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Biomedical subjects

M Jannert

Publications and source records attributed to M Jannert.

33 records · Page 2Linked to original sources
PubMed1983

Patency of the nasofrontal duct during frontal sinusitis.

In a series of frontal sinuses trephined due to frontal sinusitis the airway resistance of the nasofrontal duct was tested during the healing period as well as in a long-term follow-up study up to one year. The nasofrontal duct was more resistant to passage for air than for saline during the healing period. A high incidence of recurrences was found in cases with high airway resistance of the duct, a prolonged primary healing period and when major nasal pathology was found.

Airway Resistance↗
PubMed1983

The pulsed ultrasound method adapted for examination of paranasal sinuses.

Three different ultrasonic display systems for examination of paranasal sinuses (oscilloscope; light emitting diodes; gas discharge display) have been evaluated in model experiments, on healthy subjects and in clinical materials. With the three different ultrasonic display systems air could be separated from other types of sinusal contents in model experiments. The detectable amount of saline solution in normal sinuses was 1-5 ml with all display units. The different display units showed the same screening capacity as radiography. The oscilloscope display system was significantly more efficient than the other display systems in separating different pathological conditions. Also regarding radiography the oscilloscope display was significantly more efficient in detecting secretion, but no difference was found in the capacity of predicting intrasinusal cysts. Thus, the oscilloscope display seems to be the most useful for both clinical and scientific purposes.

Humans↗
PubMed1982

Acute sinusitis in children--symptoms, clinical findings and bacteriology related to initial radiologic appearance.

In a series of 175 children with suspected sinusitis the symptoms and clinical signs were compared with the radiologic and bacteriologic findings. URI, purulent nasal secretion and pain were the main symptoms predicting radiologic changes. In 75% of the patients the presence of two or three of these symptoms was co-existent with major radiological changes. As assessed by nasopharyngeal culture Haemophilus influenzae seemed to be the major pathogen.

Acute Disease↗
PubMed1982

Acute sinusitis in children - results of different therapeutic regimens.

The clinical material consisted of 92 children aged 1-15 years with symptoms and signs of acute sinusitis, roentgenologically verified. Sixty-one were treated with penicillin-V, 16 with pivampicillin, and 15 with erythromycin. Decongesting therapy was given to all. Altogether 77 (83.7%) were cured by a single 10-day course of treatment. The initial success rate did not vary with the type of antibiotic used. Children treated with penicillin-V had, however, a high relapse rate with H. influenzae. Because of growth of H. influenzae, 15 patients required 2 or 3 courses of treatment. The study shows that acute sinusitis in children is usually an uncomplicated disease. Almost all children will improve during a single 10-day course of treatment with antibiotics and decongestants provided that the antibiotic chosen is one to which H. influenzae is susceptible. It is therefore stressed that if penicillin-V is used as the drug of choice in acute sinusitis, the dose must be large enough to eradicate H. influenzae. As judged from this study, adenoidectomy and intranasal antrostomy are rarely indicated.

Acute Disease↗
PubMed1982

Patency tests of the maxillary ostium in health and disease.

Three different maxillary ostial function tests (simultaneous pressure recording in nose and sinus; simultaneous differential pressure and flow recording across the ostium; pressure recording at a constant artificial air-flow into the sinus) have been evaluated on healthy subjects and used in clinical materials. No quantitative evaluation of the ostial function was possible when using the simultaneous nasosinusal pressure recording method. The ostial function can be expressed as ostial resistance or as corresponding equivalent ostial diameter with the pressure-flow and the constant artificial air-flow methods. An isolated determination of the ostial function in both sinu-nasal and naso-sinusal directions during nasal breathing was only possible with the pressure-flow method. No impaired ostial function was found in cases with maxillary pain and intrasinusal cysts, but in chronic sinusitis the ostial function was considerably deteriorated. In cases with impaired ostial function the constant artificial air-flow method does not mirror the true functional state due to the non-physiological air-flow level used. Thus, the pressure-flow method seems to be the most physiological one.

Airway Resistance↗
PubMedDate not supplied

Penetration of loracarbef into the maxillary sinus: a pharmacokinetic assessment.

Loracarbef, a beta-lactam antibiotic of the carbacephem class, is active in vitro against pathogens associated with acute maxillary sinusitis. To study the extent and duration of maxillary sinus fluid penetration after administration of loracarbef, 20 patients (10 men, 10 women; average age, 41 +/- 13 years) with acute sinusitis were treated with loracarbef 400 mg every 12 hours for 10 days. A lavage catheter was inserted into the maxillary sinus, and 150-microL sinus fluid samples were obtained at 0 (baseline), 0.5, 1, 1.5, 2, and 2.5 hours after the first dose and at 24 and 48 hours (12 hours after the second and fourth doses, respectively). Venous blood samples were obtained at the same times. Maxillary fluid and serum samples were frozen immediately at -20 degrees C to -70 degrees C until later bioassay using a direct agar diffusion method. Excluding missing data or inappropriately timed samples, the mean (+/- SD) sinus fluid concentrations were 0.16 +/- 0.12 microgram/mL at baseline, 0.23 +/- 0.17 microgram/mL at 0.5 hour, 1.11 +/- 1.44 micrograms/mL at 1 hour, 1.63 +/- 2.07 micrograms/mL at 1.5 hours, 1.75 +/- 2.01 micrograms/mL at 2 hours, and 1.60 +/- 1.96 micrograms/mL at 2.5 hours after dose. The mean sinus fluid concentration before the third dose (approximately 12 hours after the second dose) was 1.01 +/- 0.89 microgram/mL and before the fifth dose (approximately 12 hours after the fourth dose) was 0.88 +/- 0.90 microgram/mL. Taking the highest sinus fluid concentration measured in each patient, the mean peak sinus fluid concentration was 2.12 +/- 1.98 micrograms/mL (range, 0 to 6.7 micrograms/mL). The pretherapy peripheral leukocyte count appeared to have a statistically significant association (P < 0.01) with loracarbef sinus fluid penetration as estimated by the sinus fluid area under the concentration-time curve at 0 to 2.5 hours. Loracarbef 400 mg twice daily achieved sinus fluid concentrations that appeared to exceed the minimum concentration required to inhibit 90% of relevant acute sinusitis pathogens throughout the 12-hour interdose interval in most patients with acute maxillary sinusitis.

Adult↗
PubMedDate not supplied

Patency tests of the maxillary ostium--model experiments.

The function of the maxillary ostia (phi 0.22-4.7 mm) has been evaluated in experiments on a nose-sinus model with variable sinusal volumes. A piston-pump producing to-and-fro volumes of 467 cm3 of air per revolution was used at a speed of 10 and 20 revolutions per minute (rpm). Three different techniques were used: simultaneous pressure recording in the sinus and the nose (Method I); simultaneous recording of the differential pressure between nose and sinus and the air-flow through the ostium (Method II); recording of the pressure rise inside the sinus upon the application of a constant artificial air-flow of 16,7 cm3 . s-1 or 2.0 cm3 . s-1 (Method III). All variables were recorded on an ink-jet recorder and onto tape when using methods I and II for later analysis on an x-y recorder. A pressure relationship of 1 : 1 was found between nose and sinus, independently of ostial diameters, sinusal volumes and piston-pump rates. The first method did not permit an isolated determination of the ostial function as the pressure values recorded are affected by ostial diameters, sinusal volumes and piston-pump rates. The pressure-flow relationship recorded with the second method was found to be dependent only on the ostial diameters. Hysteresis was observed at ostial diameters less than or equal to 1.63 mm. This is due to ostial diameter, sinusal volume and the rate of the nasal pressure changes. This method is suitable for an isolated determination of the ostial resistance, from which the equivalent ostial diameter can be calculated. With the third method using static air-flows and pressures the results are independent of the sinusal volume. This method is suitable for estimation of the ostial airway resistance and the equivalent ostial diameter. A striking similarity was observed between the results obtained with the last two methods in estimating equivalent ostial diameters.

Airway Resistance↗
PubMedDate not supplied

Patency of the maxillary sinus ostium in healthy individuals.

In a group of 20 healthy subjects the patency of the maxillary ostium has been evaluated in 35 maxillary sinuses with three different techniques: simultaneous pressure recording in the sinus and the ipsi- and contralateral nasal cavity; simultaneous recording of differential pressure between the sinus and the ipsilateral nasal cavity and air-flow through the ostium during nasal breathing; recording of the pressure rise in the sinus with an artificial air-flow of 1 litre per minute applied to the sinus. The tests were carried out in sitting and recumbent positions. In 5 persons (10 sinuses) a retest was performed after 2 months. These subjects were also tested with an inflatable neck cuff in order to obtain an increased venous pressure. Rhinomanometry at rest and after physical effort was also performed. The pressure relationship between the maxillary sinus and the ipsilateral nasal cavity was 1:1 in both the sitting and the recumbent position, but less than 1 when the contralateral nasal cavity was measured. Pressure recording alone gives no quantitative information about the patency of the ostium. Determination of the ostial resistance during nasal breathing could be performed in 13 sinuses, but in the remaining 22 the ostia were too wide to give a measurable resistance. The equivalent ostial diameter during inspiration could be estimated in 12 of the sinuses from a diagram constructed from known ostial diameters in model experiments. With an artificial air-flow applied into the sinus, the equivalent ostial diameters could be estimated from the diagram in all cases. No statistical difference was found in comparable cases between the mean equivalent ostial diameters estimated with the two methods. The equivalent ostial diameters showed a statistically significant reduction in the recumbent position and after application of the neck cuff. A statistically significant relationship was also found between the airway resistance of the nasal cavity and the equivalent diameter of the ostium in sitting and recumbent positions. Such a relationship could not be found between the equivalent ostial diameters measured at rest and the nasal resistance recorded after physical effort.

Adult↗
PubMedDate not supplied

Studies on the maxillary ostial function in cases with maxillary pain, intrasinusal cysts and chronic sinusitis.

The maxillary ostial function, measured as pressure transmission capacity, ostial airway resistance, equivalent ostial diameter during nasal breathing and with a constant artificial air-flow of 16.7 cm3 X S-1 into the sinus, was compared in three groups of patients. One group consisted of 7 sinuses in 6 patients with maxillary pain but without any signs of sinusitis; a second group of 6 sinuses in 6 patients with intramaxillary cysts; and a third group of 6 sinuses in 5 patients with chronic maxillary sinusitis. No impairment of the ostial function was found in groups one and two. In the third group an increased airway resistance of the ostia and small equivalent ostial diameters were found in both sitting and recumbent positions. With the pressure recording technique, the ostium can be judged as patent, non-patent, or partially obstructed, but no further grading can be done. With the pressure-flow technique the ostial function can be evaluated as ostial resistance or equivalent ostial diameters under 'physiological conditions' when the ostium is patent. With a constant artificial air-flow into the sinus the equivalent ostial diameter can be estimated even in non-patent ostia but the equivalent ostial diameters obtained do not always reflect the true functional state of the ostium.

Adult↗
PubMedDate not supplied

Effects of phenylpropanolamine on ostial and nasal patency in patients treated for chronic maxillary sinusitis.

Ostial and nasal patency were measured in different body positions and after phenylpropanolamine (Ppa) treatment in 12 patients earlier treated for chronic unilateral maxillary sinusitis of varying severity. Six of the sinuses were of normal appearance on sinoscopy. Phenylpropanolamine in a single dose of 100 mg was found to increase the equivalent ostial diameter significantly in the sitting and recumbent positions. The drug also reduced the nasal airway resistance. The Ppa effect might be of benefit in patients treated for chronic maxillary sinusitis.

Adult↗
PubMedDate not supplied

Effects of phenylpropanolamine on ostial and nasal airway resistance in healthy individuals.

Ostial airway resistance (OAR) of 11 maxillary ostia and the airway resistance of the nasal cavity (NAR) in 6 healthy persons were tested before and after administration of phenylpropanolamine (Ppa) and placebo. The effects of physical exercise were also tested. After logarithmic transformation, the resistance values showed a normal distribution. Significant effects on the ostial resistance in relation to initial values were found after Ppa medication. The effect was more pronounced in recumbency than in the sitting position. Physical exercise also gave a significant reduction of ostial resistance while placebo treatment was without effect. On comparison of the Ppa- and placebo-groups in an extended statistical analysis, more striking differences were found both for OAR and NAR. In this model study, Ppa thus showed effects in healthy individuals.

Adult↗
PubMedDate not supplied

Ostial and nasal patency in chronic maxillary sinusitis. A long-term post-treatment study.

In a long-term follow-up study (mean 3.5 years) after treatment of chronic maxillary sinusitis of either rhinogenous or dental origin, 72 sinuses in 66 patients were examined with respect to maxillo-ostial and nasal resistance. In sinusitis of rhinogenous etiology, the mean equivalent ostial diameter was pathologically narrowed (0.89 mm, in patients treated conservatively) whereas it was normal (2.51 mm) in sinusitis of dental etiology (dental treatment in combination with local sinus surgery). In the former group, all sinuses were diseased, compared with 3 out of 23 in the dental group. In order to distinguish between functional and organic ostial stenosis, the patients were also tested after physical exercise. The functional ostial diameter in healthy sinuses was significantly increased in contrast to the diseased sinuses. In one patient the narrow ostium was due to mucosal swelling only, but in the other cases was caused mainly by an organic stenosis. In sinusitis of rhinogenous etiology, a pathologically increased nasal resistance was found in 14.3%, while the corresponding figure in the dental group was 4.3%. Improved sinusal and nasal ventilation, achieved either pharmacologically or, preferably by surgical intervention, seems necessary for successful treatment of chronic maxillary sinusitis.

Adult↗