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Biomedical subjects

H Rauscher

Publications and source records attributed to H Rauscher.

At least 37 records · Page 2Linked to original sources

Quantification of sleep disordered breathing by computerized analysis of oximetry, heart rate and snoring.

Intermittent snoring and cyclic oscillations of heart rate and oxyhaemoglobin saturation (Sao2) are characteristic features of the obstructive sleep apnoea syndrome (OSAS). Thus, overnight recordings of laryngeal sounds and heart rate by a portable device (MESAM) and of Sao2 by oximetry are applicable to screen outpatients for the presence of OSAS. Computerized analysis for time intervals of constant heart rate and intervals between snoring sounds is used by MESAM to quantify respiratory disturbances during sleep. Rapid increases in Sao2 during the postapnoeic hyperventilation period together with the number of desaturations are used by a new software for quantitative analysis of oximetry. To elucidate reliability of results from automatically scored MESAM and oximetry recordings, we compared the four computer calculated respiratory disturbance indices from heart rate (RDIH), snoring (RDIS), resaturations (RDIR) and desaturations (RDID) with the apnoea plus hypopnoea index (AHI) from simultaneously performed polysomnography. The study population consisted of 53 snorers with an AHI of 19.0 +/- 2.6 (median +/- SEM; range 0.7-87.8). Whereas both RDI's from MESAM correlated rather weakly with the AHI from polysomnography (RDIH: r = 0.32, p less than 0.05; RDIS: r = 0.33, p less than 0.05), this correlation was much better for the RDI's from oximetry (RDIR: r = 0.951, RDID: r = 0.93; p much less than 0.0001). Accepting a plus/minus 30 percent difference from the AHI, the RDIR classified 77% of patients correctly, the RDID 62%, the RDIS 32% and the RDIH 23%. In conclusion, results from computerized analysis of oximetry for desaturations and rapid resaturations correlate more closely with polysomnography than those from automatic scoring of MESAM recordings.

Heart Rate↗

Increased sensitization to aeroallergens in competitive swimmers.

Chlorine is used to disinfect swimming pools or as a constituent of other disinfection reagents. Pulmonary diseases are occasionally observed after exposure to chlorine. In 14 competitive swimmers and in 14 matched control subjects, we searched for clinically manifest allergies, subclinical sensitization to aeroallergens, imbalance of the cellular immune system, and bronchial hyperresponsiveness. Conjunctival or respiratory symptoms were found in 11 swimmers (2 cases of conjunctivitis, 4 rhinitis, 2 rhinoconjunctivitis, 1 laryngitis, and 2 bronchitis) and in 3 controls. Sensitization to aeroallergens was confirmed in 9 swimmers by skin test and in 11 swimmers by radioallergosorbent test (RAST), compared to findings in 4 and 5 controls, respectively. An altered cellular immune system, (i.e., imbalance in T-cell system, B-cell system, or natural killer cells) was detected in 7 swimmers and only 2 controls. Bronchial hyperresponsiveness to methacholine was seen in 11 swimmers and 5 controls. This higher incidence of allergic diseases and subclinical sensitization to aeroallergens, disorders of the cellular immune system, and bronchial hyperresponsiveness in competitive swimmers compared with control subjects could be due to repeated exposure to chlorine in swimming pools.

Adolescent↗

Flow-volume curves in obstructive sleep apnea and snoring.

The diagnostic value of flow-volume curves for sleep apnea was studied in 32 patients with obstructive sleep apnea, 40 simple snorers, and 30 healthy nonsnorers. A sawtooth appearance of the flow-volume curve was seen in 22 of the sleep apnea patients (69%), 14 of the simple snorers (35%), and 10 of the nonsnorers (33%). The ratio of midexpiratory flow (FEF 50) to midinspiratory flow (FIF 50) was greater than 1 in 6 of the sleep apnea patients (19%), 3 of the simple snorers (8%), and 2 of the nonsnorers (7%). Thus, only the sawtooth sign was more frequently found in sleep apnea patients than in controls (p less than 0.01). Sleep apnea patients with a sawtooth appearance of the flow-volume curve had a higher apnea index (38.7 +/- 22 vs. 21.5 +/- 12.1; p less than 0.01) and lower nocturnal minimum oxygen saturation (68.1% +/- 16.8 vs. 81.3% +/- 9.97; p less than 0.01) than those without. In symptomatic snorers, sensitivity of the sawtooth sign for sleep apnea was 72% and specificity 61%, for a FEF50/FIF50 ratio above 1 sensitivity was 17% and specificity 83%. In asymptomatic patients, sensitivity of either sign was extremely poor (33%) and specificity was 67% for the sawtooth sign and 85% for FEF50/FIF50 greater than 1. We conclude that abnormal flow-volume curves are of limited value for predicting sleep apnea.

Adult↗

Bronchoalveolar lavage in rheumatoid arthritis and secondary Sjögren's syndrome.

Bronchoalveolar lavage (BAL) was performed to investigate pulmonary involvement in 39 patients with rheumatoid arthritis (RA) and in 7 patients with RA and secondary Sjögren's syndrome, and compared to 12 healthy controls. Lymphocytosis (more than 15%) was seen in 25, and more than 3% neutrophil granulocytes in 8 of 39 patients with RA. Lymphocytosis and/or neutrophil granulocytosis was seen in both seropositive and seronegative patients irrespective of clinical or radiologic findings. Patients with RA with or without secondary Sjögren's syndrome had increased DR+ lymphocytes in BAL compared with peripheral blood. In 7 patients with secondary Sjögren's syndrome an increased helper/suppressor cell index (OKT4+/OKT8+: 7.65 +/- 2.10) and increased natural killer cells (OKNK+: 27.3 +/- 5.5%) were found, as compared to 39 other patients with RA (OKT4+/OKT8+: 2.16 +/- 0.33, p less than 0.05; OKNK+: 14.5 +/- 2.3%, p less than 0.05). These BAL data are further evidence of frequent subclinical interstitial pulmonary involvement in RA with differences in the active autoimmune process from those in secondary Sjögren's syndrome.

Aged↗

Risk factors for sensitization to furred pets.

The risk factors for sensitization to pets was investigated in 169 male pupils. A recent or former contact with cats, dogs, and guinea pigs in own home was reported in 52 (30.8%), 42 (24.9%), and 20 (11.8%) study subjects, respectively. Clinically manifested allergy was found in two probands to cats and in two others to guinea pigs, three of them had formerly had pets and one proband with allergic rhinitis to cats had never had any pet. Sensitization to animals and aeroallergens was investigated with Phadezym-RAST. Only owners of cats had a higher incidence of cat sensitization than probands without direct contact (26.9% versus 10.3%, P less than 0.01). No statistically significant difference in sensitization to dogs and guinea pigs was found in groups with and without these pets. A strong correlation existed between sensitization to pets and other aeroallergens (house dust mite: P less than 0.025, birch pollen: P less than 0.0001, mugwort: P less than 0.0001, and grass pollens: P less than 0.0001). No association was found between sensitization to pets and smoking history, bronchial hyperreactivity to methacholine or radiological findings of the paranasal sinus.

Adolescent↗

[Mold allergies--a challenge in diagnosis and therapy].

Problems in the diagnosis of mould allergies arise from a large number of mould species, different expression of allergens and limited supply of allergens in test systems. Only the use of many different and special diagnostic methods enables an accurate clearing up of diseases. Not until all diagnostic problems are resolved, an adequate therapy is possible and should use new ways.

Alveolitis, Extrinsic Allergic↗

[Obstructive sleep apnea--a risk factor for arterial hypertension].

Obstructive sleep apnea is frequently found in middle-aged men. Usually, these patients are obese and therefore predisposed to hypertension. This study aimed to elucidate the relationships between hypertension, obesity and obstructive sleep apnea in 48 men suffering from sleep apnea. Hypertension was found in 39 of them (= 81%), 27 patients (= 56%) were morbidly obese (Broca index above 125%), 17 patients (= 36%) were moderately obese (Broca index between 100 and 125%) and 4 patients (= 8%) showed normal weight (Broca index below 100%). Severity of sleep apnea did not correlate with obesity or hypertension. Patients with sleep apnea who were hypertensive were significantly (p less than 0.025) more obese than those with normal blood pressure. Compared with an unselected population showing a similar degree of obesity, patients with obstructive sleep apnea showed a higher prevalence of hypertension and this is independent of age. These findings establish sleep apnea as a risk factor for hypertension.

Adult↗

Increased expression of HLA-DR antigen on alveolar macrophages in pulmonary diseases.

The expression of HLA-DR antigen on alveolar macrophages obtained by bronchoalveolar lavage in healthy controls and patients with different diseases was investigated, using cytofluorographic analysis and phykoerythrin conjugated monoclonal mouse anti-human HLA-DR antibody. Alveolar macrophages in patients with extrinsic allergic alveolitis (n = 4), idiopathic lung fibrosis (n = 4), sarcoidosis (n = 6), rheumatoid lung disease (n = 6) and pulmonary infection (n = 5) showed increased density of HLA-DR antigen expression compared to healthy control subjects (n = 5). The increased expression of HLA-DR antigen on alveolar macrophages confirms the importance of these cells for recognition of antigens and immunological responses in different pulmonary diseases.

Bronchoalveolar Lavage Fluid↗

Sensitization to aeroallergens depends on environmental factors.

Respiratory allergies and subclinical sensitization to aeroallergens were investigated in 129 rural and in 222 urban probands. The incidence of respiratory allergies was not significantly higher in the urban residents. Sensitization to aeroallergens was investigated with Phadezym RAST (house dust mite, Cladosporium, orchard grass, birch pollens) and the Phadiatop multi RAST and found to be significantly more frequent in polluted than in unpolluted areas. Allergen-specific IgE was detected n 37.8% of urban probands and in 25.6% of rural probands with Phadezym RAST (P less than 0.025) and a positive Phadiatop multi RAST was found in 43.7% versus 32.6 (P less than 0.05).

Adolescent↗

Effect of short esophageal acidification on airway hyperreactivity.

The influence of short esophageal acidification on the bronchial reaction to methacholine was assessed by quantitative methacholine challenge tests after ingestion of orange-juice (pH 2.7). We studied 15 stable asthmatics and 10 hyperreactive nonasthmatics. After the acidic drink, airway hyperreactivity increased in 6 of the 15 asthmatics and 4 of the 10 hyperreactive nonasthmatics. For the groups as a whole, this response did not reach statistical significance in either group. Nevertheless, the finding that 40% of the patients responded to short esophageal acidification by an increase in airway hyperreactivity points out the importance of low esophageal pH values as a possible triggering factor of asthmatic attacks.

Administration, Inhalation↗

Detection of antigen-specific antibodies on lung tissue in a patient with hypersensitivity pneumonitis.

A patient with hypersensitivity pneumonitis showed positive Ouchterlony's immunodiffusion tests against pigeon faecal extract, Cephalosporium and Pullularia antigens. Deposits of immunoglobulins-IgG and IgM antibodies-were detected in a subendothelial position in arterial and venous vessels and on alveolar macrophages in the lung tissue. The IgG deposits in blood vessels belonged to IgG1, IgG2 and IgG3 subclasses and the absorbed IgG on alveolar macrophages to all IgG subclasses. The detection of allergen specific antibodies in lung tissue was made by indirect immunofluorescent staining with FITC conjugated antigen extracts from pigeon faeces and demonstrated the aetiology of this hypersensitivity pneumonitis.

Adult↗

Short-term sensitizing antibodies in bakers' asthma.

In a prospective study the occurrence of rye-specific IgG4 was investigated. We compared 17 bakers with clinical symptoms of bakers' asthma and a more than 100% increase in specific airway resistance following rye dust provocation to 16 bakers who showed neither symptoms of asthma nor an increase in specific airway resistance following rye dust provocation. In the group of patients with allergic type I responses, specific IgG4 was found in 15 cases by an indirect immunofluorescent test on rye grains. In none of the asymptomatic bakers was rye-specific IgG4 detected. In 15 symptomatic subjects rye-specific IgE alone or together with rye-specific IgG4 was found. In 2 cases only rye-specific IgG4--the so-called short-term sensitizing antibody--was demonstrated to explain the allergic bronchial response.

Allergens↗

Indirect immunofluorescent test on spore sampling preparations: a technique for diagnosis of individual mold allergies.

To calculate their respective exposure to mold spores, volumetric spore sampling was performed with Burkard personal air samplers in the homes of six asthmatic patients with different mold allergies, of three patients with baker's asthma and of four healthy controls. The spore samples were investigated with an indirect immunofluorescent test. Spore-specific IgE was detected in the serum of all the asthmatic patients with mold allergies, even in patients with only slightly increased or no detectable specific IgE in Phadezym-RAST. In serum of patients with baker's asthma and healthy controls, no spore-specific IgE was found.

Antibodies, Fungal↗