Acute eosinophilic pneumonia(AEP) is one of uncommon causes of fatal respiratory failure. Since first reported in 1979, AEP is considered as different disease entity from chronic eosinophilic pneumonia. Recently, consensus is evolving in regard to diagnostic criteria. We experienced a 21-year old male patient presenting typical clinical and radiological characteristics of AEP. Bronchoalveolar lavage showed eosinophilia and transbronchial lung biopsy revealed infiltration of eosinophils and lymphocytes in interstitium and alveoli. This patient completely recovered within three weeks without corticosteroid. We report this case with brief review of literature.
Biopsy ; Bronchoalveolar Lavage ; Consensus ; Eosinophilia ; Eosinophils* ; Humans ; Lung ; Lymphocytes ; Male ; Pulmonary Eosinophilia* ; Respiratory Insufficiency ; Young Adult

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

BACKGROUND: Eosinophils are suggested to play a deleterious role in the inflammatory disease of the respiratory mucosa by releasing granule substances such as major basic prorein and eosinophil cationic protein. To investigate the contribution of eosinophils in the pathogenesis of nasal polyps and the mechanism of their accumulation and activation, we observed the eosinophil inhllration and expression of endotjelial and epithelial cell adhesion molecules in the nasal polyp tissues. MATERIALS AND METHODS: Polyp and inferior turbinate mueosal specimens (polyp group) taken out of 20 patients and 10 inferior turbinate mucosa specimens of non-allergic and non-infectious controls (control group) were immunohistochemically stained using EG1, EG2, and mAb for the ICAM-1, VCAM-1 and E-seleetin. The number of EG1 (+) and EG2 (+) cells within lmm2 of tissue and the expression of ICAM-1, VCAM-1 and E-seleetin on the vessels (% of total vessel) and epithelial eelis (area x intensity) were compared among three groups. RESULTS:The inferior turbinate mucosae of nasal polyp patients .were infiltrated by signifieantly higher number of eosinophils (EG1:17, EG2:16/mm2) compared with those of controls (EGi:0, EG2:0/mm2) (p<0.05), and the polyp tissue revealed much more eosinophils (EG1: 213, EG2:154/mm2) than inferior turbinates of same patients and those of controls (p<0.001). ICAM-1 expression in the vessels was frequenly observed both in polyps and in the turbinate mucosae with significant difference (median:85% vs. 67%, p<0.05), and ICAM-1 expression in the epithelial ceils was significantly different between the polyp and turbinate groups (median:9 vs. 2.5, p<0. 01). VCAM-1 was moderately expressed on the vessels of both polyps and turbinate mucosac (median:37%, 14%, respectively) and their expressions were significantly different (p<0.01). E-selectin expression was moderate to low both in the polyps and in the turbinate mucosae (median:18%, 10% respectively) and their expressions were not significantly different (p>0.05). CONCLUSION: Most of the eosinophils infiltrated into nasal tissue as well as nasal polyps were activated forms and they were significantly increased in the nasal polyps compared to the inferior turbinate mueosae of the same patients and control subjects. Significantly increased expression of ICAM-1 and VCAM-1 on the vessels and increased epithelial ICAM-1 expression in the nasal polyps indicate that interactions of eosinophils with ICAM-1 and VCAM-1 participate in the pathogenesis of nasal polyps.
E-Selectin ; Eosinophil Cationic Protein ; Eosinophils* ; Epithelial Cells ; Humans ; Intercellular Adhesion Molecule-1 ; Mucous Membrane ; Nasal Polyps* ; Polyps ; Respiratory Mucosa ; Turbinates ; Vascular Cell Adhesion Molecule-1

Occupational asthma has been defined airway inflammation, hyperresponsiveness, and reversible airway obstruction related to exposure in workplace. Several drugs can cause asthma by inhalation during the manufacture. We report a case of cephalosporin induced occupational asthma which had not been reported in Korea yet. A 28 year-old male, an laboratorian, developed paroxysmal cough, dyspnea and chest tightness for four months. He has handled powder of cephalosporins and its precursors for thirty months. His symptoms used to be worsened during and shortly after his work and subsided several hours after work. When he visited our hospital, he denied such symptoms and revealed no abnormality on physical examinations. Skin prick test revealed positive result for ceftriaxone, ACT and 7-ACA, but negative for the other antibiotics. Bronchial provocation with 7-aminocephalosporanic acid elicited a single early response. In this case, the patient showed a positive bronchial provocation test to 7-aminocephalosporanic acid and a positive skin prick test to 7-ACA, aminocephalosporanic thiazine, ceftriaxone. We presumed that pathogenic mechanism of cephalosporin-induced asthma may be an IgE-mediated allergic reaction by the strong positive reaction in skin test. But further studies will be necessary to evaluate exact pathogenesis of cephalosporin-induced asthma.
Adult ; Airway Obstruction ; Anti-Bacterial Agents ; Asthma ; Asthma, Occupational* ; Bronchial Provocation Tests ; Ceftriaxone ; Cephalosporins ; Cough ; Dyspnea ; Humans ; Hypersensitivity ; Inflammation ; Inhalation ; Korea ; Male ; Physical Examination ; Skin ; Skin Tests ; Thorax

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal bronchial wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. Its incidence ranges from 0.1 to 5%. This anomaly is usually diagnosed incidentally during bronchoscopy or bronchography in patients with various respiratory problems. Tracheal bronchus may be associated with other bronchopulmonary anomalies such as tracheal stenosis, pulmonary agenesis, pulmonary sequestration, abnormal lobulation, and Down's syndrome. In patients without specific clinical symptoms, a incidentally diagnosed tracheal bronchus does not require any treatment. We report a case of 59-year-old man incidentally detected accessory tracheal bronchus associated with bronchial asthma with review of literatures.
Asthma* ; Bronchi* ; Bronchography ; Bronchopulmonary Sequestration ; Bronchoscopy ; Down Syndrome ; Humans ; Incidence ; Middle Aged ; Tracheal Stenosis

Results from two in vitro assays, Pharmacia CAP system(CAP) and fluoroallergosorbent test(FAST), for detecting serum specific IgE to three allergens, mugwort, Derraatophagoides pteronyssinus, and eat epithelium, were compared with skin prick test(SPT) results in 53 atopie dermatitis patients with positive SPT and 25 non-atopic controls. Using SPT results as the reference standards, CAP achieved higher sensitivity than FAST in determination of three allergens. CAP for measuring total IgE and eosinophil cationic protein(ECP) was also compared with FAST and ECP radioimmunoassay(RIA), respectively. In comparison of two assays for total serum IgE, the values obtained with CAP were significantly higher than those with FAST. In comparison of CAP and RIA for measuring ECP, the values obrained with CAP were significantly higher than those with RIA and the differences between ECP values of two assays were significant in high ECP group(>8.3 micro gram/1). These results suggest that CAP is the preferred test and seems to be more appropriate method for detection of specific IgE and ECP in patients with allergic digeases.
Allergens ; Artemisia ; Dermatitis ; Eosinophil Cationic Protein* ; Eosinophils* ; Epithelium ; Humans ; Immunoglobulin E ; Radioimmunoassay* ; Skin

A controlled study was carried out in 50 patients with perennial bronchial asthma to assess the efficacy and safety of budesonide turbuhaler. Subjects have suffered from cough, wheezing, dyspnea and chest tightness and showed either 15% of reversibility in FEV after bronchodilator inhalation or airway hyperresponsiveness to methacholine(PC20 < or = 25mg/ml.) Patients were randomized to treatment with budesonide turbuhaler or terbutaline turbuhaler for 8 weeks after 2 weeks of run-in period. Budesonide turbuhaler was effective for cough, wheezing, dyspnea and chest tightness. It improved peak expiratory flow rate and FEV1. Budesonide turbuhaler was tolerated well and the laboratory tests showed no abnormality. It is suggested that budesonide turbuhaler is effective and safe in the management of bronchial asthma.
Asthma ; Budesonide* ; Cough ; Dyspnea ; Humans ; Inhalation ; Peak Expiratory Flow Rate ; Respiratory Sounds ; Terbutaline ; Thorax

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

To evaulate the possible pathogenetic significance of allergen-specific IgA antibody in respiratory secretion from asthmatics, we measured house dust mite(HDM)-specific IgA antibody in 3% saline-induced sputum from 23 HDM-sensitive asthmatics, 4 atopic asthmatics without mite-sensitivity, 6 non-atopic asthmatics, and 13 non-atopic, non-asthmatic controls (including 6 non-atopic healthy controls, 4 patients with chronic bronchitis, and 3 patients with rheumatoid arthritis) by ELISA. We also measured HDM-specific IgA antibody in serum and numbers of eosinophils in sputum. 1) Levels of HDM-specific IgA antibody in sputum from mite-sensitive asthmatics were significantly higher than those from non-atopic, non-asthmatic controls and non-atopic asthmatics(p<0.05). Levels of HDM-specific IgA antibody in sputum from atopic asthmatics without mite-sensitivity were significantly higher than those from non-atopic, non-asthmatic controls (p<0.05), however HDM-specific IgA/albumin raito was not significantly different between two groups (p>0.05). 2) The ratio of HDM-specific IgA antibody to albumin in sputum was not significantly different in mite-sensitive asthmatics with sputum eosinophila (> or = 5% of 200 counted leukocytes) and those without sputum eosinophilia (p>0.05). 3) The ratio of HDM-specific IgA to albumin in sputum from asthmatics was higher than that of serum. 4) There was no significant correlation of HDM-specific IgA/albumin ratios between serum and sputum (p>0.05). 5) When comparing sputum and saliva samples from 7 mite-sensitive asthmatics, levels of HDM-specific IgA antibody in sputum were significantly higher than those in saliva (p<0.05). In conclusion, HDM-specific IgA anti-body was increased in sputum from HDM-sensitive asthmatics, and it might be locally produced from bronchial mucosa. To evlauate the pathogenetic significance of allergen-specific IgA antibody in respiratory secretion from asthmatics, further studies might be needed.
Bronchitis, Chronic ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin A* ; Mucous Membrane ; Saliva ; Sputum*

We have studied male patients with cosmetic allergy in patch test during 5 years from September, 1982 to August, 1986 (Group A) and during 7 1/2 years from March, 1988 to August, 1995 (Group B). The results are as follows. 1. In Group A, 7 patients were diagnosed as contact allergy due to cosmetics. In Group 13, 30 patients were diagnosed as contact allergy to cosmetics. 2. Sixteen patients were positive to only cosmetic related allergens. Two patients were positive to only their own cosmetic products. Nineteen patients were positive to both cosmetic related allergens and their own cosmetic products. 3. The age of patients with cosmetic allergy ranged from 10 to 70 years with a peak in the fifties. The patients more than 50 years were about 40% of all patients. 4. The most frequently, affected area was face(n=31) followed by neck(n=6) and scalp (n = 6 ). 5. Twenty four patients with cosmetic allergy had eczematous skin lesions. Thirteen patients had pigmented skin lesions and pigmented contact dermatitis was suspected. Two out of 13 patients with pig men ted skin lesions were positive in photopatch test. 6. Cosmetic related allergens showing frequent positive reactions were paraphenylene-aliamine, fragnance mix, balsam of Peru, benzyl salicylate, amerchol L101, oakmoss absolute, musk muskene. 7. Cosmetic products showing frequent positive reactions were skin care products, hair dye, soap, after shave lotion, shampoo and toothpaste. In conclusion, cosmetic allergy in men seems to increase in our society.
Allergens ; Dermatitis, Contact ; Hair ; Humans ; Hypersensitivity* ; Male* ; Patch Tests ; Peru ; Scalp ; Skin ; Skin Care ; Soaps ; Toothpastes