[Pulmonary effects of steam].
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Biomedical subjects
Publications and source records attributed to A Lindqvist.
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For over a hundred years Finnish sauna has been documented as a physiotherapeutic method in respiratory diseases. Physiological changes of ventilation remain small (about 10%) in the sauna. Heat load, sauna air and sympathetic stimulation generally do not cause problems to the lungs. Electron microscopic studies have not shown irreversible damages to the airway epithelium. Sauna takers should avoid bathing during acute respiratory infections. Sympathomimetic drugs may provoke tachycardia and arrhythmias in the sauna.
Polyvalent killed influenza virus vaccine or saline was administered subcutaneously to 27 asthmatics to investigate the effect of influenza vaccine on respiratory function and on airway responsiveness to inhaled histamine. The patients were adults with mild to moderate asthma. Airway resistance (Raw) and intrathoracic gas volume (ITGV) were measured immediately before and 2, 3 and 21 days after vaccine or saline injection. Raw and ITGV values were used to calculate specific airway conductance (SGaw). Bronchial reactivity was expressed as the provocative dose of histamine diphosphate producing a decrease of 40% in SGaw (PD40). Fourteen (87%) of 16 asthmatics who received killed virus vaccine displayed a significant rise in serum antibody level as measured by single radial haemolysis in gel test. No significant alterations in mean Raw, ITGV and SGaw values were observed after viral vaccination. The median PD40 values for histamine also remained unchanged. However, an increased bronchial reactivity was observed in some patients after administration of virus vaccine or saline. Subclinical natural infection or allergen exposure cannot be excluded as possible causes of the increased airway reactivity in these patients. The side-effects of vaccination were minimal and no more harmful than those produced by saline injection. We conclude that the killed influenza virus vaccine used is effective in boosting serum antibody levels and is suitable for adult asthmatics when prophylactic immunisation is indicated.
Autonomic cardiac control of children with diabetes mellitus (DM, n = 12), juvenile rheumatoid arthritis (JRA, n = 12) and healthy controls (n = 12) was studied by a procedure consisting of a deep breathing test and an intermittent tilting test. Frequency selective entrainment of HR could be produced by tilting and deep breathing. No statistically significant intergroup differences were detected in the patterns of average heart rate (HR), overall or beat-to-beat heart rate variability (HRV) or HRV spectra. The DM group had an 8% higher HR and a limited short-term HRV response in relation to HR throughout the whole test procedure compared to controls. This increased HR causes an extra load to the cardiovascular system. We conclude that in spite of elevated HR and changed short-term chronotropic HR control in DM no features of autonomic failure could be detected in children with JRA.
The QT/QS2 ratio in seven 21-year-old men with a history of vasomotor lability was measured when they were resting supine and during orthostatic, Valsalva and diving reflex tests. The vasolability was characterized by an abnormal sympathicotonic heart rate (HR) response to the orthostatic test and vacillating inferoapical T waves in the ECG. The results of the vasolabile subjects were compared to those of seven fit control subjects of the same age. In spite of equal HR's in both groups the vasolabile subjects' QT/Q2 ratio constantly exceeded 1.00 during the whole test protocol and it was higher than of the controls (P = 0.04). The reversed QT/QS2 relationship in the test subjects seemed to be due both to a prolongation of the QT time and a shortening of the QS2 time. This difference prevailed throughout although the reaction pattern to autonomic stimulations was equal in both groups. We considered an inadequate neural control of the heart, possibly with metabolic and haemodynamic interactions, responsible for the prolongation of the electrical systole in relation to the electromechanical systole in the heart of the vasomotorically labile subjects.
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The reactivity of the periodic heart rate variability (HRV) to the thermal vasomotor control was studied during quiet sleep in a total of 20 neonates which were classified in 5 groups according to their maturity. Thermal stimulation on the peripheral skin was applied by an air blower at the rates of 5, 2.5 and 1.5 cycles/min. The oscillation of successive R-R intervals of the ECG was determined by a hybrid computer technique during thermal stimulations and compared to spontaneous HRV activity. The indices of the HRV and the total power of the periodic HRV remained unchanged during thermal stimulations. The response of the periodic HRV was selective at the spectral band corresponding to the frequency of stimulation. It was maximal at 5 cycles/min. The relative response was highly significant (P less than 0.001) and it increased with increasing maturity. The state of SGA (small for gestational age) seemed to decrease the vasomotor response of the HRV. The results suggested that the thermal vasomotor control was functional already in small preterm infants and it tended to increase with increasing maturity as does the autonomic cardiac control in general.
The effects of a simulator flight task on the heart rate variation (HRV) and hemodynamic variables were studied in nine pilots with instrument flight ratings. An electrocardiogram (ECG), phonocardiogram (PCG), and impedance cardiogram (ICG) were recorded continuously during three successive flights. Indices of HRV, power spectra, and autocorrelograms were computed from the R-R interval signal. Stroke volume (SV), cardiac output (CO), and systolic time intervals (STI) were determined by means of the ECG, PCG, and ICG. A scaling method for a subjective evaluation of tiredness, effort, and success during the flight was used. The repeats of the flight task decreased the heart rate (HR), CO, and cardiac index (CI). The different phases of the flight altered the HR (mean 97 min-1, S.E.M. 4 min-1), total HRV (RMSM) (mean 33 ms, S.E.M. 5 ms), and the periodic HRV. Subjectively, the pilots felt only moderate stress. The subjectively evaluated tiredness was significantly associated with the STI. Moderate informative stress in the flight simulator affected the chronotropic parameters of the heart. The inotropic state of the heart was not affected by the different phases of the flight but possibly by the diminishing sympathetic drive with accommodation during the repeats.
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A cell surface receptor that binds to the Fc region of IgA is expressed by certain strains of group A streptococci. The physico-chemical properties and binding characteristics of this receptor, called protein Arp, were studied. Like bacterial receptors that bind IgG, protein Arp has an elongated shape and no disulfide bonds. The affinity constant of protein Arp for three different molecular forms of IgA was determined, and was found to be more than ten-fold higher for serum IgA than for two complexed forms of IgA: secretory IgA and IgA bound to alpha 1-microglobulin. Cleavage of protein Arp with CNBr resulted in a peptide corresponding to the region located outside the cell wall, except for the N-terminal 52 amino acids. This CNBr-fragment did not bind IgA, which strongly suggests that the IgA-binding region of protein Arp is located in the N-terminal part of the molecule. In addition to the binding of IgA, protein Arp also binds to IgG weakly. The pH-dependence of these two types of binding is different, with maximal binding of IgA at neutral pH (5-7) and maximal binding of IgG at acidic pH (3-5). Both for IgA and IgG, protein Arp shows strong specificity for immunoglobulins of human origin.
The addition of the growth stimulator fetal calf serum (FCS, 10%) to rings of rat tail artery causes an increase in [Ca2+]i, accompanied by contraction. This response was inhibited by the calcium entry blocker verapamil (1 microM). To investigate the effect of Ca2+ entry blockade on growth and contractility, rings of rat tail artery were cultured for 4 days in medium with or without FCS and then mounted for tension registration and stimulated with noradrenaline (NA) or high-K+ solution. In cultured rings growth was quantitated by [3H]-thymidine incorporation and increase in protein contents. FCS in the medium stimulated DNA synthesis by about 2-fold and increased protein contents by about 70%. The growth-stimulated cultured rings developed less force than freshly prepared rings (2.2 +/- 0.3 vs. 8.3 +/- 1.0 mN/mm). The addition of 1 microM verapamil to the medium during culture increased maximal NA-evoked force to 5.0 +/- 0.4 mN/mm but had no effect on the increases in DNA synthesis and protein contents. Force developed by growth-arrested rings, cultured in the absence of FCS, was not different from that of freshly prepared rings (7.2 +/- 0.6 mM/mm). Verapamil did not affect maximal force in these rings. Similar responses were seen when contraction was elicited by high-K+ solution. We conclude that verapamil, present during culture, preserves contractility of arterial smooth muscle, and that this effect is not parallel to inhibition of growth.
The aim of this study was to compare the safety and efficacy of budesonide/formoterol 160/4.5 microg, two inhalations twice daily, with that of the mono-products administered at the same daily doses via separate inhalers. A total of 586 patients (mean age 45 years) was included in this six-month, open, randomised, multicentre study. Patients received either budesonide/formoterol (n=390) or budesonide plus formoterol (n=190). Safety was assessed by adverse events, vital signs and laboratory values. Efficacy was evaluated using spirometry tests, the Mini Asthma Quality of Life Questionnaire and the Asthma Control Questionnaire. Both treatments were well tolerated, with no differences in safety parameters between the groups. Mean FEV1 increased by 5-6% over baseline in both groups. There was no significant difference in the change from baseline between the groups using the disease-specific questionnaires. Asthma exacerbations occurred with low frequency in both groups. Withdrawal rates were also comparable between the groups (p=0.085). Budesonide/formoterol in a single inhaler was as effective and as well tolerated as budesonide plus formoterol via separate inhalers.