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Biomedical subjects

K Sertl

Publications and source records attributed to K Sertl.

At least 19 recordsLinked to original sources
PubMed1999

Efficiency of continuous positive airway pressure versus theophylline therapy in sleep apnea: comparative sleep laboratory studies on objective and subjective sleep and awakening quality.

Sleep apnea is the most common sleep-related breathing disorder characterized by repetitive episodes of hypoxemia. Therapies include behavioral, surgical, orthodontic, pneumological, and pharmacological interventions. The aim of the present study was to compare the efficiency of pneumological therapy by nasal continuous positive airway pressure (CPAP) versus a pharmacological approach with theophylline (Respicur retard(R) 400 mg) on respiratory variables as well as objective and subjective sleep and awakening quality in patients with moderate sleep apnea measured by polysomnography and psychometry. Under CPAP therapy all respiratory variables improved and normalized, while under theophylline only the apnea-hypopnea index and the desaturation index improved but still did not return to normal values. Regarding sleep initiation and maintenance, CPAP therapy prolonged sleep latency and reduced movement time, while patients treated with theophylline showed reduced total sleep period, total sleep time and sleep efficiency. Sleep architecture demonstrated an increase in deep sleep and REM stages under CPAP therapy, and remained unchanged under theophylline. Concerning subjective sleep and awakening quality, both treatments improved well-being in the morning. Regarding objective awakening quality, reaction time performance was improved in both groups. In conclusion, CPAP treatment is more effective than theophylline regarding respiratory variables as well as the normalization of sleep maintenance and sleep architecture in sleep apnea patients.

Bronchodilator Agents↗
PubMed1997

Severe pulmonary hypertension reversed by antibiotics in a patient with Whipple's disease.

The case is described of a 58 year old man with systemic Whipple's disease with pericardial and pleural effusions and severe pulmonary hypertension. After three months of antibiotic treatment there was a complete resolution, not only of the symptoms known to be associated with Whipple's disease (diarrhoea, arthralgia, pericardial and pleural effusions), but also of pulmonary hypertension.

Anti-Bacterial Agents↗
PubMed1995

Effect of solution and suspension type aerosol of formoterol on tremor response and airways in patients with asthma.

BACKGROUND: Aerosol delivery and deposition to the oropharynx and the lungs have been found to be different for solution-type and suspension-type metered-dose aerosols used for treatment of asthma. We investigated possible differences in clinical effects between solution and suspension metered-dose formoterol aerosols. METHODS: A total of 24 patients with asthma (forced expiratory volume in 1 second, < or = 70% predicted) inhaled single doses (12 micrograms or 24 micrograms) of formoterol solution and suspension so that we could investigate the immediate tremor, airway, and cardiovascular responses in a randomized, double-blind, crossover trial. Fenoterol suspension aerosol (400 micrograms) was used for comparison (single-blind, poststudy, nonrandomized administration). Fenoterol (400 micrograms) as a rescue medication was inhaled after 120 minutes on each of the 5 study days. RESULTS: The order of mean (+/- SEM) maximum tremor acceleration was as follows: 12 micrograms formoterol solution (67.92 +/- 4.54 cm x sec-2) < 24 micrograms solution (73.46 +/- 4.51 cm x sec-2) < 12 micrograms suspension (80.87 +/- 5.08 cm x sec-2) < fenoterol (84.13 +/- 4.21 cm x sec-2) < 24 micrograms formoterol suspension 88.54 +/- 6.26 cm x sec-2). Maximum increase in specific airway conductance ranged from 0.48 +/ 0.03 to 0.55 +/- 0.04 sec-1 x kPa-1 for all drugs (p > 0.05). No change in cardiovascular parameters occurred (p > 0.05). CONCLUSION: No difference in the bronchial response to either formulation of formoterol was found. Tremor response to suspension aerosol (24 micrograms > 12 micrograms) was higher than that to solution aerosol (24 micrograms > 12 micrograms), indicating possible differences in systemic absorption because of a different deposition pattern. Rescue medication demonstrated systemic effects on tremor that were additive to those of formoterol.

Adult↗
PubMed1995

Comparison of the single breath with the intrabreath method for the measurement of the carbon monoxide transfer factor in subjects with and without airways obstruction.

BACKGROUND: Measurement of the carbon monoxide transfer factor (TLCO) has traditionally been performed using the single breath method but recently the intrabreath method has been developed. The aim of this study was to compare the two methods in the clinical evaluation of patients with obstructive and non-obstructive pulmonary disorders. METHODS: Measurements of TLCO with the intrabreath method were carried out on a study sample composed of 50 patients with non-obstructive disorders and 50 with airways obstruction (FEV1/FVC < 70%) either before or after a single breath measurement of the TLCO had been performed. The method involves the continuous analysis of a single slow expirate using a computerised rapid multigas infrared analyser. TLCO, alveolar volume (VA), TLCO/VA, and inspired vital capacity (IVC) values were obtained for both groups by both methods. RESULTS: When measured with the intrabreath method the group with airways obstruction showed lower TLCO and TLCO/VA values than the non-obstructive group. VA was higher in both patient groups when measured with the intrabreath technique. The same test also showed higher TLCO values with the intrabreath method in the group with non-obstructive disorders and lower TLCO/VA values with the intrabreath method in those with airways obstruction. The corresponding parameters obtained by the two methods correlated closely, with no correlation between the magnitude of the differences with the magnitude of the readings. An index of gas mixing indicated a better distribution of the inspired air for the intrabreath method than for the single breath method. The VA values obtained with the intrabreath method showed a closer agreement to the actual total lung capacities measured by body plethysmography. CONCLUSION: The intrabreath method of determining TLCO is comparable to the traditional single breath method. Measurement of alveolar volume by the intrabreath method approximates more closely to total lung capacity, even in subjects with airways obstruction.

Adult↗
PubMed1994

Effects of neuropeptide Y and vasoactive intestinal peptide on human venous smooth muscle in vivo.

The direct and noradrenaline-modulating effects of neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) on venous smooth muscle were studied in healthy volunteers employing the dorsal hand vein compliance technique. Local infusions of NPY had no measurable effect on venous tone, but coinfusion of a constant high dose of NPY (242 pmol/min) with noradrenaline caused a 2.9-fold increase in the mean ED50 for noradrenaline. The dilating effect of VIP on preconstricted hand veins was weak, maximal venodilation could not be achieved, because systemic side effects occurred at submaximally venodilating doses. Coinfusion of noradrenaline with a weakly venodilating, constant dose of VIP (93.2 pmol/min) caused a 0.5-fold decrease in the sensitivity for noradrenaline. Although functional interactions between NPY or VIP and noradrenaline could be demonstrated, the dosages of the peptides required were high. Thus our results indicate that neither NPY nor VIP exert a major direct or noradrenaline-modulating effect on human veins.

Adult↗
PubMed1994

Factors contributing to the occurrence and predictability of bronchial hyperresponsiveness to methacholine in children.

Using a stepwise logistic regression analysis, we investigated clinical data, allergologic findings, spirometric data, and the cellular and humoral immune system in order to gain new insights into the role these parameters play in bronchial hyperresponsiveness to methacholine in children and to create a model for the prediction thereof. Bronchial hyperresponsiveness, which was found in 124 of 462 children (26.8%), was observed to have been influenced by an increased level of eosinophils, the positivity of the skin prick test for any of the allergens tested, a decreased baseline forced expiratory volume in 1 second (FEV1) (percent predicted), a decreased maximum expiratory flow at 50% expiration as a percent of forced vital capacity, and a decreased level of kappa-chain-assembled immunoglobulins. Logit analysis disclosed that the influence of all other parameters on the occurrence of bronchial hyperresponsiveness was of no further statistical significance. The degree of bronchial hyperresponsiveness (provocative dose causing a 20% fall in FEV1) showed a statistically significant correlation with the eosinophil count (Spearman's r = -0.198) and FEV1 (percent predicted) (Spearman's r= 0.203). Our findings suggest that allergic sensitization and eosinophilic reaction in children are major factors in contributing to the occurrence of bronchial hyperresponsiveness to methacholine.

Allergens↗
PubMed1994

Prediction of sensitization to flour allergens.

The purpose of the present study was to investigate the factors that may contribute to the sensitization to flour in baker's apprentices, and to predict this type of sensitization with a stepwise logistic regression model. Of the total of 258 baker's apprentices, 54 (20.9%) exhibited specific IgE development against flour allergens (wheat, rye, and/or barley). Allergologic variables, such as the total IgE level and IgE specific to grass pollen, tree pollen, weed pollen, molds, and animal dander, were found to correlate strongly with the sensitization to flour. However, the correlation between the presence of other manifest allergies and the sensitization to flour was weak. The presence of shadowing of the paranasal sinuses on the radiograph (mucosal thickening, opacity, air/fluid levels, and/or polypous shadowing) correlated with flour sensitization as well as with the leukocyte and lymphocyte counts in peripheral blood. Of the lung function data, only total lung capacity (in percentage of the predicted values) weakly correlated with the sensitization to flour. We were able to predict flour sensitization with a sensitivity of 63%, a specificity of 90%, and an efficiency of 84% by using the parameters that allow for the presence or absence of IgE specific to grass pollen and tree pollen, the presence or absence of radiographic shadowing, and total lung capacity in percentage of the predicted values.

Allergens↗
PubMed1994

Effects of the sauna on diffusing capacity, pulmonary function and cardiac output in healthy subjects.

The present study examined possible short-term effects of the heat stress during sauna bathing on gas exchange, especially in correlation with changes in cardiac output. The results obtained are as follows: (1) The heat stress of sauna bathing caused a slight but not significant increase in diffusion capacity (p = 0.239) and no change in other pulmonary function parameters. (2) Cardiac output and cardiac index increased slightly but not significantly (p = 0.2455 and p = 0.2719). We conclude that heat stress in sauna neither influences gas exchange nor does it cause a significant increase in cardiac output.

Adolescent↗
PubMed1993

Pharmacodynamic effects of inhaled dry powder formulations of fenoterol and colforsin in asthma.

The airway and tremor response and cardiovascular and hypokalemic effects of single doses of inhalative fenoterol dry powder capsules (0.4 mg) were compared with the fenoterol metered dose inhaler (0.4 mg) and colforsin (forskolin) dry powder capsules (10.0 mg), a direct activator of the adenylate cyclase system, in 16 patients with asthma. Subjects (FEV1 < or = 60% predicted) were investigated in a randomized, double-masked, placebo-controlled, four-period, crossover trial for a 120 minute period. All active drugs caused a significant increase in specific airway conductance (p < 0.05); the order of potency (mean +/- SEM maximum increase from baseline) was fenoterol metered dose inhaler (0.51 +/- 0.06 sec-1 x kPa-1), fenoterol dry powder capsules (0.49 +/- 0.07), and colforsin dry powder capsules (0.30 +/- 0.03). A marked increase in finger tremor amplitude resulted after fenoterol metered dose inhaler only (62.93% +/- 10.21%; p < 0.05) in contrast to fenoterol dry powder capsules (15.84% +/- 4.35%; p < 0.05) and colforsin dry powder capsules (12.87% +/- 10.44%; p > 0.05). A decrease in plasma potassium was found after fenoterol (metered dose inhaler > dry powder capsules; p < 0.05). In conclusion, fenoterol dry powder capsules caused less tremor response and hypokalemic effects than the metered dose inhaler, although the bronchodilator capacity was similar. Colforsin dry powder capsules resulted in a measurable bronchodilatation in patients with asthma.

Administration, Inhalation↗
PubMed1991

Allergenic structures in cockroach hypersensitivity.

The tissues from which cockroach allergens were derived were identified by use of serum IgE of five patients with allergic rhinitis and bronchial asthma as a result of hypersensitivity to German cockroach. RAST and skin test results demonstrated four of five patients to be positive to cockroach only, and one patient was tested positive to house dust mite as well. Allergen-specific IgE binding to German cockroach was investigated by cryostat sections by means of immunofluorescent test. In all patients with cockroach hypersensitivity, we found IgE bound to the gastrointestinal epithelium and contents of the intestinal tract. In four cases, IgE was also bound to the Malpighian vessels (equivalent in function to kidneys). In three cases, IgE was also bound to the ovarian cells. All cases revealed cytoplasmic staining.

Animals↗
PubMed1990

Increased plasma histamine levels in uraemic pruritus.

1. We determined plasma levels of histamine in uraemic patients and examined their correlation with the presence of pruritus. 2. In 27 patients with chronic renal failure, plasma histamine levels were analysed by radioimmunoassay and were compared with those of 40 healthy adult subjects. The control population showed plasma histamine concentrations of 185 +/- 33 pg/ml, which were significantly lower than those of the patients with renal insufficiency. The highest levels (552 +/- 116 pg of histamine/ml) were found in 16 patients with chronic renal failure (mean serum creatinine 5.1 +/- 1.0 mg/dl) and severe itching. 3. Twelve patients with pronounced pruritus who were on maintenance haemodialysis (serum creatinine 9.2 +/- 1.2 mg/dl) had a mean plasma histamine concentration of 515 +/- 81 pg/ml. Fifteen patients on regular haemodialysis (serum creatinine 9.0 +/- 1.5 mg/dl) and who experienced itching had plasma histamine levels (322 +/- 40 pg/ml) which were significantly lower (P less than 0.01) than those of the patients with pruritus but which were elevated compared with those of the control population (P less than 0.01). 4. No correlation could be found between increased plasma histamine levels and the type of dialysis membrane used or the method of sterilization of the membrane. 5. Haemodialysis alone did not reduce plasma histamine concentrations, although high concentrations could be detected in the ultrafiltrate. In six patients a rapid decrease in plasma histamine concentration from 565 +/- 134 pg/ml to within the normal range could be detected after 60 min of combined haemodialysis and haemoperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Risk factors for sensitization to furred pets.

The risk factors for sensitization to pets was investigated in 169 male pupils. A recent or former contact with cats, dogs, and guinea pigs in own home was reported in 52 (30.8%), 42 (24.9%), and 20 (11.8%) study subjects, respectively. Clinically manifested allergy was found in two probands to cats and in two others to guinea pigs, three of them had formerly had pets and one proband with allergic rhinitis to cats had never had any pet. Sensitization to animals and aeroallergens was investigated with Phadezym-RAST. Only owners of cats had a higher incidence of cat sensitization than probands without direct contact (26.9% versus 10.3%, P less than 0.01). No statistically significant difference in sensitization to dogs and guinea pigs was found in groups with and without these pets. A strong correlation existed between sensitization to pets and other aeroallergens (house dust mite: P less than 0.025, birch pollen: P less than 0.0001, mugwort: P less than 0.0001, and grass pollens: P less than 0.0001). No association was found between sensitization to pets and smoking history, bronchial hyperreactivity to methacholine or radiological findings of the paranasal sinus.

Adolescent↗
PubMed1989

Invasive pulmonary aspergillosis: evaluation with MR imaging.

Eleven patients with suspected invasive pulmonary aspergillosis underwent magnetic resonance (MR) imaging. Images were obtained with standard spin-echo sequences and electrocardiographic triggering before and after intravenous administration of gadolinium diethylenetriaminepentaacetic acid. Thirty-seven of 48 lesions seen on MR images were nodular infiltrates; 34 of these had a targetlike appearance, with hypointense centers and iso- or hyperintense rims. Twenty-three of 37 nodular lesions contained areas of hyperintensity on T1-weighted images. All 37 had enhanced rims on postcontrast MR images. The remaining 11 lesions were segmental infiltrates, seven of which were predominantly hyperintense on T1-weighted images. In one patient with nodular lesions, MR imaging findings were correlated with those from pathologic analysis of a resected upper lobe. Areas of hyperintensity corresponded to subacute hemorrhage permeated by Aspergillus organisms. The authors believe that the typical targetlike appearance of nodular lesions on MR images and the potential that MR imaging has to reveal hemorrhagic content will prove useful in the early diagnosis of invasive pulmonary aspergillosis.

Aspergillosis↗
PubMed1988

Vasoactive intestinal peptide receptors in rat spleen and brain: a shared communication network.

The binding sites for [125I]-vasoactive intestinal polypeptide (125I-VIP) in rat spleen and brain were localized using autoradiography. High affinity VIP receptors are present in rat spleen, and competition studies reflect structure-activity relationship typical of VIP receptors elsewhere. In spleen, specific binding of 125I-VIP occurs on red pulp and, most abundantly, on the periarteriolar lymphoid sheath (PALS) of white pulp. Unlabeled VIP competes for binding to both red pulp and white pulp, whereas secretin displaces binding to PALS more potently than to red pulp. This indicates that expression of VIP and/or secretin type receptors is limited to T lymphocytes of white pulp. In red pulp, VIP receptor bearing cells probably are monocytes/macrophages since this is the most abundant red pulp cell type. In the brain, VIP receptors are widely distributed with the highest densities occurring in "sensory" areas. Receptors are abundant in the olfactory bulb, thalamic nuclei, several cranial nuclei and the area postrema. High levels of 125I-VIP binding occurred on inner walls of blood vessels of the brain and spleen. The distribution patterns of receptors for "VIP-ergic signals" in brain and lymphoid tissue indicate interrelatedness of the two organ systems. This may serve as one biochemical rationale for a bio-psycho-social view of health and disease.

Animals↗
PubMed1988

Substance P: the relationship between receptor distribution in rat lung and the capacity of substance P to stimulate vascular permeability.

The interaction of substance P (SP) with specific receptors in intact lung tissue was autoradiographically visualized, using slide-mounted tissue sections of rat lung tissue. SP receptors are highly concentrated in the central airways and are not detectable in peripheral bronchi, vessels, and alveoli. Within central airways, receptor distribution is most concentrated in the epithelium and small vessels in the lamina propria. Smooth muscle in airway or blood vessel walls expressed no detectable SP receptors. Immunohistochemical staining for SP revealed SP-containing nerves in the same areas where the receptors are localized. Displacement curves of SP bound to rat lung indicated that the C-terminal fragment was much more effective than the N-terminal fragment at competing for SP binding. Injection of 0.3 to 30 nmol/kg SP dramatically increased vascular permeability in the trachea and to a lesser extent in the hilus. Peripheral lung failed to respond to SP with increased vascular permeability unless toxic concentrations of SP were employed. SP increased the transudation of protein into the trachea within 5 min of injection, and the extravasated protein persisted through at least 2 h. Both SP and SP(3-11) were capable of stimulating increased vascular permeability, but SP(1-4) was inactive. SP caused mast cell degranulation as reflected in increased plasma histamine levels after SP or SP(3-11) injection, but SP(1-4) had no effect. In order to determine if histamine release caused by SP contributed to the vascular permeability response, the effects of H1 and H2 antihistamine treatment were studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗