Biomedical subjects

J E Juto

Publications and source records attributed to J E Juto.

At least 19 recordsLinked to original sources

PubMed2004

Nasal histamine reactivity among adolescents in a remediated moisture-damaged school--a longitudinal study.

UNLABELLED: In a previous study, in the spring of 1995, we found that teachers, who had been working for several years in a moister-damaged school, 1 year after the renovation still reported a higher frequency of complaints and symptoms and showed significantly higher mucosal histamine reactivity compared with teachers in a control school, although the school seemed to be properly renovated. A longitudinal study of 90 randomly selected senior high school students entering the two schools was initiated to exclude or verify if the indoor air still exerted an irritant effect on the upper airways of an earlier unexposed group. The students went through a nasal histamine provocation test and answered a questionnaire on three occasions, in 1995, 1996 and 1997. No significant differences in the nasal histamine provocation curves for the students at the target school and those at the control school could be shown from start to endpoint of the study period. Neither was there any differences concerning perceived indoor air or mucosal symptoms between the target and the control group and technical measurements showed no noteworthy differences between the two schools. In conclusion, this study indicates that based on both technical and objective medical measures, the current indoor air in the remediated moisture-damaged school does not exert an irritant effect on the upper airway mucosa of the students. A 2-year follow-up of the teachers showed a decreased reactivity to histamine, giving further support to this statement. The increased mucosal reactivity observed among the teachers is probably a result of the previous long-term exposure to building dampness. No differences were seen between atopic and non-atopic students. PRACTICAL IMPLICATIONS: Persistent symptoms and increased nasal mucosal reactivity among personnel in a remediated damp building does not necessary imply an inadequate renovation. A longitudinal study with registration of subjective (questionnaires) and objective (nasal histamine reactivity) data of an earlier unexposed group residing in the same building further contributes to the evaluation whether the renovation was successful or not.

Adolescent↗

PubMed2002

Nasal mucosal histamine reactivity among young students and teachers, having no or prolonged exposure to a deteriorated indoor climate.

BACKGROUND: In a study performed in the spring of 1995, we found a significantly greater nasal mucosal histamine reactivity among teachers, who had worked for several years in a recently renovated moisture-damaged school, than in those in a control school. In the present study we investigated the students who begun their high-school studies at both schools in the autumn of 1995 and compared them with the teachers as regards mucosal reactivity, atopy and symptoms. METHODS: Twenty-eight teachers in the target school, 18 teachers in the control school and 45 students from each school underwent a nasal histamine provocation test and a skin-prick test. They also answered a standardized questionnaire. RESULTS: The teachers in both schools had more marked nasal mucosal histamine reactivity at the lowest provocation concentrations than the students. The histamine provocation curve of the target school teachers had consistently higher values than that of the students (P = 0.0001), but its slope and shape were similar (P = 0.15), while the slope of the provocation curve of the control school teachers was flatter. However, there was only a borderline significance in this respect compared to the students (P = 0.07). Teachers with a dry and crusty appearance of the nasal mucosa on anterior rhinoscopy reacted more strongly to histamine provocation than those without this finding (P = 0.0004). There was a significantly higher frequency of skin-prick test positivity (SPT+) among the students (P = 0.03). There were no significant differences in nasal mucosal histamine reactivity between atopic and non-atopic subjects out of pollen season. CONCLUSIONS: Teachers had a significantly greater mucosal histamine reactivity than the students, whereas the latter had a significantly higher frequency of atopy. These results are compatible with an age-related pattern of mucosal reactivity. A crusty appearance of the nasal mucosa seems to predispose to an increase in histamine reactivity. There were no significant differences according to histamine reactivity between atopic and non-atopic subjects.

Adolescent↗

PubMed2002

Slowly decreasing mucosal hyperreactivity years after working in a school with moisture problems.

In our first study in 1995, teachers, who had worked in a water-damaged school for more than 5 years, were tested for nasal histamine reactivity by rhinostereometry. They were found to have significantly increased reactivity compared with teachers in a school without these indoor-climate problems. This finding could not be explained by differences in atopy or other personal characteristics. In this 2-year follow-up study (1995-97), 26 of 28 teachers in the target school and all 18 teachers in the control school, who participated in the initial study, accepted to take part. They were tested with the same histamine provocation procedure and answered the same questionnaire as 2 years earlier. Technical measurements of temperature, relative humidity, dust, carbon dioxide, formaldehyde and total volatile organic compounds (TVOC) were carried out in both schools during the time period between the two test occasions. In this provocation test, the teachers from the repaired water-damaged school still demonstrated an increased reactivity to histamine compared with the teachers in the control school, but the difference between the growth curves of the provocation tests was less than in 1995. Teachers in the target school still complained about the indoor air quality more than their colleagues, although the complaints were less common. No major differences were observed in the technical investigation between the two schools and the measurements were all within values usually seen in schools in northern countries. Our conclusion is that the observed nasal mucosal hyperreactivity among the teachers in the renovated water-damaged school seems to persist over years and only slowly decrease even after successful remedial measures have been taken.

Adult↗

PubMed2000

The eye irritation and odor potencies of four terpenes which are major constituents of the emissions of VOCs from Nordic soft woods.

Eye goggles were used to estimate human thresholds for sensory eye irritation from four monoterpenes: (+)3-carene, (-)limonene and (+)alpha-pinene and (rac)alpha-terpineol all known as air pollutants emitted from wood. Only a ranking of the irritation thresholds relative to that of n-butanol is given. The measurements showed that the thresholds for eye irritation of the terpenes ranged from subthreshold to below 1,250 mg/m3. It appears that the irritation of 3-carene and limonene in contrast to the expectations was of the same size as or less than that of n-butanol. Too few subjects reported eye-irritation for alpha-pinene and alpha-terpineol to allow estimates of thresholds of these compounds which therefore have much less irritative potency than n-butanol, 3-carene, and limonene. The measurements of one terpene alcohol do not support the hypothesis that monoterpene alcohols, would have lower eye irritation threshold than monoterpene hydrocarbons. The sequence from strongest odorant to weakest was alpha-terpineol, 3-carene, n-butanol, limonene and alpha-pinene. In conclusion, the tested terpenes can probably be ruled out as cause of acute eye irritation indoors. The measured odor thresholds did not deviate from the few values reported in the literature.

Air Pollution, Indoor↗

PubMed2000

Airway reactivity and exhaled NO following swine dust exposure in healthy volunteers.

Short-time exposure to swine dust causes an intense inflammation of upper and lower airways and induces increased bronchial responsiveness to methacholine in previously non-exposed healthy volunteers. The objective to this study was to investigate the nasal inflammatory response and mucosal reactivity to swine dust exposure and whether nitric oxide metabolism is involved in the inflammatory process. Nitric oxide in expired air, nasal histamine test (NH), nasal lavage (NAL) and bronchial histamine challenges were studied before and after a 3 h exposure to swine dust in a swine confinement building in 17 non-smoking healthy subjects not previously exposed to farm dust. To detect any interference between NAL and NH, the subjects were divided into two groups: in group 1, NAL was performed after NH and in group 2, NAL preceded NH. Nasal histamine response increased significantly in group 1, but not in group 2 (P=0.012). Albumin levels in NAL were higher before as well as after dust exposure in group 1 compared to group 2 (P=0.036 and 0.015 respectively). Bronchial histamine responsiveness increased following exposure (P= 0.045). Nitric oxide in expired air decreased following bronchial histamine challenge at baseline (P=0.013) but was otherwise unaltered. Short-time exposure to swine dust increases non-specific reactivity of both nose and bronchi. Nasal lavage procedure interferes with nasal histamine test when performed with connection to each other. The inflammatory reaction may involve NO metabolism.

Adolescent↗

PubMed1999

Nasal and bronchial histamine reactivity in patients with allergic rhinitis out of season.

BACKGROUND: The correlation between non-specific hyperreactivity of upper and lower airways in pathologic conditions has not been studied extensively. OBJECTIVE: To investigate the occurrence of nasal and bronchial hyperreactivity in patients with allergic rhinitis studied out-of-season. METHODS: From patients admitted to the Allergy Unit at Stockholm Söder Hospital, 12 individuals with allergic rhinitis due to grass or birch pollen were selected. The nasal mucosa was exposed to increasing concentrations of histamine chloride and the response was recorded by rhinostereometry, an optical method that exclusively measures changes in nasal congestion. Bronchial histamine challenge was performed in connection with the nasal tests, but on different days. RESULTS: The nasal histamine response was significantly greater than in a reference group of healthy volunteers (P < .01). Nasal hyperreactivity was demonstrated in 9 of 12 patients. No clear relation between the magnitude of nasal and bronchial histamine responses was seen in the study group. CONCLUSIONS: In allergic rhinitis studied out-of-season, airway hyperreactivity is common in both upper and lower airways, but does not necessarily occur together in the same individual.

Adult↗

PubMed1999

The effects of saline-induced edema in the human nasal mucosa on laser Doppler flowmetry.

The nasal mucosa on the anteromedial surface of the inferior turbinate was studied with laser Doppler flowmetry in ten patients who were under general anaesthesia. A specially designed adapter was used, which held an injection needle with a diameter of 0.4 mm in a fixed position to the tip of the probe. The tip of the needle was inserted to a depth of 0.7 mm below the surface of the mucosa, while the tip of the probe was held at a distance of 0.3 mm from the mucosa. The laser Doppler parameters of perfusion, concentration of moving blood cells (CMBC) and velocity were recorded before and after the injection of 0.8 ml saline, thus inducing an experimental edema. After the injection no change in perfusion was detected but CMBC decreased and velocity increased. The findings agreed with the view that an increase in mucosal edema would reduce CMBC. When studying unanaesthesised subjects we normally use both rhinostereometry and laser Doppler flowmetry. It is then possible to measure the degree of mucosal congestion and micro circulation simultaneously, thus permitting study of the effects of a change in interstitial fluid content on mucosal congestion.

Edema↗

PubMed1995

Benzalkonium chloride in a decongestant nasal spray aggravates rhinitis medicamentosa in healthy volunteers.

A randomized double-blind parallel study with 20 healthy volunteers was performed to research the effect of a preservative in a decongestant nasal spray on the development of rhinitis medicamentosa. Ten subjects received oxymetazoline nasal spray with benzalkonium chloride and the others used oxymetazoline nasal spray without the preservative three times daily for 30 days. Before starting the course of treatment and after its conclusion, recordings of the mucosal surface positions were made with rhinostereometry followed by histamine challenge tests. Symptoms of nasal stuffiness were estimated on visual analogue scales (0-100) in the morning and the evening just before using the nasal spray. After 30 days, rebound swelling and nasal stuffiness were found in both groups. In the group receiving oxymetazoline nasal spray with benzalkonium chloride the mean rebound swelling was 1.1 mm and the estimated mean evening symptom score for nasal stuffiness was 43. In the group without benzalkonium chloride the corresponding variables were significantly less marked, with a mean rebound swelling of 0.5 mm (P < 0.05) and a mean evening symptom score of 25 (P < 0.05). The increase in histamine sensitivity in both groups was interpreted as a sign of nasal hyperreactivity. A new type of nasal spray bottle was used that has been shown to prevent bacterial contamination. In conclusion, the long-term use of benzalkonium chloride in oxymetazoline nasal spray accentuates the severity of rhinitis medicamentosa in healthy volunteers.

Administration, Intranasal↗

PubMed1995

The pathophysiology and treatment of rhinitis medicamentosa.

To evaluate the treatment of rhinitis medicamentosa, 10 consecutive patients discontinued their use of topical vasoconstrictors and were treated with budesonide nasal spray, 400 micrograms, daily for 6 weeks. The thickness of the nasal mucosa, the decongestive effect of oxymetazoline and the histamine sensitivity were measured with rhinostereometry. All patients were able to stop using the vasoconstrictors and objective variables showed that they needed treatment for at least 6 weeks. The results strongly support the theory that the rebound swelling is due to interstitial oedema rather than to vasodilatation. The presence of tachyphylaxis reflected by a reduction in both the decongestive effect of oxymetazoline and a reduction of drug duration was seen.

Administration, Topical↗

PubMed1995

Four-week use of oxymetazoline nasal spray (Nezeril) once daily at night induces rebound swelling and nasal hyperreactivity.

A randomized double-blind parallel study with 20 healthy volunteers was performed to examine the effect of oxymetazoline nasal spray on the development of rhinitis medicamentosa. For 30 days, 10 subjects were given oxymetazoline nasal spray once daily at night and placebo in the morning and at noon, while the others used oxymetazoline nasal spray three times daily. Before and after the course of treatment, the mucosal surface positions were determined with rhinostereometry, followed by histamine challenge tests. In the morning and the evening just before use of the nasal spray, symptoms of nasal stuffiness were evaluated on visual analogue scales (0-100). After 30 days, rebound swelling and nasal stuffiness were found in both groups. In the group receiving oxymetazoline nasal spray once daily at night, the mean rebound swelling was 0.8 mm (p < 0.01) and the estimated mean symptom score for nasal stuffiness in the evening was 43 (p < 0.05). In the group receiving the same nasal spray three times daily, the mean rebound swelling was 1.1 mm (p < 0.01) and the mean evening symptom score was 43 (p < 0.05). The finding of an increase in histamine sensitivity in both groups was taken to indicate nasal hyperreactivity. There was no significant difference in the investigated variables between the two groups. It is concluded that the risk of developing rebound swelling and nasal hyperreactivity remains, whether oxymetazoline nasal spray is used once or three times a day for 30 days.

Administration, Intranasal↗

PubMed1995

Sustained use of xylometazoline nasal spray shortens the decongestive response and induces rebound swelling.

Long-term use of topical vasoconstrictors for the nose may result in rhinitis medicamentosa, drug addiction and tachyphylaxis. Some authors also believe that the severity of rebound swelling is proportional to the period during which the drug has been used, the frequency of its administration, and the amount of drug given. It has previously been reported that four-week use of the recommended dose of oxymetazoline induces rebound swelling, a sign of rhinitis medicamentosa. To study the effect of an increased amount of vasoconstrictor on rebound swelling and the decongestive effect of the drug, nine healthy subjects were given xylometazoline nasal spray in double the recommended dose (1.0 mg/ml; 0.28 ml in each nostril thrice daily) for 30 days. After 30 days on xylometazoline, the decongestive effect was the same 1 h after drug administration as before starting the medication. Similarly, after 30 days on xylometazoline, the decongestive effect was less 5 h after drug administration than it was 6 h after drug administration at the start of medication (p < 0.005). After 10 days no rebound swelling was recorded, but after 30 days rebound swelling occurred in eight out of nine subjects (p < 0.05). When comparing the results of this trial with the corresponding results of the oxymetazoline study, no further increase in rebound swelling was found. We conclude that long-term use of xylometazoline nasal spray shortens the decongestive response in healthy volunteers. Moreover, double the recommended dose of xylometazoline did not further increase the rebound swelling seen when using the recommended dose of oxymetazoline.

Adolescent↗

PubMed1994

Correlation between subjective and objective assessment of nasal hyperreactivity.

The aim of this study was to investigate if there is a correlation between symptom score and response to histamine challenge in patients suffering from non-allergic nasal hyperreactivity. Eighteen patients with perennial rhinitis entered the trial. All had negative skin prick tests and normal total IgE. The nasal mucosa was challenged with three histamine concentration levels, 1, 2 and 4 mg/ml. The objective response was recorded with rhinostereometry and was compared to symptom scores estimated by the patients on a visual analogue scale. With simple analysis of regression there was a significant correlation when challenging with 2 mg/ml (R = 0.695, p < 0.01) and 4 mg/ml (R = 0.569, p < 0.05). The results indicate that the model could be useful for objective assessment of the degree of non-allergic nasal hyperreactivity.

Adolescent↗

PubMed1994

Histamine sensitivity in the nasal mucosa during four-week use of oxymetazoline.

In order to objectively study the histamine sensitivity of the nasal mucosa during 30 days of regular use of oxymetazoline nasal spray (0.5 mg/ml; 0.1 ml in each nostril, thrice daily), eight healthy volunteers were examined with rhinostereometry. After 10 days on being treated, the histamine sensitivity was slightly enhanced. After a further 20 days the sensitivity was significantly increased compared to that before the start of the medication (p < 0.05). This increase in histamine sensitivity for the group is significantly greater than that of healthy drug-free volunteers, and the level is comparable with that of patients with non-allergic nasal hyperreactivity (NANH). It is concluded that a hyperreactive mucosal reaction develops after a relatively short time on oxymetazoline and that the results of this study are in line with the recommendation that the drug should not be used for more than 10 days.

Administration, Intranasal↗

PubMed1993

A test for objective diagnosis of nasal hyperreactivity.

The aim of this study was to develop a method for the objective diagnosis of nasal hyperreactivity. The method should be standardized and simple enough to be used in clinical practice. In the study nasal challenge test with histamine was performed. Ten healthy volunteers and ten patients with a history of nasal hyperreactivity entered the trial. Recordings of nasal mucosa congestion were made with rhinostereometry. The results indicate that this method can indeed be used for the objective diagnosis of nasal hyperreactivity.

Adult↗

PubMed1993

Nasal hyperreactivity. A histamine provocation model.

The aim of the study was to see whether it is possible to select non-allergic persons with hyperreactivity, especially in the nose, from healthy individuals with a histamine standardization test. Another aim was to elucidate whether a so-called priming effect could be present in such a non-allergic disorder. Seven patients with a history of perennial rhinitis, expressed as either or both swelling or discharge from the nose and a negative allergic investigation, were examined on three up to seven consecutive occasions. Rhinostereometry was used to register the reaction in the mucous membrane to a solution of histamine in successively increased concentrations. The results showed a statistically significant difference between this group compared with a control group of healthy volunteers. We could not detect any increase in the sensitivity during repeated provocations.

Adolescent↗

PubMed1992

Nasal mucosa reaction. A model for mucosal reaction during challenge.

Rhinological symptoms in aspects of hyperreactivity and allergy are increasing problems. Previous reports on this subject are based on studies of airway obstruction (rhinomanometry), secreted substances during challenge, and symptom scores. To be able to define and evaluate the pathological reactions in nasal hyperreactivity and allergy, it is necessary to find principles to describe and standardize the reactions of the healthy nasal mucosa. The aim of this study was to examine congestion of the nasal mucosa in healthy volunteers. Existing measuring methods, in this aspect, are either indirect or not accurate enough for this purpose. With the development of rhinostereometry, an optical measuring method, it is possible to record nasal mucosa congestion with high accuracy. A nasal challenge test was made in healthy volunteers with gradually raised concentrations of a histamine solution, which was applied to the inferior concha on the right side. Recordings of the mucosal congestion were made with rhinostereometry. We found that it is possible, with statistical significance, to standardize the reactions of the healthy nasal mucosa: There is no congestion more than 0.4 mm with a histamine concentration of less than 4 mg/ml (p less than 0.05); congestion of more than 0.4 mm is present at histamine concentrations of 16 mg/ml (p less than 0.05).

Adult↗

PubMed1985

Human nasal mucosa reaction during chilling of the feet.

As rhinostereometry, an optical measurement method, allows meticulous studies of changes in nasal mucosa congestion, the mucosal reaction in eight healthy volunteers was studied with this technique before, during and after 20 minutes' chilling of the feet in cold water. In five volunteers there were no observable mucosal reactions. In three volunteers the mucosal congestion changed but not uniformly, and not in such a way that the change could be explained as an effect of chilling of the feet. In four volunteers there was a clearly observable increased nasal secretion. This gives a possible explanation of the increased nasal breathing resistance observed in similar studies using rhinomanometry as the measuring method.

Adult↗

PubMed1983

Methods for standardization of nasal mucosa decongestion in man.

As physical exercise has been shown to reduce nasal breathing resistance, the effect of physical exercise on the nasal mucosa congestion was studied, using rhinostereometry, an optical measurement method. Submaximal physical exercise as well as oximetazolinechloride sprayed into the nose, caused mucosal decongestion but the stimuli were not strong enough invariably to produce maximal mucosal decongestion as studied in 16 volunteers at repeated tests. Maximal physical exercise as well as oximetazolinechloride applied to the mucosa on a soaked piece of cottonwool, caused a considerable (0.5-4.1 mm) decongestion. Furthermore, in each of the 8 studied volunteers the final position of the mucosal surface was the same in repeated tests. Thus, this mucosal surface position can be considered as the state of maximal decongestion and can in physiological and pharmacological studies be used as reference position.

Adult↗