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Biomedical subjects

H Nolte

Publications and source records attributed to H Nolte.

At least 19 recordsLinked to original sources
PubMed1993

Cutaneous histamine reactivity, histamine content of commercial allergens, and potential for false-positive skin test reactions in dogs.

The cutaneous reactivity of normal and atopic dogs to intradermal injections of histamine phosphate was evaluated. Significant differences were not found in the mean wheal diameters of either group. Commercial allergens used for intradermal skin testing and immunotherapy were determined to contain histamine. To determine whether allergen histamine content was sufficient to cause false-positive skin test results, the cutaneous response of Johnson grass allergic dogs was compared, using commercial Johnson grass allergen and commercial Johnson grass allergen with histamine removed. Significant differences were not noticed between Johnson grass and dehistaminized Johnson grass. Therefore, the histamine content of commercial Johnson grass allergen did not appear to cause false-positive skin test results for this group of Johnson grass allergic dogs.

Allergens↗
PubMed1993

[Prolongation and normalization of bleeding time during therapy with different doses of acetylsalicylic acid].

The present study investigated whether there is a statistically significant correlation between platelet aggregation inhibition (TAI) and prolongation of subaqueous bleeding time (SBT) under therapy with 40 mg (n = 20) and 500 mg (n = 20) acetylsalicylic acid (ASA) daily and when parameters return to normal after discontinuation of long-term (4 weeks) and short-term (1 week) treatment. The results of this study may be helpful in clinical practice when deciding upon indications for certain operative or anaesthetic procedures. RESULTS. Under ASA treatment, neither TAI nor prolongation of SBT was dependent on dosage or time (Figs. 1-4). After discontinuation of ASA, platelet aggregation returned to normal 1-4 days later than SBT, depending on the dosage and duration of medication. SBT declined to its initial value on the 3rd day following discontinuation of ASA in both dosage groups (Figs. 2 and 4). Normalisation of platelet aggregation depended on dosage: in those groups with 40 mg ASA, thrombocyte aggregation had normalised on the 4th day irrespective of duration of medication; in groups with 500 mg aggregation capacity was completely restored on the 5th day after 1-week therapy and on the 7th day after 4-week therapy (Figs. 1 and 3). Considering these results, an important factor is the time of discontinuation of ASA intake. Prior to scheduled operative procedures or regional anaesthetics near the spinal cord, ASA should be discontinued, depending on the dosage, 2-3 days ahead. At this time SBT has reached the initial value, however, the aggregation capacity of thrombocytes is still reduced for a few days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Pneumatosis intestinalis--histology, immunocytochemistry and new theory of morphogenesis].

Based on the light microscopical and immunocytochemical findings in two cases of pneumatosis intestinalis, a new theory is advanced on the morphogenesis of the cysts that can be observed in this disease. The cavities identifiable in both cases in the submucosa of the small intestine and of the colon, respectively, were partially lined by histiocytes and foreign-body giant cells. Most of the lumina found in the subserosa of the stomach, small intestine and colon had an identical aspect. In addition, there were numerous true cysts here with a narrow, single-layered cells seam, showing the immunocytochemical characteristics of the mesothelium, but not the capillary endothelia. Thus, contrary to previous assumptions, pneumatosis interstinalis apparently does not develop from cystic dilatation of gas-filled lymph vessels that shrink and disappear in the process of an inflammatory foreign body reaction. Rather, the disease initially seems to manifest itself through gas-filled pseudocysts partially bordered by histiocytes and foreign-body giant cells, which become secondarily mesothelialized in the subserosa. Lymph vessels would thus not have significance for the morphogenesis of this disease.

Aged↗
PubMed1992

The histamine content of allergen extracts.

The histamine content of 108 inhalant, food, and venom extracts from four commercial sources was measured by chemical (glass fiber-based) and immunologic (competitive RIA) methods. Histamine was present in 64 of 76 inhalant extracts (range, 0.005 to 7.4 micrograms/ml), 20 of 26 food extracts (range, 0.16 to 23 micrograms/ml), and six of six venoms, 100 micrograms/ml (range, 1.0 to 38 micrograms/ml). Histamine was removed by treatment with diamine oxidase or dialysis of an extract. Repeat assay of selected extracts after addition of known amounts of histamine in the glass fiber-based method produced additive results, and glycerin- or phenol-extract preservatives did not affect assay performance. Timed extractions of dried-pollen grains demonstrated maximal histamine content at 30 seconds, suggesting that histamine is an inherent component of at least some pollens. Histamine found in some allergen extracts could, under extreme circumstances, produce false-positive results in skin testing and in basophil histamine release assays, and could affect the result of research that uses intact pollen or allergen extracts.

Allergens↗
PubMed1992

[Long-term medication with acetylsalicylic acid--a problem in regional anesthesia?].

In patients medicated with acetylsalicylic acid (ASA) and undergoing regional anaesthesia there is a risk of traumatically induced haematoma, particularly near the spinal cord. The increased bleeding tendency following aspirin administration is due to a change in thrombocyte aggregation caused by irreversible inhibition of prostaglandin synthesis. In order to assess the bleeding risk, it was investigated whether and how much subaqueous bleeding time (SBT) and aggregation inhibition (AGI) change under low-dose medication, and when these values return to normal after the end of administration. RESULTS. 1. SBT increased significantly with daily ASA medication of 100 mg or of 300 mg. However, only 4.5% of the values measured were within a pathologic range. After discontinuation of the medication SBT significantly dropped on the 2nd day, reaching the initial level on the 4th day at the latest. 2. AGI was significantly reduced, to 20% of the normal value. Depending on the dosage, the 100-mg group reached full aggregation capacity on the 4th day and the 300-mg group on the 7th day following discontinuation of medication. 3. AGI returned to normal 2-3 days later than SBT. CONCLUSIONS. 1. In the case of pathologically increased values (greater than 6 min), the determination of SBT may indicate an increased bleeding risk. 2. If SBT is within the normal range during or shortly after ASA administration, thrombocytic function is still disturbed. Whether there is a correlation between inhibition of thrombocyte aggregation and the occurrence of spinal haematomas is not yet known. 3. In view of these results, the effect of ASA should be investigated by determining SBT prior to scheduled regional anaesthetic procedures near the spinal cord. 4. If SBT is increased (greater than 6 min) and regional anaesthesia near the spinal cord is indicated, the procedure involving the slightest trauma (spinal anaesthesia) should be chosen [31]. Careful postoperative follow-up (1-2 days) should be guaranteed with regard to neurological disorders.

Adult↗
PubMed1992

[Determination of the spread of epidural anesthesia. A comparison between pin-prick and a new method using a metallic roller].

A new method (metal roller) for testing the spread of analgesia in regional anesthesia is introduced. The possible advantages of testing with a metal roller (cold sensation) in comparison to the pinprick method are investigated and discussed to determine whether loss of cold-sensation is comparable to loss of pinprick-sensation and thus reliable in clinical practice. METHOD AND MATERIAL. Spread of analgesia was tested with both the metallic roller and the conventional pinprick method in 40 patients (20 epidural and 20 spinal blocks), and pain perception or cold perception were compared. RESULTS. In epidural as well as in spinal anesthesia, similar levels of loss of pain perception and cold perception were found. DISCUSSION. Testing the spread of analgesia after nerve bock by the pinprick method is sometimes unpleasant for the patient. The metal roller is not unpleasant, and the possible danger of contamination or pinprick pain is virtually impossible because physical integrity is preserved and the feeling of "cold" is not harmful.

Anesthesia, Epidural↗
PubMed1992

[Does an injection filter modify the cranial spread of a sensory blockade in epidural anesthesia?].

UNLABELLED: In a prospective study we compared the spread of sensory blockade in epidural anaesthesia with and without Micropore filter. MATERIALS AND METHODS: A total of 32 patients undergoing varicose vein stripping under epidural anaesthesia were randomly assigned to two groups of 16 each. Bupivacaine 0.75% and POR 8 (0.1 IU/ml) were administered by means of a constant-velocity perfusor. In group A a Micropore filter was inserted between the perfusor syringe and the epidural catheter. In group B the epidural catheter was connected to the syringe without the filter. The puncture was performed at the L3-4 interspace with the patient in a sitting position. An epidural catheter was advanced 3 cm cephalad. Using the pin-prick method, the sensory level of the blockade was tested 5, 7, 10, 15, 20 and 30 min after injection of the local anesthetic solution. Statistical evaluation was performed with the t-test for unpaired samples. RESULTS. After 10 min the spread of analgesia was 5.75 +/- 1.26 segments in group A and 8 +/- 1.89 segments in group B; after 15 min it was 7.06 +/- 1.62 segments and 9.56 +/- 1.54 segments; after 20 min, 7.87 +/- 1.62 segments and 10.62 +/- 1.45 segments; and after 30 min 8.12 +/- 1.66 segments and 11.12 +/- 1.45 segments in group A and B, respectively. At any time sensory blockade was higher in group B (without Micropore filters) than in group A. The mean difference between the two groups amounted to 2-3 segments. The differences were significant at any time (P less than 0.001). These results show that the use of a Micropore filter in epidural anaesthesia leads to a reduced spread of sensory blockade. In our own examinations we found lowering of the pressure of the local anaesthetic solution that passes through the Micropore filter compared with the pressure of the solution injected without the filter. This seems to be the reason for the reduced spread of sensory blockade. Using these filters the onset of analgesia is delayed, and a given spread of analgesia needs a larger dose of local anaesthetic and is thus accompanied by a higher toxicity.

Adult↗
PubMed1992

[Subdural and epidural hematomas following epidural anesthesia. A literature review].

Of 434 cases of epidural, subdural, and intracranial haematomas published in the last 2-3 decades, 61 had developed following spinal, epidural or caudal anaesthetic procedures; 29 haematomas were around the spinal cord and 32, within the cranium. The most frequent secondary cause of this complication was pre-, intra-, or postoperative administration of drugs influencing blood coagulation. Simultaneous traumatic and haemorrhagic punctures may favour the development of a haematoma. The most common primary symptom of lumbothoracic haematomas was back pain with and without radicular symptoms, while intracranial haematomas were predominantly accompanied by persistent headache. Continuous postoperative follow-up of such patients is essential. Postoperative results of laminectomies for lumbothoracic haematomas has been found to on the time interval between the first symptoms and the start of surgery. If surgery is performed within 8 h after the onset of paraplegia the prognosis is relatively good. Compared with the frequency of spinal, epidural, and caudal anaesthetic procedures throughout the world, haematomas of the lumbothoracic or cranial region are extremely rare complications.

Adult↗
PubMed1991

Biochemical signal transduction of mechanical strain in osteoblast-like cells.

The responses to mechanical loading of two types of osteoblast-like cells and skin fibroblasts were investigated using two new devices for applying defined and homogeneous strains to cells. The results indicate that only periostal (bone surface) osteoblasts are sensitive to strains within the physiological range and that a specific strain mechanism is responsible. Osteoblasts derived from the haversian system and skin fibroblasts do not respond except at higher, unphysiological strains. The mechanism is located in the cytoskeleton and activates the membrane phospholipase C within milliseconds and may react to distension of a strain sensitive protein. Activation of phospholipase C can account for only some of the observed responses of bone to mechanical loading such as stimulation of cell division, increase in collagen and collagenase production. Application of over 10,000 mu strains results in a de-differentiation of the osteoblasts and a change in cell morphology to become fibroblast-like.

Animals↗
PubMed1991

Suppressive effect of loratadine on allergen-induced histamine release in the nose.

It has been speculated whether the recently developed non-sedating antihistamines may possess other properties than merely being antagonists at the H1-receptors. To investigate this suggestion 12 patients with strictly seasonal allergic rhinitis participated in a double-blind placebo controlled randomized cross-over study outside the pollen season. At steady state levels of 10 mg loratadine, a new non-sedating antihistamine, the patients were challenged with methacholine. This was followed by a nasal challenge with increasing doses of allergen. 24 h later the patients were rechallenged nasally with the same methacholine dose as the day before. The volume of the methacholine-induced nasal secretion was measured and the response to allergen was determined by scoring technique. In returned nasal lavage fluid the levels of histamine and TAME-esterase activity were measured. It was found that loratadine significantly reduced the immediate allergic nasal symptoms compared with placebo (P less than 0.01). Loratadine also reduced the allergen-induced release of histamine into the nasal cavity after the strongest allergen dose, from 9.6 +/- 1.5 (mean +/- SEM) to 6.4 +/- 1.4 ng/ml (P less than 0.05). A similar decrease in the TAME-esterase activity after treatment with loratadine was observed. The TAME-esterase activity decreased from 11.6 *10(3) +/- 2.47 *10(3) to 5.60 *10(3) +/- 1.45 *10(3) CMP (P less than 0.05). There were no significant changes between the active and placebo treatments regarding the methacholine-induced secretory response. This was true for the initial methacholine challenge as well as the secretory response 24 h later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[An attempt at a mathematical prediction of the depth of insertion of the needle in peridural anesthesia].

The purpose of the investigation was to correlate the distance from the skin to the flaval ligament with the individual data of patients such as bodyweight, height, sex and age with the aim of predicting the depth of insertion of the needle. In a retrospective study we examined 448 patients (217 men and 231 women). In the anaesthetic records the depth of insertion of the needle was noted together with the patients' personal data. Evaluation of the material showed that there is no correlation of statistically significant relevance between the depth of insertion and the bodyweight and age of the patient, but there is a correlation between depth of insertion on the one hand and the variables bodyweight, overweight and the quotient body height/weight on the other. This correlation showed a somewhat higher significance in women than in men. The correlation can be expressed in a formula like y = K + fx, whereby for the relation between depth of insertion and body weight the equation for men is y = 1.87518 + 0.02761x. The equation for women is y = 2.23985 + 0.03559x. With these formulae a rough prediction for the depth of insertion can be made, with x representing the bodyweight and y the expected depth in cm. The measured values fluctuated between 3.5 and 7.4 cm in the 217 men, with the medium value at 4.08 cm. In the 231 women the measured values fluctuated between 3.3 and 6.9 cm with the medium value at 4.67 cm.

Adolescent↗
PubMed1990

Immunochemical cross-reactivity between albumin and solid-phase adsorbed histamine.

For production of an antibody against histamine, this was coupled to human serum albumin (HSA) and used for immunization of rabbits. To test the antiserum, an immunoradiometric assay was developed comprising solid-phase bound histamine, antisera and radiolabelled protein A. Titration and inhibition experiments revealed that histamine adsorbed onto a solid-phase could bind the antiserum. However, neither free histamine nor histamine coupled to unrelated carriers could inhibit the binding of antiserum to the solid-phase histamine. Cross-reactivity was demonstrated between HSA and solid-phase bound histamine, as the immunoradiometric assay was inhibited by HSA. This unexpected cross-reactivity was established, as a commercially available antiserum with specificity to HSA without histamine also bound to the solid-phase bound histamine. It is suggested that preparations of antibodies against histamine are tested for this possible cross-reactivity.

Adsorption↗
PubMed1990

Measurement of histamine in nasal lavage fluid: comparison of a glass fiber-based fluorometric method with two radioimmunoassays.

The determination of histamine in nasal secretions and nasal lavage fluid may be of importance to monitor activation of histamine containing cells in the nasal cavity. However, such studies have been besieged by controversy, specifically to findings of changes in histamine levels in relation to allergenic stimulation. This controversy may be due to the specificity and accuracy of the various methods used to determine histamine in the nasal fluid. We have therefore applied and compared three new methods to determine histamine in nasal lavage fluids obtained before and after allergen challenge in normal subjects and patients with allergic rhinitis. We used a fluorometric glass fiber-based histamine method (FHR) and two RIAs, I and II. The FHR (detection limit, 7.0 nmol) and the RIA II (detection limit, 0.2 nmol) are specific for histamine itself, whereas the RIA I (detection limit, 18.0 nmol) measures mainly methylhistamine and cross-reacts to some extent with histamine. The histamine levels in the nasal lavage fluids from the nasal challenges demonstrated histamine values between 100 and 2000 nmol/L of histamine with significantly higher levels in the postallergen challenges for the allergic subjects as compared to the normal control subjects. The FHR correlated well with the RIA I and RIA II methods with correlation coefficients of 0.77 to 0.88 (p less than 0.001), respectively. However, the RIA I (methylhistamine antibody) always demonstrated absolute histamine values 5% to 20% of values measured by the RIA II (at the level of cross-reactivity to histamine).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Diagnostic value of a glass fibre-based histamine analysis for allergy testing in children.

The aim of this study was to compare the diagnostic value of common allergy tests with basophil histamine release in 124 children with symptoms of asthma. The patients were evaluated by case history, skin prick test, RAST-analysis, and basophil histamine release using a glass fibre-based histamine assay to 10 common inhalant allergens. The bronchial provocation test was used as a reference of "true" IgE-mediated asthma. To compare the various diagnostic parameters each absolute test value was classified into a scoring system. The concordance between the tests varied between 85-97%. In general, the best concordance was found between basophil histamine release and RAST. Sensitivity, specificity and predictive values were calculated on the basis of 104 bronchial provocation tests. It was found that histamine release was the best single analysis, followed by RAST and prick testing. The sensitivity of RAST and histamine release was very high (1.00) for pollen and house dust mites. Histamine release showed a predictive value between 0.91 and 1.00 for pollen and house dust mites, thus indicating the possibility of omitting the bronchial provocation test. In the dander group histamine release gave the best sensitivity (0.91), however at the expense of specificity (0.64), whereas RAST and skin prick test gave a specificity of 1.00. In the mould group histamine release also showed the best diagnostic value. The combination of skin testing with histamine release or RAST was of no additional diagnostic help. It is concluded that the glass fibre-based histamine analysis, which makes routine histamine release testing possible, is a reliable diagnostic test in children.

Asthma↗
PubMed1990

Basophil histamine release in the diagnosis of house dust mite and dander allergy of asthmatic children. Comparison between prick test, RAST, basophil histamine release and bronchial provocation.

The aim of the study is to compare the glass fibre-based basophil histamine release test with skin test (Phazet), RAST (Phadebas) and bronchial provocation test in children with allergic asthma. The study comprised 68 selected children with a case history of extrinsic allergic asthma to danders (cat and dog) and house-dust mite. Skin prick test, RAST, and histamine release were performed in all children and the bronchial provocation test was used as a reference of "true allergic asthma". A total of 81 allergen bronchial challenges were performed and 44 children experienced 49 positive provocations. In 2.9% (2/68) of the children histamine release could not be performed due to technical difficulties (low histamine release with anti-IgE). Concordances in the range 76-87% were observed with no significant difference between the tests. The highest concordance (87%) was found between histamine release and bronchial provocation test followed by skin prick test vs bronchial provocation (84%) and RAST vs bronchial provocation (80%). The sensitivity and specificity were calculated for each test. All tests showed sensitivities in the range 90-94% and no significant difference between them was observed. The specificity of histamine release, skin prick test, and RAST was 0.78, 0.69, and 0.63, respectively. The specificity of histamine release was better than RAST demonstrated by 95% confidence intervals. In conclusion, it was found that the histamine release test is a convenient diagnostic method and the study indicates a diagnostic value comparable to the common diagnostic methods in clinical allergy.

Animals↗