Bronchoalveolar lavage of pig farmers.
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Adult↗
Biomedical subjects
R Dahl
Publications and source records attributed to R Dahl.
Pulmonary function and bronchial reactivity in asthmatics during low-level formaldehyde exposure.
This study evaluated whether formaldehyde, at concentrations similar to those found in the indoor environment, could produce adverse effects on the lower airway of 15 asthmatic persons with documented bronchial hyperresponsiveness who were exposed for 90 min in a climate chamber to clean air containing formaldehyde vapor at levels of 0.85 mg/m3, 0.12 mg/m3, and 0.008 mg/m3. No significant changes in forced expiratory volume in 1 sec (FEV1), airway resistance (Raw), specific airway resistance (SRaw), and flow-volume curves could be detected during formaldehyde exposure. Furthermore, histamine challenge tests performed immediately after formaldehyde exposure showed no evidence of changes in bronchial reactivity. No late reactions were registered during the first 14-16 hr after exposure. The results suggest that residential levels of formaldehyde are of minor importance in the emergence of pulmonary symptoms. Discrepancies between the present study and previous data may be due to differences in environmental conditions.
Adolescent↗
Allergen-induced increase of eosinophil cationic protein in nasal lavage fluid: effect of the glucocorticoid budesonide.
It was our aim to study the effect of nasal allergen provocation on the concentration of eosinophil cationic protein (ECP) in nasal lavage fluid, with and without glucocorticoid pretreatment. Twenty grass-pollen sensitive volunteers were provoked outside the pollen season on 2 consecutive days after pretreatment for 2 weeks with the glucocorticoid, budesonide, as a nasal spray (400 micrograms/day) and with placebo with a double-blind, crossover design. Nasal lavage fluid was repeatedly collected during a 10-hour period to study both early and late-phase responses. 99mTechnetium-albumin was added to the lavage fluid, making it possible to calculate the amount of secretion and the degree of dilution. The results were as follows: (1) There was no correlation between ECP concentration and dilution factor in the individual samples. (2) The mean concentration of ECP in lavage fluid from untreated, prechallenge noses was 400 micrograms/L. (3) The ECP level did not increase during the early phase response. (4) There was a late occurring increase in the ECP concentration (6 to 24 hours). (5) This increase was completely inhibited by budesonide pretreatment. (6) The glucocorticoid therapy also reduced the prechallenge ECP concentration. In conclusion, allergen provocation in the nose results in a late occurring increase of ECP in nasal lavage fluid, and one of the therapeutic effects of topical glucocorticoid therapy may be an inhibition of the allergen-induced increase of this cytotoxic molecule.
Adult↗
Exercise-induced asthma and the generation of neutrophil chemotactic activity.
Heat-stable neutrophil chemotactic activity (HS NCA) has been demonstrated in serum of subjects with asthma after exercise and after allergen inhalation challenge. Heat-labile neutrophil chemotactic activity (HL NCA) has been investigated only after allergen inhalation challenge. In this study, we have measured HS NCA and HL NCA after exercise of 22 adult patients with asthma, 13 of whom had exercise-induced asthma (EIA). In the 13 patients, the effect of pharmacologic pretreatment on the generation of HS NCA and EIA was evaluated in a double-blind study with inhalation of either disodium cromoglycate, terbutaline, or budesonide 15 minutes before exercise. Additionally, the effect of 4 weeks of treatment with budesonide aerosol was evaluated in an open study. A significant increase (p less than 0.01) in HS NCA was found in the patients with EIA with peak activities 15 minutes after exercise. In patients without EIA, the activity of HS NCA was variable. No HL NCA was detectable after exercise. EIA was inhibited by disodium chromoglycate, terbutaline, and 4 weeks of treatment with budesonide. The generation of HS NCA was more or less inhibited by all three drugs with 4 weeks of treatment with budesonide as the most potent regimen. No late-phase asthmatic reactions to exercise were found. It is concluded that only HS NCA is generated after exercise of subjects with asthma and that this production is controlled by antiasthmatic drugs. However, the generation of HS NCA occurs irrespective of EIA.
Adult↗
Mite allergy and exposure to storage mites and house dust mites in farmers.
Sensitization to house dust mites, storage mites and other common inhalation allergens was studied in 144 farmers using SPT and RAST. The study population was selected from a random sample of 808 farmers and consisted of 47 persons who had declared themselves to suffer from asthma, 63 persons who had reported respiratory symptoms, and 34 healthy persons without respiratory symptoms. The most prevalent RAST was towards storage mites and was found in 17% of farmers who suffered from asthma and was estimated to occur in 5% of the random sample of farmers. A positive RAST to house dust mites was found in 17% of farmers who reported to suffer from asthma. Sensitization to pollens, animal dander and grain species was rare. A positive RAST to moulds was not found. There was a strong association between a positive RAST to house dust mites and a positive RAST to storage mites (odds ratio 21.0). A positive RAST to storage mites was significantly associated with living in a dwelling in the past which was recalled as damp (odds ratio 4.9). A high number of house dust mites was found in nearly all dwellings (median count 148 mites/0.1 g dust) and a high number of storage mites was found in some dwellings. This study suggests that in humid and temperate regions of Europe, allergy to storage mites in farmers is not caused exclusively by occupational exposure but damp housing conditions and indoor exposure to storage mites may also be important.
Agriculture↗
Allergy to storage mites in asthmatic patients and its relation to damp housing conditions.
The relation between allergy to house dust mites and allergy to storage mites was studied in 326 patients with bronchial asthma. A positive RAST to house dust mites was found in 24.5% and to storage mites in 7.4%. There was a close association between a positive RAST to house dust mites and a positive RAST to storage mites, and 91.6% had a positive RAST to both. Only 0.9% with a negative RAST to house dust mites had a positive RAST to storage mites, whereas the frequency was 27.5% in those with a positive RAST to house dust mites. Present occupation with exposure to storage mites was found in 20.8% with a positive RAST to storage mites. A positive RAST to both house dust mites and storage mites was significantly associated with anamnestic indicators of damp housing conditions. The close association between allergy to house dust mites and allergy to storage mites in this study is probably caused by a common environmental factor, i.e. damp housing conditions.
Agricultural Workers' Diseases↗
Nasal inhalation of the glucocorticoid budesonide from a spacer for the treatment of patients with pollen rhinitis and asthma.
Glucocorticoid sprays are increasingly used for the treatment of allergic rhinitis and asthma. This therapy is highly effective, and side effects are few and mild. It was the aim of the present study to evaluate a physiological nasal inhalation technique, which results in airway deposition of the steroid molecule similar to that of inhaled allergen particles. Thirty adults with grass pollen-induced rhinitis and asthma inhaled the steroid molecule budesonide through the nose from a pressurized aerosol attached to a spacer device. Compared with inhalation of placebo, the treatment resulted in a significant reduction of nasal symptoms (P = 0.005), of bronchial symptoms (P = 0.005), but not of eye symptoms. In addition, nasal peak inspiratory flow (P = 0.0003) and oral peak expiratory flow (P = 0.02) increased. There was no difference between budesonide and placebo with regard to local side effects, such as nose bleeding, hoarseness, and irritation in mouth and throat. It is concluded that nasal inhalation of a steroid from a spacer offers effective therapy of pollen rhinitis and asthma without significant local side effects. This therapeutic modality may have advantages over the ordinarily used nasal and bronchial spray treatment in patients with both rhinitis and asthma, especially when conventional spray therapy is associated with local side effects.
Administration, Topical↗
Effect of nicotine, silver acetate, and ordinary chewing gum in combination with group counselling on smoking cessation.
Four hundred and ninety six smokers participated in a randomised comparison of the effect of silver acetate, nicotine, and ordinary chewing gum on smoking cessation. All were motivated to stop smoking abruptly and all had smoked at least 10 cigarettes a day for at least five years. Side effects and taste acceptability were related to outcome after six months. The participants attended nine meetings over a year, at which lectures, support, and advice about stopping smoking were given. Tobacco abstinence was confirmed by measurement of carbon monoxide in expired air. The chewing gums were used for 12 weeks. After 12 weeks there was a trend towards more abstainers in the nicotine group (59%) than in the silver acetate (50%) and ordinary (45%) chewing gum groups that was not quite significant (p = 0.07). At 26 and 52 weeks the number of cigarette abstainers was similar in the three treatment groups. Subjects in the nicotine chewing gum group had a longer mean time before relapse than those in the silver acetate and ordinary chewing gum groups. Mean success rates for all subjects combined at 12, 26, and 52 weeks were 52.8%, 39.7%, and 23.3%. The side effects of nicotine and silver acetate chewing gum were generally mild and transient, and unimportant except for mouth irritation from silver acetate, which had a negative effect on outcome, and the low taste acceptability of nicotine, which had a strong negative influence on the success rate. The results suggest a short term effect on nicotine chewing gum on smoking cessation, but the abstinence rates after one year were generally disappointing.
Acetates↗
Long-term treatment of chronic bronchitis with positive expiratory pressure mask and chest physiotherapy.
Long-term treatment of chronic bronchitis with chest physiotherapy with or without positive expiratory pressure (PEP) by mask was studied in 43 patients randomly allocated to PEP treatment (PEP group, 20 patients) and conventional chest physiotherapy (control group, 23 patients). After instruction, the treatments were self-administered twice daily for 12 months (34 patients) and 5 months (9 patients). Twice weekly, patients filled in a diary concerning symptoms. The PEP group had significantly less cough and less mucus production. The number of acute exacerbations were calculated from the diaries and were lower in the PEP group compared to the control group, and 85 percent of the patients in the PEP group were free from acute exacerbations versus 48 percent in the control group. The PEP group also used less antibiotics and mucolytics. The PEP group had a small increase in FEV1 of mean 62 ml compared to a small decrease of 43 ml for the control group. Treatment with a simple PEP device can reduce morbidity in patients with chronic bronchitis and may preserve lung function from a more rapid decline.
Breathing Exercises↗
Precise diagnosis of airflow obstruction - does it matter for treatment? The assessment of reversibility; what drugs?
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Adrenal Cortex Hormones↗
House dust mites and atopic dermatitis. A case-control study on the significance of house dust mites as etiologic allergens in atopic dermatitis.
The occurrence of house dust mites was measured in homes of 24 patients with atopic dermatitis, 30 patients with mite-sensitive asthma and 32 patients with asthma not related to house dust mites. Patients with mite-positive asthma and patients with atopic dermatitis had significantly higher exposure to house dust mites compared with patients with mite-negative asthma. For atopic dermatitis the higher exposure to house dust mites corresponded to a relative risk of 4.7 and a clear dose-response relationship was demonstrated between exposure and risk of disease in the subgroups of patients with atopic dermatitis. The present epidemiologic results support the idea that house dust mites may be an etiologic factor in a proportion of adult patients with atopic dermatitis.
Allergens↗
[Alveolocellular carcinoma diagnosed by bronchoalveolar lavage].
Alveolocellular carcinoma is localized to the bronchioles and alveoli and the diagnostic procedures usually employed will only rarely contribute to the diagnosis. A case is presented where performance of fiberbronchoscopy and bronchoalveolar lavage with cytological examination of the cyto-centrifuged preparation led to the diagnosis of alveolocellular carcinoma in a patient with diffuse infiltrates.
Adult↗
[Fiber bronchoscopy and bronchoalveolar lavage in patients with asthma. A description of the method].
Fiber bronchoscopy under local anaesthesia is an examination procedure frequently employed in the remainder of Scandinavia, Europe and USA. It requires only few resources and the costs are considerably less than fiber bronchoscopy under general anaesthesia. Bronchoalveolar lavage (BAL) in connection with fiber bronchoscopy is rapidly undertaken but analysis of the material obtained requires considerable time. A method of induction of local anaesthesia, performance of BAL and preparation of the washings obtained is described. Fiber bronchoscopy and BAL are considered to be safe examination procedures in patients with mild asthma in a stable phase. The examination is only associated with slight discomfort for the patients, who will frequently accept repeated investigations, and complications are rare. BAL is a valuable examination procedure in research and the results have increased the knowledge of mechanisms in a series of interstitial pulmonary diseases. Future investigations of the humoral and cellular components in BAL fluid in asthmatic patients will contribute to increase knowledge of the pathological mechanisms in asthmatic disease.
Adult↗
In vivo administration of interleukin-1 inhibits glucose-stimulated insulin release.
Recombinant interleukin-1 beta (IL-1 beta) was administered intraperitoneally for 3 days to normal C57BL/6ByJ (B6) mice. The islets from IL-1-treated and control animals were isolated and glucose-stimulated insulin secretion studied in the perifusion system. The total islet insulin content and the ultrastructure of the islets isolated from the animals treated with IL-1 did not differ from those seen in control animals. However, glucose-stimulated insulin release was significantly impaired after 3 days of in vivo administration of IL-1, either 3 micrograms/animal/day or 0.3 micrograms/animal/day. The administration of IL-1 inhibited an acute phase of glucose-induced insulin release, whereas neither basal insulin secretion nor insulin release from 10-30 min of perifusion with glucose was impaired. There was an only partial (27%) and non-significant restoration of the insulin secretory response to glucose stimulation 4 days after discontinuation of IL-1 treatment. We conclude that IL-1 administered in vivo is capable of adversely affecting pancreatic islet response to glucose stimulation. After 3 days of administration, these changes are confined to the process of insulin release, with the islet cell morphology and total insulin content being unaffected.
Animals↗
[Bronchial asthma caused by isocyanate in the internal/external environment].
Di-isocyanates have resulted in sensitizing and bronchial asthma in 4-5% of exposed workers in industry. A case of bronchial asthma is described in which the primary sensitization occurred during the period 1968-1970 as a result of work in a factory producing polyurethane plastic foam. The patient sought other employment on account of severe asthmatic symptoms and was, thereafter, symptom-free for 15 years. He was then engaged in a factory in the neighbourhood of the plastic foam factory and the asthmatic symptoms recurred on account of exposure via the external environment. The influences of various public authorities on handling of this case are described.
Asthma↗
[Heart-lung transplantation].
During recent years, lung transplantations have been performed as lung transplantations or heart-lung transplantations in approximately 300 patients with terminal pulmonary or pulmonary vascular disease where other forms of treatment were considered hopeless. Two of the patients were Danish and operation was undertaken in England. One and three year's survival are now so good that this form of treatment need no longer be regarded as being of experimental nature. The indications and contraindications for operation are described and the postoperative immuno-suppressive therapy and complications are reviewed. Employing strict criteria in selection, the annual number of patients in Denmark is estimated to be approximately 50 and this is an adequate basis for a transplantation centre. At present, the procedure for selection of patients for operation is still vague and random in Denmark.
Denmark↗
Cortisol secretion in prepubertal children with major depressive disorder. Episode and recovery.
Plasma cortisol concentrations were measured every 20 minutes for 24 hours in a group of 45 rigorously assessed, drug-free, prepubertal children who met the unmodified Research Diagnostic Criteria for major depressive disorder (MDD), 20 children with nonaffective psychiatric disorders, and eight normal controls. All children were studied in a low-stress environment. There were no significant differences in plasma cortisol concentration among the three groups as measured by 24-hour mean, peak, nocturnal rise, or nadir values. Division of the MDD group into subgroups based on endogenicity, psychotic symptoms, and suicidality also failed to reveal significant differences for cortisol secretion. Hypersecretion of cortisol (defined as 2 SDs above the grand mean) was identified in only four children with depressive illness and one normal control. Following clinical recovery, 24 depressed children were restudied in a drug-free state and compared with themselves during the episode of illness and with both groups of controls. No significant differences in plasma cortisol concentrations were found. All four depressed hypersecretors were restudied after clinical recovery, and one showed persistence of hypersecretion. These results suggest that abnormalities of cortisol secretion occur infrequently in prepubertal children with major depression when they are studied in a nonstressful environment.
Age Factors↗
High-pressure freezing for the preservation of biological structure: theory and practice.
The two main advantages of cryofixation over chemical fixation methods are the simultaneous stabilization of all cellular components and the much faster rate of fixation. The main drawback pertains to the limited depth (less than 20 microns surface layer) to which samples can be well frozen when freezing is carried out under atmospheric conditions. High-pressure freezing increases the depth close to 0.6 mm to which samples can be frozen without the formation of structurally distorting ice crystals. This review discusses the theory of high-pressure freezing, the design of the first commercial high-pressure freezing apparatus (the Balzers HPM 010), the operation of this instrument, the quality of freezing, and novel structural observations made on high-pressure-frozen cells and tissues.
Animals↗