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K Alanko

Publications and source records attributed to K Alanko.

At least 55 records · Page 3Linked to original sources
PubMed1996

Repeatability of a rapid dosimetric method for methacholine challenge using a pocket turbine spirometer for FEV1 measurements.

The repeatability of a rapid dosimetric method for methacholine challenge was evaluated with 11 asthmatic patients. A Spira Elektro 2 dosimeter was used for methacholine delivery and a pocket turbine spirometer (Micro Spirometer) for FEV1 measurements. Methacholine was delivered in four successive, increasing doses ranging from 80 micrograms up to a cumulative dose of 6900 micrograms. The single determination standard deviation was low (12.5%), corresponding to a 95% confidence interval of +/- 0.925 doubling doses. The mean difference (+/- SE) between measurements of log PD20 FEV1 was -0.015 (0.056), and the absolute value of the difference in log PD20 FEV1 was not significantly related to the average log PD20 FEV1 (r = -0.155, P = 0.65). The rapid dosimetric methacholine challenge test, performed with a pocket turbine spirometer, proved to be as reproducible as previous methods. Furthermore, this methacholine challenge is clearly less time consuming than conventional provocations, including bronchodilator aerosol (given to resolve post-challenge bronchoconstriction); the whole test can be performed in 20 min. This is especially valuable in epidemiologic studies, as well as in clinical practice.

Administration, Inhalation↗
PubMed1996

Oral mucosal diseases investigated by patch testing with a dental screening series.

The rôle of contact allergies in oral mucosal diseases was studied. The subjects were 24 patients out of 479 tested, who had oral mucosal symptoms and positive patch test reactions in a dental series during 1987-1994 at the Department of Dermatology, Helsinki University Hospital. The clinical diagnoses were oral lichen planus (LPO, 13 patients), leukoplakia (2), glossodynia, i.e., 'burning mouth syndrome' (4), stomatitis (3) and recurrent angioedema (2). Only 1 patient had symptoms in relation to dental care. All but 2 patients had allergic reactions to mercury (Hg) (12 patients), gold sodium thiosulfate (Au) (13 patients) or both. A clinical connection between oral symptoms and contact allergy was seen in 10 patients. 9 patients (7 LPO, 2 leukoplakia) had Hg allergy. In these cases, the oral lesions disappeared after the amalgam fillings had been removed. 1 patient had recurrent stomatitis and perioral eczema after dental care and 2,2-bis(4-(2-hydroxy-3-methacryloxypropoxy)phenyl)propane (BIS-GMA) allergy. Her symptoms were caused by drilling of acrylic fillings. In addition, a connection between localized stomatitis and contact allergy was considered probable in 2 cases. 1 patient had stomatitis from contact with an orthodontic device and nickel allergy. The other had stomatitis from contact with a dental gold crown and gold allergy. No clinical connection was found between gold allergy and the oral symptoms of other patients.

Adult↗
PubMed1996

Occupational allergic contact dermatitis caused by photobonded sculptured nails and a review of (meth) acrylates in nail cosmetics.

BACKGROUND: Mono(meth)acrylates (monoacrylates and monomethacrylates) are moderate to strong sensitizers. They are used in the production of a great variety of polymers, including nail cosmetics. OBJECTIVE: A patient who became occupationally sensitized to photobonded sculptured nails is reported. Detailed patch testing and analyses of the patient's nail cosmetics containing mono(meth)acrylates clarified the cause of her hand and face dermatitis. The current knowledge on mono(meth)acrylates in nail cosmetics is also reviewed. METHODS: Patch testings with conventional methods, including patch testing with the patient's own substances, were performed. The patient's nail cosmetics suspected of containing mono(meth)acrylates were analyzed with gas chromatography/mass spectrometry analysis. RESULTS: In the (meth)acrylate series, 15 of the 31 (meth)acrylate compounds tested gave an allergic reaction: 2 acrylates, 5 methacrylates, 3 dimethacrylates, and 5 diacrylates. Epoxy diacrylates, cyanoacrylate, triacrylates, and methacrylic acid were negative. Three of seven of her own nail cosmetic preparations contained mono(meth)acrylates as revealed by the gas chromatography/mass spectrometry analysis, and these also gave allergic patch test reactions, namely, the nail liquid, nail hardener, and UV-cured nail gel. CONCLUSION: The patient probably had been sensitized to the following (meth)acrylate compounds from her nail cosmetics: tripropylene glycol diacrylate and methyl acrylate from her photobonded nail gel; ethyl methacrylate, triethylene glycol dimethacrylate, and methyl methacrylate from her nail liquid; and butyl methacrylate from her nail hardener. She was probably also sensitized to the rare sensitizer aliphatic urethane diacrylate, but the source was not verified. Because nail cosmetics containing mono(meth)acrylates are strong sensitizers, both the workers and the customers should be aware of their sensitizing capacity; they should use no-touch techniques regarding the skin before the mono(meth)acrylates are polymerized.

Acrylates↗
PubMed1994

Topical provocation of fixed drug eruption. A study of 30 patients.

Topical provocation with the causative agent was performed in 30 patients with fixed drug eruption (FDE). The epicutaneous open test method was used on inactive sites of old FDE lesions. Drugs at 10% in the vehicles petrolatum, alcohol and dimethylsulfoxide (DMSO) were used as test preparations. Positive reactions were always seen with phenazone salicylate (16 patients) and carbamazepine patients (3 patients), and in an individual case from chlormezanone. Both positive and negative reactions were seen with trimethoprim (3 and 2, respectively), doxycycline (2 and 1) and sulfadiazine (1 and 1). Control tests on unaffected skin with drug preparations and pure vehicles remained negative. The present results confirm our previous observation that topical provocation is a reliable test method in FDE caused by phenazone salicylate. The present study also shows that topical provocation may be useful in FDE caused by carbamazepine. In FDE caused by trimethoprim, doxycycline and sulfonamides, a positive, but not a negative, skin reaction is informative.

Adolescent↗
PubMed1993

Patch testing in cutaneous reactions caused by carbamazepine.

The usefulness of patch testing in the diagnosis of carbamazepine-induced allergic skin eruptions was studied in 18 patients with previous histories of skin eruptions caused by carbamazepine. The etiological role of carbamazepine was ascertained by peroral or topical provocation in 15 (out of 18) patients. The clinical reactions caused by the drug were classified as maculopapular exanthema with general symptoms (7 patients), other type of exanthema (3), exfoliative dermatitis (erythroderma) (3), fixed drug eruption (3), erythema multiforme (1) and urticaria (1). Patch testing showed positive reactions to carbamazepine in 7 patients; in addition, 2 patients had doubtful reactions. Positive patch test reactions were seen only in patients with exfoliative dermatitis (all 3 patients) and maculopapular exanthema (4 out of 7). None of the patients with fixed drug eruption, erythema multiforme or urticaria, or the control subjects, had positive patch test reactions to carbamazepine. The present study suggests that patch testing is useful in the diagnosis of carbamazepine allergy in patients with maculopapular eruptions or erythrodermas.

Adolescent↗
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↗
PubMed1984

[Chylothorax].

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Aged↗