Biomedical subjects

J E Juto

Publications and source records attributed to J E Juto.

32 records · Page 2Linked to original sources

PubMedDate not supplied

Intranasal histamine challenge in normal subjects and allergic rhinitis before and after intranasal budesonide studied with rhinostereometry and micromanipulator-guided laser Doppler flowmetry.

Ten healthy subjects and 10 patients suffering from allergic rhinitis to birch pollen were investigated with the combination of rhinostereometry and laser Doppler flowmetry, thus simultaneously measuring changes in mucosal swelling and microcirculation, following intranasal histamine challenge. Compared to normals, the allergies had a higher degree of congestion and a lower increase in perfusion and velocity of flow. In the allergies there was a decrease in CMBC (concentration of moving blood cells) that was not seen in normals. The decrease in CMBC seen in allergies could be attributed to an increase in vascular permeability producing an interstitial edema, a well-known effect of histamine. After treatment with 1 week of intranasal steroid, most of the differences in the reaction pattern between normals and allergies had disappeared.

Administration, Topical↗

PubMedDate not supplied

An objective method to record changes in nasal reactivity during treatment of non-allergic nasal hyperreactivity.

Non-allergic nasal hyperreactivity is a common problem and many patients suffer from daily symptoms demanding medication. Hitherto there exists no objective method to study congestional changes in clinical practice, to evaluate the efficacy of different therapies. This study is an attempt to develop a method for this purpose. Eleven patients with non-allergic nasal hyperreactivity entered the trial. A histamine challenge model with three different histamine concentrations was used. Recordings of the reactivity of the nasal mucosa were made with rhinostereometry before and after 14 days of topical treatment with budesonide 200 micrograms/day. The results were compared to symptom scores before and after treatment. It was found that there was a significant improvement after treatment both with regard to symptom score and to the recorded reactivity of the nasal mucosa. There was a correlation between symptom score and recorded reactivity before treatment, but not after treatment. The results indicate that the symptom score technique is sufficient in situations where only a semiquantitative method is required. However, when studying changes in the degree of hyperreactivity, the demands for an objective measuring method is greater. The study indicates that the presented method may be adapted for this purpose.

Administration, Topical↗

PubMedDate not supplied

Decongestion effect and rebound swelling of the nasal mucosa during 4-week use of oxymetazoline.

The aim of this study was to investigate whether long-term use of oxymetazoline induces a rebound swelling of the nasal mucosa and whether the decongestion effect is altered during medication. Eight healthy volunteers had oxymetazoline nasal spray (0.5 mg/ml; 0.1 ml in each nostril, three times daily) for 30 days and registrations of the mucosal surface positions were made using rhinostereometry. Compared to the registrations before the start of medication, no rebound swelling was registered after 10 days. After 30 days, however, a rebound swelling was registered in all subjects (p < 0.001). All of them, then, also reported nasal stuffiness. The decongested position of the nasal mucosa after one single dose of oxymetazoline was the same in the whole study. It is concluded that rhinitis medicamentosa develops after a relatively short time on oxymetazoline, even in healthy volunteers, and that the swelling probably is due to a vasodilatation rather than an edema. The study supports the recommendation that the drug should not be used over periods > 10 days.

Adult↗

PubMedDate not supplied

The nasal reactivity in patients with nasal polyps.

Nasal polyposis is a common clinical problem. The polyps commonly arise from the ethmoid sinuses and the etiology is still poorly understood. There is a connection between nasal polyps and asthma, cystic fibrosis and aspirin intolerance, but it is unclear whether there is a connection between nasal polyps and nasal hyperreactivity. The aim of this study was to investigate whether there is a connection between nasal hyperreactivity and nasal polyposis. Ten patients with nasal polyposis entered the trial. The nasal reactivity was studied with rhinostereometry during provocation with histamine. It was found that the patients with polyps did not have any nasal hyperreactivity.

Adolescent↗

PubMedDate not supplied

Correlation between objective nasal mucosal swelling and estimated stuffiness during long-term use of vasoconstrictors.

The correlation between nasal mucosal swelling and estimated stuffiness was evaluated in 13 healthy volunteers who entered the trial. The nasal mucosa was challenged with increasing concentrations of histamine solutions. The amount of mucosal swelling was recorded using rhinostereometry, and the stuffiness was estimated by the subjects on a visual analogue scale. Then the subjects were randomly chosen to receive either oxy- or xylometazoline nasal spray for 30 days. After 10 days on the drug, the histamine sensitivity was enhanced, and after another 20 days, it had increased further, reflecting the development of rhinitis medicamentosa. Before the subjects started the nasal spray and after 10 days on the drug, a correlation between stuffiness and swelling was seen in the individual subject only when the degree of stuffiness almost obliterated the nasal opening. At the end of the month, no correlation was present. In all histamine provocations throughout the month, a very high correlation was noted between mean mucosal swelling and mean stuffiness. It is concluded that the symptom scores for nasal obstruction are useful for determining nasal mucosal swelling in groups. However, in the individual subjects one can estimate the mucosal swelling only when the amount of swelling almost obliterates the nasal opening. This cannot be done when the mucosa is hyperreactive.

Drug Eruptions↗

PubMedDate not supplied

Airway reactivity of nose and bronchi in patients with nasal polyps.

The aim of the study was to determine whether patients with nasal polyps have a hyperreactive nasal mucosa and/or bronchi and whether there is any correlation between nasal and bronchial hyperreactivity. Twenty-six healthy volunteers and 10 consecutive patients with nasal polyps participated in the study. They were challenged with increasing concentrations of histamine. The nasal mucosa response was studied with rhinostereometry and the bronchial response was estimated by peak flow. One of the patients was mildly hyperreactive in the nose and 6 patients were hyperreactive in the bronchi. There was no correlation between nasal and bronchial hyperreactivity. Patients with nasal polyps do not have a hyperreactive nasal mucosa but there seems to be a high incidence of bronchial hyperreactivity in patients with nasal polyps.

Adult↗

PubMedDate not supplied

Rhinostereometry and laser Doppler flowmetry in human nasal mucosa: changes in congestion and microcirculation during intranasal histamine challenge.

The nasal mucosa of 10 healthy volunteers was studied with the combination of rhinostereometry and laser Doppler flowmetry during a challenge with 0.14 ml histamine dihydrochloride in stepwise increasing concentrations of 0.5, 1.0, 2.0, 4.0, 8.0 and 16.0 mg/ml. Five and 10 min after each challenge the degree of congestion and the microcirculatory parameters perfusion, velocity of flow and concentration of moving blood cells were recorded. A complex reaction pattern was seen. It was possible to measure simultaneously the degree of congestion and the microcirculatory parameters. With this combination of methods, it seemed possible to identify the effects of histamine on the different components of the nasal mucosa. The combination of the two methods appears to make possible detailed studies of the relationship between changes in congestion and microcirculation during intranasal challenges in humans.

Administration, Intranasal↗

PubMedDate not supplied

The impact of the measuring distance on laser-Doppler measurements of the microcirculation in human nasal mucosa. A study of rhinostereometry and micromanipulator-guided laser-Doppler flowmetry.

Fourteen healthy volunteers were examined using rhinostereometry (RSM) and micromanipulator-guided laser-Doppler flowmetry (LDF) on the inferior turbinate and nasal septum. There were significant differences of the flowmetry readings at different distances from the mucosal surface within 0-1.0 mm. Changes in LDF values due to a change in distance between probe and mucosa seem to be an important artefact that will influence the flowmetry, especially if the probe is fixed to the framework of the nose (i.e. the skull) and if the congestive status of the mucosa changes. This can be a problem especially during intranasal challenges with substances that influence congestion. These artefacts can be eliminated by using an RSM-guided micromanipulator that allows the probe to follow changes in congestion.

Adult↗

PubMedDate not supplied

Nasal hyperreactivity among teachers in a school with a long history of moisture problems.

Upper airway symptoms have frequently been reported in people working or residing in damp buildings. However, little information has been available on objective pathophysiologic findings in relation to these environments. Twenty-eight teachers, who had worked for at least five years in a recently renovated school that had had severe moisture problems for years, were randomly selected for this study. Eighteen teachers, who had worked in another school that had no moisture problems, were randomly selected to serve as the control group. Although remedial measures had been taken, an increase in the prevalence of mucous membrane irritations was still reported by the teachers in the target school. We used a nasal challenge test with three concentrations of histamine (1, 2 and 4 mg/mL). Recordings of swelling of the nasal mucosa were made with rhinostereometry, a very accurate optical non-invasive method. The growth curves of mucosal swelling induced by the three concentrations of histamine differed significantly between the two groups (p < 0.01). The frequencies of atopy, evaluated with the skin-prick test, were almost identical in both groups. The study indicates that long-term exposure to indoor environments with moisture problems may contribute to mucosal hyperreactivity, of the upper airways. Such hyperreactivity also seems to persist for at least one year after remedial measures have been taken.

Air Pollution, Indoor↗

PubMedDate not supplied

Nasal histamine provocation of tenants in a sick-building residential area.

Health problems associated with the indoor climate have aroused an increasing scientific interest, and the term "sick-building syndrome" (SBS), which describes the most frequent symptoms in this context, has been coined. However, it has been difficult to demonstrate objectively any pathophysiological changes in the subjects affected. Thirty-three healthy and nonatopic persons were randomly selected on the basis of answers in a postal questionnaire dealing with discomfort or health symptoms experienced in their home environment. Twenty-three lived in a residential area with indoor climate problems (SBS area) and 10 lived in an area without climate problems (non-SBS area). Twelve persons from the SBS area reported nasal symptoms, which they ascribed to their home environment. The remaining 11 persons from the same area, as well as the 10 subjects from the non-SBS area, had no nasal distress. They were examined with rhinostereometry during histamine provocation. Hyperreactivity, defined as mucosal swelling exceeding 0.4 mm at 5 and 10 minutes after provocation with 0.14 ml of 2 mg/ml histamine chloride, was frequent in the symptomatic SBS group as well as in the asymptomatic SBS group. The analysis of the increment of mucosal swelling for the whole range of histamine chloride concentrations (0.1 mg/ml to 16 mg/ml) showed significantly different growth curves for the three groups in the residential areas and an external reference group, (p < 0.0001). Subjects living in the SBS area were prone to nasal hyperreactivity, whether they reported symptoms from the upper airways or not. The results support the hypothesis that living in an SBS area increases the risk of developing nonspecific nasal hyperreactivity.

Adult↗

PubMedDate not supplied

Studies of spontaneous fluctuations in congestion and nasal mucosal microcirculation and the effects of oxymetazoline using rhinostereometry and micromanipulator guided laser Doppler flowmetry.

The mucosa of the inferior turbinate was studied using rhinostereometry and micromanipulator-guided laser Doppler flowmetry in 10 healthy volunteers. First, spontaneous fluctuations were studied measuring congestion and multiple microcirculatory parameters simultaneously every 2 minutes. The subjects were then challenged with oxymetazoline using the same measuring technique studying the effects of the challenge during 12 minutes. There were spontaneous variations in congestion of up to 2.1 mm and variations in perfusion from 38% to 175% of average. There was no correlation between congestion in itself, or change in congestion, to perfusion or any other microcirculatory parameter. After challenge with oxymetazoline there was a rapid decrease in perfusion at 3 minutes after which there were no significant changes. The congestion decreased gradually throughout the procedure. Because congestion reflects the filling of the venous sinusoids and the flowmetry the state of the superficial vessels, we conclude that there are spontaneous short-term fluctuations in the sympathetic tone with independent actions on the different vessels. After challenge with a sympathomimetic drug, there was a decrease in both swelling and flow, but not synchronized. The combination of rhinostereometry and micromanipulator-guided laser Doppler flowmetry is a useful tool to study the dynamics of intranasal challenge reactions.

Depression, Chemical↗

PubMedDate not supplied

An optical method for determining changes in mucosal congestion in the nose in man.

As the methods available for studying physiological and drug-induced changes in mucosal congestion in the nose involve manipulations of the mucosa or alteration of the physiological conditions in the nose, a non-invasive measurement method with a high degree of accuracy has been evolved. According to this method, the subject to be examined is fixed to a measuring apparatus consisting of a microscope with low-power magnification, standing on a mechanical stage. The displacement of the mucosal surface within a small, well-defined area in the nose is studied in the microscope. The method has been tested on 6 volunteers, and statistical calculations show that the overall error is less than +/- 0.37 mm for a measurement value when the greatest observed variation in the swelling was 4 mm. The size of the mucosal area studied was smaller than 3.2 mm x 0.4 mm and the area could be reidentified at different times. As the method has a high degree of accuracy it can be considered suitable for examination of physiologic and drug-induced mucosal changes.

Humans↗

PubMedDate not supplied

Variation in nasal mucosa congestion during rest.

Since the late nineteenth century, the physiological variation in nasal mucosa congestion has aroused considerable interest (Kayser, 1895). It has been claimed in several reports that a cyclic variation exists in humans at rest (Hasegawa & Kern, 1977; Keunig, 1968). This cyclic variation of the congestion has been found in as many as 80% of the subjects studied (Heetderks, 1927). The measuring methods used in these studies have been rhinoscopy and rhinomanometry, neither of which can be regarded as ideal for the purpose. The accuracy level of rhinoscopy is rather low. Rhinomanometry, on the other hand, is an indirect method utilizing the air pressure and air flow in the nose as parameters. The relationship between these parameters and mucosal congestion is, however, not yet established. An optical measuring method was recently invented that allows the registration of even small changes in the position of the nasal mucosa surfaces (Juto & Lundberg, 1982). Consequently it was decided to apply this method to the study of the variations in mucosal congestion during rest in healthy individuals.

Adult↗

PubMedDate not supplied

Nasal mucosa reaction, catecholamines and lactate during physical exercise.

The relation between changes in mucosal congestion, as studied by rhinostereometry, and blood concentrations of lactate, epinephrine and nor-epinephrine was studied in 7 volunteers during physical exercise to effort maximum and a subsequent rest period. In 6 volunteers the mucosa decongested evenly during exercise. The concentration of nor-epinephrine began to rise when half of the mucosal decongestion ability was utilized, but the concentrations of lactate and epinephrine did not rise until almost maximal decongestion was established. When exercise ceased the mucosa recongested rapidly and parallel to the decrease of the epinephrine and nor-epinephrine concentrations. The lactate concentrations remained at a high level until the mucosa had recongested considerably. In two of three tests of the remaining volunteer, after an initial partial decongestion, the mucosa began to recongest during continued exercise but the concentration of lactate, epinephrine and nor-epinephrine increased as in the other 6 volunteers. The present results support the view that nasal mucosa decongestion during exercise is due to sympathetic stimulus, but also show that there may exist a congestive stimulus stronger than the sympathetic stimulus. This latter observation implies the need for direct control of the nasal mucosa congestion during rhinological studies.

Adult↗