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Biomedical subjects

H Matthys

Publications and source records attributed to H Matthys.

At least 91 records · Page 5Linked to original sources

Mucociliary clearance in smokers.

The mucociliary clearance characteristics and the correlation between the extent of smoking and bronchial mucociliary dysfunction were studied in 71 smokers (15 without chronic bronchitis, 16 with simple and 40 with obstructive chronic bronchitis). Mucociliary clearance (MC) was measured with 99mTc-tagged human erythrocytes. Lung function values were determined by whole body plethysmography. All three smoking groups had significantly (p less than 0.001) lower TMC60.min rates (total MC in 60 min) on the average than the predicted values. The mean TMC60.min rates of heavy smokers with simple and obstructive chronic bronchitis were significantly (p less than 0.001) lower than that of light smokers without chronic bronchitis. There was no significant difference between the TMC60.min rates of smokers with simple and obstructive chronic bronchitis. The decrease in the MC rates was more pronounced in the central than in the peripheral airways. A significant (p less than 0.001) correlation was found between the extent of smoking (pack years) and the decrease of MC. The results suggest that the decrease of MC is an early functional abnormality in smokers, which precedes the development of symptoms of chronic bronchitis as well as functional detectability of airways obstruction.

Bronchitis

[Gold-induced fibrosing alveolitis].

Fibrotic alveolitis appeared in a 54-year-old patient undergoing gold therapy. In differential diagnosis, this infrequent side effect of gold therapy is to be distinguished from rheumatoid lung fibrosis. Lymphocyte sub-populations were determined in the broncho-alveolar lavage fluid of the patient. The results obtained support the view that the side effect is due to an immunologically mediated process.

Arthritis, Rheumatoid

[Objectivation of the effect of antitussive agents using tussometry in patients with chronic cough].

The antitussive effect of several antitussive agents has been objectively evaluated in patients with chronic stable cough due to bronchial carcinoma, pulmonary tuberculosis or chronic obstructive lung disease. The patients received the active antitussive drugs or placebo in a double-blind, randomized crossover design. The preparations were administered at 10 p.m. and 2 a.m. on 7 consecutive nights and no antitussive was given for the following 20 hours. Cough frequency and intensity were recorded from 10 p.m. until 6 a.m. The active medications were noscapine (30 mg), dextromethorphan (20 mg), dihydrocodeine (30 mg) and codeine (20, 30 and 60 mg) at 10 p.m. and 2 a.m. Cough frequency and intensity were objectively assessed with a pressure transducer placed over the trachea and recorded on a chartrecorder. Statistical analysis was performed with analysis of variance and multiple range testing. Noscapine, dextromethorphan, dihydrocodeine and codeine (60 mg) significantly (p less than 0.001) reduced the cough frequency compared to placebo. They also produced a greater reduction of cough intensity than placebo, codeine (20 mg) and codeine (30 mg) (p less than 0.001). The duration of action of low-dose codeine (6 hours) was unsatisfactory. Subjective preference for dextromethorphan indicates a psychotropic central nervous action of this drug not assessed by the measuring device. Noscapine was equally well tolerated but more neutral psychologically.

Adult

Pulmonary deposition of aerosols by different mechanical devices.

With a new method for easy labeling of beta 2-agonists we measured intra- and extrapulmonary aerosol deposition after the administration of a bolus from a metered-dose inhaler at residual volume (RV) inhaling after a pause of 2 s and after immediate administration into the inspiratory flow at functional residual capacity (FRC). Immediate administration during a slow inspiratory vital capacity maneuver gives the highest intrapulmonary deposition (30-40%). Compressed air and ultrasonic nebulizers with a particle distribution pattern of 2-5 micron aerodynamic mass median diameter (AMMD) allow in normal subjects to achieve an intrapulmonary deposition of 30-60% during standardized tidal breathing at rest, the magnitude of the deposition depending mainly on each subject's larynx geometry. The outlet system leads to different deposition patterns in aerosol generators with the same AMMD. Many commercially available aerosol generators do not fulfill the criteria for any intrapulmonary aerosol deposition. For drug administration into the lungs, condensation aerosol generators ('steam boiler nebulizers') are useless as well as compressed-air, ultrasonic and steam driven nebulizers with a particle size of more than 10 micron AMMD.

Adrenergic beta-Agonists

Influence of 0.2 mg ipratropium bromide on mucociliary clearance in patients with chronic bronchitis.

14 patients with chronic bronchitis were subdivided into 2 groups of 7 patients. They were given at random 10 puffs of placebo or ipratropium bromide (0.2 mg). The mucociliary clearance rate was measured immediately after ipratropium inhalation (group 1) or 24 h after ipratropium inhalation (group 2). In group 1, the mucociliary clearance after ipratropium bromide was significantly better than after placebo (p less than 0.01). In group 2 there was no difference in the mucociliary clearance rates measured after ipratropium bromide or placebo, but the clearance rate still tended in favour of ipratropium bromide. We conclude that ipratropium bromide should be inhaled in high doses (0.2 mg) by hypersecretory patients with chronic bronchitis to improve mucociliary transport.

Adult

Ia-like antigens on T-cells and their subpopulations in pulmonary sarcoidosis and in hypersensitivity pneumonitis. Analysis of bronchoalveolar and blood lymphocytes.

We investigated the expression of Ia antigens on T-cells from lung and blood, as a sign of T-cell activation, in 17 patients with active pulmonary sarcoidosis, 12 patients with inactive sarcoidosis, 9 patients with hypersensitivity pneumonitis, and 10 normal control subjects. Lymphocyte subsets were identified by mouse monoclonal antibodies using a peroxidase-antiperoxidase method. Patients with active sarcoidosis and patients with hypersensitivity pneumonitis had a significant increase in Ia+ T-cells in bronchoalveolar lavage fluid compared with that in patients with inactive sarcoidosis and that in control subjects (p less than 0.01). Blood T-cells from the same patients did not show this sign of activation. The highest numbers of Ia+ T-cells were recovered from the lungs of patients with hypersensitivity pneumonitis, indicating the high state of activation of immunoregulatory T-cells in this disease. Additional analysis revealed that in sarcoidosis, Ia+ lung T-cells were exclusively of the OKT4+ helper phenotype, whereas in hypersensitivity pneumonitis, OKT4+ helper as well as OKT8+ suppressor lung cells expressed in part Ia antigens. These observations suggest that different T-cell subpopulations are activated in sarcoidosis and in hypersensitivity pneumonitis.

Adolescent

Mucociliary clearance and airways obstruction in smokers, ex-smokers and normal subjects who never smoked.

On 17 ex-smokers (7 without chronic bronchitis, 10 with chronic bronchitis) and 48 smokers (13 without chronic bronchitis, 35 with chronic bronchitis) we analyzed the correlation between smoking habits (pack years, smoking and ex-smoking time), mucociliary clearance rate (mC) and airways obstruction. The mC was measured with 99mTc tagged monodisperse erythrocytes. The static and dynamic lung volumes, the maximal expiratory flow volume curve and the airway resistance were measured by whole body plethysmography. The ex-smokers without chronic bronchitis showed the same mucociliary clearance rate (t-mC in 1 h = 38.3 +/- 10.3%) as the 80 control subjects who never smoked (t-mC in 1 h = 36.9 +/- 12.6%). But the subjects who never smoked showed less airway obstruction. The mucociliary clearance rate in normal subjects who never smoked is a function of age: t-mC in 1 h = -0.37 X age + 53; c-mC in 1 h = -0.45 X age + 73; p-mC in 1 h = -0.25 X age + 38. The smokers without chronic bronchitis showed normal ventilatory function tests but a lower mC rate (t-mC in 1 h = 27.8 +/- 12.3%) than the healthy ex-smokers and the control subjects who never smoked (p less than 0.01). The ex-smokers and smokers with chronic bronchitis had a lower mC rate (t-mC in 1 h = 21.2 +/- 11.3% and 18.1 +/- 9.1) and more airway obstruction (p less than 0.001) than the subjects who did not report any symptoms of chronic bronchitis. The ex-smokers with persistent symptoms of chronic bronchitis showed the severest degree of airways obstruction. The smokers with chronic bronchitis showed the most delayed central mC (c-mC) rate, but less airway obstruction than the ex-smokers with persistent symptoms of chronic bronchitis. The smoking habits (pack years) correlated with the decreased mC rate (p less than 0.01) and the degree of airways obstruction (p less than 0.001).

Adult

[Fenoterol in chronic obstructive bronchitis--comparison of the efficacy of various application forms. Advantages and disadvantages of metered dose inhalers with a small or large expander and a mechanical atomizer].

After an initial inhalation of 1,25 mg fenoterol in 2 ml 0,9% NaCl by means of Pari Privat randomized on the following two days, two groups of ten respectively eleven patients with relatively stable respiratory tract obstruction were tested for the reversibility of the obstruction with a metered dose inhaler as follows: Group 1 (10 patients) received the metered dose inhaler with a small expander alternatively on even days and on the odd days without the expander. Group 2 (11 patients) received the metered dose inhaler with the large expander (130 mm X 35 mm) alternatively on the even days and with the small expander (100 mm X 30 mm) on the odd days. All patients showed a significant improvement of the bronchial obstruction regardless of the type of inhalation. Auxiliary appliances (inhalation appliances, expanders for the metered dose inhaler) are therefore only necessary, when the patients cannot cope at all or cannot cope optimally with the simple metered dose aerosol.

Adult

[The connections between smoking, mucociliary clearance and airway obstruction].

The connection between smoking habits (pack years, smoker and ex-smoker period), mucociliary clearance (mC) and the obstruction of the respiratory passages was investigated in 17 ex-smokers (7 without bronchitis; 10 with bronchitis) and 48 smokers (13 without bronchitis; 35 with bronchitis). The ex-smokers without chronic bronchitis showed the same clearing behaviour as the healthy non-smokers, but the non-smokers did not have the least obstruction of the respiratory system. The smokers without chronic bronchitis showed a normal lung function, but a worse clearing behaviour than the healthy non- and ex-smokers (p less than 0,01). Compared to volunteers without bronchitic symptoms the ex-smokers and smokers with chronic bronchitis had a bad clearing behaviour (p less than 0,001) and a distinctly obstructive ventilation disorder. Furthermore, it was noticeable that the ex-smokers with persistent bronchitis showed the worst respiratory system obstructions, whilst the smokers with chronic bronchitis had the greatest restriction of the central mC (c-mC) with less respiratory system obstruction than the ex-smokers with chronic bronchitis. The smoking habits (pack years) correlated with the decrease of the mC (p less than 0,01) and the grade of the respiratory system obstruction (p less than 0,001).

Bronchitis

T-lymphocytosis in bronchoalveolar lavage fluid of hypersensitivity pneumonitis. Changes in profile of T-cell subsets during the course of disease.

Recently, increased proportions of OKT 4+ helper T-lymphocytes have been reported in bronchoalveolar lavage (BAL) fluid of patients with active sarcoidosis. In this study we were interested in T-cell subsets of hypersensitivity pneumonitis, a disease characterized by a similar increase in BAL T-lymphocytes as active sarcoidosis. We applied an immunoperoxidase method performed on glass slides using the monoclonal antibodies OKT 3, 4, and 8 to study T-cell subsets in blood and BAL of eight patients with hypersensitivity pneumonitis, 11 patients with active sarcoidosis, and ten control subjects. OKT 8+ suppressor cells were found to be the predominant cell type in the BAL of patients with hypersensitivity pneumonitis and recent antigen exposure. After avoidance of further antigen exposure, suppressor cells decreased and helper cells increased. The results suggest that T-lymphocytosis in BAL of hypersensitivity pneumonitis and pulmonary sarcoidosis is mediated by different immunologic mechanisms.

Adult