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Biomedical subjects

J N Fink

Publications and source records attributed to J N Fink.

At least 145 records · Page 8Linked to original sources
PubMed1982

Evaluation of the patient for occupational immunologic lung disease.

Careful evaluation of the worker patient is essential to detect occupational immunologic disease (OILD) and to define the source of the illness. The history is essential, especially in view of the temporal relationships between symptoms and exposure: the presence of variable latent periods between exposure and symptoms must be considered. Once OILD is suspected, additional evaluation is of value. Physical examination may be normal or may detect features of asthma or interstitial disease, depending on the stage of the illness. Chest x-ray evaluation may also reflect the type and stage of illness. Serologic studies may detect precipitating antibodies against environmental antigens. Skin tests with common antigens are useful in detecting an atopic background. Environmental studies may reveal particular antigens in the form of fungi, thermophilic actinomycetes, or chemicals that are volatile, soluble, or could be aerosolized. Pulmonary function studies before and after the work shift or after a period of avoidance may provide clues as to the environmental nature of the illness. Bronchopulmonary challenge with occupational environmental materials may be valuable in obtaining a definitive diagnosis. Therapy of OILD depends on the worker's response, degree of illness, and feasibility of avoidance of protection.

Bronchial Provocation Tests↗
PubMed1982

Elevation of serum chemotactic factor inactivator activity during acute inflammatory reactions in patients with hypersensitivity pneumonitis.

Inflammatory mediators such as the vasoactive and chemotactic factors derived from the activation of the complement system are extremely potent biological peptides that are under rigid control of specific serum-derived regulators, e.g., the anaphylatoxin inactivator (AI) and the chemotactic factor inactivator (CFI). We have previously demonstrated that serum chemotactic factor inactivator concentrations are altered during chronic inflammatory states; here we demonstrate that a rapid elevation of serum CFI activity occurs during acute inflammatory reactions in patients suffering from hypersensitivity pneumonitis. Specifically, serum CFI concentrations were evaluated in patients with hypersensitivity pneumonitis (pigeon breeder's disease) and control subjects (asymptomatic) after aerosol challenge with 2 ml of sterile pigeon serum. At 4 h postchallenge, serum CFI concentrations in the patients with hypersensitivity pneumonitis increased rapidly to 3 times the prechallenge serum concentrations. Asymptomatic (control) subjects showed no increase in serum CFI concentrations after exposure to pigeon serum. In independent studies, we have also demonstrated that serum CFI concentrations are elevated in (1) rabbits with glycogen-induced peritonitis, (2) rabbits after intravenous infusion of C5-derived chemotactic factors, and (3) patients undergoing hemodialysis. These combined data clearly demonstrate that serum CFI activity is rapidly elevated during acute inflammatory reactions within both patient and animal populations, and suggest that serum CFI may represent a "hyperacute" phase reactant that is elevated during inflammation. Possibly, this elevation of CFI may be induced in response to inflammatory mediators produced during inflammation. Thus, the acute elevation of serum CFI concentrations that occurs during acute inflammation may represent the control system that would be responsive to the regulatory needs of the body during inflammatory reactions.

Alveolitis, Extrinsic Allergic↗
PubMed1981

Streptomyces albus: a new cause of hypersensitivity pneumonitis.

Hypersensitivity pneumonitis is an immunologic lung disease known to be induced by the inhalation of either organic or inorganic antigens, and it may thus be associated with a variety of occupations and microorganisms. To identify an inciting allergen, environmental, bacteriologic, immunologic, and bronchial challenge studies must be employed. These techniques were used to demonstrate that a bacterium uniformly present in processed dirt, Streptomyces albus, was responsible for a biopsy-proven case of hypersensitivity pneumonitis.

Adult↗
PubMed1981

Allergic bronchopulmonary aspergillosis in corticosteroid-dependent asthmatics.

Forty-two corticosteroid-dependent asthmatics were studied to determine whether their underlying disease might be allergic bronchopulmonary aspergillosis (ABPA). The clinical and laboratory characteristics studied included age, sex, atopic status, mean corticosteroid doses, skin tests to Aspergillus fumigatus (Af), precipitins to Af, total serum IgE, and chest roentgenograms. Twelve patients had four or more of the seven primary criteria used and were considered as the ABPA suspect group. Further studies identified three patients who were considered to have definite ABPA and an additional three patients with probable ABPA. This study suggests that previously undiagnosed ABPA can be detected in populations of corticosteroid dependent asthmatics. Corticosteroid therapy may mask ABPA, and serial evaluations of these patients may be of value in detecting additional cases of the disease.

Adolescent↗
PubMed1981

Hypersensitivity lung disease presumptively due to Cephalosporium in homes contaminated by sewage flooding or by humidifier water.

Two cases of hypersensitivity lung disease apparently caused by home environment contamination with Cephalosporium have been identified. In one case repeated flooding of the home with sewer water appeared to be important in maintaining an environment contaminated with Cephalosporium, and in the other case a contaminated humidifier appeared to be the source. Both patients had chronic respiratory symptoms remitting during absence from the home, and both presented problems in diagnosis. In both cases cultures of the home environment or humidifier and serum antibody studies indicated Cephalosporium as the antigenic source responsible for the airway disease. An inhalation challenge in one case was positive, adding further evidence for Cephalosporium as the antigenic source and etiologic agent. In both cases complete remission followed moving from the home. Cephalosporium is reported as an apparent antigenic source for home contamination resulting in significant chronic pulmonary morbidity.

Acremonium↗
PubMed1981

Rinkel injection therapy: a multicenter controlled study.

The American Academy of Allergy sponsored a 2-yr "double blind" multicenter study of the effect of Rinkel injection therapy (RIT) compared with a histamine placebo in subjects with atopic rhinitis. Accumulated data included the symptom, medication, and physical examination scores and specific IgE antibody levels measured by the radioallergosorbent test (RAST). A total of 155 subjects (81 treated, 74 placebo) entered the project from six centers during their respective ragweed, grass, and mountain cedar pollen (from one center) seasons for a total of 11 pollen seasons. The total mean cumulative dose of extract was 18.6 PNU, which is much lower than recommended for standard immunotherapy. With one exception, none of the centers reported a consistent significant difference between the pollen extract-treated and placebo-treated groups in any of the weekly mean scores or the RAST before, during, and after the pollen seasons. For 4 wk after the height of the mountain cedar season the group treated with pollen extract showed a significant decrease in weekly mean symptom and medication scores as compared with the placebo group. The overall comparison of the mean seasonal scores for the entire study, however, showed no significant difference between the treated and placebo groups. We conclude the RIT is no more effective than a histamine placebo in influencing the weekly mean symptom, medication, and physical examination scores or IgE antibody levels.

Adolescent↗
PubMed1981

Characterization of Micropolyspora faeni antigens.

Culture filtrate antigens of Micropolyspora faeni grown in a synthetic medium in a stirred fermentor were characterized. The culture filtrate antigens were fractionated by preparative isoelectric focusing with a pH gradient of 3.5 to 5.5. The fractions were pooled according to their reaction with rabbit anti-M. faeni sera. A pool containing two major antigens which were resolved by analytical isoelectric focusing and polyacrylamide disc gel electrophoresis was obtained. One antigen was stainable with Coomassie blue and periodic acid-Schiff stain and was determined to have a mass of 51,000 daltons. The other antigen was stainable only with Coomassie blue and was determined to have a mass of 29,000 daltons. When used at 1 mg/ml, this pool reacted with the sera from all patients with farmer's lung disease by immunodiffusion but failed to react with control sera.

Antigens, Bacterial↗
PubMed1981

Serum angiotensin-converting enzyme levels in patients with pigeon-breeder's disease.

The serum concentration of angiotensin-converting enzyme is frequently elevated in individuals with active sarcoidosis. The enzyme is presumably actively synthesized by the epithelioid and giant cells of the granuloma. Hypersensitivity pneumonitis, resulting from the inhalation of antigens from pigeons by susceptible individuals, is associated with the development of a granulomatous interstitial and alveolar infiltrate in the pulmonary parenchyma. Because the clinical and pathologic presentation may mimic that of sarcoidosis, we compared the serum levels of angiotensin-converting enzyme in these two diseases. The concentration of angiotensin-converting enzyme is not elevated in individuals with active hypersensitivity pneumonitis, in contrast to its frequent elevation in sarcoidosis. We suggest that the granulomatous response in hypersensitivity pneumonitis may differ at a biochemical level from that of sarcoidosis, since the synthesis of angiotensin-converting enzyme does not appear to be increased.

Allergens↗
PubMed1981

A genetic defect of granulocyte oxidative metabolism in a man with disseminated aspergillosis.

A 26-year-old man presented with progressive pneumonia, and Aspergillus was grown from cultures of lung, cutaneous nodules, and urine. His PMNs had a poor CL response after exposure to phagocytic stimuli (S. aureus, latex, aggregated IgG and IgG-coated latex) (p less than 0.01 vs. controls) and soluble stimuli (PMA, sodium fluoride, and Con A) (p less than 0.05). His PMNs failed to reduce NBT, oxidize 14C-1 glucose (p less than 0.001), or iodinate proteins (p less than 0.001), normally, compared with controls, and his PMNs killed Candida albicans and Staphylococcus aureus abnormally (p less than 0.05). The patient was anergic; his plasma inhibited responsiveness of his lymphocytes to stimulation with Aspergillus and Candida antigens. His lymphocytes failed to produce the lymphokine LMIF normally. The patient's 10-month-old daughter was demonstrated to have the same defects of PMN metabolism and function. The findings in this patient were similar to those in CGd, but transmission of the defect from father to daughter and the presence of lymphocyte abnormalities make this diagnosis unlikely. Inhalation of Aspergillus by patients with defective PMN oxidative metabolism may be associated with development of significant infection.

Adult↗
PubMed1981

Antigens of aspergillus fumigatus. 1. Purification of a cytoplasmic antigen reactive with sera of patients with aspergillus-related disease.

An antigen has been purified from the mycelial cell sap of Aspergillus fumigatus (strain 507). The same component appears to be present in the extracellular phase (culture filtrate) in a partially degraded form. The cell sap protein has a structure composed of four polypeptides of 45,000 daltons linked through disulphide bonds. The isoelectric point (5.2-5.6) and carbohydrate content (12.5% neutral hexose) indicate that this protein is an acidic glycoprotein. It shows reactions with 75% of sera from patients with aspergilloma and allergic bronchopulmonary aspergillosis and is not reactive with sera from normal individuals of patients with other fungal diseases. It also appears to be a component of other A. fumigatus strains.

Antigens, Fungal↗
PubMed1980

Prevalence of precipitins in groups at risk of developing hypersensitivity pneumonitis.

A study was made of the prevalence of serum precipitins to Micropolyspora faeni, Thermoactinomyces vulgaris, Aspergillus fumigatus, and pigeon serum in population groups suspected to be at high risk for the development of hypersensitivity pneumonitis. Pigeon breeders' sera contained precipitins mainly to pigeon serum (38%) and A. fumigatus (18%). Occupants of homes in which forced air heating systems were investigated for the presence of microorganisms reacted mostly with M. faeni (13%) and A. fumigatus (8%). Individuals from environments where several cases of hypersensitivity pneumonitis were discovered reacted largely with M. faeni (28%) and T. vulgaris (21%). Sera supplied by physicians from patients with respiratory symptoms reacted primarily to A. fumigatus (24%) and to a lesser extent to M. faeni (16%) and T. vulgaris (9%). The results indicate that the prevalence of precipitins to the tested antigens is not uniform and may be influenced by the environment. Furthermore, the prevalence of precipitins in groups at risk is greater than previously reported for the normal population.

Alveolitis, Extrinsic Allergic↗
PubMed1980

Skin test reactivity to dog-derived antigens.

Skin test reactivity to canine antigens was studied by testing atopic patients and veterinarians using a commercially prepared mixed-dog epithelial antigen and breed-specific antigens including dander extracts, serum and urine, obtained from thirty-one different pure-bred dogs. Increased skin test reactivity was noted using breed-specific antigens as compared to the mixed-dog commercial screening extract. Variation in skin test responsivity related to specific breed antigens was also noted. The results suggest that skin tests using canine urine and serum antigens, in addition to the conventional dander antigens, may be useful in the diagnosis of hypersensitivity to dogs.

Animals↗