Biomedical subjects
Publications and source records attributed to L Malm.
Nasal secretory activity was measured in seven dogs in response to topical stimulation by histamine and methacholine. The methacholine response was blocked by atropine but not by chlorpheniramine. The histamine response was blocked by chlorpheniramine but not by atropine. These results suggest that there are two independent mechanisms of nasal secretion in the dog.
With two methods which in cats simultaneously recorded changes of blood flow through the mucosa of a nasal cavity and changes of the nasal patency in the same cavity, it was found that alpha-adrenoceptor agonists and the peptide, angiotensin constricted both the resistance and the capacitance vessels. Beta-adrenoceptor agonists and the peptide VIP dilated the vessels. Further, a filter paper method in dogs demonstrated that a large increase in nasal secretion was obtained with alpha-adrenoceptor stimulation in combination with methacholine, more than that with methacholine alone. Beta-adrenoceptor agonists seem to elicit a very scanty secretion. The peptide, substance P was also found to evoke a nasal secretion.
In order to facilitate measurements and calculations in rhinomanometry a microprocessor is used. Pressure and flow signals, obtained from microtransducers, are automatically calibrated by drawing known volumes of air through a standardized test-nose, while the signals are read by the computer. When the patient is connected, the pressure-flow curves are displayed on a screen. At adequate breathing, the computer reads the pressure and flow 200 times per second for a few breaths. It performs all calculations and presents data describing the pressure-flow relationship, e.g. in terms of the resistance, where the curve crosses a circle with a certain radius in a polar coordinate system. Automatically calculated data were compared to manually derived ones in six healthy subjects and twenty patients with symptoms of nasal obstruction. There was a close correlation between the two sets of data. It is concluded that the described automated rhinomanometer facilitates the rhinomanometric procedure and gives accurate data on nasal airway resistance.
Numerous nerve fibres containing acetylcholinesterase and noradrenaline, as well as avian pancreatic polypeptide-, vasoactive intestinal peptide-, or substance P-like immunoreactivity are observed around arteries in the external carotid rete of the cat. The nerves are located in the adventitial layer close to the media. It is possible that adrenergic, cholinergic and peptidergic nerve fibres may have a strong neurogenic influence on the rete blood vessels.
Nasal airway resistance and nasal symptoms were evaluated in patients with perennial non-allergic rhinitis before and after vasoconstrictory drugs and placebo taken orally. The patients were partly selected; those suffering mainly from nasal obstruction being tested. Phenylpropanolamine (PPA) in a dose of 100 mg in a sustained-release preparation clearly decreased the nasal airway resistance measured rhinomanometrically. PPA in a dose of 50 mg and combined with an antihistamine had no obvious decongesting effect. Placebo and dihydroergotamine (DHE) in a dose of 5 mg did not decrease the nasal airway resistance PPA (100 mg) and the combined preparation containing PPA in the lower dose (50 mg) taken twice a day in a cross-over, double-blind study significantly reduced nasal obstruction, secretion, and sneezing compared with placebo. Side effects of PPA are discussed.
The nasal airway resistance in various positions of the body was investigated in 24 patients with perennial non-allergic rhinitis and in 10 normal subjects. No difference in nasal airway resistance between inspiration and expiration was found. the patients had higher resistance than the controls, a difference providing an anatomical explanation of their complaint of nasal obstruction. When the patients changed from the recumbent to the sitting position, the resistance did not decrease until after about one hour. The corresponding time for the controls was 10 minutes. This difference suggests that oedema is a more important cause of nasal swelling in the patients than in normal subjects. Local treatment of the patients' nasal mucosa with terbutaline revealed no clear oedema-reducing effect to the drug.
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The value of three objective tests of the nasal mucosa in 22 patients with perennial non-allergic rhinitis treated with a topical corticosteroid has been investigated. Placebo and three different dosages of a new steroid, budesonide, were administered intranasally using a double-blind, cross-over technique. Nasal airway resistance was not reduced by the steroid treatment as compared with the placebo treatment. Eosinophilia in nasal smears was reduced by budesonide. However, the value of this test was decreased by the fact that eosinophilia was found in less than 50% of the patients at the beginning of the trial. Metacholine-induced nasal secretion was significantly reduced by the budesonide treatment. Symptom scores for nasal obstruction, secretion and sneezing attacks were also significantly reduced by the steroid.
Numerous nerve fibres containing vasoactive intestinal peptide (VIP), substance P (SP) or immunoreactive avian pancreatic polypeptide (APP) occur in the nasal mucosa of several mammals, including man. Generally, the nerve fibres are distributed around small blood vessels and seromucous glands. In addition, SP containing fibres can be seen in the nasal epithelium. The pterygopalatine ganglion contains acetylcholinesterase (AChE) positive nerve cell bodies together with VIP and SP containing ones. After exposure to colchicine it could be shown that the VIP and SP containing nerve cell bodies also were positive for AChE. VIP and SP are potant mediators of atropine resistent vasodilatation in the mucosa. The physiological effects of APP are not known.
Nerves containing vasoactive intestinal peptide (VIP) were observed in salivary glands of rat, cat and man. VIP nerves were numerous in the cat while they were moderate in number in rat and man. The measured concentrations of immunoassayable VIP were in agreement with the immunohistochemical findings. Electrical stimulation of the feline chorda lingual nerve, which stimulates salivary secretion and local blood flow, resulted in a marked elevation of VIP in the venous effluent from the submandibular gland. VIP was not measurable in saliva. Gel permeation chromatography of extracts from cat submandibular gland and from venous plasma collected before and during nervous stimulation revealed one immunoreactive peak with an elution position identical to that of highly purified porcine VIP. The finding of neuronal VIP in salivary glands, its release upon nerve stimulation and its known effect on local blood flow support the view that VIP is a neurotransmitter in the salivary glands.
A patient who for five years had obstinate unilateral facial pain, difficult to interpret, was found to have an expanding process in the left retromaxillary space. Histological examination of a biopsy specimen revealed chondromyxoid fibroma. This tumour is rarely seen in the bones of the face and has never before been described in this area. The clinical and histological findings are described and discussed.
Twenty-one patients with vasomotor rhinitis, with no relevant allergens known, completed a special double-blind trial of beclomethasone dipropionate aerosol (BDA) and placebo intra-nasally. Each patient took 200, 400 and 800 mug BDA and placebo during four consecutive 2-week periods and in different sequences. The symptom scores of the last week of each period of nasal blockage, watery secretion and sneezing were significantly reduced by all doses of BDA as compared with placebo. There were no differences between the effects of the different doses of BDA except for secretion, which was reduced more by using 800 than 200 mug. Cortisol in serum and 17-hydroxycorticosteroids in 24-hour urine were not significantly changed by BDA treatment and no increased frequency of pathogenic bacteria or fungi could be demonstrated in the nasal secretion. For treatment of patients with vasomotor rhinitis, intra-nasal BDA in a daily dose of 200 mug can be recommended when antihistamines, sympathomimetic drugs and sodium cromoglycate are not sufficiently effective.
Vernous blood flow from the mucosa of one nasal cavity and changes in nasal patency of the same cavity were simultaneously recorded in the cat. Information about responses evoked in resistance vessels (mainly small arteries and arterioles) and in capacitance vessels (mainly venous vessels ansd sinusoids) could thus be provided. Close arterially administered infusions of angiotensin, noradrenaline, adrenaline and dihydroergotamine elicited constrictions in the resistance as well as the capitance vessels. Analysis of the ratio of the resistance and the capacitance responses allowed an evaluation of the relative effectiveness of the drugs in constricting the two types of vessel.
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