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Biomedical subjects

K Alanko

Publications and source records attributed to K Alanko.

At least 19 recordsLinked to original sources
PubMed1992

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↗
PubMed1989

Cutaneous drug reactions: clinical types and causative agents. A five-year survey of in-patients (1981-1985).

We collected a 5-year series of drug eruptions. There were 225 cases, 128 of them verified by a positive provocation test. The most common types of clinical reaction were fixed drug eruptions, exanthematous eruptions and urticarias. The drugs most often responsible for the eruptions were antimicrobial agents and antipyretic/anti-inflammatory analgesics. Comparing this series with our three previous series from the same hospital, the total number of drug eruptions proved to have decreased over the last 30 years. The main groups of drugs causing skin reactions have remained the same, but in recent years the proportion of sulphonamides has diminished.

Adolescent↗
PubMed1989

The superiority of combination beclomethasone and salbutamol over standard dosing of salbutamol in the treatment of chronic asthma.

We studied the clinical effect of a combination aerosol containing salbutamol and beclomethasone dipropionate in comparison to doubling the standard dose of salbutamol from an inhaler. Fifty-seven patients completed the double-blind, crossover study. They were treated with either an aerosol of 100 micrograms beclomethasone dipropionate and 200 micrograms salbutamol or 400 micrograms salbutamol alone. Both regimens were administered four times a day for 4 weeks. The patients showed significant improvement in FEV1, PEFR, and symptom scores after treatment with beclomethasone dipropionate and salbutamol compared with pre-trial values and with treatment with double the dose of salbutamol. The patients demonstrated a clear preference for treatment with the combination of beclomethasone dipropionate and salbutamol. Regular treatment with beclomethasone dipropionate in addition to salbutamol as a combination inhaler provides much better control of asthma than merely increasing the dose of salbutamol in those patients poorly controlled on standard doses of inhaled bronchodilators.

Adolescent↗
PubMed1988

Poor accumulation of technetium-99m glucoheptonate in sarcoidosis and other diffuse infiltrative lung diseases as compared with gallium-67 citrate.

Forty-two patients with diffuse infiltrative lung diseases were imaged with Ga-67 citrate and Tc-99m glucoheptonate (GH). Twenty patients had sarcoidosis, six had fibrosis, six had tuberculosis, nine had lung infiltration, and one had pleural empyema. The main difference between Ga-67 and Tc-99m GH was the much greater uptake of Ga-67 in sarcoidosis than that of Tc-99m GH. Fifteen patients with sarcoidosis had positive Ga-67 scans but only six had positive Tc-99m GH scans. The results in other diffuse infiltrative lung diseases were almost equal with Ga-67 and Tc-99m GH. Although Tc-99m GH is less expensive and simpler to use, it is not an adequate substitute for Ga-67 in diffuse infiltrative lung diseases.

Gallium Radioisotopes↗
PubMed1987

Topical provocation of fixed drug eruption.

To determine whether topical provocation could be used for the diagnosis of fixed drug eruption (FDE) instead of systemic provocation, we applied the suspected drug at various concentrations (1-10%) in either petrolatum, 94% ethanol or dimethyl sulphoxide (DMSO) as an open test on both clinically normal skin and on previous FDE lesions in 24 patients with established FDE due to phenazone salicylate, a sulphonamide, doxycycline, trimethoprim, chlormezanone, a barbiturate, or carbamazepine. In 18 of the 24 patients, local provocation of FDE was seen at sites or previous eruption but never on clinically normal skin. With some drugs, e.g. phenazone salicylate, positive provocation of FDE was seen with all the vehicles used; with sulphamethoxazole and trimethoprim, a positive result was seen only in DMSO. To study cross-reactions to other phenazone derivatives in patients with an FDE caused by phenazone salicylate, we applied topical phenazone, aminophenazone and propyphenazone to sites of previous FDE lesions in three patients. In all three, a positive reaction was seen with phenazone, but only one patient showed positive results with aminophenazone and propyphenazone. The present study suggests that topical provocation is useful with several drugs causing FDE. Testing should always be performed on sites of previous FDE, and the sensitivity of the open topical testing can be increased in certain cases by using a vehicle which increases penetration of the drug.

Administration, Topical↗
PubMed1987

Comparison of gallium-67 citrate and technetium-99m glucoheptonate in the evaluation of pulmonary malignancies.

Sixty-five patients with suspected or proven pulmonary malignancy were examined with [67Ga]citrate and [99mTc]glucoheptonate ([99mTc]GH) scintigraphy. In the final diagnosis 39 had primary lung carcinoma, four metastases in lung, mediastinum, and pleura from carcinomas elsewhere, and 22 benign pulmonary diseases. The sensitivity in the detection of pulmonary malignancies was 91% with 67Ga and 95% with [99mTc]GH. The intensity of uptake was somewhat greater with 67Ga than with [99mTc]GH in almost all malignant lung tumor groups. The specificity to detect malignant tumors was 82% with both radiopharmaceuticals. Irradiation and chemotherapy seemed to decrease 67Ga uptake but not [99mTc]GH uptake. Only four of 22 benign diseases showed accumulation of both 67Ga and [99mTc]GH. The intensity of uptake in benign processes was almost equal with that in malignant diseases, but most malignant processes were better delineated than the benign lesions. There were many differences between 67Ga and [99mTc]GH uptake, which suggest different mechanisms of accumulation of these agents. It is concluded that some 67Ga studies could be replaced by cheaper and more practical [99mTc]GH.

Diagnosis, Differential↗
PubMed1986

Treatment of asthma bronchiale with a combination of ipratropium bromide and fenoterol.

The efficacies of inhaled doses of fenoterol 200 micrograms, ipratropium bromide 40 micrograms and their combination (200 + 40 micrograms) were compared in a double-blind, placebo-controlled cross-over study in 24 adult patients with stable asthma bronchiale. The tests were performed during 4 consecutive days. The change in bronchial obstruction was assessed by means of spirometry [forced expiratory volume in 1 s (FEV 1.0), forced vital capacity (FVC), peak expiratory flow (PEF)] and body plethysmography [thoracic gas volume (TGV), airway resistance (Raw)] measurements. The values of FEV% and specific airway conductance (SGaw) were calculated. The frequency of side-effects was recorded. During the treatment with the combination of ipratropium bromide and fenoterol the change in the mean SGaw differed highly significantly (p less than 0.001) from placebo in the initial bronchodilator response and at 3, 4 and 5 h. With fenoterol, compared to placebo, a highly significant difference in bronchodilator effect lasted for 4 h, with ipratropium bromide for 3 h. Similarly, a highly significant difference measured with FEV 1.0 during the medication with the combination of ipratropium bromide and fenoterol lasted for 4 h, with fenoterol alone for 2 h, and with ipratropium alone for 1 h. The most harmful side-effect in this group of asthmatics proved to be muscular tremor, caused most often by the combination of ipratropium bromide and fenoterol. The findings of this study suggest that the combination of ipratropium bromide and fenoterol gives a stronger bronchodilatation and a more prolonged effect in asthmatics than ipratropium bromide or fenoterol alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

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↗
PubMed1979

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↗
PubMed1978

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↗
PubMed1978

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↗
PubMed1978

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↗
PubMed1978

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↗
PubMed1977

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↗