Search PubMedSearch

Biomedical subjects

K Alanko

Publications and source records attributed to K Alanko.

13 recordsLinked to original sources

Suction blister fluid histamine in fixed drug eruption.

The histamine concentration was measured from suction blister fluid obtained from normal and lesional skin of 8 patients with fixed drug eruption (FDE) caused by phenazone salicylate and from that of 2 healthy control subjects. In blister fluid samples obtained before peroral challenge with phenazone salicylate, the histamine concentrations were below 5 nmol/l both in uninvolved skin and in sites of previous FDE lesion (sample 0). After challenge, samples were taken from the incipient reaction that was visible after an average of 155 min. Histamine levels were significantly elevated in the blister fluid of 2 out of 8 FDE lesions (200 and 640 nmol/l) but in none of the uninvolved skin (sample 1). Two hours later (sample 2) the histamine levels were elevated in both uninvolved (mean 51.4 nmol/l) and lesional skin (mean 168 nmol/l). After 24 h (sample 3) the corresponding mean value was 25.4 nmol/l for uninvolved skin and 108 nmol/l for lesional skin. The histamine values in the blister fluid from FDE lesions in samples 2 and 3 were significantly higher (p less than 0.05) than those in the control blisters of uninvolved skin. An elevation of histamine levels comparable to that in the uninvolved skin of FDE patients was seen in the 2 healthy control subjects studied. The present study provides direct evidence of early release of histamine from mast cells or basophils in FDE and suggests that histamine is one of the mediators of clinical symptoms of FDE.

Adolescent

Humidifier-associated extrinsic allergic alveolitis.

Three cases of allergic alveolitis due to indoor humdification systems are described. Thermoactinomyces vulgaris precipitins were detected in the serum of a 37-year-old female patient who had typical febrile attacks during exposure to cool-mist from a home humidifier. When the cause was detected and eliminated, the symptoms and signs disappeared and the woman's gas transfer factor improved from 56% to normal within six months. In a printing office a 60-year-old woman had had febrile attacks with cough for more than a year. The patient herself associated the respiratory disease with a cool-mist humidifier sometimes used at work. The water reservoir was heavily contaminated with amoebas (Amoeba proteus), which might have been the causative organisms in this case. Aspergillus fumigatus precipitins were found in the serum of a 53-year-old female printer with the clinical picture of occupational allergic alveolitis. The same organism was detected in the ambient air of the printing office.

Adult

HLA-B18 antigens and protection from pulmonary fibrosis in asbestos workers.

HLA antigens were identified in 64 patients with radiographic asbestosis and 37 matched controls with equivalent asbestos exposure but no radiographic pulmonary fibrosis. A high prevalence of HLA-B18, B27 and Cw2 was found in the controls. This result might indicate that the possessors of these HLA antigens are thus protected from the development of diffuse pulmonary fibrosis from asbestos exposure. Signs of susceptibility were not demonstrated. The radiographic severity and progression of asbestosis were not associated with any of the HLA antigens tested.

Adult

Immediate-type hypersensitivity to reactive dyes.

Reactive dyes have gained extensive use in recent years. This paper reports four cases of immediate-type occupational allergy to these compounds. All the patients had had symptoms of asthma and allergic rhinitis, and had been weighing dyes for a minimum of 2 years. The skin prick tests were positive, and nasal and bronchial provocation challenges also produced positive immediate reactions. A high serum titre of specific IgE could be demonstrated for at least one dyd by the radioallergosorbent test. The identification of specific IgE shows that the mechanism of the hypersensitivity is immunological, reactive dyes acting probably as haptens.

Adult

Occupational asthma in Finland.

In Finland occupational asthma caused by protein allergens and reactive chemicals present in the air of work environments is increasing. This communication describes provocative challenge tests and methods for measuring exposure under simulated work conditions. The importance of lung function measurements during non-exposure and placebo periods is stressed. Especially late reactions are difficult to assess because of the great circadian variation in the lung function parameters of asthmatics. For a positive challenge test, a decrease in peak flow values of at least 15% and a clear deviation from normal circadian variation and placebo periods is required. The allergens of vegetable or animal origin primarily affect patients with an atopic constitution. Chemical allergens seem to attack all exposed workers in the same way. The report lists the occupations with risk for asthma and refers to the population at risk; bakers seem to be the group with the most risk. The importance of early diagnosis, removal of the worker from exposure and improvement of the hygienic aspects of the work environment are stressed.

Air Pollutants

Radiographic and physiological findings in patients with asbestosis.

Radiographic and respiratory functional findings are reported for a series of 133 Finnish patients with asbestosis. Of these patients, 65 (49%) were found to have radiographically mild diffuse pulmonary fibrosis (profusion 0/1, 1/0 or 1/1), 48 (36%) moderate fibrosis (1/2, 2/1 or 2/2) and 20 (15%) diffuse fibrosis in an advanced stage (2/3 or more). The type of fibrosis was mostly irregular (110 = 83%). Fibrosis was typically the most advanced in the lower zones of the lungs. Of the 133 patients, 88 (66%) showed pleural changes and 78 (59%) pleural calcifications. The more severe the fibrosis, as seen in the radiographs, the greater the decrease in vital capacity (VC) and expiratory volume in 1 s (FEV1.0). Transfer factor was generally impaired only in advanced cases of asbestosis (fibrosis 2/3 or more). In general, obstruction was not observed in this series. Pleural changes seemed to decrease VC and FEV1.0 when the fibrosis was mild (0/1, 1/0 or 1/1). They had no effect on diffusion capacity (TLco).

Adult

Amount and distribution of welding fume lung contaminants among arc welders.

The amount and distribution of the welding fume lung contaminants was measured in 44 arc welders from two shipyards. The measurement was made from the determination of the permanent field after the subject was magnetized in a low external magnetic field, the values being used for the calculation of the amount of contaminants in the lungs. Less than 4 mg of dust was found in the lungs of nonexposed controls. In the shipyard welder's lungs, after two years of exposure, on the average 7 mg (range 4-15) of welding dust was observed. After a continuous exposure of about 18 years the amounts were 200 mg (range 30-1,500) in shipyard A and 700 mg (150-2,000) in shipyard B, respectively. On the basis of data obtained from retired welders, the clearance rate of 45% in welders from shipyard A and 18% in shipyard B were calculated, the latter figure being probably more accurate. The distribution of contaminants was 52% in the right and 48% in the left lung. The radiological findings correlated well with the amounts of welding fume contaminants measured with the magnetic method.

Adolescent

Comparison of salbutamol and ephedrine in oral bronchodilator combinations with theophylline and hydroxyzine: their effects on asthmatics.

The efficacies of three antiasthamatic bronchodilator combinations were compared using data obtained from sixteen patients. During the trial the patients measured their peak expiratory flow (PEF) every day at 7.00 a.m., 10.00 a.m. and 9.30 pm. Six patients also measured their PEF at 1.30 a.m. The frequency and severity of symptoms and side-effects as well as the auxiliary use of isoprenaline inhalations were also recorded. This double-blind cross-over trial consisted of five four-day periods including three periods with different drug combinations and two placebo periods. By increasing the sympathomimetic activity of the basic oral drug combination of theophylline and hydroxyzine with salbutamol or ephedrine the therapeutic effect of the combination was also increased although not statistically significantly. All combinations tested differed significantly from placebo in their effect. Harmful side-effects increased in proportion to the potency of the sympathomimetic drug used in the combination; they were minimal during treatment with the basic theophylline-hydroxyzine combination. Circadian variation of bronchial obstruction was a constant phenomenon in all asthmatics participating in this trial.

Administration, Oral

The efficacy, as modified by the circadian rhythm of salbutamol administered by different routes.

Fourteen asthmatic outpatients participated in a total of 16 trials with salbutamol administered by different routes. Drug dosage was one 4-mg tablet, of two inhalations of 100 mug of salbutamol aerosol or a combination of both, four times daily. During the trial the patients measured their peak expiratory flow (PEF) every day at 1.00 a.m., 7.00 a.m., 10.00 a.m. and 9.30 p.m. The frequency and severity of symptoms and side effects as well as the auxiliary use of isoprenaline inhalation were also recorded. A clear-cut circadian rhythm in bronchial obstruction was observed during both active drug and placebo periods. PEF values during all active periods differed significantly from those during placebo periods at 3 and 2.5 h after drug intake (at 10.00 a.m. and 9.30 p.m.). Moreover, a distinction between the effects of the various active drug forms was possible at 10.00 a.m., salbutamol tablets and the combination of salbutamol tablets and aerosols being then superior to aerosol treatment alone. At night and in the early morning PEF values were generally lower than during the day owing to the circadian rhythm, and bronchodilator response to drugs at these times was also less pronounced. Isoprenaline consumption was highest during placebo periods and lowest during periods of combined active treatment. No serious side effects were seen. Cumulative evidence has shown that this kind of study with outpatients is suitable for comparing the clinical effects of bronchodilator drugs.

Administration, Oral

The first two cases of coccidioidomycosis in Finland.

Endemic areas of coccidioidomycosis are described. The mycology of Coccidioides immitis is reviewed, with special reference to the risk of laboratory infection. A classification of coccidioidomycosis is listed and two cases from Finland are presented. The first patient had typical X-ray and clinical findings, including a positive coccidioidin test. The second case, occurring soon after a visit to Arizona, was confirmed by positive fungal cultures from the sputum and from a resected specimen. Because the latter patient became pregnant and the risk of dissemination was considered great, legal abortion was performed. The resection of the pulmonary cavitation with infiltration around it took place under coverage of pre- and postoperative amphotericin B medication. Complete recovery was obtained. The indications for thoracic surgery are briefly listed. Diagnostic and mycologic aspects of this rare and exotic disease are discussed. Among other things, the importance of a good medical history in finding the contact with infective environment or material is stressed.

Adult