Measurement of local blood flow in the nasal mucosa by the method of hydrogen clearance]

The hydrogen clearance method was used to measure local blood flow in the inferior concha nasalis of 22 patients, aged 18 to 48 years. According to the method, the nasal mucosa was saturated with hydrogen and the rate of hydrogen washout was recorded in the form of hydrogen clearance curves. The response was tested by applying 0.1% epinephrine solution and the volume blood flow velocity was calculated. In response to epinephrine, blood flow velocity in the nasal mucosa diminished significantly. The hydrogen clearance method allowed an accurate quantitative evaluation of the volume blood flow velocity in a limited area of concha nasalis. The epinephrine test demonstrated a high sensitivity of the method that gave an adequate idea of mucosal microcirculation. This method, together with other procedures, can be used to examine the nasal mucosa.     

吸入性氢气清除法鼻粘膜微循环血流量测定

目的测定国人鼻粘膜微循环血流量。方法应用ＡｍｅｆｌｏｗＨ２微循环测量仪对１３０例鼻粘膜微循环血流量在局部喷雾血管收缩剂前后进行了测量，其中健康成人９８例；鼻息肉患者１８例，变应性鼻炎患者１４例。统计学处理采用ｔ检验。结果健康成人对照组鼻粘膜微循环血流量大于鼻息肉组及变应性鼻炎组（Ｐ＜０．０１）。血管收缩剂应用后各组微循环血流量均下降（Ｐ＜０．０１），以鼻息肉组下降最为明显。结论氢气清除法微循环血流量测定具有定位好、可连续测定和重复、损伤小等优点。     

吸入性氢气清除法鼻粘膜微循环血流量测定

测定国人鼻粘膜微循环血流量。方法 应用Ａｍｅｆｌｗ－Ｈ２微循环测量仪对１３０例鼻粘膜微循环血流一在局部喷雾血管收缩剂前后进行了测量，其中健康成人９８例，鼻息肉患者１８例，应变性鼻炎患者１４例。统计学处理采用ｔ检验。结果 健康成人对照组鼻粘膜微循环血流量大于鼻息肉组及变应性鼻炎组。     

Measurement of blood flow to human nasal mucosa in normal and pathological conditions by the use of the 133Xe clearance technique

Summary The blood flow to nasal mucosa in normal subjects and in allergic rhinitis, vasomotor rhinitis and laryngectomized patients was measured using the ¹³³Xe clearance technique. The results were statistically compared and correlated with capillary diameter. Compared to the normal group, the blood flow to nasal mucosa increased in allergic and vasomotor rhinitis patients and decreased in laryngectomized patients. There was a statistically significant difference between allergic and vasomotor groups (p < 0.01), so the present method could be used in the differential diagnosis of rhinitis.     

A method for determination of blood flow with 133Xe in human nasal mucosa

The 133Xe wash-out technique was used as a method for calculation of the blood flow in human nasal mucosa. The disappearance of 133Xe from the nasal mucosa was followed using scintillation detectors. In laryngectomies it was shown that the disappearance of 133Xe from the mucosa depended mainly on the blood flow. Leakage of 133Xe from the mucosa to the nasal air was unimportant. The disappearance rate of 133Xe was decreased by oxymetazoline and increased by histamine, mostly likely due to the effects of these vasoactive drugs on the mucosa blood flow. The 133Xe wash-out technique would seem to be a simple method to study nasal mucosal blood-flow changes in humans.     

电刺激蝶腭神经节对鼻粘膜血流的调控作用

为了解蝶腭神经节在鼻粘膜血流调节中的作用，应用激光多普勒血流仪观察刺激蝶腭神经节对猫鼻粘膜血流变化的调控作用，结果表明，电刺激一侧蝶腭神经节可以引起双侧鼻粘膜血管扩张，血流增加，并产生喷嚏反应，这种反应依电刺激的强度，频率而异，且与刺激时间有关。     

电刺激蝶腭神经节对鼻粘膜血流的调控作用

为了解蝶腭神经节在鼻粘膜血流调节中的作用，应用激光多普勒血流仪观察刺激蝶腭神经节对猫鼻粘膜血流变化的调控作用。结果表明，电刺激一侧蝶腭神经节可以引起双侧鼻粘膜血管扩张，血流增加，并产生喷嚏反射，这种反应依电刺激的强度、频率而异，且与刺激时间有关。电刺激一侧副交感神经（切除颈上交感神经节的翼管神经）远侧游离端，只引起同侧血管反应。提示刺激蝶腭神经节引起的血管反应可能是通过中枢反射机制起作用。实验还显示刺激蝶腭神经节具有“反向血流调节作用”，这种调节作用的机制有待于进一步研究。     

Sympathetic neurogenic control of blood flow in human nasal mucosa

Nasal mucosal blood flow was investigated in patients undergoing a stellate ganglion blockade. Elimination of the sympathetic neurogenic control did not affect the resting blood flow in the mucosa, as registered with the 133Xe washout technique. This indicates that the basal sympathetic vasoconstrictor activity is low in the mucosal vessels that regulate blood flow. With laser doppler flowmetry, the normal pattern of spontaneous oscillations in blood flow was seen to be altered following stellate ganglion blockade. This suggests that vasomotion in the mucosa is partly dependent on sympathetic neurogenic activity. Furthermore, the decrease in blood flow normally induced by a peripheral cold provocation could not be elicited after the ganglion blockade, which means that the decrease is mediated by sympathetic vasoconstrictor fibres.     

Distribution and clearance of radioactive aerosol on the nasal mucosa

The distribution and clearance of aerosolized radioactive technetium 99m pertechnate in physiologic buffered saline was analyzed in four human adult asymptomatic volunteers following delivery into one nostril in the same manner as for nasal challenge testing (i.e., 0.1 ml via a 251 DeVilbiss atomizer powered by a compressor delivering 0.10 +/- 0.01 gm/spray). For comparison, squeeze bottles and spray bottles from commercial sources, a 114 and a 127 DeVilbiss atomizer, and a pipette were employed. Lateral imagery via minicomputer processing was used to determine both distribution and clearance of the radiotracer. The counts after 1 minute were lower following pipette delivery than with the other devices. None yielded discernable , wide-spread distribution of aerosol throughout the nasal cavity. Following delivery from the 251 atomizer, mean clearance at 17 minutes was 60.0%. Similar clearance rates were obtained with the other spraying methods except for lower values with the squeeze bottle. Analysis of six hour clearance studies by linear regression showed a relatively rapid initial phase, which is probably due largely to mucociliary clearance, and a prolonged late phase related to the very slow disappearance of residual material located far anteriorly in the nose. Achieving good initial retention and rapid clearance of material deposited anteriorly in the nose are desirable attributes of devices employed for administering materials intranasally.     

Measurement of water loss in human nasal mucosa

BACKGROUND: Regulation of the barrier function in the nasal epithelium seems to be affected by the pathogenesis of allergic rhinitis. The measurement of transepidermal water loss has proven to be an important noninvasive method for assessing the efficiency of the skin as a protective barrier. Although the nasal mucosal epithelium also has such a protective function, the precise mechanism still is unknown. METHODS: We studied the alteration of nasal mucosal water loss in the basal state and after the nontraumatic applications of physiological saline, hypertonic saline (10% NaCl), nasal barrier cream, and 10% glycerol on the mucosal surface of the inferior turbinate. RESULTS: We observed that nasal mucosal water loss was increased by hypertonic saline and decreased by nasal cream and glycerol. CONCLUSION: For the first time, we showed the human nasal mucosal water loss both in the basal state and after topical application of various substances.     

Allergen-induced leukotriene production by nasal mucosa and peripheral blood leukocytes

The relationship between release of leukotriene C4 (LTC4) from nasal mucosa in vivo and from peripheral blood leukocytes (PBLs) in vitro was examined in 18 patients with untreated rhinitis allergic to the house dust mite, Dermatophagoides pteronyssinus, and in 20 nonallergic control subjects following challenge with the specific allergen. Allergic patients were subjected to intranasal and PBL challenge with D pteronyssinus and a nonrelevant allergen, Artemisia vulgaris. In all allergic patients, intranasal challenge by D pteronyssinus, but not by A vulgaris, resulted in a release of substances from the nasal mucosa that reacted in a radioimmunoassay with antiserum to LTC4. Dermatophagoides pteronyssinus challenge in vitro of PBLs from the same patients, but not A vulgaris challenge, induced release of the same immunoreactive material into the supernatant. By comparison, the nonallergic subjects challenged with D pteronyssinus showed significantly lower LTC4 levels in their nasal secretions and PBL supernatants. The results show that, following specific allergen challenge, the release of LTC4 by the allergic nasal mucosa is similar in extent and nature to that of PBLs, indicating that these procedures can be used as tools to measure the efficacy of topically and systemically administered antiallergic drugs.     

The effect of topical decongestant on blood flow in normal and infected nasal mucosa

The nasal mucosal blood flow was determined by means of the 133Xe wash-out method in an early stage of acute rhinitis and in health and the effect of a topical decongestant (oxymetazoline) was evaluated. During an early stage of acute rhinitis, a statistically significant increase of blood flow was found. The topical decongestant in therapeutically recommended doses decreased the blood flow significantly in acute rhinitis as well as in healthy subjects. The effect was more pronounced in acute rhinitis. The effect of oxymetazoline was dose dependent and a statistically significant decrease was found in doses of about 1/50 of the therapeutically recommended. The clinical implication is that it might be possible to reduce the dose of the decongestant in order to minimize the negative side effect of a decreased blood flow.     

Measurement of tonsillar blood flow in normal and pathological conditions by the use of the 133Xe clearance technique

Summary By using the ¹³³Xe clearance technique, we measured the blood flow to the human palatine tonsil in 10 normal volunteers, 11 patients with chronic tonsillitis, and 11 with hypertrophic tonsils. We found that the mean blood flow was 30.08 ± 5.39 ml/ 100 g per min in normal tonsils, 17.06 ± 3.72 in chronic tonsillitis and 49.50 ± 9.30 in hypertrophie tonsils. Our results show a statistically significant decrease in blood flow in chronic tonsillitis (P<0.01) and a significant increase in hypertrophic tonsils (P<0.01) when compared to the normal controls. The difference between the blood flow in chronic tonsillitis and hypertrophic tonsils was also statistically significant (P<0.01). In all three groups studied, no statistically significant difference was observed in the blood flow to the right and left tonsils (P<0.05).     

Laser-Doppler flowmetry compared to intravital microscopy for assessment of blood flow in the nasal mucosa of the rabbit.

Laser-Doppler flowmeter (LDF) studies of the rabbit nasal mucosal microcirculation were compared with intravital videomicroscopy and with flow measured in single blood vessels in order to evaluate the applicability of the LDF technique. Access to the nasal mucosa for a microscope objective was gained surgically through the maxilla. Transillumination for microscopy was achieved through a prism inserted on the contralateral side of the septal cartilage. Blood flow changes were induced by the inhalation of N2, CO2 and O2 and by topically applying the vasoconstricting alpha-adrenoceptor agonist oxymetazoline. The effects were registered by LDF and direct visual observation. Flow in veins and capillaries was calculated using on-line cross-correlation, and off-line a computerized video-analysis system. LDF did not correlate to flow in single veins or capillaries but agreed well with the visual impression. LDF is considered a valuable method for the assessment of over-all blood flow changes in the nasal mucosa.     

Blood flow in human nasal mucosa after total laryngectomy

The blood flow in the human nasal mucosa was determined in 10 laryngectomees with the 133Xe wash-out method. The blood flow was estimated to be 19.3 +/- 2.1 ml . min-1 . (100 g)-1 (mean +/- SEM) which is significantly lower than in healthy non-laryngectomees. The decreased blood flow could be one of the explanations of the functional and morphological alterations in the nasal mucosa after total laryngectomy.     

实验性变应性鼻炎鼻粘膜神经生长因子的测定

目的 探讨同种异体预定形态组织工程化软骨在有免疫功能动物体内构建的可 行性及其对甲状软骨缺损的修复能力。方法 利用组织工程技术制备同种异体片状和“C” 型半管状工程化软骨;将4周形成的片状工程化软骨用于修复12只新西兰大白兔甲状软骨大 片缺损;一定时间取材,分别对预定形态工程化软骨的构建情况及其修复效果进行大体和组 织学评价。 结果 ①构建4周形成的预定形态工程化软骨呈乳白色,有弹性和支撑力,8周时软骨 呈瓷白色,镜下观察显示软骨组织特征;②甲状软骨缺损修复术后4、8、12周观察,修复区 愈合良好,组织学 检查修复区与正常软骨间的界面区可见软骨细胞生长及软骨基质生成,无免疫排斥迹象。 结论 在有免疫功能的动物体内可形成同种异体预定形态组织工程化软骨,获取的工程化软 骨对甲状软骨缺损有良好的修复效果,无明显免疫排斥反应。