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Biomedical subjects

M B Dolovich

Publications and source records attributed to M B Dolovich.

31 records · Page 2Linked to original sources
PubMed1981

Standardization of inhalation provocation tests: two techniques of aerosol generation and inhalation compared.

Comparison of methods of aerosol generation and inhalation is required to improve standardization of inhalation provocation tests. We compared two widely used methods in 10 asthmatics, by measuring the dose and distribution of radiolabeled aerosol deposited in the throat and lung, and the provocation concentration of inhaled histamine required to reduce the FEV1 by 20% (PC20). In one method, aerosol was generated by a DeVilbiss 646 nebulizer attached to a dosimeter, and was inhaled by 5 inspiratory capacity breaths. The measurements with each method were repeated once to determine the reproducibility of results. Both methods deposited the same dose in the lung, but the distribution of the dose was different; the dosimeter method deposited more aerosol in the throat and central airways. The PC20 obtained with each method was the same. The reproducibility of all measurements in the same subject was similar. The lung dose deposited by each method in different subjects varied to the same degree. The results indicated that the bronchial response to inhaled histamine can be measured as reliably using a nebulizer and tidal breathing as by a more complex dose-metering device. They also suggested that, when the methods are regulated as described, the PC20 will have the same clinical significance.

Adolescent↗
PubMed1981

The preferential deposition of inhaled isoproterenol and propranolol in asthmatic patients.

This study describes the use of central and diffuse airway deposition patterns of isoproterenol and radiotracer aerosol alone, and in the presence of centrally deposited propranolol and radiotracer aerosol, to investigate the distribution of beta 2 adrenoreceptors in six asthmatic patients. The central deposition technique was only partially successful. No definite beta 2 receptor distribution pattern could be interpreted from the airway function responses. It was noted that 3-10 micrograms of isoproterenol in the airways was able to produce 50 percent of the maximum possible flow rate response. Centrally deposited propranolol was an effective antagonist of isoproterenol.

Adult↗
PubMed1979

Effects of postural drainage, exercise, and cough on mucus clearance in chronic bronchitis.

The effects of postural drainage, exercise, and cough on mucus clearance were compared in 8 patients with chronic bronchitis. A bolus of 99mTc albumin aerosol was inhaled at a high inspiratory flow rate to enhance proximal deposition. Retention of deposited aerosol in the lung, as a function of time, was quantified using a gamma camera and subsequent computer analysis. Coughing greatly accelerated total lung (P less than 0.005) and peripheral (P less than 0.005) mucus clearance. Exercise resulted in much smaller changes than did cough, but significantly increased total lung clearance (P less than 0.005). Postural drainage in which coughing was prohibited did not alter clearance. These results have therapeutic implications and stress the importance of controlling cough when evaluating therapeutic interventions by these techniques.

Aged↗
PubMed1978

The effects of preferential deposition of histamine in the human airway.

Two inhalation techniques were performed to obtain airway and diffuse airway deposition of histamine aerosol. A radiotracer method was used to confirm the patterns of aerosol deposition and to measure the dose of histamine aerosol in the airways. In 5 subjects the effect of cumulative doses of histamine aerosol given either centrally or diffusely to the airways was measured. Histamine aerosol deposited predominantly in the large airways was more effective in increasing airway obstruction that was diffusely deposited histamine aerosol, suggesting that the receptors mediating the action of histamine reside mainly in the large airways.

Adult↗
PubMed1978

Aerosol therapy with Sch 1000. Short-term mucociliary clearance in normal and bronchitic subjects and toxicology in normal subjects.

The anticholinergic bronchodilator drug, Sch 1000, was administered as an aerosol by a metered-dose inhaler (200 microgram) to six normal and six bronchitic subjects. The short-term effect on mucociliary clearance was assessed and compared to a placebo (propellant and dispersal agent) in a double-blind crossover study. Mucociliary clearance in the normal group was significantly faster with administration of Sch 1000 than with placebo (P less than 0.01). There was no significant difference between the effects of administration of Sch 1000 and placebo on mucociliary clearance in the bronchitic group. Pulmonary function was significantly increased by therapy with Sch 1000 (as compared to administration of placebo) in the bronchitic group for two hours (P less than 0.05) and in the normal group for one hour (P less than 0.05). In another study, 12 normal subjects inhaled aerosols containing 40 microgram of placebo or 400 microgram of Sch 1000 from metered-dose inhalers on separate days in a randomized double-blind fashion. A significant sustained improvement in pulmonary function (P less than 0.05) and a transient fall in diastolic blood pressure were observed after administration of Sch 1000.

Adult↗
PubMed1977

Effects of exercise and eucapnic hyperventilation on bronchial clearance in man.

The effects of exercise and eucapnic hyperventilation on bronchial clearance were assessed in 10 healthy nonsmoking adults. A 99mTc-albumin aerosol was inhaled as a bolus in late inspiration under controlled conditions to produce deposition primarily in large airways. Lung retention of radioactivity was quantified using a gamma camera and subsequent computer analysis. Compared with quiet breathing (control), exercise significantly speeded clearance (P less than 0.05). Resting eucapnic hyperventilation at levels similar to those achieved during exercise produced less speeding. Compared to control conditions these changes may be brought about by a) mechanical effect of increased lung movement, and b) effects on the autonomic nervous system, mediated via the parasympathetic pathway producing stimulation of airway mucus glands and/or sympathetic stimulation of cilia due to exercise-induced catecholamine release.

Adult↗
PubMed1977

Pulmonary aerosol deposition in chronic bronchitis: intermittent positive pressure breathing versus quiet breathing.

Quiet breathing by mouth of a 3-mum aerosol was compared with intermittent positive pressure delivery of the same aerosol to the lung in a group of bronchitics. The pattern of lung deposition and the total dose delivered to the lung were measured. The differences between quiet breathing and intermittent positive pressure breathing were found not to be significant (P greater than 0.5). In addition, during similar or greater total ventilation, intermittent positive pressure breathing delivered a mean of 32% less aerosol to the lung than did quiet breathing. These findings suggest that intermittent positive pressure breathing as currently used for aerosol delivery cannot be expected to enhance peripheral deposition of inhaled aerosols in patients with airway obstruction.

Aerosols↗
PubMed1976

Aerosol penetrance: a sensitive index of peripheral airways obstruction.

Early injury of the small airways has been demonstrated in asymptomatic smokers. Ventilatory tests including the maximum midexpiratory flow rate and closing volume have been useful in clinical detection of small airways disease in symptomatic subjects. In the present study, airway "obstruction" was assessed aerodynamically by gamma camera measurements of chest radioactivity following the inhalation of 131I-labeled aerosol (aerodynamic mass median diameter 3 mum). Studies were performed in normal subjects, asymptomatic smokers, and patients with chronic obstructive lung disease. An aerosol penetrance index (AeP) was devised from determinations which involved 1) an analysis of central (inner zone) and peripheral (outer zone) deposition of aerosol in the lung and 2) a ratio of initial counts to 24-h counts in the periphery (outer zone) of the lung. AeP values were 41.5 +/- 11.5 for the normal group, 20.9 +/- 7.6 for the smoker group, and 10.6 +/- 5.2 for the subjects with chronic obstructive airway disease. AeP was significantly reduced in the smokers indicating that the AeP is a sensitive index of early peripheral airways obstruction.

Aerosols↗
PubMedDate not supplied

Nicotine microaerosol inhaler.

OBJECTIVE: To measure the droplet size distribution of a nicotine pressurized metered-dose inhaler using a nicotine in ethanol solution formulation with hydrofluoroalkane as propellant. MATERIALS AND METHODS: Sizing was performed at room temperature by multistage liquid impinger and quartz crystal impactor. RESULTS: The mass median aerodynamic diameter of the nicotine aerosol produced was measured at 1.6 mm by multistage liquid impinger and 1.5 mm by quartz crystal impactor. CONCLUSIONS: The inhaler formulation used produces a microaerosol of sufficiently fine droplet size that mimics the puff-by-puff pulmonary arterial bolus nicotine delivery of tobacco smoke. The absence of combustion products such as heat, carcinogens and carbon monoxide permits safer nicotine delivery via the inhaler than is possible via smoked tobacco.

Aerosol Propellants↗