P Kaspar’s scientific contributions

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Publications (12)


Therapy with expectorants in COPD patients: A double-blind randomized study comparing Ambroxol and Cineol
  • Article

January 1998

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78 Reads

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17 Citations

Atemwegs- und Lungenkrankheiten

M. Wittmann

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W. Petro

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P. Kaspar

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[...]

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In former controlled investigations Ambroxol and Cineol were shown to improve FEV1 and FVC in patients with COPD versus placebo. To compare the effects of oral therapy with Cineol (3 x 200 mg/day), a monoterpene of eucalyptus oil, and Ambroxol (3 x 30 mg/day) after a treatment over one week, a randomized double-blind, double-dummy, cross-over trial in 29 patients with COPD (which showed at least a 15% reversibility in FEV1 after 200 μg inhaled Fenoterol) was performed. The parameters of interest were lung function (including bodyplethysmography with Raw and sGaw), peak-flow protocol and a dyspnoe score. A constant co-therapy with inhaled steroids and with Theophyllin was allowed. Four patients had to be excluded from the study because of acute upper airway infections and one patient because of an allergic exanthem under therapy with Ambroxol. The lung function improved from day 1 (before therapy) to day 7 (2.5 hours after therapy) concerning VC (p < 0.05), Raw (p < 0.005) and sGaw (p < 0.005) statistically significant for both drugs - Cineol and Ambroxol. FEV1 also improved, but without significance. Only under therapy with Cineol ITGV was reduced from 4.41 to 4.20 (p < 0.05), without any change under Ambroxol. All parameters of lung- function, peak-flow (not significant) and the symptom-score (for dyspnoe at rest) showed better improvement under therapy with Cineol, but field to reach statistical significance in comparison with Ambroxol because of the small number of patients (for ITGV p-value 0.08). The cooperation-independant parameters of plethysmography showed higher p values than only VC and FEV1 indicating that plethysmography is a better instrument for studies comparing drugs. In summary, the expectorant Cineol seems to have an additional bronchodilator effect.


Effect of BAL on lung function, bronchial reactivity and ciliary beat frequency

January 1996

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2 Reads

Broncho-alveolar lavage (BAL) is a routine technique useful in the diagnosis of parenchymal lung disease of varying etiology. The very low but established complication rate prompted us to study the effect of BAL on lung function, bronchial reactivity and ciliary beat frequency. We studied the lung function of 38 patients one day before and one day after BAL, as well as immediately, 2 hours and 4.5 hours after the procedure. Methods of evaluation included bodyplethysmography, the oscilloresistometry, measurement of bronchial reactivity by means of inhaled carbachol, diffusion analysis, lung compliance and blood gas analysis. Ciliary frequence was determined before and after BAL by studying the respiratory epithelium obtained by bronchial brush biopsies under a phase-contrast microscope and the pH of the lavaged fluid was also recorded. Clinical parameters were recorded, chest x-ray was taken before and after the procedure, and a questionnaire of symptoms was completed by the patients before and after BAL. The procedure was well tolerated; typical complications occurred with 3 patients developing fever and 2 patients with a new lung infiltrate seen on chest x-ray. Lung function analysis showed a mild, temporary restriction, a predominantly peripheral obstruction and no hypoxemia. There was no evidence of a disturbance in diffusion or change in lung compliance. BAL did not cause an increase in reactivity or hyperreactivity. The combination of a functional lesion with a decrease in ciliary beat frequency and a disturbance of mucociliary clearance and surfactant, together with bacterial inoculation, may be the explanation for the fever reaction and regional pneumonial infiltrate seen in some cases of our study group.


The house dust mites D. pteronyssinus and D. farinae in low and high altitude levels with consideration to the location and time of year of sampling

January 1995

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5 Reads

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1 Citation

Climatic and geographical factors are known to have a significant effect on the presence of house dust mites. The percentage levels of D. pteronyssinus and D. farinae house dust mites at various altitudes were studied according to the place and time of year of dust test sampling. Two groups of houses (540-650 meters above sea level; 800-1150 meters above sea level) and the guanine concentration of the house dust (Acarex test) as well as an immunological analysis of the Der pI and Der fI antigens were compared. A significantly lower number of house dust mite antigens (p < 0.05) was found in the groups of houses located at higher elevations. In fall, significantly higher antigen concentrations for D. farinae were found than in spring. Mainly bed mattresses were contaminated with house dust mite allergens; significantly lower amounts of mite antigens were found on upholstered furniture or carpets. The correlation of guanine detection and ELISA is overall good (r = 0.59; p < 0.001) but unclear findings appear in low levels of the Acarex test. Other authors' conclusions concerning the influence of altitude and season as well as the predilection for colonisation in mattresses are confirmed. Of interest is the fact that mite antigen levels often exceeded the suggested hygienic threshold values, even in the higher elevated homes.


Comparison of secretolytics. Change of ciliary frequency and lung function after therapy with Cineol and Ambroxol

January 1994

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110 Reads

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19 Citations

In a three-way cross-over, randomized, double-blind-clinical study efficacy of Cineol and Ambroxol was studied by the parameters mucociliary clearance by measuring the ciliary frequency of nasal cilias and the 'saccharine-time' as well as the improvement of lung function in patients with reversible obstructive airway diseases in comparison to placebo. After randomisation of the patients to the Cineol, Ambroxol and placebo therapy over a period of 4 days a statistically significant increase of ciliary frequency was determined after treatment with Cineol of 8,2% but, on the opposite, no significant changes were observed after placebo and Ambroxol with an increase of 1,7 or 1,1%. Changes of ciliary frequency after therapy with Cineol were statistically significant in comparison to the Ambroxol and placebo control groups. Decreases of saccharine-time were determined as 41 seconds after placebo, 48 seconds after Ambroxol and 241 seconds after Cineol therapy but were clinically relevant and statistically significant only after Cineol therapy. An improvement of lung function by determination of the parameters forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in comparison to control values was shown to be clinically relevant and statistically significant after therapy with Cineol and Ambroxol. The improvement of lung function for Ambroxol and Cineol was shown to be clinically equivalent.



[Analysis of respiratory mechanics in fiberoptic bronchoscopy in healthy probands and patients]

March 1990

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3 Reads

Pneumologie

The airway resistance was measured via oscillation in 30 patients during routine bronchoscopy. In 10 healthy subjects body plethysmographic measurements were done during fiberoptic bronchoscopy. It was found that fiberoptic bronchoscopy results in an only slight, but significant increase in airway resistance. The Raw rose from an average of 1.94 to 3.04 mbar/l/s.





[Inhalative immunostimulation in patients with chronic bronchitis]

February 1988

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3 Reads

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2 Citations

H& G Zeitschrift fur Hautkrankheiten

80 patients with chronic bronchitis were treated inhalatively for a time of 3 weeks with a polyvalent bacterial lysate (IRS 19) or with placebo. The study was carried out in a double-blind fashion. Treatment with IRS 19 resulted in improved bronchoscopic findings compared with the pretherapy findings. Patients with bronchial hyperreactivity showed in the IRS 19 group small improvement of the hyperreactivity. In this group the contents of IgG in the BAL fluid showed a significant reduction, the other parameters were unchanged.


Citations (2)


... This inhibitory activity was comparable to the inhibitory eff ect of therapeutic airway concentrations of budesonide (10 − 8 M). This investigation showed anti-infl ammatory action of 1,8-cineole by 2 separate mechanisms: inhibition of the AA-metabolism by reduction of the 2 major AA-metabolites of the 5-lipoxygenase (LOX) and cyclooxygenase (COX) pathways of LTB 4 and PGE 2 as well as inhi- [ 26 ] In vitro study in isolated monocytes from healthy subjects to compare the mediator inhibitory activity of cineole and budesonide on AA-metabolism and cytokine production at known plasma levels of cineole Like cineole, the inhibition of IL-1β and PGE 2 production was stronger than the inhibition of LTB 4 production Mediator inhibition by budesonide (10 − 8 M) was 100-fold stronger compared to cineole, but equal at the therapeutic plasma concentration of cineole. = > steroid-like anti-infl ammatory action of cineole [ 27 ] In vitro study on the profi le of infl ammatory mediator inhibition by cineole in human monocytes Healthy volunteers as blood donor Isolated monocytes incubated with cineole for 20 h, in the presence of LPS or IL-1β ...

Reference:

Anti-inflammatory Properties of the Monoterpene 1.8-cineole: Current Evidence for Co-medication in Inflammatory Airway Diseases
Comparison of secretolytics. Change of ciliary frequency and lung function after therapy with Cineol and Ambroxol
  • Citing Article
  • January 1994

... In the intestinal as well as the bronchial tract, 1,8-cineole also comes into contact with smooth muscle fibre. Investigations of the effects of 1,8-cineole on SMF, whether receptor-specific or receptor-independent, are expected to contribute to understanding of the clinical efficacy of 1,8-cineole, e.g. in inflammatory bronchial diseases [9]. Our results show that the mechanisms of this inhibition are due to an effect specific to the human bronchial system. ...

Therapy with expectorants in COPD patients: A double-blind randomized study comparing Ambroxol and Cineol
  • Citing Article
  • January 1998

Atemwegs- und Lungenkrankheiten