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Biomedical subjects

H Matthys

Publications and source records attributed to H Matthys.

At least 19 recordsLinked to original sources
PubMed1992

A prospective trial using salivary-theophylline levels to guide asthma therapy.

In three prospectively designed studies, first saliva (SA) samples were collected simultaneously with serum (SE) from 86 children who received slow-release theophylline (Th) b.i.d. for treatment of bronchial asthma. SA was collected with a standardized sampling procedure. Regression analysis revealed a close correlation between SE and SA-Th levels (r = 0.959; SE = 1.87 x SA + 0.05) and yielded a "therapeutic SA-Th range" of 5.8 to 10.7 mg/L. In 16 children the diurnal variation was then assessed by measuring 6 SA-Th levels within 24 hr, using the same sampling method. At 0, 9, and 24 hr SE-Th levels were also measured. The levels of SE-Th and SA-Th were again closely correlated (0.914 less than or equal to r less than or equal to 0.949) and both remained constant over the 24-hr period. In the third prospective trial only SA levels were used to monitor Th therapy in 50 asthmatic children. Seven days after starting therapy SA-Th levels were measured and then the Th dose was increased weekly until SA-Th levels above 5.8 mg/L were reached. The following day SE and SA samples were collected simultaneously and their Th levels compared. In 36 of the 47 children who completed the study therapeutic SE-Th levels (greater than or equal to 10 and less than or equal to 20 mg/L) were measured; in one patient it was greater than or equal to 20 mg/L, in 6 it was between 8.0 and 10 mg/L, and only 4 had SE levels less than 8.0 mg/L.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Morphology and density features of eosinophil leukocytes in eosinophilic pneumonia. A case report.

We compared the morphological characteristics and density properties of eosinophil leukocytes obtained from the blood and bronchoalveolar lavage fluid of a 29-year-old patient with chronic eosinophil pneumonia during exacerbation. The lavage eosinophils were significantly increased in size when compared with blood cells (surface area: 208 +/- 12 microns 2 versus 161 +/- 13 microns 2). Moreover, eosinophils contained slightly more granules (23.4 versus 20.7 per cell surface area), but no difference was found when the number was corrected for cell size. Electron microscopy revealed a loss of granule contents in eosinophils from both blood and bronchoalveolar lavage. Finally, 61% of the lavage eosinophils were hypodense (with a density less than 1.085 g/ml), whereas 96.3% of the blood cells were normodense. In conclusion, our data demonstrate that in chronic eosinophil pneumonia, eosinophils obtained from bronchoalveolar lavage and blood show differences in both their morphology and density, suggesting that eosinophils during migration into the lung may become activated.

Adult↗
PubMed1992

[Therapy for smoking: consensus in German-speaking countries].

The german speaking countries (Austria, Germany, Switzerland) are not the most advanced in the world when it comes to the control of tobacco related diseases. The medical system in these countries has yet to be convinced that smoking cessation is not only necessary but feasible. In order to provide a basic document for further activities, a consensus development process was initiated. The consensus development process forms part of the activities performed by the UICC (International Union Against Cancer) Project Smoking Cessation, which is a project within the framework of the UICC Tobacco and Cancer Programme. The 1988 Report of the US Surgeon General states very clearly, that the use of tobacco products is not a matter of free choice, but is the result of an addiction as scientifically valid as the addiction to heroin and other narcotics. The scientific literature provides informations on many methods and techniques for a smoking cessation, both pharmacological and non-pharmacological. Many pharmacological approaches have been tried to treat nicotine dependence in man. According to scientific standards and many controlled studies, nicotine has been the only drug found to be effective in treating nicotine dependence. Many techniques, ranging from self help to sophisticated combined therapeutic approaches including pharmacological interventions, are now available to deal with the nicotine addiction. Smoking cessation treatment uses time, effort and other resources and the question of reimbursement for these services has to be considered. As with any other form of treatment, costs needed to be paid either by the individual patient/client and/or by other sources including private and national health insurance systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Acupuncture Therapy↗
PubMed1992

Cytokines, platelet activating factor and eosinophils in asthma.

Understanding of the pathogenesis of asthma has increased considerably during the past few years. These advances were possible through scientific progress in three areas which contribute to this complex and multifaceted disease: (a) the much clearer understanding of eosinophil function; (b) the defining of lipid mediators in tissue inflammation and bronchial obstruction; and (c) the growing knowledge about the biological action of a new class of protein hormones, collectively called cytokines. In line with this, evidence has accumulated of how these components may interact with each other in providing the basis of inflammatory processes in asthma. Hence it seems appropriate to review the potential implications of this new information for the pathogenesis and therapy of this disease.

Animals↗
PubMed1991

Ca(2+)-channel blockers modulate expression of 3-hydroxy-3-methylglutaryl-coenzyme A reductase and low density lipoprotein receptor genes stimulated by platelet-derived growth factor.

The effects of Ca(2+)-channel blockers (amlodipine, nifedipine, nitrendipine, and verapamil) on expression of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase (EC 1.1.1.88) and low density lipoprotein receptor (LDL-R) genes stimulated by recombinant platelet-derived growth factor BB isomer (PDGF-BB) were evaluated in human skin fibroblasts. The drugs enhanced expression of the LDL-R protein on the plasma membrane of the cells; in contrast, they inhibited expression of the HMG-CoA reductase gene. In addition, PDGF-BB-dependent stimulation of transcription of c-fos mRNA was inhibited also by the Ca(2+)-channel blockers. We conclude that PDGF-BB-dependent activation of the two genes is inhibited effectively by the Ca(2+)-channel blockers, at therapeutic concentrations, although they are unable to lower systemic cholesterol levels at these concentrations; however, they do modify responses of the two genes that are involved crucially in regulation of cellular cholesterol homeostasis.

Amlodipine↗
PubMed1991

Management of bronchial asthma.

The goals of the therapy of bronchial asthma are: (1) freedom from symptoms (within days); (2) normal spirometry (within weeks); (3) reduced or absent hyperreactivity and eosinophilia (within months), and (4) no airway inflammation = normal mucociliary clearance rate ('cured asthma'). Nobody knows how to cure asthma, but we know that we can reach at least stages 1 and 2 with consequent pharmacotherapy, and often also stages 3 and 4 by avoiding asthma-triggering agents and using long-term topical glucocorticoid therapy by inhalation.

Acute Disease↗
PubMed1991

Bronchoalveolar lavage cell data in alveolar proteinosis.

In bronchoalveolar lavage fluid (BAL) from nine patients with alveolar proteinosis (AP), total and differential cell count and T-lymphocyte phenotyping were done and compared with those in 12 healthy volunteers comparable as to age and tobacco consumption. Although total cell count was not significantly different from that in control subjects, the most prominent feature in patients was an increase in the number of CD4 and CD8 T-lymphocytes within the alveoli. Conversely, the macrophage population was significantly reduced. The ratio of CD4/CD8 T-lymphocytes tended to be high, but this increase did not reach statistical significance. The pathophysiologic mechanism and the meaning of these alveolar cell changes in AP remain to be elucidated.

Adult↗
PubMed1991

[Aerosol deposit sample in aspecific bronchial provocation test: a nuclear medicine study for quantification].

A method of standardization of inhalation bronchial provocation tests is induced. The distribution of radioactivity of in- and exhaled 99mTc human albumin (Venticoll) enables an exact calculation of intrabronchial aerosol deposition. The investigations were carried out at twelve normal test persons by using the device of bronchial provocation tests of PARI. Linearity exists between nebulized aerosol quantity in the bag and bronchial aerosol deposition. The intrabronchial aerosol deposition is calculated about 100 mg after emptying the ten liter-bag. Slowly inspiratory maneuvers of vital capacity produce a precision of the inhaled aerosol of about 15 percent.

Aerosols↗
PubMed1990

Definition and assessment of asthma.

Bronchial obstruction, its reversibility, airway hyperreactivity and inflammation are key variables of asthma. In clinical practice they can be assessed with repeated noninvasive lung function measurements (spirometry and mucociliary clearance). The asthmatic inflammation in contrast to chronic bronchitis is characterized by increased IgE and eosinophils depending on the disease state (seasonal, perennial, chronic symptomatic or asymptomatic asthma). Based on the above-mentioned clinically applicable measurements, a classification of asthma, chronic (obstructive) bronchitis, and emphysema is proposed because the three groups of diseases have different etiology and need different prophylactic and symptomatic treatment.

Airway Resistance↗
PubMed1990

Inhalation delivery of asthma drugs.

In the immediate future, metered-dose inhalers (MDIs) with spacers remain the aerosol application of choice for topical steroids, mainly to reduce side effects. For beta 2-agonist, anticholinergics and prophylactic drugs, MDI (with or without demand valve), dry powder inhalers (multidose inhalers), ultrasonic or jet aerosol generators (with or without mechanical breathing assistance [IPPB]) are chosen according to the preference or the ability of the patients to perform the necessary breathing maneuvers as well as the availability of different products in different countries.

Adrenal Cortex Hormones↗
PubMed1990

Survival in chronic obstructive pulmonary disease after diagnosis of pulmonary hypertension related to long-term oxygen therapy.

Long-term oxygen therapy has proven increased survival rates of patients with severe chronic obstructive pulmonary lung disease and remains the only treatment so far to prolong life in these patients. No study has related hemodynamic measurements, lung function data, and age at beginning of long-term oxygen treatment to prognosis in these patients. In a retrospective study, we analyzed these parameters for 76 survivors and 51 deceased, starting supplemental oxygen therapy in 1981 and thereafter, concerning significant differences using the Proportional Hazards General Linear Model Procedure. A longer survival could be shown for PaP less than 30 mmHg when compared to PaP greater than 30 mmHg (p = 0.0442) and for the age less than 60 yrs compared to greater than 60 yrs (p = 0.0317). No contribution to prognosis could be made by FEV1, IVC, PaO2 and nationality. We conclude that hemodynamic measurements prior to long-term oxygen treatment are necessary since, besides age, they serve as the only indicator for prognosis in these patients.

Aged↗
PubMed1990

A multiuser system for whole body plethysmographic measurements and interpretation.

A multiuser system for whole body plethysmographic measurements and interpretation which has been developed under clinical conditions is described. The following measurements can be carried out in a rapid way and in one session with the patient: specific airway resistance during spontaneous breathing, determination of functional residual capacity, static lung volumes, and maximal forced expiratory data. Each section is normally measured twice and can be repeated up to ten times. The final results are displayed and printed together with a consistent system of normal reference values. All values and selected original curves are stored automatically in an integrated data base system. Obstructive patients are measured again after the inhalation of a bronchodilator. All results are evaluated by an automatic interpretation program. This analyzes and graduates airway obstruction, lung volumes, and pharmacological airway reversibility using standardized texts which are written below all numerical printouts and graphical plots. The interpretation algorithm is tree structured and uses the normal reference values as a knowledge base. The system supports up to four online laboratories with their own A/D converter and up to 20 video terminals, printers, plotters, and modems. Our laboratory performs 8,297 such complete measurements on 4,671 different patients per year with one body box.

Diagnosis, Computer-Assisted↗
PubMed1990

Acute and long-term amiloride inhalation in cystic fibrosis lung disease. A rational approach to cystic fibrosis therapy.

Cystic fibrosis (CF) is the most common inherited fatal disorder among Caucasians. Bronchial mucus in CF contains more potassium and less sodium, which may be due to increased sodium absorption, resulting in a reduced airway water content. We studied 23 patients with CF after inhalation of normal saline or amiloride (10(-3) M), a sodium transport blocker. Mucociliary clearance (MC) and cough clearance (CC) were determined with a gamma camera that traced the movement of 99mTc-labeled, hardened erythrocytes over a 1-h period after the patients inhaled these particles as an aerosol. Before and after each investigation pulmonary function tests (PFT) and blood pressure (BP) were measured. Sputum thread formation was measured by means of a filancemeter. Six of the patients also completed a 3-wk trial of amiloride inhalation therapy. MC increased significantly (p less than 0.001) after acute amiloride inhalation (bronchial deposition, 0.07 mg amiloride) compared with that in the saline control. CC also increased, but not as much as MC. After 3 wk of amiloride inhalation (2 times a day) clearance values (both MC and CC) were markedly enhanced (p less than 0.01); after a similar period of saline inhalation, clearance values were not different from baseline. Sputum filance values also decreased significantly after amiloride inhalation. There were no adverse effects of the amiloride inhalation compared with saline. We conclude that amiloride inhalation administered as a single dose or as long-term therapy is able to increase MC and CC in CF airways and that the effect of 10(-3) M amiloride inhalation on MC lasts at least 40 min. (ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1990

[Acute and long-term effects of chronic obstructive lung diseases].

In patients with chronic obstructive pulmonary diseases and cor pulmonale, long-term treatment with oxygen leads to a reduction in pulmonary arterial pressure. The aim of this study was investigate the question as to the extent to which pulmonary arterial pressure reduction in response to acute administration of oxygen differed from the long-term effect of oxygen treatment, and whether it was possible to determine prognostic factors that would identify the patients who would obtain particular benefit from long-term oxygen therapy. Twenty patients suffering from severe obstruction, global respiratory failure and precapillary hypertension, were treated with oxygen for a period of 20 +/- 6 months. At the beginning of the treatment, the acute oxygen-induced reversibility of pulmonary hypertension with an FIO2 of 80% was established. After an average of 20 months, catheter examination was repeated. A comparison was made between reversibility with acute oxygen and the long-term effects of oxygen. Long-term treatment with oxygen led to a reduction in pulmonary arterial pressure (18%), which was comparable to the reversibility established for acute oxygen inspiration (20%). While, over the long-term, a reduction in pulmonary arterial pressure was caused solely by a drop in pulmonary vessel resistance, acute application of oxygen resulted in an approximately equal decrease in pulmonary vessel resistance and cardiac output. The more pronounced the pulmonary hypertension prior to treatment the greater the pressure reduction achieved with long-term oxygen treatment. Patients with a particularly marked acute oxygen reversibility also had greater long-term benefit, in the sense that, in these cases, the decrease in pulmonary arterial pressure was more substantial than in patients with smaller acute reversibility.

Arrhythmias, Cardiac↗
PubMed1990

[Trans-tracheal long-term oxygen therapy in respiratory failure].

The benefit of long-term oxygen therapy for patients under refractory hypoxaemia has been proven. Dealing with side effects due to high oxygen flow rates for sufficient oxygenation we treated four patients via a transtracheal oxygen catheter. Data are shown. Refractory hypoxaemia was successfully treated requiring 50% less oxygen. There were no complications related to the insertion procedure. Increased mucous plugging, while acute bacterial infection was observed, required frequent instillation of 0.5 cc normal saline. All patients experience an improvement in their quality of life with transtracheal oxygen.

Adult↗
PubMed1990

[Lung deposition of 300 and 600 mg pentamidine, inhaled with 3 different inhalers].

Intracorporal, especially pulmonary, and extracorporal deposition of pentamidine was studied following inhalation of 300 or 600 mg in 6 ml Aqua dest. each dose in six patients with one previous episode of pneumocystis carinii pneumonia. Three different nebulizers--two mechanical nebulizers (Respirgard II and Pari-IS-2) and one ultrasonic device (Portasonic) - were compared. The following results were obtained: 1.300 mg pentamidine in 6 ml Aqua dest. is a sufficient dose for prophylaxis provided an appropriately constructed nebulizer and an optimal respiratory manoeuvre (inspiratory vital capacity breathing) are employed. With the nebulizer Portasonic, the frequency of cough was higher compared with the two mechanical nebulizers, which is attributed to its higher mist density. 2. Application of 600 mg pentamidine in 6 ml Aqua dest. as an aerosol is difficult to apply owing to clinical and technical problems caused by severe respiratory tract irritation and a high viscosity of the nebulizer solution. We assume that ultrasonic nebulization is affected more by the high viscosity than mechanical pneumatic nebulization. 3. Inspiratory vital capacity breathing (12/min) leads to five- to eight-fold higher pulmonary and improved peripheral deposition rates compared with commonly used spontaneous respiration. We therefore recommend to shorten the duration of inhalation by applying this respiratory technique while maintaining a generally tolerated and optimally nebulizable concentration of pentamidine, i.e. about 300 mg in 6 ml Aqua dest.

Aerosols↗