No abstract available.
Bronchial Provocation Tests*

No abstract available.
Bronchial Provocation Tests*

We experienced two cases of occupational asthma induced by Elk dander in Elk-feeders and confirmed these cases by the bronchial provocation test with Elk dander. Both of them showed dual asthmatic response. They also showed positive reaction to the skin prick test with EIK dander. Now one of them has no asthmatic symptoms at all after complete avoidnce of EIK dander.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dander ; Skin

PURPOSE: It is very important to compare the particle size and total output from inhalation devices for standardization of bronchial provocation test. METHODS: Total output (mass output, salt output) from 4 nebulizer/compressor combination (LC plus/Pari-boy, Long life/Pari-boy, Pulmoaid/Pulmoaid, DeVilbiss/DeVilbiss) which were charged with 2 mL of 0.9% normal saline was measured. Aerosol particle size was measured directly using laser diffraction by Marvern Master Sizer and by evaluating Mass median aerodynamic diameter (MMAD). RESULTS: The LC plus nebulizer had the highest output rate and delivered the largest particles. The Maximal output rates of the 3 nebulizer/compressor combination was half that LC plus /Pari-boy combination. CONCLUSION: The results suggest that it might be different in mass output and particle size by inhalation devices. These differences can influence to the results of bronchial provocation test such as FEV1. We emphasizes that it is necessary to standardize the total output and particle size from each inhalation devices to perform and interpretate the results of bronchial provocation test.
Bronchial Provocation Tests* ; Inhalation* ; Nebulizers and Vaporizers* ; Particle Size*

OBJECTIVEAsthma is the most common chronic respiratory disease of children. The association between asthma and bronchial hyperresponsiveness (BHR) has been well-demonstrated. The objective of the study was to investigate relationship between the bronchial responsiveness and the peripheral obstruction in stable asthmatic children.

METHODSThirty-nine children with stable asthma, 28 boys and 11 girls with a mean age of 128 (77 - 197) months, received the bronchial provocation test by the maximal expiratory flow-volume (MEFV) curve measurement. The children were divided into two groups: one with maximal mid-expiratory flow (MMEF) < 80% (n = 15) and the other with MMEF >/= 80% (n = 24). Positive rates of bronchial provocation test were compared between groups of MMEF < 80% and >/= 80% and between the children whose relief duration was 12 months (n = 13). Statistical analysis was performed by using Chi-square, rank sum test or t test (SPSS10.0), P values < 0.05 were considered significant.

RESULTSIn the 39 stable asthmatic children, 15 (38%) were detected MMEF < 80% and 28 (72%) had BHR. There was no significant difference in BHR between the children with MMEF < 80% and those with MMEF >/= 80% (P > 0.05). There was no significant difference in BHR between the children whose relief duration was 12 months (P > 0.05), either.

CONCLUSIONSThe stable asthmatic children still had peripheral obstruction and BHR, which indicated the presence of airway inflammation. There was no significant difference in BHR between the children whose relief duration was 12 months.

Asthma ; physiopathology ; Bronchial Hyperreactivity ; physiopathology ; Bronchial Provocation Tests ; Child ; Female ; Humans ; Male ; Maximal Midexpiratory Flow Rate

BACKGROUND AND OBJECTIVES: There are evidences that allergic rhinitis and asthma represent a continuity of disease. It is known that bronchial hyperreactivity is a most contributing factor for asthma, yet it remains controversial whether there is a direct cause-and-effect relationship between the upper and lower airway. This study was performed to evaluate a direct cause-and-effect relationship between the two diseases by using early allergic responses and to define the clinical factors for predicting bronchial hyperreactivity in allergic rhinitis patients. SUBJECTS AND METHOD: Seventy three patients with allergic rhinitis and 36 patients without allergic rhinitis were included in this study, where exclusion criteria were diagnosed asthma, chronic obstructive pulmonary diseases, nasal polyp and chronic paranasal sinusitis. Nasal provocation tests with allergen were applied to 29 allergic rhinitis patients. After 30 minutes, we investigated lower airway using symptom scores, bronchial provocation test with methacholine and pulmonary function test. Bronchial provocation test with methacholine was applied to 44 allergic rhinitis patients and 36 non-allergic rhinitis patient. We checked nasal symptom scores and the change of nasal volume by VAS and acoustic rhinometry, respectively. We also investigated the incidence and the predictive factors of bronchial hyperreactivity in allergic rhinitis patients. RESULTS: The early allergic response provocated at nasal cavity had little effect on bronchus. Bronchial stimuli with methacholine did not affect nasal cavity. The incidence of bronchial hyperreactivity is significantly higher in allergic rhinitis patients than in non-allergic rhinitis patients. Type of allergic rhinitis (especially persistent, moderate-severe group) and the disease-durations are valuable predictive factors of the bronchial hyperreactivity. CONCLUSION: Although early allergic response has little effect on the nasobronchial relationship, there may be a significant correlation between allergic rhinitis and bronchial hyperreactivity. The correlation is more significant in the persistent, moderate-severe group of allergic rhinitis with long disease duration.
Asthma ; Bronchi ; Bronchial Hyperreactivity* ; Bronchial Provocation Tests ; Humans ; Incidence ; Lung Diseases, Obstructive ; Methacholine Chloride ; Nasal Cavity ; Nasal Polyps ; Nasal Provocation Tests ; Respiratory Function Tests ; Rhinitis* ; Rhinometry, Acoustic ; Sinusitis

To characterize the patients whose asthma may be caused by Artemisia pollen extracts, we studied the bronchoprovocation test with Korean Artemisia pollen extracts (1:20 w/v), methacholine bronchial challenge test and wormwood-RAST in 32 asthmatic patients sensitized to Artemisia pollen. Twenty-six(81%) developed a 15% or greater decrease in FEVI after the inhalation of Artemisia pollen extracts and 13 patients showed early responses, 8 dual, and 5 late only. Thirteen(50%) out of 26 positive responders complained of seasonal aggravation of their asthmatic symptoms. Seven(53.8%) of the 13 seasonal type patients, 10(76.9%) of the 13 perennial type and 5(100%) of the 5 negative responders showed concurrent positive responses in the house dust bronchoprovocation test. The bronchial responsiveness to allergen(PD15) was more dependent upon the specific IgE level(bound radioactivity on wormwood-RAST) and multiple regression analysis revealed that the specific IgE level and methacholine PC20 may be contributory to allergen PD15. These results suggested that specific IgE to Artemisia pollen appears to be the major contributor to susceptibility to Artemisia bronchial challenges and this pollen may be considered as one of the important allergenic etiologies of atopic asthma in this country.
Allergens ; Asthma/diagnosis/*etiology ; Bronchial Provocation Tests ; Human ; *Pollen ; Radioallergosorbent Test ; Skin Tests

We surveyed 26 employees of a shell-handling factory on whom skin tests with 12 common allergens and shell powder extract were done. Specific bronchial Provocation tests with shell powder extract were performed on the subjects who had respiratory symptoms. Positive skin responders to shell powder extract were 8 among the 26 subjects (30.8%), and subjects who were positive responders to any one of 12 common allergens showed a higher positive rate than negative responders. Among the 8 subjects who had a positive skin response, four had respiratory symptoms. Three subjects were positive bronchial responders to bronchial provocation tests.
Adult ; Asthma/epidemiology* ; Bronchial Provocation Tests ; Human ; Korea ; Male ; Occupational Diseases/epidemiology* ; Shellfish* ; Skin Tests

Adult ; Bronchial Hyperreactivity ; physiopathology ; Bronchial Provocation Tests ; Chronic Disease ; Cough ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Respiratory Function Tests

PURPOSE: It is well-known that the bronchial challenge test is very important to evaluate the bronchial hyperresponsiveness in asthma. This study was done to find the items of clinical symptoms and signs as a predictors for bronchial hyperresponsiveness in compare with methacholine challenge test. METHODS: The methacholine challenge test and allergy questionnaire(total 90 items) were done for 76 children with suspected asthma aged 4 to 11 years old who visited children's allergy clinic from the February to the June in 1999. Methacholine was used in increasing doses from 0.125 mg/mL to 16 mg/mL to a greater-than-20%(PC20) drop in FEV1 was obtained, or to the maximum concentration of 16 mg/mL was reached. The subjects were requested to inhale each preparation for 2 minutes. The bronchial hyperreactivity was considered severe if a PC20 was reached at a concentration of 0.125 mg/mL, moderate if the PC20 was reached at between 0.25 and 0.5 mg/mL(group C), mild if the PC20 was obtained with concentrations between 2 and 8 mg/mL(group B), and negative if the PC20 was obtained with concentrations 16 mg/mL or not obtained with any of the concentrations used(group A). We compared bronchial hyperreactivity with items of the questionnaire. RESULTS: 1) Fifteen children are normal(group A), thirty-nine are mild(group B), nineteen are moderate(group C), and three are severe(group C) among 76 children. 2) Symptom score and bronchial hyperreactivity showed statistical significant correlation. 3) Items which had statistical significance(P<0.05) between the methacholine challenge test and the questionnaire are dyspneic asthma attack, more than twice of asthma attck, asthma history diagnosed by doctor, wheezing regardless of common cold, and wheezing episode for last three months. 4) Family history, residential environment, duration of cough and other allergic disease history didn't have any relation. CONCLUSION Some items of asthma questionaire had a close relationship with the severity of bronchial hyperresponsiveness by methacholine challenge test for the children with suspected asthma. We hope that those items of asthma qyestionaire be helpful to predict the airway hyperresponsiveness for childhood asthma.
Asthma* ; Bronchial Hyperreactivity ; Bronchial Provocation Tests ; Child ; Common Cold ; Cough ; Hope ; Humans ; Hypersensitivity ; Methacholine Chloride* ; Surveys and Questionnaires ; Respiratory Sounds