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Biomedical subjects

G Hillerdal

Publications and source records attributed to G Hillerdal.

At least 73 records · Page 4Linked to original sources
PubMed1988

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids.

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.

Actinomycetales Infections↗
PubMed1988

Phenotypes of peripheral blood lymphoid cells in patients with asbestos-related pleural lesions.

Asbestos-related parietal pleural plaques develop slowly and are of little clinical significance. Other asbestos-related pleural reactions, for example acute exudative pleurisy and progressive pleural fibrosis, are of clinical importance. The pathogenesis of these reactions is unknown, but one hypothesis is that immunological disturbances are involved. To investigate this hypothesis a phenotypic characterization of lymphoid cells was performed in the peripheral blood of 45 patients with asbestos-related pleural lesions; 20 with pleural plaques (PP), 15 with diffuse pleural fibrosis (DPF), and 10 with benign asbestos pleural effusion (BAPE). Twenty-four healthy blood donors were used as controls. All asbestos groups together had a significantly higher percentage of B-cells than the controls. The percentage number of "helper/inducer" T-cells was significantly lower in the BAPE and DPF groups than in the control and PP groups. Thus, significant aberrations in peripheral blood lymphoid cells were found in patients with DPF and BAPE. This differed from patients with PP only who were similar to normals.

Aged↗
PubMed1987

Byssinosis in carpet weavers exposed to wool contaminated with endotoxin.

All the 303 full time day workers in a carpet weaving factory were submitted to a physical examination, chest radiography, and vitalograph test, and answered a respiratory questionnaire. Fifty four healthy non-exposed subjects served as controls. Dust concentrations and concentrations of bacterial endotoxin were measured. Of the 303 workers, 259 (85.5%) had airway symptoms and 62 (20.5%) had maximum mid-expiratory flow (MMF) values of less than 60% compared with 9.2% of the controls. The symptoms in 68 workers (22%) were compatible with byssinosis and 36 of these workers underwent vitalography before starting work and after four hours work on Mondays when significant reductions of their FEV1 and MMF were found. Twenty one of these 36 workers were tested on Tuesday and no differences in these measurements were found between measurements before work started and four hours later. The airborne dust concentrations in the factory were high and bacterial endotoxin was found. These findings suggest that a large number of workers in this carpet weaving factory suffer from a disease indistinguishable from byssinosis even though wool is used almost exclusively, the only cotton being the warp. The finding of endotoxin together with the absence of cotton confirms the theory that "byssinosis" is due to bacterial endotoxin rather than to cotton per se.

Adult↗
PubMed1987

Benign asbestos pleural effusion: 73 exudates in 60 patients.

All patients seen in 1975 to 1984 with benign asbestos pleural effusion (BAPE) were studied. In all, 73 exudates occurred in 60 patients, 40 on the left side and 33 on the right. Relapses occurred on the same side in two patients; 11 had bilateral exudates, three of them concomitantly, in the other patients with a free interval of 1-15 years. The mean latency time from the first exposure to asbestos was 30 years, with a range of 1 to 58 years. The effusions lasted from 1 to 10 months, with a median of 3 months. The most common symptoms were pain, fever, cough, and/or dyspnoea; however, 46% of the episodes were symptomless. The total number of thoracocenteses was 66, with removal of 50 to 2000 ml (mean 460) each time. Fifty-three per cent of the pleural fluids were macroscopically haemorrhagic and 26% eosinophilic. Two findings contribute to a better understanding of the entity: first, even a comparatively slight occupational exposure can be sufficient; secondly, BAPE can occur many years after exposure to asbestos, and not only in the first one or two decades.

Asbestos↗
PubMed1986

Pulmonary involvement in ankylosing spondylitis.

Thirty two patients with ankylosing spondylitis were investigated with a set of pulmonary function tests and the results compared with those for a control population. The patients had no complaints about lung symptoms and their chest radiographs were normal. The main pathological findings were reduced lung volumes, a raised closing volume/vital capacity ratio, and a decreased volumic airway conductance. The lung volume reduction correlated with disease duration, thoracic mobility, and degree of acute phase reaction. The stiff spondylitic thorax probably makes the main contribution to the impairment of lung function in these patients, but the findings in this study also suggest an involvement of the small airways. This type of pulmonary function testing seems valuable even in patients with ankylosing spondylitis without lung symptoms and it might be used as a tool in the staging of the disease, to evaluate treatment and to differentiate from fibrosis.

Adolescent↗
PubMed1986

Phenotypic characterisation of peripheral blood lymphoid cells in people exposed to fibrous zeolite.

Among inhabitants of the village of Karain in Turkey there is an extremely high incidence of malignant mesothelioma, most probably due to exposure to erionite, which is a fibrous zeolite and similar in appearance and properties to asbestos. This mineral may be found in the dust in the village. To characterise possible disturbances in the immune system of people exposed to fibrous zeolite, a phenotypic characterisation of lymphoid cells in the peripheral blood of 74 immigrants to Sweden from Karain was performed. Compared with normal controls, the mean percentages of Leu 4+ cells (Pan-T) and Leu 3a+ cells ("helper/inducer" T cells) were significantly decreased, whereas the mean percentage of Leu 2a+ cells ("suppressor/cytotoxic" T cells) was normal, leading to a significant reduction of the Leu 3a/Leu 2a subset ratio. The percentage of B cells (Leu 12+ cells) was significantly increased, whereas the percentages of both HLA-DR+ and HLA-DQ+ cells were normal. The percentage of natural killer cells (NK) and killer (K) cells as defined by the monoclonal anti-Leu 7 and anti-Leu 11b were also normal. These findings indicate that exposure to fibrous zeolite causes a numerical imbalance between the two phenotypically different T cell subsets similar to that seen in asbestos exposed individuals.

Adult↗
PubMed1986

Corynebacterium parvum in malignant pleural effusion. A randomized prospective study.

In a randomized trial, pleurodesis was attempted with Corynebacterium parvum in one group and bleomycin in another. Patients with malignant pleural effusion which required repeated drainage were treated with instillation of one of these agents after complete drainage of the pleural effusion. There were 32 patients who could be evaluated. Sixty-five per cent of the patients treated with C. parvum had no recurrence after one treatment and another 29% after two treatments. In the bleomycin group, two patients needed only one treatment while the remainder - 13 out of 15 patients - needed further drainage treatments even after two instillations of the drug. The difference was highly significant (p less than 0.001).

Adjuvants, Immunologic↗
PubMed1985

Malignant mesothelioma secondary to chronic inflammation and old scars. Two new cases and review of the literature.

Old scars of the pleura, for example from chronic empyema or therapeutic pneumothorax, can cause a malignant mesothelioma appearing some decades later. The authors describe two cases of primary pleural tumors, which probably had such an etiology. A literature review revealed 20 further cases, the majority of which were squamous cell carcinomas. Whether these tumors developed from metaplastic mesothelium or inplanted cells from the skin is not clear.

Aged↗
PubMed1985

Peritoneal mesothelioma and malignant lymphoma in mice caused by fibrous zeolite.

Dust from the village of Karain containing the fibrous zeolite erionite, talc, and physiological saline were tested by intraperitoneal injection in 486 Swiss albino mice. Malignant tumours were found in 84 (41 mesotheliomas, 31 lymphomas, 1 peripheral epidermoid carcinoma, and 11 lymphomas and mesotheliomas together) of the 321 animals which died spontaneously within nine to 32 months after injection of Karain dust (26.1%). Three mesotheliomas and no lymphomas were found among 24 animals injected in the same way with talc during the same time (12.5%). In 46 control animals injected with physiological saline three mesotheliomas and one lymphoma were seen (8.7%). Thus Karain dust appears to be a potent carcinogen, causing both mesotheliomas and malignant lymphomas.

Aluminum Silicates↗
PubMed1985

Adverse reaction to locally applied preservatives in nose drops.

A 33-year-old woman with documented hypersensitivity to acetylsalicylic acid (ASA) and preservatives, causing bronchial asthma and rhinitis when ingested, was investigated because of 'allergy to nose drops'. It was found that she had a serious local reaction caused by the preservative used in the nose drops prescribed. This reaction might occur more commonly than realized, since sensitivity towards ASA is fairly common in the general population.

Administration, Intranasal↗
PubMed1985

Chyliform (cholesterol) pleural effusion.

Chyliform pleural effusions are a little known occurrence only sparingly reported in the literature. At the lung department in Uppsala, Sweden, 11 cases have been seen the last few years. Typically, the exudate develops in a long-standing pleural thickening resulting from therapeutic pneumothorax many years earlier. The exudate contains a high level of cholesterol, probably breakdown products from blood cells. It is usually sterile, and only very rarely can one find tubercle bacilli growing from it. There is a tendency toward recurrence. If the patient benefits clinically from aspiration of the fluid, decortication is indicated.

Cholesterol↗
PubMed1985

Nonmalignant pleural disease related to asbestos exposure.

Asbestos and other mineral fibers are well known to cause pleural changes. These changes are of various types, the most common being pleural plaques, which are slowly growing and of little clinical importance. Other benign changes include asbestos pleurisies, rounded atelectases, and other pleuropulmonary changes.

Adult↗
PubMed1984

Laryngeal edema as the only symptom of hypersensitivity to salicylic acid and other substances.

Idiosyncrasy to salicylic acid and related substances is well known, the most common symptoms being asthma, rhinorrhea and urticaria. We here describe two cases whose only symptoms were hoarseness and in which inspection revealed laryngeal edema when the patients ingested any of these substances. In cases of chronic recurring hoarseness, a history should be taken with respect to such hypersensitivity and suspect cases should be challenged, since a strict diet may improve the symptoms.

Adult↗
PubMed1984

Asbestos related pleuropulmonary lesions and the erythrocyte sedimentation rate.

Asbestos related lesions of the lung parenchyma and the pleura can be divided into three main types: parietal pleural plaques, diffuse interstitial fibrosis ("classical asbestosis"), and a third type of reaction affecting both the pleura and the lung parenchyma. The last type includes such lesions as acute pleurisy, diffuse pleural thickening, and rounded atelectasis. Among 1344 patients with asbestos related pleural lesions, 1190 had pleural plaques, 29 of whom also had pulmonary fibrosis (asbestosis); 83 had unilateral sequelae of pleurisy, of whom nine had asbestosis; and 71 had bilateral sequelae of pleurisy, of whom 23 also suffered from asbestosis. The erythrocyte sedimentation rate (ESR) was measured in 184 patients--79 with pleural plaques, 44 with unilateral sequelae of pleurisy, and 61 with bilateral sequelae. In patients with pleural plaques with or without asbestosis the ESR was usually normal, the mean being 9.6 mm in one hour. Among patients with sequelae of pleurisy, however, many had a raised ESR. The mean ESR was 25.7 mm in one hour in those with bilateral changes and 13.2 in those with unilateral changes. Statistical analysis showed that in this group of subjects the presence of sequelae of pleurisy was a highly significant determining factor for the ESR (p less than 0.0001). Asbestosis alone was not a significant determining factor but there was a low grade of significance for the combined effect of asbestosis and sequelae of pleurisy (p less than 0.05). These findings suggest that the pathogenesis of the various changes is different.

Asbestos↗