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G C Kane

Publications and source records attributed to G C Kane.

29 records · Page 2Linked to original sources

Pulmonary function and gastroesophageal reflux in systemic sclerosis.

OBJECTIVE: To determine the relations among esophageal dysfunction, gastroesophageal reflux, and lung involvement in patients with systemic sclerosis. DESIGN: Retrospective review of esophageal motility, esophageal pH, and pulmonary function data. SETTING: University hospital outpatient clinic and community. PATIENTS: 39 consecutively referred patients who were grouped according to the presence or absence of abnormal distal (pH < 4.0 for > 5% of the 24-hour monitoring period) or proximal (pH < 4.0 for > 1% of the 24-hour period) gastroesophageal acid reflux. Patients were also grouped according to the presence or absence of distal esophageal peristalsis. MEASUREMENTS: Esophageal manometry, dual-probe (distal and proximal) esophageal 24-hour pH measurements, and pulmonary function studies (forced vital capacity, forced expiratory volume at 1 second, total lung capacity, and single-breath carbon monoxide diffusing capacity [DLco]). RESULTS: The mean total lung capacity (values as percentage predicted) was 87.1% +/- 11.2% (SD) for patients with abnormal proximal reflux and 77.8% +/- 21.6% for patients with normal proximal reflux (difference, 9.3%; 95% CI, -1.4% to 20.0%). The mean forced vital capacity for these patients was 91.1% +/- 12.4% and 85.4% +/- 25.6%, respectively (difference, 5.7%; CI, -6.9% to 18.1%). The mean total lung capacity was 83.8% +/- 15.4% for patients with abnormal distal reflux and 77.9% +/- 22.7% for patients with normal distal reflux (difference, 5.9%; CI, -7.6% to 19.4%). Among potential confounders of pulmonary measures, only smoking was related to decreased pulmonary function (smoking related to decreased DLco P < 0.01). Smoking was more common in patients with abnormal distal reflux than in those with normal distal reflux (65% compared with 25%, P = 0.03). After adjusting for smoking, the difference in mean DLco between patients with abnormal compared with normal distal reflux was 7.19% (Cl, -8.5% to 22.9%). CONCLUSION: Important measures of lung volume indicative of interstitial lung disease (total lung capacity, forced vital capacity) do not appear to be related to abnormal gastroesophageal acid reflux in patients with systemic sclerosis.

Esophagus↗

Eosinophils recruited to the lung by segmental antigen challenge show a reduced chemotactic response to leukotriene B4.

Inflammatory cells, particularly eosinophils, are thought to be important in allergic airway disease. However, the mechanisms responsible for their recruitment to the lung have not been well established in humans, in vivo. In this report we demonstrate that eosinophils recruited to the lung of ragweed allergic volunteers by segmental antigen challenge have a decreased chemotactic response to leukotriene (LT) B4 ex vivo, in comparison with eosinophils isolated from peripheral blood (80% inhibition at 10(-8) M LTB4, the optimal concentration, p < 0.01). Their chemotactic response to formyl-methionyl-leucyl-phenylalanine (FMLP) was normal. Although the response to platelet activating factor also appeared to be reduced, this reduction was not statistically significant. These data suggest that lung eosinophils were exposed to LTB4 in vivo and are consistent with the hypothesis that LTB4 is important in the recruitment of eosinophils to the lung during IgE-mediated reactions in the lung in humans.

Allergens↗

Hypersensitivity pneumonitis secondary to Klebsiella oxytoca. A new cause of humidifier lung.

A 30-year-old woman developed recurrent episodes of fever, dyspnea, and nonproductive cough after repeated exposure to a home humidifier. The diagnosis of hypersensitivity pneumonitis was confirmed by detection of serum-binding antibodies at significant titer to Klebsiella oxytoca colonizing the humidifier water but not to other potential antigens. This represents a newly recognized cause of hypersensitivity pneumonitis related to exposure to K oxytoca contaminating a commercially available ultrasonic cold air home humidifier. The potential role for these frequently used home humidifier devices in unexplained pulmonary illness is emphasized.

Adult↗