whether the velocity of aerosol inhaled intothe nose affected the distribution of particle in the nasal cavity or not. The fluticasone propionate (FP) aerosol particles were inhaled through a spacer (Volumatic, Allen & Hanburys Ltd.) to a nasal model. A simulated nasal cavity made of acryl resin (Kohken Co. Ltd.) and modified by impression material was used for theexperiment. Ten superficial hollows were made at the lateral wall of nasal cavity. Each hollow was filled with round shaped filter paper, 5 mm in diameter and 0.5 mm in thickness. FP aerosol sprayed in the spacer was delivered to the nasal model under artificial respiration. FP was also delivered directly to the model by means of gas and liquid. FP content of each filter paper was measured using HPLC.
When FP was delivered directly using gas, the highest concentration was found at the anterior portion of the middle turbinate. When FP was delivered using liquid, it was impossible to measure FP content of filter paper, because the aerosol particles had a tendency to gather each other. When FP was delivered through a spacer, although the content of FP of each filter paper decreased, the distribution of FP tended to extend more posteriorly. These results suggested that not only size of the aerosol particle but also the velocity affected the distribution of drugs within the airway during the aerosol therapy.

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The purpose of this study was to demonstrate characteristics of an aerosol inhalation nebulizer produced for multi-targeting clinical use and necessity of “multi-mechanismus”, as well.
Our sample device was a jet (compressor, 25W)-ultrasonic (1.7 MHz)-vibration (100 Hz; 58, 64 and 70 dB) nebulizer.
Characteristics of aerosols generated by available conditions of the device were then demonstrated concerning clinical use for the respiratory diseases.
Aerosol particle size distribution, etc were demonstrated by a particle analyzer, LUSEX-450 and a computor, HP-85.The results obtained was as follows:-Without vibration, logarithmic nomal probability distribution of generated aerosol particle size was observed both by compressor nebulizer and by ultrasonic nebulizer.
There was no statistical difference of aerosol particle size distribution obtained between the two nebulizers.On the other hand, with vibration, biphasic aerosol particle size distribution was observed both by compressor nebulizer and by ultrasonic nebulizer, showing the higher of vibration-amplitude, the larger of aerosol size.
All the results obtained and clinical evaluations of the device satisfied the multi-targeting clinical availability for the upper and the lower air way diseases.However, it was also demonstrated that “multi mechanisms” such as ultrasonic aerosol generation and jet mechanism with or without vibration were not always necessary condition of multi-targeting clinical availability.

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It is well known that Bordetella bronchiseptica is common in the respiratory tract of guinea pigs, occasionally causing the broncho-pneumonia. In this study, the lung of guinea pigs infected withB. bronchiseptica were observed after inhaling Broncasma Berna ® (BB) aerosolised with nebulizers.
Thirty-nine male Hartley guinea pigs were divided into 5 groups.Each of 2 groups was inhaled either 0.4% phenol solution (UP) or BB solution (UBB) by ultrasonic nebulization. Other 2 groups were exposed to the each solution (JP, JBB) by jet nebulization.These treatments were carried out everyday for one week and were repeated after an interval of seven days.All animals were killed after 1 week from the last inhalation.Control group received no treatment. The Agglutination test for antigen of B. bronchiseptica showed 61% positive on sera of the all guinea pigs.Histologically, various phases of granulomatous inflammation were observed in all groups.In each group, the findings were classfied into 4 pathological phases (A, B, C, D) of Bordetellosis.Then, each granulation size on the lung cross sections was measured.The size of granulation in the UBB group reduced with statistically significant (P<0.05) on the regeneration phase (C) in comparison with control group. Additionally, the lung in the UBB group was the cleanest among the groups on the recovery phase (D).On the other hand, the cell from paratracheal lymph nodes in the UBB group exhibited a higher response to PHA than those in the other groups.Also, the culture medium of lung macrophages of the UBB and JBB groups inhibited the proliferration of the fibroblast.
These findings suggest that BB inhalation is effective for Bordetellosis, and that BB influences the activation of T cells and lung macrophages on the lower air way.

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We discussed mucosal lesions of the stomach as side effects of steroid inhalation therapy. In this study, we carried out steroid inhalation tests on four groups of rats: the physiological salt solution inhalation group, the steroid inhalation group, the non-steroid anti-inflammatory drugs (NSAIDs) suppository group, and the steroid inhalation+ NSAIDs suppository group.
The following results were obtained:
1. In the physiological salt solution inhalation group and the steroid inhalation group, no remarkable changes in the gastric mucosa were noted.
2. In the NSAIDs suppository group that was also administered alcohol, bleeding and erosion of the gastric mucosa was observed.
3. In the steroid inhalation+NSAIDs suppository group that was also administered alcohol, significant bleeding and erosion as well as linear ulceration of the gastric mucosa were observed.
When steroid inhalation therapy is carried out, special attention should be paid to patients on other drugs, with other diseases or who drink alcohol.In these patients, the possibility of the development of acute gastric mocosal lesions during steroid inhalation therapy should be considered.

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Nasal mucosal permeability for proteins were evaluated in normal and actively sensitized guinea pigs.Nasal mucosal permeability was monitored by means of PCA reactions in the dorsal skin which was caused by antigen administered into the nose.10³and10⁴/μg/ml of histamine which was applied prior to the administration of antigen into the nose, significantly enhanced the PCA reactions dose dependently in normal guinea pigs.In actively sensitized guinea pigs against DNP-Ascaris, PCA reactions in the dorsal skin caused by ovalbumin which was administered into the nose were significantly enhanced after nasal challenge with DNP-Ascaris done before the administration of ovalubumin. These results suggest that allergic reaction, especially histamine enhances the nasal mucosal permeability. This might be caused by the increase in permeability of epithelial tight junction.

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The effects of inhibiting nasal symptoms and signs of nasal hyperresponsiveness on local hyperthermotherapy were studied in 15 patients. Patients with perennial nasal allergy and vasomotor rhinitis were perfomed inhalation of saturated hot air (43°C) by Skainar-Steam ® II (EISAI) for 4 weeks.Each treatment consisted of two or three 10 minutes sessions, was treated for everyday at home. Subjective response was recorded on a dialy symptom score during the treatment.Nasal symptoms and signs were determined before, after 2-weeks, and after treatment by physical examination. Local hyperthermia treatment resulted in both severe and moderate amelioration of rhinitis symptoms and signs of increased in 35.7% for 2 weeks and in 60% for 4 weeks. There were increased statistically significant in comparison with amelioration of 4 weeks-group between 2 weeks-group (Wilcoxon-test, p<0.001).And no side effects were noted, during either treatment or follow up. In analysis, there was sligtly correlation nasal provocation test (pre-treatment) score with that amelioration of symptoms and signs. The results suggest that local hyperthermotherapy have an effect on inhibiting nasal symptoms and signs of nasal hyperresponsiveness and it is one of the effective treatment inhalation in clinical use.

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In order to decrease the loss of medical aerosol drugs, some useful techniques are discussed with the particle deposition efficiency of the drugs. The aerosol generator named SPSU, Synchronized Rectangular Pressure with Spiral-typed Nozzle-Ultrasonic Aerosol Generator, has been proposed to decrease total loss of aerosol drugs for maxillary sinus diseases, because other general equipments would have disadvantages of the total loss about 15.7-76.2% due to longer tubing, unsuitable shape of nasal adaptor, particle deposition in the vessel of generating part, and useless amount of drugs in expiration period.
Judging from the experimental results of measuring partial deposition efficiency in each part of aerosol generator, a new equipment named SPSU-12 modified from SPSU is noticed to improve the total loss of aerosol delivery by using following effective procedures: The length of tubing between aerosol generator and nose adaptor equipped horizontally is 15 cm, the nose adaptor with spairal nozzles consists of two tubings of which sized are same as human nostril in diameter, the shape of cover of the vessel is used as smaller size of spherical one to recirculate the medical drugs into the vessel by decreasing the amount of particle deposition on the wall of vessel, and the aerosol drugs is controlled by leaking the air flow at the buffer tank in SPSU to deliver only at the inspiration period.

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Therapeutic effects on snoring of nasal spray EN 028 were determined in 36 patients with the chief complaint of snoring. They consisited of 25 males and 11 females aged 23 to 68 years. Each patient was instructed to spray EN 028 into each nasal cavity 2 to 4 times at bedtime. Overall efficacy evaluations were classified as “excellent” in 1 patient, “good” in 12 patients, “fair” in 9 patients and “poor” in 14 patients. The rate of effectiveness was 36.1% when “good or excellent” responses were taken into account. The response was “good or excellent” in 9 of 18 patients over 50 years of age (50%). EN 028 was more beneficial in elderly patients. Adverse drug reactions were experienced by none of the patients. Thus overall, EN 028 can be considered to be a clinically useful drug for snoring.

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Many years ago, Hippocrates used vapor, from a kettle, for dryness of nose and throat.
At present, there are many aerosol-generators in medicine for the treatment of upper or lower respiratory tract diseases.
A moisturizer using the newest electronics and mechanisms appears most effective.

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1) Present views of the aerosol therapy among the practitioners of otolaryngology were surveyed. Most of them are using the aerosol therapy for chronic sinusitis. The aerosoltherapy is evaluated by combinations of widening treatment of the middle nasal meatus.
2) Choice and absorption of drugs for the aerosol therapy were clinically discussed.
3) Effects of the aerosol drugs for the mucous epithelium were studied by using both light and electron microsocopy.

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In the treatment of chronic sinusitis accompanied by irreversible mucosal lesions in the ostiomeatal complex, it is necessary to surgically widen the ostium of the maxillary sinus, as well as the middle nasal meatus.This is because it is difficult for drug aerosols to reach the inner region of sinuses, such as the maxillary sinus and ethmoidal sinus, even when these sinuses are normal, due to their intricate structure.Aerosols of a drug can exert efficacy on diseased mucosae of the sinuses only after the ostium has been surgically opened wide.Surgical opening of these structures improves ventilation and drainage through the sinuses and is thought to result in healing of the disease due to the efficacy of the drug delivered as a result of these improvements. Accordingly, in treatment of chronic sinusitis using a nebulizer, the first requirements are widening of the middle nasal meatus and ostium and removal of the retained fluid in the sinuses by aspiration.

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