No abstract available.
Asthma, Occupational*

No abstract available.
Asthma*

Heterogeneity in clinical features and pathogenesis of non-steroidal anti-inflammatory agent (NSAIDs) hypersensitivity have been reported. NSAIDs can cause bronchial constriction in asthmatics or hives and angioedema in patients with chronic urticaria, in which case causative drugs show cross-reactivity with other NSAIDs. Normal subjects without allergic diseases may develop urticaria angioedema or anaphylaxis after ingestion of a specific NSAID. In this type of reaction, cross-reactivity between causative drugs and other NSAIDs does not occur. We experienced a case of acetaminophen anaphylaxis without aspirin sensitivity in a 38-year-old male, which was confirmed by oral provocation test. An oral challenge with 150mg of acetaminophen induced urticaria in lower legs, and erythema, with febrile sensation in ears. With a dose of 600mg acetaminophen, urticaria developed in trunk and extremities with facial angioedema. An oral provocation test with 650mg of aspirin was well tolerated without any adverse reactions. We report acase of acetaminophen anaphylaxis, which occurred in a normal individual at a small dose(150mg) without cross-reactivity with aspirin. This type of reaction supports heterogenei~ty of NSAIDs hypersensitivity and it may be caused by an other mechanism, not by cyclooxygenase inhibition.
Acetaminophen* ; Adult ; Anaphylaxis* ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Aspirin* ; Bronchoconstriction ; Ear ; Eating ; Erythema ; Extremities ; Humans ; Hypersensitivity ; Leg ; Male ; Population Characteristics ; Prostaglandin-Endoperoxide Synthases ; Sensation ; Urticaria

BACKGROUND AND OBJECTIVE: House dust mites have been known as the most important allergens in respiratory allergic disease. Since environmental factors may have influences on the pathogenesis of allergic disease, the study using Korean house dust mites for immune and biologic reactions in house dust mite-sensitive allergic disease is considered as significant. MATERIAL AND METHOD: We made two in-house allergenic extracts of Korean house dust mites (D. farinae and D. pteronpsssinus) and performed this study for the allergen standardization by in vivo methods and for the evaluation of the reliabilities for clinical applications. RESULT: As a results of biologic standardization using skin prick test teachnique, the activity of 1: 1,500w/v of D. farinae extract was estimated 1,000 biology unit(BU), concentration that elicits a wheal of the same size as that of histamine dihydrochloride 1mg/ml. The activity of 1: 1,000w/v of D. pteronyssinus was condiered as 1,000BU. The activity of 1:100w/v of both D. farinae and D. pteronpssiuns extracts were considered as 100,000 Allergy Unit(AU), based on intradermal skin testing of 30 subjects with strong sensitive reaction. The concordant rates between results of skin prick test done with 5,000BU/ml concentration of in-house allergenic extracts and thoae with the commercially available allergen(Bencard Co., UK) were 84.6% and 81.0% for D. farinae and D. pteronpssinus, respectively. The wheal erythema size and A/H ratios induced by in-house extracts were significantly correlated with those induced by Bencard allergen. CONCLUSION: This results suggest that in-house extracts of the whole bodies of two house dust mites have good allergenic activities in vivo. It is considered to be clinically useful and reliable allergenic extracts.
Allergens ; Biology ; Dust* ; Erythema ; Histamine ; Hypersensitivity ; Pyroglyphidae* ; Skin ; Skin Tests

OBJECTIVE: The aim of this study was to investigate the usefulness of serum ECP as a marker of the severity of asthma and extent of airway inflammation. METHOD: We investigated 108 patients suffering from bronchial asthma, who were classified as mild intermittent(n=19), mild persistent(n=27), moderate persistent(n=42), and severe persistent(n=20) and 10 healthy controls. Atopy was defined as those who showed >2+ responses on skin prick test. Serum ECP, peripheral blood eosinophil, sputum eosinophil, and PEFR were measured on the same date and meth~acholine PC20 were determined within 2 weeks. RESULTS: Serum ECP levels were 10.1+- 2.0 ug/L in controls, and 29.1+- 23.6 ug/L in asthmatic patients. According to symptom severity, serum ECP levels were 22.9 +- 15.6 ug/L, 28. 6 +- 24.1 ug/L, 29.5 +- 22.2 ug/L, and 34.6 +- 31.2 ug/L in mild intermittent, mild persistent, moderate persistent and severe persistent asthmatic patients, respectively and there were no significant differences among four groups(p>0.05). Serum ECP levels correlated with peripheral blood eosinophil counts(r=0.48, p<0.01), but not with sputum eosinophil, PEFR, and methacholine PC20 levels. There was no significant difference in serum ECP level between atopic and non-atopic asthma(p>0.05). CONCLUSION: Single measurevment of ECP level at clinic could not represent the severity of asthma.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Humans ; Inflammation ; Methacholine Chloride ; Peak Expiratory Flow Rate ; Skin ; Sputum

In this study, clinical effectiveness of Pharmacia CAP system for determination of allergen specific IgE was evaluated depending on the results of Bencard skin prick tests in 100 atopic and 18 nonatopic asthmatics. The Pharmacia CAP specific IgE positive rates were higher as the SPT grades were increased : negative (n=623) (17.8%); + (n=81) (34.6%); 2+ (n=223) (56.5%); 3+ (n=106) (70.8%); and 4+/-< (n=127)3+ (92.1%), respectively. The overall concordant rate between Bencard SPT and Pharmacia CAP system was 81.7% with range of 70.7~92.1%. The Overall sensitivity of Pharmacia CAP system was 80.7%. The sensitivities for 10 allergens, which ranged from 57.5% to 100 %, were as followed; D.pteronyssinus (96.1%), D.farinae (96.7%), cat dander (61.5%), cockroach (65.2%), Aspergillus fumigatus (57.1%), ragweed (62.5%), mugwort (75.0%), Meadow fescue (100%), birch (62.4%), and oak (80.0%), respectively. Overall specificity of Pharmacia CAP system was 82.2%. The specificity of CAP system in nonatopic subjects (n=18, 160 test) was 94.4% which was quite different with the 77.6% of atopic subjects (n=100, 463 test). SPT A/H ratios were significantly correlated with Pharmacia CAP specific IgE concentration (KU/L) in D.pteronyssinus (r=0.520, p<0.001), D.farinae (r=0.490, p<0.001), A.fumigatus (r=0.315, p<0.01), mugwort (r=0.210, p<0.05), ragweed (r=0.213, p<0.05), birch (r=0.232, p<0.05), M.fescue (r=0.410, p<0.001). But, in cockroach (r=0.192, p<0.1), cat dander and oak pollen, SPT A/H ratios were not correlated with the concentration of specific IgE. These results suggest that Pharmacia CAP system is useful for etiologic evaluation of immediate hypersensitivity and quantitative evaluation of specific IgE in atopic asthma.
Allergens ; Ambrosia ; Animals ; Artemisia ; Aspergillus fumigatus ; Asthma* ; Betula ; Cats ; Cockroaches ; Dander ; Evaluation Studies as Topic ; Hypersensitivity, Immediate ; Immunoglobulin E* ; Pollen ; Sensitivity and Specificity ; Skin

OBJECTIVE: We evaluated the clinical implications of serum ECP and peripheral blood eosinophil counts as indices of airway inflammation during the follow-up of asthmatics (BA). METHODS: We repeatedly measured the serum ECP, peripheral blood eosinophil counts and peak expiratory low rate (PFR) during the follow up of 24 symptomatic BA. RESULTS: Mean serum ECP level of BA at uncontrolled status of airflow limitation was significantly higher than that of controlled state (24.5i3.7 ng/ml rs. 16.2+1.9 ng/ml, p<0.05) and the ECP levels of controlled and uncontrolled status were significantly higher than that of health control subjects (n=10, 10.1+/-2.0 ng/ml, p<0.01 respectively). Pe ripheral blood eosinophils were also significantly increased in uncontrolled status than in controlled status of BA (535.7+/-81.0/1tL vs. 300.4+33.4/micro liter, p < 0.05). In controlled status, 8 BA had higher circulating ECP levels than in uncontrolled status, but with peripheral blood eosinophil counts, only 3 BA had higher levels in controlled status than in uncontrolled status. Variations of PFR correlated with the variations of serum ECP level (r=-0.5370, p<0.01) and variations of peripheral blood eosinophil count (r=-0.6215, p<0.001). CONCLUSION: Measurement of serum ECP and peripheral blood eosinophil count would be useful tools for monitoring the disease activity of asthma, but we could not obtain any more informations from the measureinert of serum ECP levels than from the peripheral blood eosinophil counts.
Asthma* ; Eosinophil Cationic Protein* ; Eosinophils* ; Follow-Up Studies ; Humans ; Inflammation

To study the immediate effects of high-dose intravenous methylprednisolone pulse therapy on the immune mechanisms in the absence of other immunosuppressive agents, we treated ten patients with active systemic lupus erythematosus, six with renal and three with central nervous system involvement with three daily 1 gram intravenous doses of methylprednisolone and measured the immune response before and just after discontinuation of the drugs. After the treatment, the mean seum IgG, IgA and IgM levels were essentially unchanged. Likewise, serum C3 and C4 levels were not changed significantly. In nine of ten patients, methylprednisolone pulse therapy reduced the levels of circulating immune complexes (p < 0.05). Thus the immediate clinical improvements with methylprednisolone pulse therapy are suggested to be the result of depression of the circulating immune complex levels.
Adolescent ; Adult ; Antigen-Antibody Complex/*analysis ; Case Report ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Human ; Immunoglobulins/*analysis ; Infusions, Intravenous ; Lupus Erythematosus, Systemic/*drug therapy/immunology ; Male ; Methylprednisolone/*administration and dosage ; Support, Non-U.S. Gov't

BACKGROUND: Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway resposiveness to a variety of stimuli. METHOD: Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of 'Global initiative for asthma, Global strategy for asthma management and prevention' (NHLBI/UNO) with PFR(%) larger than 8055, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/HNO, group 5 (long term control group). patients who were controlled for more than 2 years by step 1 or 2 treatment of NHHI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC2O and Peripheral blood eosinophil counts pulmonary function test steroid doses and aggrevation numbers after treatment. RESULTS: On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and Initial pulmonary function was better. The long term control group required 1ower amounts of oral steroid, had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control. Atopy, allergic skin tests sputum and blood eosinophil, total IgE, nonspecific bronchial resposiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was 20.3α9.7 months and relapse did not occur. CONCLUSION: Patients who had asthma of onset age younger, shorter symptom duration better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.
Adult ; Age of Onset ; Aspirin ; Asthma* ; Cough ; Eosinophils ; Follow-Up Studies* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Methacholine Chloride ; Recurrence ; Respiratory Function Tests ; Respiratory Sounds ; Rhinitis ; Skin Tests ; Smoke ; Smoking ; Sputum ; Thorax

The relationship of stress perception and frequency of stressors with serum total Ig E level was investigated in 54 outpatients with bronchial asthma. The GARS (global assessment of recent stress) scale and SRRS (social readjustment rating scale) were used to measure the degree of stress perception and frequency of stressors during a one-year period Total serum Ig E was measured by the PRIST method. 56% of the patients were found to have psychosomatic disorders, but there was no significant difference in stress perception and frequency of stressors between psychosomatic and non-psychosomatic groups. A considerable number of patients (63%) rated their symptoms as severe, but no significant correlation was found between severity of symptoms and stress perception. Severity of stress perception and frequency of stressors did not correlate with serum total Ig E level. Multiple regression analysis revealed that female patients were significantly higher in stress perception than male ones, and that chronicity of illness was more likely to increase stress perception. Extrinsic asthmatics had significantly more negative stressors than intrinsic ones. In conclusion, serum Ig E is considered a stable indicator of allergy not influenced by stress. It was also indicated that patients with bronchial asthma were more likely to perceive physical symptoms than psychological stress.
Adolescent ; Adult ; Asthma/*blood/*psychology ; Female ; Human ; Immunoglobulin E/*blood ; Male ; Middle Age ; Stress/*blood ; Support, Non-U.S. Gov'