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Biomedical subjects

N Stjernberg

Publications and source records attributed to N Stjernberg.

At least 37 records · Page 2Linked to original sources
PubMed1991

Endobronchial biopsy positive sarcoidosis: relation to bronchoalveolar lavage and course of disease.

Sixty-two patients with newly diagnosed sarcoidosis were examined with fibreoptic bronchoscopy, endobronchial biopsies and bronchoalveolar lavage (BAL) were analysed. Epithelioid granulomatosis in endobronchial biopsies were found in 28 (45%) of the patients (BPOS). The patients in this BPOS group showed higher inflammatory activity in BAL fluid compared to those with negative biopsies (BNEG), with significant increases in lymphocyte and mast cell counts, and concentrations of procollagen III peptide and albumin. The patients were followed over a period of 2 years. The BPOS group tended to have a worse clinical course with more patients having a progressive disease and more patients requiring treatment with systemic steroids. We conclude that the findings of epithelioid granulomatosis in endobronchial biopsies may reflect a more intense and widespread inflammation in the lung.

Adult↗
PubMed1991

Exposure to peat dust: acute effects on lung function and content of bronchoalveolar lavage fluid.

Mechanised production of peat for fuel consumption is associated with high concentrations of organic dust, which is inhaled by the peat workers. In the present study 17 workers at two peat bogs in northern Sweden were examined. Personal sampling of total dust and the respirable fraction was performed during several workshifts. Dynamic spirometry was carried out before and at the end of shifts. Bronchoscopy with bronchoalveolar lavage (BAL) was performed in six subjects at the end of the working season and the results were compared with unexposed reference subjects. Peat workers using modern machines with ventilated cabins containing air filters were found to be exposed to low concentrations of peat dust. The recorded dust concentrations were below the threshold limit value for organic dust (5 mg/m3 air) in all but one worker. The respirable fraction of peat dust recorded in the breathing zone of the workers correlated significantly with a decrease in forced expiratory volume in one second (FEV1). The effect on lung function in non-asthmatic peat workers was, however, small. The concentration of lysozyme positive alveolar macrophages in BAL fluid was significantly lower in the peat workers compared with reference subjects. An inverse correlation was found between the mentioned cells and exposure to the respirable fraction of the peat dust. Furthermore, one particularly dust exposed worker had pronounced increases in alveolar macrophages, fibronectin concentration, and mast cells in BAL fluid.

Adolescent↗
PubMed1991

Obstructive lung disease in northern Sweden: respiratory symptoms assessed in a postal survey.

The prevalence of respiratory symptoms in 6,610 adults (3,372 men and 3,238 women); 35-36, 50-51 and 65-66 yrs of age, living in selected areas of Norrbotten, northern Sweden, were assessed in a postal survey. Response rates were identical in men and women, and at least one respiratory symptom was reported by 41% of each sex. Twenty two percent reported sputum production, and 14% reported wheezing. Despite differences in smoking habits and in the different age groups, the prevalence of symptoms did not differ between the sexes, or between urban and rural areas. Symptoms were as common in people living in the rural interior as in the industrialized coastal area. Present or past history of asthma was reported by 323 (5.9%) subjects, whilst 234 (4.1%) subjects stated that they had chronic bronchitis or emphysema. Less than half of the subjects who reported attacks of breathlessness together with wheezing stated that they had at any time had asthma. Whilst the exact prevalence of had asthma. Whilst the exact prevalence of at any time had asthma and chronic bronchitis cannot be assessed from this postal survey, its results indicate that the prevalence of asthma may be higher in northern Sweden than has been reported from the south of Sweden.

Adult↗
PubMed1991

Inflammatory cell response in bronchoalveolar lavage fluid after nitrogen dioxide exposure of healthy subjects: a dose-response study.

The combination of environmental chamber exposure and bronchoalveolar lavage (BAL) was used to study the effects of the common air pollutant nitrogen dioxide (NO2). Eighteen healthy nonsmokers were exposed to NO2 during 20 min in an exposure chamber during light bicycle ergometer work. All subjects were examined with BAL at least 3 wks before exposure, as a reference. The subjects were re-examined with BAL, in groups of eight, 24 h after exposure to 4, 7 and 10 mg NO2.m.3 (2.25, 4.0 and 5.5 ppm), respectively. An inflammatory cell response was found after exposure to all concentrations. An increase in the number of lymphocytes in BAL fluid was observed after 7 and 10 mg.m.3 (p less than 0.05 and 0.02, respectively). An increase in the number of mast cells, that appears to be dose-dependent, was found after exposure to all concentrations. The proportion of lysozyme positive alveolar macrophages was elevated after exposure to 7 mg.m.3. The inflammatory mediators fibronectin, hyaluronan, angiotensin converting enzyme (ACE) and beta 2-microglobulin were unchanged by exposure. Due to the findings of inflammatory cell changes far below the peak exposure limits for work places in industrialized countries, 9-18 mg.m.3, the safety of these limits is questioned. Studies are in progress in our laboratory using BAL to evaluate the effects of repeated NO2 exposure.

Adult↗
PubMed1990

Bronchoalveolar mastocytosis and lymphocytosis after nitrogen dioxide exposure in man: a time-kinetic study.

The combination of environmental chamber exposure and bronchoalveolar lavage (BAL) was used to study the time-course of the cell response in the human lung to nitrogen dioxide (NO2). Healthy subjects were exposed for 20 min to 7 mg NO2.m-3 (4 ppm), a concentration which occurs indoors in industries and is below the peak exposure limit for work places in most countries, 10 mg.m-3 (5.5 ppm). BAL was performed in all subjects several weeks before exposure and 4, 8, 24 and 72 h after exposure, in eight subjects at each time. Mastocytosis and lymphocytosis were found in BAL fluid 4-24 h after exposure, with normalization after 72 h. A mild increase in lysozyme positive macrophages was found 24-72 h after exposure. The time-course of the human pulmonary cell response to NO2, demonstrated in BAL fluid, represents a new and previously not reported finding after exposure to this common air pollutant. Our findings are diverging from results obtained in animal studies, using approximately the same NO2 concentrations, indicating that the results from the animal studies may not be transferable to man.

Adult↗
PubMed1989

Inflammatory response in bronchoalveolar lavage fluid after inhaling histamine.

To examine the influence of the histamine chloride challenge test on the bronchoalveolar lavage cell population, lavage fluid from 15 subjects was collected 24 h after the histamine test, and was compared with the lavage fluid from a reference group of 25 subjects. Inhaled histamine is commonly used to quantitate non-specific bronchial responsiveness. Increase in airway responsiveness after exposure to ozone or allergen is associated with airway inflammation. Bronchoalveolar lavage, has therefore become a valuable tool in the study of bronchoalveolar cells and mediators in subjects with asthma and bronchial hyperresponsiveness. The total cell number and differential cell counts in bronchoalveolar lavage fluid 24 h after inhalation challenge test with histamine-chloride were studied. There was a significant increase in lymphocytes, mast cells and neutrophils after histamine test. The conclusion was that inhaled histamine-chloride can induce an inflammatory cell response in the lung. Thus the histamine-chloride test should not be performed before bronchoalveolar lavage.

Adult↗
PubMed1989

Is the short term limit value for sulphur dioxide exposure safe? Effects of controlled chamber exposure investigated with bronchoalveolar lavage.

Bronchoalveolar lavage (BAL) which has not previously been used in investigating the effect of sulphur dioxide (SO2) on the human lung was performed on 12 subjects before and after controlled chamber exposure with SO2 for 20 minutes. BAL fluid 24 hours after exposure with 10 mg SO2/m3 (4 ppm, 10 subjects) showed increased alveolar macrophage activity as judged by an increase in lysozyme positive macrophages. Twenty four hours after 20 mg/m3 (4 subjects) a further increase was seen, which was accompanied by an increase in total numbers of macrophages and lymphocytes. Seventy two hours after exposure (4 subjects) cell numbers had virtually returned to pre-exposure levels. These previously uninvestigated reactions indicate potentially noxious effects of SO2 in the lungs at exposure levels that are regarded as relatively safe.

Adult↗
PubMed1989

Association between haptoglobin groups and hereditary predisposition for bronchial asthma.

Haptoglobin (Hp) groups were investigated in 148 patients with bronchial asthma. A significant (p less than 0.005) deviation from the expected Hardy-Weinberg equilibrium, with a decreased frequency of heterozygotes, was observed among patients with a family history of asthma. This deviation was more pronounced among patients with adult onset of asthma. The presence or absence of atopy had no significant influence on the phenotype distribution.

Acute-Phase Proteins↗
PubMed1989

Cell response in bronchoalveolar lavage fluid after exposure to sulfur dioxide: a time-response study.

Bronchoalveolar lavage (BAL) has been performed in 22 healthy nonsmoking male volunteers after exposure to 8 ppm SO2 (20 mg/m3). The exposure level exceeds the US Short-Term Exposure Limit (STEL) of 5 ppm, but occurs as peak exposures in industrial indoor environments. Exposures were made during light work on a bicycle ergometer in an environmental exposure chamber for 20 min. BAL was performed 2 wk or more before exposure and 4, 8, 24, and 72 h after exposure in eight subjects at each time interval. Four hours after exposure significant increases were found in the numbers of lysozyme-positive macrophages, lymphocytes, and mast cells (p less than 0.02 to 0.05). Lymphocytes, lysozyme-positive macrophages, total count of alveolar macrophages, and total cell number increased to peak values 24 h after exposure (p less than 0.02 to 0.05). Seventy-two hours after exposure the cell numbers and distribution had returned to normal. The time course of the cell reactions found in BAL fluid after controlled SO2 exposure represents a new and previously not reported response to a noxious gas.

Adult↗
PubMed1989

Cell response in bronchoalveolar lavage fluid after sulfur dioxide exposure.

Environmental chamber exposure and bronchoalveolar lavage (BAL) were used to study the dose-response relationship between short-term exposure to sulfur dioxide (SO2) and inflammatory reactions in the human lung as reflected in BAL fluid. Healthy subjects were exposed to 10, 13, 20, or 30 mg/m3 for 20 min. BAL was performed several weeks preexposure and 24 h postexposure. Mast cells, lymphocytes, lysozyme positive macrophages, and the total number of macrophages were significantly increased after SO2 exposure. A dose-dependent increase in the cell response in BAL fluid was observed after exposure to 10-20 mg/m3, but no further increase was detected after 30 mg/m3. Inflammatory cell response was found in BAL fluid at SO2 levels that occur in industrial indoor environments worldwide, and cell response to SO2 was also seen below the short-term exposure limit of Sweden and many other countries (13 mg/m3).

Adult↗
PubMed1988

Follow-up study of pulmonary function and respiratory tract symptoms in workers in a Swedish iron ore mine.

In 1967, 240 workers in the Kiruna, Sweden, mine were examined with regard to lung function and respiratory symptoms. Seventeen years later, 167 of these workers were reexamined using a structured interview which covered respiratory symptoms, smoking habits, and workplace, and lung function tests, including dynamic spirometry and closing volume. The prevalence of chronic bronchitis in the present study was 9.6%. There was a strong relationship between chronic bronchitis and smoking but no relationship between chronic bronchitis and working underground in the mine. Only three persons had chronic obstructive lung disease. In the still active mine workers, dynamic spirometry results showed no difference between smokers or nonsmokers or between underground and surface workers. Thus, we found no excess of chronic obstructive lung disease or lung function disturbances in the mine workers studied. This probably reflects a self-selection process whereby the workers with airway obstruction due to smoking or underground exposure have left underground work and also the company. Underground workers with chronic mucous hypersecretion, on the other hand, have not felt motivated, because of this, to leave underground work. Some, however, may have stopped smoking but not necessarily because of the hypersecretion.

Adult↗
PubMed1988

Exercise test in patients with sarcoidosis. The importance of repolarization disturbances.

The study population comprises 28 patients with sarcoidosis who all had repolarization disturbances in their exercise ECGs. None of the patients had hypertension or known cardiovascular disease, and all but two were non-smokers. The mean age was 45 years. Exercise test with beta-adrenergic blockade was performed within one month of the first examination. Persisting abnormal ST-T changes in exercise ECGs after beta-blockade were seen in 12 (43%) patients. No significant relationship was found between persisting ST-T changes and age, sex, chest X-ray stage, lung function or working capacity. In an earlier study, we found ST-T abnormalities in exercise ECG in 56 of 127 individuals (44%) in a consecutive 5-year study of patients with newly detected sarcoidosis. From this and the present report we postulate that, in our region, as much as 20% of the patients with newly detected sarcoidosis might have organic myocardial disease, possibly of sarcoid origin, as shown by repolarization disturbances in exercise ECG. If ECG abnormalities in the ST-T region are present in patients with sarcoidosis, exercise ECG with beta-blockade is a simple way of establishing suspicion of organic myocardial lesions. If exercise ECG abnormalities in the ST-T region persist after beta-blockade, careful clinical follow-up is recommended, and, in some patients early steroid therapy should be considered.

Arrhythmias, Cardiac↗
PubMed1988

Lung function abnormalities in patients with primary biliary cirrhosis.

Twenty-five patients with primary biliary cirrhosis (PBC) in different stages were investigated with respect to pulmonary function abnormalities. The results were compared with a reference sample of 17 sex- and age-matched healthy subjects. A high prevalence of lung function impairment was found in the PBC patients (14/25 [56%]). Bronchial asthma was present in three patients, and severe lung emphysema in one. These four patients had an abnormal lung function, mainly of obstructive type. There was a statistically significant difference between the remaining 21 PBC patients without chronic obstructive lung disease and the reference subjects with respect to diffusion capacity. Almost all abnormal lung function data were found in the symptomatic PBC patients (i.e. symptoms of pruritus, xanthoma, xanthelasmata, jaundice, hyperpigmentation, hepatosplenomegaly), 13 out of 18 (72%), whereas only one out of seven asymptomatic patients was affected. Nine patients (36%) had reduced diffusion capacity compared with none of the reference subjects. The lung function abnormalities in PBC patients are similar to those found in sarcoidosis, another granulomatous disease.

Adult↗
PubMed1987

Tuberculostearic acid in lymph nodes from patients with sarcoidosis.

It has earlier been suggested that mycobacteria may play an aetiological role in the development of sarcoidosis. To investigate this further we analyzed the presence of a characteristic mycobacterial constituent, tuberculostearic acid (TS, 10-methyloctadecanoic acid), in lymph nodes from 22 patients with sarcoidosis and in eleven children and three adult controls. To detect TS gas chromatography/mass spectrometry was used. These findings were compared with the results from conventional mycobacterial culture and radiometric respirometry. Although the latter techniques failed to detect mycobacteria in all the tested tissue samples, TS was found in various amounts. Thus, 0-3 micrograms TS/g freeze-dried tissue was noted in eight sarcoid patients, 3-50 micrograms TS/g in eight and 51-400 micrograms TS/g in the remaining six patients. Among the controls only 1/14 had detectable TS. In one patient with lymph node tuberculosis TS was in the range 51-400 micrograms/g. We conclude that the findings could be explained by the presence of mycobacteria not cultivable with the studied techniques or with the presence of remnants after an earlier colonisation with mycobacteria, e.g. BCG-vaccination. Mycobacteria or mycobacterial cell-envelope in sarcoid tissue may possibly act as cofactors in the development of the disease, i.e. they might function as triggering agents (adjuvans) of the immune response. On the other hand the findings may be without any aetiological significance. In that latter case a hitherto unknown lack of wax decomposition during several decades has to be considered.

Adult↗
PubMed1987

Pulmonary function in patients with sarcoidosis. A three year follow-up.

During a 3 year period, 101 patients were consecutively diagnosed as having sarcoidosis. During the 3 year follow-up 9 patients died, 6 of them directly or indirectly due to their sarcoidosis. In 78 patients bronchoscopy and spirometry were performed at the primary investigation, and after 3 years a new spirometry was performed. A positive bronchial mucosal biopsy, bronchial sarcoidosis, was found in 31 (40%) of the 78 patients. Mean values of vital capacity, total lung capacity and forced expiratory volume in one second were normal in both patients with bronchial sarcoidosis and those without. Abnormal spirometry was found in 16 (21%) patients at the initial examination and in 11 (14%) at the follow-up. There were 10 (32%) patients with and 6 (13%) without bronchial sarcoidosis who had an abnormal spirometry. At follow-up a normalized lung function was found in 8 (50%) of the 16 patients with abnormal spirometry. Only 3 (4.8%) patients with initially normal lung function had abnormal lung function at follow-up. Our findings indicate a very little risk of developing abnormal lung function if there are normal findings at the primary investigation. Corticosteroids seem to have some effect, especially in patients with endobronchial sarcoidosis.

Adult↗