phenylephrine-hydrochloride and Reflex--Abnormal

Eye symptoms frequently occur in patients with allergic rhinitis and are among the most bothersome symptoms. Intranasal steroids have been shown to reduce ocular symptoms associated with allergic nasal symptoms, even though they do not reach the eye.. To elucidate a mechanism to explain these observations.. We performed a double-blind, placebo-controlled, crossover experiment in 20 subjects with seasonal allergic rhinitis. Nasal antigen challenge was performed consecutively for 3 days after 1 week of treatment with either placebo or fluticasone furoate nasal spray (FFNS). Subjects recorded their nasal and ocular symptoms, and nasal secretions were quantified. Nasal scrapings to quantify eosinophils were obtained before each antigen challenge.. Nasal challenge with antigen led to sneezing, a nasonasal, and a nasal-ocular reflex. Priming in the number of sneezes, contralateral nasal secretion weights, and total eye symptoms were observed. Treatment with FFNS reduced sneezing, the nasonasal and nasal-ocular reflexes, and the amount of eosinophils in nasal secretions.. We confirmed that a nasal-ocular reflex follows nasal challenge with allergen and that it can contribute to the ocular symptoms associated with allergic rhinitis. FFNS reduced eosinophil infiltration, priming, and ocular symptoms. Furthermore, our results support a mechanism by which control of eye symptoms can be achieved during nasal administration of an intranasal steroid in patients with seasonal allergic rhinitis.

Topics: Administration, Intranasal; Adult; Allergens; Androstadienes; Anti-Allergic Agents; Cross-Over Studies; Double-Blind Method; Eosinophils; Eye; Female; Humans; Male; Nasal Provocation Tests; Nose; Reflex, Abnormal; Rhinitis, Allergic, Seasonal

To examine the role of disturbed upper airway reflexes in aspiration, we administered 20 microliters of the adenovirus (Ad) vector Ad-CMV-LacZ or 20 microliters of phosphate buffered saline (PBS) intranasally to C57 black mice. We investigated expression of the LacZ gene by this Ad vector in the nostrils of each mouse, with or without anesthesia. Under anesthesia, LacZ gene expression was detected in the lungs of every mouse given the Ad vector. However, no LacZ gene expression was found in the trachea or lungs of mice given the Ad vector without anesthesia. In mice given PBS or wild-type adenovirus transnasally during anesthesia, there was no LacZ gene expression in the nostrils, trachea, or lungs, suggesting that with 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside (X-gal) staining, blue-stained cells indicated transferred LacZ gene expression. These results suggested that aspiration of intranasal solution into lower airways was caused by disturbed upper airway reflexes during anesthesia. This process can be analyzed by the distribution of LacZ gene expression in airways. We next examined the effect of age on anesthesia-induced aspiration. Twenty-six-mo-old mice exhibited more LacZ gene expression in their lungs than did 6-mo-old mice at a concentration of 0.5 to 4.0% halothane in 100% oxygen. This suggests that light anesthesia may depress upper airway reflexes and cause aspiration in older animals. This novel model of aspiration, generated with the Ad-CMV-LacZ vector, may be useful for elucidating the mechanism of development of aspiration pneumonia in relation to age-related impairment of upper airway reflexes.

Topics: Adenoviridae; Age Factors; Anesthetics, General; Anesthetics, Inhalation; Animals; beta-Galactosidase; Chromogenic Compounds; Coloring Agents; Disease Models, Animal; DNA, Recombinant; Galactosides; Gene Expression Regulation, Viral; Gene Transfer Techniques; Genetic Vectors; Halothane; Indoles; Lac Operon; Lung; Male; Mice; Mice, Inbred C57BL; Nose; Oxygen; Pneumonia, Aspiration; Reflex, Abnormal; Trachea

The present report describes a benign disorder of neonates or young infants presenting with generalized hypertonicity accompanied by brisk muscle stretch reflexes, intermittent clonus, and exaggerated startle response. This condition is termed hyperexplexia, and may be either familial or sporadic. Two affected families are reported: Two sisters and their mother are involved in the first family; in the second family, where the parents are asymptomatic first degree cousins, all three siblings suffer from hyperexplexia of various severity. Nose tapping in infants of affected families induced a uniform reaction of facial twitching accompanied by head extension, and a generalized flexor spasm, all of which may be a hallmark of hyperexplexia. Severely hypertonic infants were treated with small doses of benzodiazepines and improved markedly, all becoming asymptomatic by two years of age. Unnecessary investigation and treatment may be avoided by sufficient awareness of possible hyperexplexia.

Topics: Child, Preschool; Female; Humans; Infant; Muscle Hypertonia; Nose; Pedigree; Reflex, Abnormal; Reflex, Startle; Spasm

A case is reported of bradycardia and sinus arrest induced by insertion of a nasal temperature probe. Other possible causes of bradycardia and sinus arrest under anaesthesia are reviewed briefly. Evidence for the neurological basis of a nasocardiac reflex, similar to the oculocardiac reflex, is presented. A minor, trivial stimulus may elicit this reflex.

Topics: Adult; Alfentanil; Anesthesia, General; Electrocardiography; Female; Heart Arrest; Humans; Nitrous Oxide; Nose; Physical Stimulation; Reflex, Abnormal

Topics: Animals; Axons; Basement Membrane; Capillaries; Collagen; Ear; Foot; Granuloma; Hindlimb; Humans; Leprosy; Macrophages; Median Nerve; Mice; Mice, Inbred Strains; Microscopy, Electron; Mycobacterium leprae; Myofibrils; Nerve Crush; Nose; Peripheral Nerves; Reflex, Abnormal; Schwann Cells; Sciatic Nerve; Skin; Time Factors

Topics: Black People; Emotions; Genetics, Medical; Humans; Hypersensitivity; Light; Nose; Parasympathetic Nervous System; Physiology; Reflex; Reflex, Abnormal; Respiratory Hypersensitivity; Rhinitis; Sex; Sneezing; Sunlight; Vasomotor System