Biomedical subjects

J Kumlien

Publications and source records attributed to J Kumlien.

35 records · Page 2Linked to original sources

PubMed1989

Experimentally induced sinusitis: the importance of vasomotor regulation.

An acute pneumococcal maxillary sinusitis was induced in New Zealand white rabbits by unilateral obstruction of the sinus ostium and then injecting 10(8) Streptococcus pneumoniae into the sinus. After subjecting this bacterial strain to one animal passage, the bacteria were reisolated in nine of ten infected maxillary sinuses. All rabbits developed a unilateral purulent sinusitis, while a non-purulent sinusitis could be induced by occlusion only of the maxillary ostium. By using a non-diffusable tracer, microspheres labelled with Sn113, blood flow measurements were performed on these sinuses. These studies showed that the blood flow of the infected sinuses was significantly higher than on the control side. However, in chronic sinusitis (with a blocked ostium), the blood flow did not differ significantly from that on the control side. Biochemical studies in the animals with purulent sinusitis demonstrated that lactate concentration in the mucosa was significantly higher as compared to the control side. The glucose concentration was significantly lower in the mucosa of the infected side, as was the ATP content of the sinus mucosa in purulent sinusitis. These results indicate an increased glycolysis as well as a relative energy depletion in the sinus mucosa in purulent sinusitis, which could result in an impaired epithelial function.

Animals↗

PubMed1989

Determination of a glucose-containing tetrasaccharide in urine of patients with acute pancreatitis.

The oligosaccharide Glc alpha 1-6Glc alpha 1-4Glc alpha 1-4Glc (Glc4), formed by amylolytic degradation of starch and glycogen, is excreted at extremely high levels in the urine of patients with acute pancreatitis. To determine if Glc4 is a useful indicator for this disease, we studied 55 patients admitted to the hospital because of acute abdominal pain (possibly acute pancreatitis). The highest values of Glc4 excretion in urine was found in a group of 11 patients with acute pancreatitis. The Glc4 values, but not serum and urine amylase values obtained at admission, correlated significantly with the severity of the disease. In two patients, followed through convalescence, the Glc4 excretion remained elevated for 7 and 2 wk in contrast to serum and urine amylase that returned to normal levels within a few days. It seems probable that glycogen, released from the liver and subsequently degraded by amylase originating from the pancreas, can be measured as Glc4 in the urine. This might be valuable for diagnosing acute pancreatitis and gives indications of the prognosis.

Acute Disease↗

PubMed1989

Analysis of a glucose-containing tetrasaccharide by high-performance liquid affinity chromatography.

In the present work we have explored conditions for using a pulsed amperometric detector for on-line analysis of oligosaccharides eluted from a high-performance liquid affinity chromatography column. A monoclonal antibody that specifically binds a glucose-containing oligosaccharide is coupled to a SelectiSphere-10-activated tresyl column. The system is eluted isocratically and easily detects 10 ng of the oligosaccharide with a linear response up to 250 ng. Analysis of both serum and urine samples from normal individuals and patients with acute pancreatitis gives a single retarded peak with a retention time identical to that of authentic (Glc)4. Retarded material pooled from several analyses of urine was positively identified as (Glc)4 by GC-MS analysis. As this method requires little cleanup and no chemical derivitization of the sample and is performed rapidly (less than 20 min) at sensitivities of at least 10 micrograms/liter in biological fluids, it represents a substantial improvement over previous GC-MS, radioimmunoassay, and enzyme-linked immunoadsorbent assay methods used to determine (Glc)4.

Animals↗

PubMed1989

Structural and immunochemical analysis of three alpha-limit dextrin oligosaccharides.

Complete structures are described for three urinary oligodextrins from one patient with type II and one patient with type III glycogen storage disease. GLC-MS, direct probe MS, and 1H NMR demonstrate two heptasaccharides and one hexasaccharide containing only alpha 1-4 and alpha 1-6 linkages. The observation that all three oligosaccharides were present in urine of both patients and the occurrence of alpha 1-4 and alpha 1-6 linkages in characteristic sequences indicates that the oligodextrins are limit dextrins derived from alpha-amylolytic degradation of glycogen. The binding affinities of the oligodextrins for a monoclonal antibody (401/6) raised against Glc alpha 1-6Glc alpha 1-4Glc alpha 1-4Glc, were determined by frontal analysis. The highest affinity was exhibited by Glc alpha 1-6Glc alpha 1-4Glc alpha 1-4Glc followed by the two heptasaccharides and the hexasaccharide. The results from quantitative affinity measurements agree with results of structural analysis by physical methods in that all oligodextrins containing the nonreducing terminal sequence, Glc alpha 1-6Glc alpha 1-4Glc . . . , are specifically bound by the antibody with similar affinities, but the affinity is somewhat higher for chains containing the tetrasaccharide sequence Glc alpha 1-6Glc alpha 1-4Glc alpha 1-4Glc at the nonreducing terminal. Utilization of affinity methods offers clear advantages for isolation and characterization of oligosaccharides with very similar structures.

Antibodies, Monoclonal↗

PubMed1988

Urinary excretion of a glucose-containing tetrasaccharide. A parameter for increased degradation of glycogen.

The urinary excretion of a glucose-containing oligosaccharide, Glc alpha[1-6Glc alpha[1-4Glc alpha[1-4Glc, (Glc4) has been measured in various physiological and pathological conditions. The Glc4 content of 24 h samples from the same individual was relatively constant, whereas 2 h samples showed up to 4-fold variations in Glc4 concentration. This variation is associated mainly with increased excretion of Glc4 after meals. A carbohydrate-rich diet, starvation or a protein-rich diet, and intense physical activity all affected the urinary excretion of Glc4. Both oral and intravenous administration of glycogen in a Rhesus monkey resulted in increased excretion of Glc4. When Glc4 itself was injected intravenously in small amounts renal clearance was rapid and complete. In contrast, injection of a larger amount resulted in incomplete (approximately 10%) renal clearance, probably due to uptake and metabolism of the oligosaccharide. In patients with glycogen storage diseases, certain malignancies, and pancreatitis, 24 h urinary Glc4 excretion exceeded the normal range. The diagnostic implications of these observations deserve evaluation. The results presented suggest a need for standardization of nutritional status and physical activity when monitoring urinary Glc4 excretion for diagnostic purposes.

Adult↗

PubMed1988

A clinical follow-up of septal surgery with special attention to the value of preoperative rhinomanometric examination in the decision concerning operation.

A consecutive series of 57 patients who had undergone an operation on the nasal septum was followed up 1.5-3.5 years postoperatively. Rhinomanometric measurements, a clinical examination of the exterior of the nose, and rhinoscopy were performed. These same examinations had been carried out preoperatively and the results recorded preoperatively. The results of the preoperative rhinomanometry were not known to the surgeon and the indication for surgery was based on clinical examination alone. At follow-up the patients also answered a questionnaire. According to the findings at rhinomanometry 52 of the 57 patients had a better airway after the operation. In 11 patients who subjectively did not consider the nasal airway to have been improved by the operation, an allergy or vasomotor rhinitis was found and in some cases the results of preoperative rhinomanometry (total nasal resistance) were normal. To measure the error of the method, a separate series of duplicate measurements was performed on 50 subjects. The standard deviation of the difference between duplicate measurements was found to be 15% of the mean value and the error of the method was considered small enough to justify rhinomanometry as a method for interindividual comparisons, provided the laboratory standard is well known.

Adolescent↗

PubMed1985

The effect of ipratropium bromide (Atrovent) on the air conditioning capacity of the nose.

The air conditioning capacity of the nose was assessed by a method which permits measurements in both nasal cavities without blockage of the passage between the nasopharynx and oropharynx. By this method the degree of warming of the air and its humidification during the passage through the nasal cavity can be calculated. The effect of intranasal application of ipratropium bromide (Atrovent) on the air conditioning capacity of the nasal mucosa was evaluated in a group of normal subjects and a group of patients with vasomotor rhinitis. In this short term trial Atrovent was found not to have any effect on this capacity.

Adult↗

PubMed1979

Methodological aspects of rhinomanometry.

Rhinomanometry is an objective method for determining nasal patency; its reliability and relevance as an aid in defining and solving problems connected with nasal obstruction have, however, received scant attention. In the present study more than 200 subjects were submitted to rhinomanometry--most of them only by the posterior technique. In 50 of these subjects duplicate determinations of the pressure drop across the nose at the flow rate of 0.3 l/s were made within a short interval; the coefficient of variation was 20--25 per cent. The rhinomanometric values in a small group showed a day-to-day variation of 55 per cent. Because rhinomanometry allows only a moderate level of accuracy the method is unsuitable for detecting a borderline case. As the influence of the variability of the method is smaller in large materials, rhinomanometry is more suitable for comparison of groups than of individual patients.

Evaluation Studies as Topic↗

PubMedDate not supplied

Experimental studies of the human nasal air-conditioning capacity.

Nasal air-conditioning capacity was measured in human subjects by a method reported in 1977, which enables determinations to be made in each nasal cavity separately without introducing a foreign occluding structure between the soft palate and the posterior pharyngeal wall. The enthalpy for vaporization and for the warming of the air and the water vapour can be calculated separately. The error due to the escape of air from the lower airways, measured with both carbon dioxide and helium as tracer, was found usually to be about 1%, but sometimes greater. By varying the air flow through the relevant nasal cavity it was found that the maximum air conditioning capacity had still not been reached at 7 l/min. However, the patient suffered discomfort at flows in excess of 5 l/min. The nasal air conditioning capacity was lower at night than in the daytime. The total enthalpy and vaporization decreases with age.

Aging↗

PubMedDate not supplied

The vascular arrangement of the sinus mucosa. A study in rabbits.

Seventy-seven New Zealand White rabbits, with an average weight of 3 kg, were used in studies on the paranasal sinus. Replica moulds of the sinus revealed a sinus cavity composed of three compartments with a total volume of 2-3 ml. The sinus cavity was connected with the nasal cavity through an ostium. By intravascular injection of silicone rubber for dissection and of methacrylate for production of corrosion casts, the vascular bed and the vessels passing to and from the sinus cavity were studied. The main arterial supply and venous drainage takes place through the ostium, which is surrounded by a dense venous plexus. Compared with the nasal mucosa, the number of vessels per volume unit is about the same in the sinus mucosa. Many vessels perforating through the osseous walls, both arteries and veins, were found, however, indicating that the blood supply is not derived exclusively from vessels coming through the ostium.

Animals↗

PubMedDate not supplied

Blood flow in the rabbit sinus mucosa during experimentally induced chronic sinusitis. Measurement with a diffusible and with a non-diffusible tracer.

Chronic sinusitis was induced in New Zealand White rabbits. Access to the sinus cavity in question was obtained through a hole drilled in the dorsum of the nose, and for induction of sinusitis either cotton wool together with a suspension of 10(8) Streptococcus pneumoniae was introduced, or this method was combined with blocking of the sinus ostium with methacrylate. In 9 rabbits (weight range 3.6-5.0 kg), blood flow was determined 5 weeks-9 months after the induction of sinusitis, at a point in time when heavy inflammatory signs were present. The blood flow was determined both with radioactively labelled microspheres 16 +/- 1.5 micron in diameter and with Rb86Cl. Cardiac output as determined with the microsphere method was 127 +/- 28 ml X min-1 X 1 000 g-1. The blood flow in the sinus mucosa was 0.60 +/- 0.16 ml X min-1 X g-1 with the microsphere method and 0.51 +/- 0.20 ml X min-1 X g-1 with use of Rb86Cl. These values did not differ significantly from the corresponding values found previously in healthy rabbits.

Animals↗

PubMedDate not supplied

Blood flow measurements in rabbit sinus mucosa. A comparison between fluorescein flowmetry and blood flow measurements with microspheres and Rb86Cl.

The blood flow of the sinus mucosa was studied in 14 rabbits of the New Zealand White strain. The blood flow was determined by fluorescein flowmetry and the values were compared with those obtained from the same sinus mucosa with use of Sn113 radioactively labelled microspheres and with Rb86Cl. One sinus cavity in each animal received nose drops prior to the blood flow measurement. The blood flow index in the sinus mucosa was 0.039 +/- 0.019 density units Xs-1 and was significantly reduced to 0.016 +/- 0.011 density units Xs-1 by administration of nose drops. Blood flow in the sinus mucosa was 1.0 +/- 0.53 ml X min-1 X g-1 as measured with microspheres and 0.52 +/- 0.12 ml X min-1 X g-1 with the Rb86Cl method. Following administration of nose drops the values were reduced to 0.29 +/- 0.13 and 0.22 +/- 0.07 ml X min-1 X g-1 respectively. There was a significant difference in blood flow obtained with the Rb86Cl and microsphere methods in the sinus mucosa without decongestion. This might be explained by possible shunting of blood in the mucosa due to hyperaemia caused by the surgical trauma to the sinus.

Animals↗

PubMedDate not supplied

Fluorescein flowmetry in human nasal mucosa.

In sixteen patients a relative blood flow, expressed as an index, in the nasal mucosa was measured by fluorescein flowmetry (FF) using an endoscope technique. Duplicate determination showed slightly lower values in the second measurement performed 5 min after the first one. This difference might be due to a too high background fluorescence in the tissue. The blood flow index was reduced to 1/3 of the original blood flow index by the administration of nose drops. These changes in man due to decongestion are comparable to the changes in blood flow index observed in a previous work (2) in rabbit sinus mucosa, using the corresponding technique.

Adolescent↗

PubMedDate not supplied

Experimental acute sinusitis in rabbits. A bacteriological and histological study.

A bacteriological and histological study of experimentally induced acute pneumococcal sinusitis was performed in 69 New Zealand White rabbits. The sinus ostium was blocked on one side on the first day of the experiment. On the second day, 10(7)-10(9) Streptococcus pneumoniae in 1 ml were injected into the same sinus cavity. Purulent sinusitis developed unilaterally in all rabbits. Histological examination of the sinus mucosa revealed edema, dilated venules, leukocytic infiltration of the mucosa as well as localized epithelial lesions. On staining with acridine orange at pH 4.0, the bacteria were observed in the secretion but not in the mucosa. When we used Streptococcus pneumoniae subjected to an animal passage, the bacteria were re-isolated in 9/10 infected sinuses. Neither sole occlusion of the ostium nor injection of pneumococci into a sinus cavity with a patent ostium resulted in a bacterial sinusitis. Obstruction of the sinus ostium and the use of a virulent Streptococcus pneumoniae strain were essential for the induction of sinusitis in rabbits.

Acute Disease↗

PubMedDate not supplied

Blood flow in the rabbit maxillary sinus mucosa during experimentally induced acute sinusitis.

The blood flow in the maxillary sinus mucosa was studied in 35 New Zealand White rabbits. The blood flow measurements were made by two methods, one with use of Rb86Cl and the other with 15 microns Sn113-labelled microspheres. With the Rb86Cl method the blood flow of the infected sinus mucosa was about 0.8 ml x min-1 x g-1 when correction was made for radioactivity in the secretion. The radioactivity found in the secretion probably reflects an increase both in vascular and mucosal permeability and in blood flow. When microspheres labelled with Sn113 were used, the mean mucosal blood flow in the presence of sinusitis was found to be 0.83 +/- 0.56 ml x min-1 x g-1. This blood flow was significantly higher than on the control side. In a control series, mere blocking of the ostium did not significantly alter the blood flow in the sinus mucosa.

Animals↗

PubMedDate not supplied

Experimental acute sinusitis in rabbits. Energy metabolism in sinus mucosa and secretion.

In previous studies, sinus secretions have been analysed concerning pO2, pCO2 and pH. In this study the energy metabolism in the maxillary sinus mucosa and secretion was studied in 33 New Zealand White rabbits. In freeze-dried samples, glucose and lactate were analysed by enzymatic assays and ATP by HPLC. In the purulent sinusitis, lactate concentration in the mucosa was 5.67 mmol X kg-1 w.w. and significantly higher than in the control sinus. Also in the non-purulent sinusitis, lactate was increased in the mucosa. The lactate concentrations in the secretion were 9.8 and 8.4 mmol X kg-1 w.w. in purulent and non-purulent secretions respectively and are probably the result of a diffusion from the mucosal cells and of leukocyte metabolism. A reduced ATP content, with increases in ADP and AMP, in the sinus mucosa of the purulent sinusitis suggests a relative energy depletion which could result in impaired epithelial function.

Adenine Nucleotides↗

PubMedDate not supplied

Experimental acute sinusitis in rabbit. A study of mucosal blood flow.

An experimental model of sinusitis in the rabbit was developed, using type 3 pneumococci. The superior parts of the rabbit maxillary sinuses were surgically exposed and the maxillary ostium was unilaterally blocked. The following day a challenge dose of 10(7)-10(9) colony-forming units of Streptococcus pneumoniae, capsular type 3, was injected into the sinus. When the pneumococci used had been subjected to an animal passage, bacteria were recultured after 4 days. Histological examination showed thickening of the mucosa, with dilated venules and infiltration of granulocytes. No bacteria were seen in the mucosa on staining with acridine orange. With use of microspheres 15 micron in diameter labelled with Sn113, the mucosal blood flow was found to be higher than on the control side.

Acute Disease↗