Biomedical subjects
Publications and source records attributed to P Borum.
During the 6th Taekwondo World Championship more than 4 per cent of the competitors were admitted to hospital. The majoirity of the severe injuries were to the head and neck. More padding and a change of rules are recommended.
It has previously been demonstrated that hair spray sprayed onto the hair of experimental subjects reduces the mucociliary transport in the trachea and nose. Ladies hairdressers are exposed to the effects of hair spray throughout the whole working day, and we therefore investigated the nasal mucociliary transport of 60 hairdressers and 15 control subjects before and after a working day by the saccharin method. We found a significant reduction in the mucociliary transport of the ladies hairdressers during the working day (P less than 0.001), but not in control subjects. The reduction in mucociliary transport could be correlated to the amount of hair spray applied by the individual hairdresser to the hair of the customer during the day.
To study whether a histamine H1 receptor antagonist inhibits allergic rhinitis symptoms by a peripheral or a central mode of action 21 normal volunteers were challenged with 500 micrograms histamine chloride in the right nasal cavity on four occasions after bilateral pretreatment with an H1 antihistamine spray and a placebo spray in various combinations. The H1 antihistamine (chlorpheniramine maleate, 0.5 mg) significantly inhibited histamine-induced tickling (P less than 0.01), sneezing (P = 0.01) and discharge (P less than 0.01), but only when it was given on the same side as histamine. This is highly suggestive of a local effect on sensory nerve endings, which prompts further studies on the topical use of antihistamines in the nose.
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As parasympathetic reflexes are of importance for nasal hypersecretion, treatment of rhinorrhoea with a cholino-ceptor antagonist seems rational. We have therefore studied the topically active anti-cholinergic drug ipratropium in laboratory studies and clinical trials. This drug, as a nasal spray, could markedly inhibit metacholine-induced hypersecretion for a prolonged period, in a dosage having no demonstrable systemic effects, in treatment of patients with perennial rhinitis and watery rhinorrhoea as the major symptoms. The daily use of ipratropium spray caused a moderate reduction in the use of handkerchiefs. It is concluded that this new treatment can be of value in such patients, but it is important to realize that the effect is strictly monosymptomatic. Finally, how this type of therapy can be further improved is discussed.
The aim of the trial was to examine the effectiveness of an oral decongestant in common cold. Thirty subjects with naturally acquired colds got a 100 mg sustained release tablet containing norephedrine on one day and a placebo tablet on another day in double blind design. Changes in nasal patency were assessed by rhinomanometry, measurement of nasal expiratory peak flow, and a self-assessment test, and the number of sneezes and of nose blowings were recorded in a 10 hours period after medication. Rhinomanometry, but not peak flow measurements showed a significant difference (p less than 0.02) two hours after medication, and the self-assessment of nasal blockage showed that the effect lasted for the entire 10 hours observation period (p less than 0.01). Nasal respiration was reestablished in half of the blocked noses. There was no effect on number of sneezes and nose blowings. In conclusion, oral norephedrine has a moderate decongestant effect, which may justify its use in adults with common colds. This symptom amelioration must be balanced against cost of therapy and risk of side effects. A prevention of otitis media and of sinusitis has not been documented in the literature.
Beta-adrenergic agents have a direct relaxing effect on bronchial smooth muscle. In vitro investigations of a number of sensitized preparations have demonstrated an inhibition of the antigen-induced histamine release. Grass pollen allergic patients were pretreated in the laboratory, out of the season, with different dosages of intranasal fenoterol before an allergen challenge and hay-fever patients treated with fenoterol during the season in a clinical trial. The laboratory studies demonstrated a moderate and significant (p less than 0.01) inhibitory effect on the immediate allergen-induced symptoms, suggesting an action on mediator release from mast cells. Fenoterol had only a slight, although significant (p less than 0.05), effect on nasal symptoms in the clinical study. In conclusion, fenoterol seems to have an anti-allergic effect, when applied to the airway mucosa, but the effect on allergic rhinitis does not seem sufficient to justify the introduction of fenoterol as a nasal spray.
The purpose of this review is to present data on nasal reactivity to methacholine, histamine and allergen in normal subjects, patients with common colds, perennial rhinitis and hay-fever. Nasal challenge is performed by spraying the agent into the nose and counting the sneezes, measuring the resulting secretion and the increase in nasal airway resistance during a 15 minute period. We found that there was a small increase in reactivity during a common cold, but a considerable increase during the hay-fever season and associated with perennial rhinitis. We conclude that a nasal challenge test may be a valuable tool as an objective parameter for the diagnosis and for the estimation of the severity of rhinitis. It may also be helpful in the evaluation of new drugs and give information regarding pathogenetic mechanisms as well as the mode of action of specific drugs.
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The aim of this experiment was to study the importance of histamine H1 and H2 receptors in the human nose. We therefore provoked 25 healthy human subjects with histamine after local pretreatment with the H1 receptor antagonist, chlorpheniramine maleate, the H2 receptor antagonist, ranitidine hydrochloride, and a combination of these two antihistamines. The histamine-induced increase in nasal airway resistance was 52% inhibited by combined use of the two antihistamine sprays (p less than 0.05), 22% by chlorpheniramine alone (p less than 0.05), and 29% by ranitidine. The two sprays together were significantly better than the H1 antagonists alone (p less than 0.05). These results suggest an equal importance of H1 and H2 receptors in nasal blood vessels, and an additive effect of H1 and H2 antihistamines. Although chlorpheniramine effectively blocked tickling and the reflex-mediated symptoms, sneezing and hypersecretion, ranitidine had no effect, which suggests an H1 and not an H2 effect on sensory nerve endings in the airway epithelium.
In the majority of diagnostic tests usually used in the search for acoustic tumors, there is a large difference in the outcome between patients with and without tumors. Because of a possible coherence between the tests applied, a statistical analysis of this connection was performed with the aid of a logistic model. The best single investigation used to differentiate between patients with and without tumors was tomography of the internal acoustic meatus. This examination was used in combination with the differential caloric test and the alternate binaural loudness balance recruitment test to differentiate completely between patients with and without tumors. Results of other examinations did not contribute significantly to the differentiation between patients with and without tumors. This factor did not render the other examinations superfluous because the analysis was valuable only in patients with a hearing level better or equal to 80 dB. By applying the other tests, information was obtained on pressure conditions in the internal acoustic meatus and possible difficulties at surgery, as well as information about the size of the tumor.
The radiological appearance of the internal acoustic meatus, obtained by tomography of the temporal bone, is presented for 115 patients with normal inner-ear function. These patients served as normal controls, and their tomograms are compared with those obtained in 48 patients who were initially suspected of having acoustic neuromas but in whom Pantopaque cisternography was negative. These are also compared with the findings obtained in 59 patients with surgically-verified acoustic neuromas. In normal persons the size of the vertical diameter of the meatus on the two sides, as measured by tomography, differed in only a few cases by more than 1 mm. The results obtained in patients who were suspected of having a neuroma, but in whom Pantopaque cisternography had excluded such a diagnosis, coincided completely with the results found in the normal group, and a difference of more than 1 mm. between the right and left sides is therefore indicative of a pathological process in the internal and acoustic meatus. A normal meatus does not exclude the presence of a tumour, since 10 per cent of patients with neuromas have identical meatus. No evidence of radiological destruction was found, either in the normal material or in the group of patients suspected of having a neuroma. Destruction of the bone surrounding the meatus must therefore be regarded as highly suggestive of the presence of a tumour, but lack of destruction does not exclude a tumor. Tomography of the temporal bone should be applied routinely in the search for acoustic neuromas, in patients with unilateral acoustic or vestibular complaints. The evaluation of the tomograms, however, should be performed by a few, specially interested radiologists.
A need is often present for symptomatic treatment of the common cold. A blocked nose can be opened by a vasoconstrictor, but no effective therapy is known today for rhinorrhea. The aim of the present trial was to study the effect of the topically active parasympatholytic, ipratropium, on rhinorrhea. In a placebo-controlled group comparative trial, 80 micrograms of ipratropium were taken as a nasal spray 4 times daily for 1 wk by 40 adults with spontaneously occurring common colds. All subjects administered an intranasal vasoconstrictor (xylomethazoline, 0.1%) 5 min before administering placebo or ipratropium. Ipratropium treatment resulted in a significant reduction in nasal discharge compared with that of placebo treatment during the whole treatment period (p less than 0.001), but the drug was especially effective the first 3 days, when the watery secretion was predominant. It was concluded that this new spray can be of value in the first days of a cold, when nasal discharge is a nuisance.
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