P Ruoppi

Kuopio University Hospital, Kuopio, Province of Eastern Finland, Finland

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Publications (25)68.55 Total impact

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    ABSTRACT: Weight loss is considered an effective treatment for obstructive sleep apnoea (OSA) in overweight patients. Some patients, however, do not benefit from weight loss. It has been postulated that nasal obstruction may act as an independent risk factor for OSA. The aim of our study was to evaluate whether impaired nasal airflow might explain the missing effect of weight reduction on OSA. Fifty-two overweight adult patients with mild OSA were recruited. After the 12-month lifestyle intervention, all patients who achieved more than 5% weight loss were divided into two groups based on whether they still had OSA or not. Change in nasal resistance measured by rhinomanometer and AHI were the main outcome variables. A total of 26/52 patients achieved 5% weight reduction. Of those 26 patients, 16 were objectively cured from OSA and 10 patients did not benefit from weight loss. Nasal resistance reduced significantly more in patients who had been cured from OSA. Smoking had a negative impact on both nasal resistance and improvement of AHI. Impaired nasal breathing and smoking may prevent the beneficial effects of weight reduction in the treatment of OSA.
    Rhinology 12/2011; 49(5):587-92. · 1.72 Impact Factor
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    ABSTRACT: Elevated nasal resistance and obesity predispose to obstructive sleep apnea (OSA). Weight loss has been shown to result in an alleviation of OSA, but its effect on nasal airflow has not been studied. This study was a prospective, randomized, controlled study with two parallel groups. A total of 52 adult overweight patients (body mass index [BMI], 28-40 kg/m2) with mild obstructive sleep apnea (apnea-hypopnea index (AHI), 5-15) were randomized into two study groups. The intervention group (n = 26) followed a very low calorie diet with a supervised lifestyle intervention while the control group (n = 26) received routine lifestyle counseling. The changes in BMI, total nasal resistance, total nasal volume, and quality of life scores (Mini Rhinoconjunctivitis Quality of Life Questionnaire, MiniRQLQ) were assessed at baseline and after the intervention at 3 months. The reduction in BMI in the intervention group was significantly greater than that achieved by patients in the control group (5.4 kg/m2 versus 0.5 kg/m2). Accordingly, AHI was reduced by 3.2 events/hour in the intervention group and by 1.3 in the control group. However, there were no significant changes in rhinometric measurements despite significant weight loss. There was no correlation between the reduction of BMI and the change in nasal resistance or MiniRQLQ scores. Weight reduction does not seem to have any effect on nasal resistance or volume in overweight patients with mild OSA. Patients with OSA and impaired nasal breathing need specific medical or surgical treatment to restore nasal airflow.
    American Journal of Rhinology 01/2008; 22(4):410-5. · 1.36 Impact Factor
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    ABSTRACT: Enzymes are high-molecular-weight proteins and highly sensitizing occupational allergens used widely in industrial processes. Lactase has been described to cause work-related respiratory and conjunctival immunoglobulin (Ig)-E-mediated sensitizations in workers in the pharmaceutical industry. In these previous reports, allergic rhinoconjunctivitis or asthma was confirmed with prick tests but not by challenge tests. Lactase previously has not been described as a cause of immediate or delayed contact skin reaction. Furthermore, there are no previous reports of lactase-specific IgE. We report a case of protein contact dermatitis and allergic rhinoconjunctivitis from occupational exposure to lactase in a pharmaceutical worker. The patient exhibited strong positive responses to lactase in prick tests. In an open application test, lactase elicited whealing, and in patch testing, lactase elicited an eczematous reaction. Serum lactase-specific IgE antibodies were demonstrated in immunospot and radioallergosorbent test assays, and lactase-IgE-binding fractions and their specificities were examined in immunoblot and immunoblot inhibition assays. The chamber challenge test was performed to detect the association between lactase sensitization and rhinoconjunctival symptoms. Our results have confirmed the previous observations that lactase can induce occupational IgE-mediated respiratory and conjunctival sensitizations, but they show that contact skin reactions caused by lactase may also occur.
    Contact Dermatitis 09/2007; 57(2):89-93. · 2.93 Impact Factor
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    ABSTRACT: A long-term safety study of intranasally administered budesonide, a topical glucocorticoid, has been performed. 104 patients with perennial rhinitis, allergic or non-allergic, participated in a multicentre study in seven ENT-clinics utilising an identical protocol. A budesonide dosage of 400 μg/day was used as starting dose, but the patients were at liberty to reduce the daily dose to 200 μg. The patients were observed at intervals up to 12 months. At the entry and follow-up visits the following parameters were recorded: rhinoscopic findings, nasal symptom scores, blood chemistry, hematology, urinalysis and determination of plasma cortisol levels before and after stimulation with ACTH (Synacthen®). Nasal biopsies taken from 50 of the patients at the beginning and completion of the study were examined in a blinded way by an indepndent pathologist. The analysis revealed no histopathological changes of the nasal mucosa. At rhinoscopy no signs of atrophy or Candida were reported. Lividity of the nasal mucosa was significantly reduced during the trial, which was also the case for nasal congestion and secretion. All nasal symptom parameters assessed by the patients were significantly reduced from baseline during the follow-up period. No clinically significant changes in the hematological and blood chemistry parameters were observed. Plasma cortisol analysis before and after challenge with ACTH revealed no influence on the hypothalamic pituitary adrenal axis. No tachyphylaxis was observed; on the contrary, there was a clear tendency for reduction of the daily dose of budesonide necessary to keep the patients symptom-free. The present study suggests that intransal budesonide in the dose of 400 μg/day is a safe and valuable addition to our therapeutic armory for perennial rhinitis.
    Allergy 04/2007; 41(3):179 - 186. · 5.88 Impact Factor
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    ABSTRACT: To investigate the occupational exposure and sensitization to storage mites (SM) in sales staff working in a moisture-damaged and three healthy reference buildings. The study population consisted of the entire personnel (n=12) in the moisture-damaged grocery store. They all suffered from persistent upper respiratory tract symptoms. Twelve (in results 11) symptom-free controls working in three healthy reference groceries were matched with age, sex and occupation. Dust samples from each building were examined for mites. The clinical study consisted of otorhinolaryngological examination and determination of IgE reactivity. Specific serum IgE antibodies were measured against three SMs and two house dust mites (HDM). Skin prick tests (SPT) were made to the same five mites and to five common aeroallergens. If sensitization to any of the SMs was detected, a nasal provocation test (NPT) was performed. SMs were found in all buildings. In all, seven cases and four control subjects showed IgE-mediated reactivity. Sensitization to mites was detected in six cases and in three controls and in 2/12 and 3/11 this was the only IgE antibody response observed. In addition, one case and one control subject were sensitized to common aeroallergens. NPT with SMs was positive in four cases and in one control. In grocery stores, the personnel are exposed to SMs. The risk of sensitization to mites is obvious and an IgE response can occur without any reactivity to common aeroallergens. SM allergy may in some cases explain the chronic rhinitis related to moisture-damaged buildings.
    International Archives of Occupational and Environmental Health 09/2006; 79(7):602-6. · 2.10 Impact Factor
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    P Ruoppi, T Koistinen, S Pennanen
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    ABSTRACT: To determine the frequency of sensitisation to mites among rhinitic laboratory animal workers and to clarify whether sensitisation could be occupational. Skin prick tests (SPT) were performed in 40 subjects who were working with laboratory animals in Kuopio University research units and who had been referred to Kuopio University Hospital for work related rhinitis. The SPT panel consisted of three storage mites, two house dust mites, 11 other common environmental airborne allergens, latex, and 2-4 individually relevant laboratory animals. To determine signs of mites in animal facilities, guanine was determined in 22 dust samples taken from feedstuffs or bedding material used for laboratory animals and from rooms where these materials were stored and handled. Positive SPT results were found in 35 out of 40 workers: in 14 for storage mites, four for house dust mites, 25 for other common aeroallergens, as well as positive reactions to laboratory animals in 19 individuals. The guanine test was positive, indicating the presence of mite derived material in 21 out of 22 dust samples. This study suggests that subjects who are occupationally exposed to laboratory animals are also exposed to mite derived allergens. Sensitisation to mites is common and may be work related.
    Occupational and environmental medicine 10/2005; 62(9):612-5. · 3.64 Impact Factor
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    ABSTRACT: Deer keds (elk fly) have not previously been described as a cause of respiratory or conjunctival sensitization. To report a case of IgE-mediated allergic rhinoconjunctivitis from occupational exposure to deer ked. Skin prick testing (SPT) was performed with pollens, animal danders, mites, molds, and deer ked. The serum deer ked-specific IgE level was examined in ImmunoSpot and radioallergosorbent test assays, and deer ked IgE-binding fractions and their specificities were examined in immunoblot and immunoblot inhibition assays. Nasal provocation testing (NPT) and conjunctival provocation testing (CPT) were performed to detect the association between deer ked sensitization and rhinoconjunctival symptoms. Both SPT and NPT were performed with deer ked whole-body extract, whereas CPT was performed with deer ked wing. The results of SPT, NPT, and CPT were positive for deer ked. In laboratory tests, serum deer ked-specific IgE antibodies were demonstrated in radioallergosorbent test and ImmunoSpot assays. In immunoblot, IgE-binding bands were demonstrated at 17, 33, 70, and 85 kDa, which were clearly inhibited with deer ked extract but not with the control extract. Occupational IgE-mediated rhinoconjunctival allergy to deer ked was confirmed in this patient.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 06/2005; 94(5):604-8. · 3.45 Impact Factor
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    ABSTRACT: Nodular fasciitis is a benign, rapidly growing proliferation of fibroblasts, which is histologically difficult to distinguish from neoplasms. In several reports, as many as half of all cases have been initially misdiagnosed as a fibrosarcoma or some other malignancy. Although the head and neck is a region of predilection in infants and children, only eight periocular lesions have previously been reported in paediatric patients. We present a case of nodular fasciitis which occurred in the periorbital region in a 1 1/2-year-old girl. The process was excised locally in order to perform a biopsy. The mass was initially classified as a sarcoma but subsequently as infantile fibromatosis. Only after a thorough review of the case and four independent pathological consultations was the final diagnosis of nodular fasciitis confirmed. No further treatment was scheduled. Although the primary surgical removal of the tumour was not radical, no recurrence was observed during a 3-year follow-up period.
    Acta Oto-Laryngologica 05/2004; 124(3):324-7. · 1.11 Impact Factor
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    ABSTRACT: Occupational risk for laboratory animal allergy (LAA) is well known, but prevention is often insufficient and new cases keep appearing. A questionnaire on work-related symptoms was sent to all laboratory animal workers in Kuopio University. Subjects with rhinitis were invited to an examination for LAA, which consisted of an otorhinolaryngological examination and skin prick testing (SPT) with 16 common environmental allergens and two to five relevant laboratory animals. In cases of occupational sensitization, a challenge test was performed. The questionnaire was completed by 156 of 245 (64%) subjects. Rhinitis was reported by 65 of the respondents (42%) of whom 47 were examined for LAA. The duration of exposure before the onset of rhinitis varied from 1 month to 18 years. Twenty-seven persons (57%) had a history of some previous atopic symptoms. Forty subjects (85%) showed positive reactions in SPT, 24 (51%) for laboratory animals. Fifteen of the 26 animal challenge tests performed were positive, confirming the diagnosis of occupational allergic rhinitis in three subjects, occupational dermatitis in five and both diseases in seven subjects. The frequency of occupational allergic rhinitis among all participants was 10 of 156 (6%). Atopic constitution and work-related sensitization were common in rhinitic laboratory animal workers. Occupational allergic disease was diagnosed in nearly every third case.
    Allergy 04/2004; 59(3):295-301. · 5.88 Impact Factor
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    ABSTRACT: The aim of this study was to determine whether mold allergy mediated through immunoglobulin E (IgE) was responsible for the chronic nasal symptoms experienced by residents of moldy dwellings. A secondary aim was to investigate whether nasal mucosal findings were a possible reflection of other pathological mechanisms of chronic rhinitis. Sixteen adults living in moldy housing and complaining of chronic rhinitis were compared with sixteen healthy referents without any known mold exposure. All the buildings were surveyed for visible signs of moisture and mold. Microbial measurements were performed in the damp buildings with mold problems and in half of the reference buildings. The clinical study consisted of an otorhinolaryngological examination, nasal cytology, and skin prick tests. In the study cases, nasal provocation tests with fungi cultured from the homes and nasal mucosal biopsy were performed. In the housing with signs of moisture and mold, the concentrations of microorganisms were elevated, but were within the normal range of those of the reference buildings. The only positive skin reaction for molds was detected in one referent. No reactions were elicited in the nasal provocation tests with molds. Squamous metaplasia were detected in four biopsies and three cytograms of the cases but not in the nasal smears of the referents. In this material, the respiratory symptoms reported by occupants of moldy residences were not caused by mold allergy but were apparently related to nonspecific inflammation following irritation.
    Scandinavian Journal of Work, Environment & Health 01/2004; 29(6):461-7. · 3.10 Impact Factor
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    ABSTRACT: Mucormycosis of the nose and paranasal sinuses is a rare invasive fungal infection, which often has a very fulminant course and characteristic clinical findings. The patients are usually immunocompromised, with diabetic ketoacidosis being the commonest underlying disorder. In some immunocompetent patients, the disease is associated with local predisposing factors, such as chronic sinusitis. Although the prognosis has improved in recent decades, the disease can still be fatal. The underlying disease is an important determinant of prognosis and correction of the metabolic disorder, if present, is essential. Herein we report two cases: one of our patients was immunocompetent but had earlier suffered from polypous rhinosinusitis whereas the other had mild adult-type diabetes. Both patients were successfully treated with surgical debridement and amphotericin B.
    Acta Oto-Laryngologica 01/2002; 121(8):948-52. · 1.11 Impact Factor
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    ABSTRACT: About one in every four cases of occupational rhinitis recorded in Finland is animal-induced. Bovine allergens are the most important in this respect and the largest patient group consists of dairy farmers. Allergen immunotherapy, if proven effective, safe and feasible, would be ideal for their treatment. The development of recombinant allergens has offered new potential therapeutic prospects. Fragments of recombinant Bos domesticus (Bos d 2) allergen could be suitable for this purpose because they are recognized by T cells but their IgE-binding capacity is attenuated. The aim of this study was to verify whether the potential of the two fragments of recombinant Bos d 2 (corresponding to amino acids 1-131 and 81-172) to induce immediate allergic reaction in a shock organ (nose) was decreased compared to the complete recombinant allergen, which would be an advantageous property for a preparation intended for allergen immunotherapy. The study group consisted of 10 dairy farmers with cow-induced allergic rhinitis. We used the IgE titres against native Bos d 2 measured by indirect IgE ELISA to characterize the level of sensitization and compared the IgE titres in the rhinitis patients with 12 cow-sensitized asthmatic farmers and 12 healthy students. In vitro reactivity against recombinant Bos d 2 and its two fragments was studied by indirect IgE ELISA and in vivo reactivity by nasal provocation tests. The IgE titres against native Bos d 2 of patients with rhinitis tended to be lower than the titres of asthmatics. The healthy students did not exhibit any detectable IgE reactivity to native Bos d 2. In the patients with rhinitis, there was no statistically significant difference between IgE responses against native and recombinant Bos d 2, whereas with both in vitro and in vivo, the reactivity to both fragments of recombinant Bos d 2 was lower than the reactivity to the complete recombinant allergen. Due to the decreased in vivo capacity to induce immediate allergic reactions, the fragments may be better tolerated in allergen immunotherapy than the complete allergen.
    Clinical & Experimental Allergy 07/2001; 31(6):915-9. · 4.79 Impact Factor
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    ABSTRACT: To detail the underlying pathological conditions, symptoms, signs, and outcomes of patients with isolated sphenoid sinus involvement. A retrospective survey. An academic referral center of a university hospital. All 39 patients, aged 7 to 85 years, treated in the Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland, from 1988 through 1997 for isolated sphenoid sinus disease. Sinusitis was characterized as acute in 26 patients, subacute in 5 (including 1 pyocele), and chronic in 8 (including 2 fungal infections). No tumors were found. Isolated sinus cysts were excluded from the study. Headache, the main symptom in 32 patients (82%), was localized most commonly on the vertex. Other common complaints were rhinitis, dizziness, eye symptoms, and fever. In 2 patients, the finding was occult. Eight patients (21%) presented with cranial nerve deficits, and 1 patient had an intracranial complication. Sinus irrigation was performed in 16 patients (41%) and sphenoidotomy was performed in 10 (26%). Fifteen patients (38%) were treated with antibiotic drugs alone. Within 3 months, 31 (84%) of 37 patients had recovered from the illness; 5 still experienced headaches despite having normalized radiographic findings; and 1 had permanent unilateral visual loss. Two patients were lost to follow-up. Sphenoid sinus opacity is mostly inflammatory in origin. Despite the benign nature of the disease, there is a risk of complications with high morbidity and mortality. Early and, if necessary, aggressive therapy to guarantee drainage of the sinus is recommended.
    Archives of Otolaryngology - Head and Neck Surgery 07/2000; 126(6):777-81. · 1.78 Impact Factor
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    ABSTRACT: During the indoor cattle feeding season, dairy farmers are continuously exposed to allergenic bovine-derived materials for a long time every year. Limited information is available about the dynamics of exposed people's antibody responses under the influence of this kind of exposure. In this study, the level of antibodies to bovine epithelial antigen (BEA) was found to reflect the level of clinical allergy. On the other hand, the level of immunoglobulin (Ig)E, IgA and IgG antibodies to bovine urinary antigen (BUA) was lower in the group of bovine-allergic farmers than among other farmers. It was concluded that antibodies to different allergen extracts reflect different phenomena. Antibodies to BEA seem to be associated more with allergic symptoms, where as anti-BUA antibodies might reflect the level of bovine exposure. The indoor cattle feeding season did not cause any major changes in dairy farmers' humoral responses. The continued allergen exposure did not increase the level of sensitization as determined by antibody responses.
    Acta oto-laryngologica. Supplementum 02/1997; 529:169-72.
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    ABSTRACT: The efficacy and side effects of once-daily astemizole-D, a combination of 10 mg astemizole and 240 mg pseudoephedrine, were compared with those of twice-daily brompheniramine-D, a combination of 12 mg brompheniramine and 50 mg phenylpropanolamine (Lunerin), in 64 patients with seasonal allergic rhinitis caused by birch pollen. Efficacy was monitored by patient's diary scores, investigator assessments of nasal and eye symptoms and need of rescue medication during the 4-week study period. Both astemizole-D and brompheniramine-D reduced nasal and eye symptoms of allergy. There were no significant differences between the treatment groups regarding obstruction, but brompheniramine-D alleviated symptoms of rhinorrhoea and itchy eyes significantly more than astemizole-D. On the other hand, the patients in the brompheniramine-D group reported dry mouth, tiredness and drowsiness more often than those in the astemizole-D group. The results indicate that the two drugs are effective in the treatment of seasonal allergic rhinitis, but astemizole-D is better tolerated than brompheniramine-D.
    Rhinology 04/1996; 34(1):21-3. · 1.72 Impact Factor
  • E Nikanne, P Ruoppi, M Vornanen
    Duodecim; lääketieteellinen aikakauskirja 02/1996; 112(20):1871-5.
  • Clinical & Experimental Allergy 01/1994; 23(12):1011-4. · 4.79 Impact Factor
  • P Ruoppi, J Seppä, J Nuutinen
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    ABSTRACT: A retrospective analysis of patients with acute frontal sinusitis treated at Kuopio University Hospital between 1981 and 1990 was performed to define etiological factors, clinical course and response to treatment. The study comprised 91 patients, 67 men and 24 women, aged from 9 to 65 years with a mean age for men of 32 years and for women of 29 years. Thirty-nine patients (43%) had previously been suffering from seasonal or chronic rhinitis, which in 22 was allergic, in 15 vasomotoric and in 2 due to intolerance to acetylsalicylic acid. In one case there was a recent and in another an old nasal trauma. Forty-seven patients (52%) were hospitalized, the others treated as outpatients. All received medical treatment. In 49 patients (54%) there was contemporary maxillary sinusitis which was treated with irrigations. Nasal polyps were detected and removed in 18 patients (20%). Anterior ethmoidectomy was made in 11 patients (12%) and trephination of the diseased frontal sinus to avoid complications in 8 patients (9%). No complications occurred. In 5 patients (5%) acute frontal sinusitis recurred once and a chronic course was seen in another 5 patients of whom 3 had chronic allergic and one vasomotor rhinitis.
    Acta Oto-Laryngologica 04/1993; 113(2):201-5. · 1.11 Impact Factor
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    ABSTRACT: Nineteen dairy farmers with nasal symptoms associated with working in cowhouses participated in the study. Nasal challenge with bovine epithelial antigen (BEA) and bovine urinary antigen (BUA) was made before and after the indoor feeding season. Nasal challenge made before the indoor feeding season with BEA was positive in five patients and three of them showed positive reaction in nasal challenge also with BUA. After the indoor feeding season the results in nasal challenge with BEA were approximately equal to BEA and four of them showed positive response in nasal challenge to BUA. However, we did not find any significant increase in sensitivity in nasal challenge to BEA or BUA after the indoor feeding season. In addition to these patients, two patients who were excluded from nasal challenge before the indoor feeding season showed positive results in nasal challenge after the indoor feeding season with both BEA and BUA. Our results suggest that BUA in addition to BEA may have significance to nasal symptoms.
    Rhinology 07/1992; 30(2):121-7. · 1.72 Impact Factor
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    ABSTRACT: Bovine epithelial and urine antigen extracts were compared using enzyme-linked immunosorbent (ELISA) inhibition assay and sodium-dodecyl-sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with immunoblotting. According to ELISA inhibition results, the two extracts share about 2% of their antigenic components. Urine-derived antigens seem to be antigenically closer to serum proteins than epithelial antigens, as determined by rabbit immune sera. The IgG responses of allergic farmers against epithelial antigens were directed mainly against a protein of 20 kD, while non-allergic farmers had only very weak reactions. Generally, the IgG response against urinary antigens seemed to be more heterogeneous than against epithelial antigens. Almost all cow-allergic farmers reacted with a band at 20 kD in IgE immunoblotting against urinary and epithelial antigen while all non-allergic farmers showed negative results.
    Allergy 02/1990; 45(1):30-9. · 5.88 Impact Factor

Publication Stats

267 Citations
68.55 Total Impact Points

Institutions

  • 1990–2005
    • Kuopio University Hospital
      • Department of Otolaryngology
      Kuopio, Province of Eastern Finland, Finland
  • 1997
    • University of Kuopio
      • Department of Clinical Microbiology
      Kuopio, Eastern Finland Province, Finland