PURPOSE: Exercise-induced bronchoconstriction (EIB) is common in “high ventilation” athletes, and the Eucapnic Voluntary Hyperpnea (EVH) airway provocation test is the standard EIB screen. Although the EVH test is widely used, the in-test performance in high ventilation athletes as well as the reproducibility of that performance has not been determined. Reproducibility of pre- and post-test spirometry and self-reported atopy/cough was also examined. METHODS: High ventilation athletes (competitive swimmers; n=11, 5 males) completed an atopy/cough questionnaire and EVH testing (operator controlled FiCO₂) on 2 consecutive days. RESULTS: Swimmers achieved 85%±9% and 87%±9% of target FEV1 volume on days 1 and 2, respectively, (P=0.45; ICC 0.57 [0.00-0.86]) resulting in a total ventilation of 687 vs 684 L [P=0.89, ICC 0.89 (0.65-0.97]) equating to 83%±8% and 84%±9% of predicted total volume (ICC 0.54 [0.00-0.85]) between days 1 and 2. FiCO₂ required to maintain eucapnic conditions was 2.5%. Pre-test FEV1 was less on day 2 (P=0.04; ICC >0.90). Day 1 to 2 post-test FEV1 was not different, and 4 swimmers were EIB positive (>10% fall in pre-post FEV1) on day 1 (3 on day 2). CONCLUSIONS: EVH in-test performance is reproducible however required less FiCO₂ than standard protocol and the swimmers under-ventilated by 125 and 139 L/min for days 1 and 2, respectively. How this affects EIB diagnosis remains to be determined; however, our results indicate a post-test FEV1 fall of ≥20% may be recommended as the most consistent diagnostic criterion.
Asthma, Exercise-Induced ; Athletes* ; Bronchoconstriction ; Cough ; Diagnosis ; Humans ; Respiratory Hypersensitivity ; Spirometry ; Swimming ; Ventilation*

Aspergillus is a ubiquitous fungus which is found in soil, composed piles, and even in the air. It causes various clinical syndromes, which are mainly determined by the immunocompetence of host; simple colonization in normal person, aspergilloma in patients with lung cavities (e.g. after tuberculosis), chronic necrotizing pneumonia in mildly immunocompromised hosts (e.g. DM or alcoholics) or those who have chronic lung diseases, invasive aspergillosis which is severe and commonly fatal in immunocompromised patients. It may cause hypersensitivity reaction; IgE-mediated asthma, hypersensitivity pneumonitis (extrinsic allergic alveolitis), allergic Aspergillus sinusitis, allergic bronchopulmonary aspergillosis (ABPA). It is essential for clinicians to be familiar with the spectrum of Aspergillus-related clinical syndromes. After a brief review of each clinical syndrome, ABPA that is a typical allergic disease was reviewed in detail.
Alveolitis, Extrinsic Allergic ; Aspergillosis ; Aspergillosis, Allergic Bronchopulmonary ; Aspergillus ; Asthma ; Colon ; Fungi ; Humans ; Hypersensitivity ; Immunocompetence ; Immunocompromised Host ; Lung ; Lung Diseases ; Pneumonia ; Pulmonary Aspergillosis* ; Sinusitis ; Soil

Exposure to fungal spores occurs frequently in indoor as well as in outdoor. Residential area, office, factory and farm fields are the common places of fungal spore exposure. Role of fungal spores as the causes of hypersensitivity reactions, bronchial asthma, allergic rhinitis and hypersensitivity pneumonitis was underestimated due to the lack of intensive research on the allergenicity of fungal spores. As the knowledge on fungal spores is accumulating, it is necessary to reevaluate the role of fungal spores in the field of allergic diseases.
Alveolitis, Extrinsic Allergic ; Asthma ; Fungi ; Hypersensitivity ; Rhinitis ; Spores ; Spores, Fungal*

Exposure to fungal spores occurs frequently in indoor as well as in outdoor. Residential area, office, factory and farm fields are the common places of fungal spore exposure. Role of fungal spores as the causes of hypersensitivity reactions, bronchial asthma, allergic rhinitis and hypersensitivity pneumonitis was underestimated due to the lack of intensive research on the allergenicity of fungal spores. As the knowledge on fungal spores is accumulating, it is necessary to reevaluate the role of fungal spores in the field of allergic diseases.
Alveolitis, Extrinsic Allergic ; Asthma ; Fungi ; Hypersensitivity ; Rhinitis ; Spores ; Spores, Fungal*

PURPOSE: To identify the causes and clinical characteristics, and the efficacy of various diagnostic approaches, we studied, prospectively, pediatric patients with chronic recurrent chest pain. METHODS: A prospective study of 122 patients with chronic recurrent chest pain from June 1998 to June 2003 was performed. The male and female ratio was 81:41, age 9.3+/-3.1 year. A single chart including pain description(histoy) and pain questionaire, with associated symptoms, was used for systematic history taking. The patients were devided in two groups, Group A, before June 2001(n=70), Group B, after June 2001(n=52). Chest X-ray and ECG were checked in all patients. Allergy tests and echocardiography, 24 hour ECG monitoring, exercise tests, pulmonary function tests, and gastrointestinal fiberendoscopy were performed selectively. RESULTS: Idiopathic origins were most common(32%). The remaining causes were psychogenic(23%) and exercise-induced asthma(20.5%), hyperventilation syndrome(9.1%), tachyarrhythmia(4.9%), cardiac (4.1%), pulmonary(3.3%), reflux esophagitis(2.5%), in order. The positive rate of allergy tests(24%) was higher than that of cardiac examinations(11-20%). Exercise-induced asthma was more common than psychogenic causes after June, 2001. Various abdominal symptoms accompanied idiopathic and psychogenic chest pains, and hyperventilation syndrome. Headaches were more commonly found in psychogenic pain, but chest tightness and dyspnea were common in hyperventilation syndrome. About half of exercise-induced asthma patients had symptoms of allergic rhinitis. CONCLUSION: In the majority(72%) of exercise-induced asthma, the chest pain was induced or aggravated by exercise, and relieved by rest. Causative antigens were detected in 69.2% of group B patients with exercise-induced asthma. Exercise-induced chest pain might be a first manifestation in allergy patients. So, we recommand allergy tests for patients with recurrent chest pains induced or aggravated by exercise. Hence, cardiac examinations such as echocardiography or 24 hour ECG monitoring could be performed selectively, case by case.
Asthma, Exercise-Induced ; Chest Pain* ; Child* ; Diagnosis* ; Dyspnea ; Echocardiography ; Electrocardiography ; Exercise Test ; Female ; Headache ; Humans ; Hypersensitivity ; Hyperventilation ; Male ; Prospective Studies ; Respiratory Function Tests ; Rhinitis ; Thorax*

No abstract available.
Alveolitis, Extrinsic Allergic* ; Hypersensitivity*

No abstract available.
Alveolitis, Extrinsic Allergic* ; Hypersensitivity*

No abstract available.
Alveolitis, Extrinsic Allergic* ; Hypersensitivity*

Hypersensitivity pneumonitis (HP) is an immunologically-mediated disease resulting from repeated exposure to sensitizing agents, such as organic dusts or chemicals. Isocyanate is a volatile and highly reactive chemical that is extensively used in the manufacturing of automobiles, upholstery, and polyurethane foam. Occupational respiratory diseases associated with isocyanate, such as bronchial asthma, are well-known. It is thought that HP is one of the rare diseases induced by isocyanate with a very low frequency worldwide. We report a case of HP in an automobile painting sprayer which appeared to be associated with isocyanate.
Alveolitis, Extrinsic Allergic ; Asthma ; Automobiles ; Dust ; Hypersensitivity ; Paint ; Paintings ; Polyurethanes ; Rare Diseases

Asthma ; Humans ; Respiration Disorders ; Respiratory Hypersensitivity