration.

OBJECTIVE: The aim of this study was to investigate the influence of odorant concentration on the olfactory event-related potential (OERP). METHODS: OERP were evaluated in 8 men and 8 women (17-34 years of age) in response to 4 concentrations of vanillin (7, 28, 56 and 84% v/v). Sixteen presentations of each concentration (stimulus duration 200 ms, interval 40 s, flow 81/min) were applied in a randomized order. EEG recordings were made at 3 midline sites (pos. Fz, Cz, Pz). Amplitudes and latencies of four peaks were measured (latencies in ms at Pz after stimulation with 84% v/v vanillin): P1 (277), N1 (348), P2 (412) and P3 (496). Statistical analysis was performed with MANOVAs ('concentration', 'recording site' = within-subject-factors; 'age' as covariate). RESULTS: With increasing stimulus concentration amplitudes became significantly larger; this was most pronounced for P3 (P1N1: F = 2.90, P < 0.05; N1P2: F = 5.15, P < 0.01; N1P3: F = 35.7, P < 0.001; P3: F = 38.6; P < 0.001). Correspondingly, latencies shortened with increasing concentrations (P1: F = 25.2; N1: 17.51; P2: 14.8; P3: 13.4; all P < 0.001). While there was no correlation between OERP amplitudes and butanol odor detection thresholds, latencies were the shorter the lower the subjects' thresholds (coefficients of correlations for peak latencies at Cz for 84% v/v: P1 rl5 = -0.59; N1 rl5 = 0.58; P2 r15 = -0.55; P3 r15 = -0.45). CONCLUSIONS: The results indicated that both OERP amplitudes and latencies are related to the concentration of olfactory stimuli. They also suggested that latencies exhibit a stronger relation to changes in stimulus intensity compared to OERP amplitudes.

Adolescent

Handedness is a determining factor in lateralized olfactory discrimination.

The study aimed to re-investigate differences in olfactory thresholds and odor discrimination between the left and right sides in relation to the handedness of healthy subjects. Twenty left- and 20 right-handers participated; all were in excellent health with no indication of any major nasal or health problems, and all were non-smokers. The two groups were comparable in terms of sex and age (left-handers: 11 women, 9 men, median age 25 years; right-handers: 9 women, 11 men, median age 26 years). Odor thresholds did not differ in relation to handedness. However, in the odor discrimination task the left-handers performed significantly better at the left side compared with the right nostril; this pattern was reversed in the right-handers. The data indicate that, similar to other sensory systems, higher olfactory functions exhibit a certain degree of lateralization.

Adult

Trigeminal chemosensitivity: Differences in relation to the time of the day.

Day-night differences of trigeminal chemosensitivity were investigated in 18 healthy volunteers employing both pain-related cortical potentials and pain ratings in response to stimulation of the nasal mucosa with CO2. Day-night differences were found with N 1 P2 amplitudes, P2 latencies and pain ratings. It is concluded that the time of the day must not be ignored when human chemosensitivity is investigated at suprathreshold levels.

Adult

Lateralized and bilateral olfactory function in patients with chronic sinusitis compared with healthy control subjects.

Results of this study demonstrated that a new olfactory test, the "Sniffin' Sticks," can be used to distinguish hyposmic patients with chronic sinusitis (n = 63) from control subjects. Dirhinic testing yielded improved olfactory sensitivity compared with monorhinic testing. However, dirhinic results were not significantly different from results obtained for the best nostril.

Adolescent

Olfactory and intranasal trigeminal event-related potentials in anosmic patients.

The aim of this study was to investigate the usefulness of chemosensory event-related potentials (CSERPs) in response to both olfactory and intranasal trigeminal stimulation in the diagnosis of anosmia. Forty-four patients participated. Gaseous CO2 was used for trigeminal stimulation, vanillin and H2S were used as olfactory stimulants. Event-related potentials to olfactory stimuli could not be obtained in any of the anosmic patients, indicating the complete loss of the sense of smell. However, all patients responded to stimulation of the trigeminal nerve with CO2. These data clearly demonstrate the clinical significance of CSERPs in the assessment of anosmia.

Adolescent

Responses to nasal irritation obtained from the human nasal mucosa.

Responses to chemical irritation can be obtained from the human respiratory mucosa in response to stimulation with gaseous CO2; these negative mucosal potentials (NMPs) are thought to be summated receptor potentials from chemosensitive nociceptors. The present study aimed to investigate the relation of this response to both stimulus concentration and perceived intensity. A total of 29 healthy volunteers participated. Maximum negative amplitudes occurred 1.1 s after stimulus onset. The negativity exhibited a higher coefficient of correlation to intensity estimates of the painful sensations (r = .65) than to the stimulus concentration (r = .46); it appeared at the same time when the subjects' tracking of the painful sensations reached its maximum amplitude. These findings suggest that the NMP is suited for the investigation of peripheral nociceptive events in man.

Adult

Comparison of the antinociception produced by two oral formulations of ibuprofen: ibuprofen effervescent vs ibuprofen tablets.

OBJECTIVE: The aim of this study was to compare the dose-related effects of both ibuprofen tablets and ibuprofen effervescent [placebo, 400 and 800 mg ibuprofen (Aktren)] on phasic pain. PATIENTS: Twenty volunteers participated in this randomized, double-dummy, fivefold crossover study. METHODS: Measurements were obtained before and 15, 60 and 240 min after drug administration. Pain was produced by CO2 pulses applied to the left nostril. Subjects rated the intensity of the painful stimuli by means of a visual analogue scale. In addition, chemosomatosensory event-related potentials were recorded. RESULTS: In line with previous work, ibuprofen produced a dose-related decrease in pain-related potential amplitudes P1N1, indicating its antinociceptive effects. Higher plasma concentrations of ibuprofen were reached 15-40 min after administration of the effervescent while ibuprofen tablets had a tmax 60-90 min after administration. In addition, 60 min after intake of the effervescent a prolongation of the latencies of the potentials was observed, possibly reflecting superior antinociceptive properties when compared to ibuprofen tablets. In addition, the effervescent appeared to have more consistent effects on intensity estimates compared to ibuprofen tablets.

Administration, Oral

The negative mucosal potential: separating central and peripheral effects of NSAIDs in man.

OBJECTIVE: We wanted to test whether assessment of both a central pain-related signal (chemo-somatosensory evoked potential, CSSEP) and a concomitantly recorded peripheral signal (negative mucosal potential, NMP) allows for separation of central and peripheral effects of NSAIDs. For this purpose, experimental conditions were created in which NSAIDs had previously been observed to produce effects on phasic and tonic pain by either central or peripheral mechanisms. METHODS: According to a double-blind, randomised, controlled, threefold cross-over design, 18 healthy subjects (11 males, 7 females; mean age 26 years) received either placebo, 400 mg ibuprofen, or 800 mg ibuprofen. Phasic pain was applied by means of short pulses of CO2 to the nasal mucosa (stimulus duration 500 ms, interval approximately 60 s), and tonic pain was induced in the nasal cavity by means of dry air of controlled temperature, humidity and flow rate (22 degrees C, 0% relative humidity, 145 ml.s-1). Both CSSEPs as central and NMPs as peripheral correlates of pain were obtained in response to the CO2 stimuli. Additionally, the subjects rated the intensity of both phasic and tonic pain by means of visual analogue scales. RESULTS: As described earlier, administration of ibuprofen was followed by a decrease in tonic pain but-relative to placebo-an increase in correlates of phasic pain, indicating a specific effect of ibuprofen on the interaction between the pain stimuli under these special experimental conditions. Based on the similar behaviour of CSSEP and NMP, it was concluded that the pharmacological process underlying this phenomenon was localised in the periphery. By means of the simultaneous recording of interrelated peripheral and central electrophysiologic correlates of nociception, it was possible to separate central and peripheral effects of an NSAID. The major advantage of this pain model is the possibility of obtaining peripheral pain-related activity directly using a non-invasive technique in humans.

Adult