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R Meinert

Publications and source records attributed to R Meinert.

At least 37 records · Page 2Linked to original sources
PubMed1997

Glutathione, glutathione S-transferase alpha and pi, and aldehyde dehydrogenase content in relationship to drug resistance in ovarian cancer.

Glutathione, glutathione S-transferases alpha and pi, and aldehyde dehydrogenase are associated with resistance to carboplatin and/or cyclophosphamide in cell lines. Therefore, we examined whether the expression of these factors in ovarian cancer tissue specimens is associated with resistance of the patients to combination chemotherapy with cyclophosphamide/carboplatin. Ovarian cancer tissue specimens were taken intraoperatively from 139 patients and frozen in liquid nitrogen, and the contents of glutathione S-transferases alpha and pi, total glutathione, and aldehyde dehydrogenase activity were determined. No association between the levels of glutathione S-transferases alpha and pi or aldehyde dehydrogenase activity in tumor tissue and the survival time was observed in patients with primary ovarian cancer. Significantly higher levels of aldehyde dehydrogenase were observed in FIGO stage I and II compared to FIGO stage III and IV tumors (P = 0.019, Wilcoxon test, two sided). The median survival time was significantly longer in patients with primary ovarian cancer with a tumor glutathione content of <4.9 microg/mg protein compared to patients with a tumor glutathione content of > or =4.9 microg/mg protein (P = 0.047). However, glutathione was not an independent prognostic factor, but was significantly associated with FIGO stage resulting in higher levels in FIGO stage III and IV tumors than in FIGO stage I and II tumors (P = 0.0094, Wilcoxon test, two sided). In conclusion the glutathione content was associated with progression of ovarian carcinomas but neither glutathione nor glutathione S-transferases alpha and pi or aldehyde dehydrogenase were independent factors of resistance to cyclophosphamide/carboplatin.

Aldehyde Dehydrogenase↗
PubMed1997

[Intraventricular obstructions in dobutamine stress echocardiography: determinants of their development and clinical sequelae].

UNLABELLED: Dobutamine stress echocardiography (DSE) leads to strong hypercontraction, tachycardia, and peripheral vasodilatation. In previous studies systolic obstruction of the left ventricular outflow tract (LVOT) was observed as a result of these factors. To evaluate left ventricular function and morphology in patients (pts) with induced systolic LVOT obstruction, we used continuous wave (CW) doppler registrations in combination with quantitative 2-D-echocardiography in 100 pts during routinely performed DSE (5-40 micrograms/kg/min). In addition left ventricular wall thickness was measured. Symptoms were registered using a standardised questionnaire and cardiac arrhythmias were counted over a two minute interval at rest and during the maximal heart rate of each patient. During DSE dynamic flow acceleration with late systolic peak velocity above 2 m/second (s) was considered to represent LVOT obstruction in pts with normal flow profiles in the LVOT before infusion of dobutamine. For invasive studies pts were investigated with femoral catheterisation by the method of Judkins. A greater than 50% stenosis was judged to be significant. RESULTS: Examinations in 73 pts provided data of sufficient quality for echocardiographic and Doppler sonographic evaluations. 39 pts, 26 men, 13 women, mean age 64 +/- 8 years, developed late systolic flow velocities above 2 m/s and therefore formed the obstructive group (grp A). Grp B consisted of 34 pts, 26 men and 8 women, mean age 66 +/- 10 years, who showed normal time velocity integrals during DSE. In 41 pts invasive data provided information concerning the existence and severity of coronary artery disease. There were no significant differences in the increase of heart rate, the product of maximal systolic blood pressure and maximal heart rate or the percentage of pts, who reached their age corrected submaximal heart rate during DSE. Obstructive pts (group A) showed late systolic dynamic acceleration of systolic flow with a mean maximal speed of 315.4 +/- 139.8 cm/s, which peaked 0.12 +/- 0.04 s after the R-wave. From the velocities we calculated a mean pressure gradient of 47.5 +/- 39.7 mm Hg using the modified Bernoulli equation. Group B patients showed lower and earlier maximal speeds with a mean value of 158.2 +/- 37.6 cm/s, 0.09 +/- 0.04 s after the R-wave, corresponding to a pressure gradient of 10.6 +/- 4.9 mm Hg (p < 0.001). Ejection fractions were higher (p < 0.001) before the test in grp A: 68.2 +/- 8% compared to 55.7 +/- 10.4% in B. This difference increased during peak stress: 74.1 +/- 7.7% compared to 59.5 +/- 12.8%. End diastolic (EDVI) and end systolic volume indexes (ESVI) were lower in grp A (p < 0.001). During DSE, the decrease in ESVI was somewhat stronger for pts in grp A. Left ventricular hypertrophy was more often seen with obstruction. Septal thickness was increased in A: 1.45 +/- 0.34 cm compared to 1.13 +/- 0.27 cm in B (p < 0.001). Left ventricular posterior wall measured 1.03 +/- 0.28 cm in A and 0.83 +/- 0.23 cm in B (p < 0.01). 27 pts in grp B and only 9 in grp A had a history of previous myocardial infarction. Showing no difference at rest, wall motion score indexes raised under DSE in both groups and developed significantly higher scores in grp B at peak stress: 1.30 (1.0-1.90) compared to 1.18 (1.0-1.75) in A. We observed typical chest pain more often in grp B. Unspecific symptoms and arrhythmogenic complications were not statistically different, with the exception of ventricular bigeminy which was more often observed in grp B. A decline in the diastolic blood pressure was observed in pts with very severe obstruction (> 3.5 m/s, p < 0.05). Sensitivity of DSE was 84%, specificity 79%. No significant differences between pts with and without obstruction were observed. SUMMARY: Intraventricular obstructions during DSE are often observed in pts with normal systolic function at rest and during peak stress, especially in the case of left ventricular hypertrophy. (ABSTRACT TRU

Blood Flow Velocity↗
PubMed1997

[Reversibility of changes in left and right ventricular geometry and hemodynamics in pulmonary hypertension. Echocardiographic characteristics before and after pulmonary thromboendarterectomy].

Pulmonary thromboendarterectomy (PTE) leads to an acute decrease of right ventricular (RV) afterload in patients with chronic thromboembolic pulmonary hypertension. We investigated the changes in right and left ventricular (LV) geometry and hemodynamics by means of transthoracic echocardiography. The prospective study was performed in 14 patients (8 female, 6 male; age 55 +/- 20 years) before and 18 +/- 12 days after PTE. Total pulmonary vascular resistance and systolic pulmonary artery pressure were significantly decreased (PVR: preoperative 986 +/- 318, postoperative 323 +/- 280 dyn x s/cm5, p < 0.05; PAP preoperative 71 +/- 40, postoperative 41 +/- 40 mm Hg + right atrial pressure, p < 0.05). End diastolic and end systolic RV area decreased from 33 +/- 12 to 23 +/- 8 cm2, respectively, from 26 +/- 10 to 16 +/- 6 cm2, p < 0.05. There was an increase in systolic RV fractional area change from 20 +/- 12 to 30 +/- 16%, p < 0.05. RV systolic pressure rise remained unchanged (516 +/- 166 vs. 556 +/- 128 mm Hg/sec). LV ejection fraction remained within normal ranges (64 +/- 16 vs. 62 +/- 12%). Echocardiographically determined cardiac index increased from 2.8 +/- 0.74 to 4.1 +/- 1.74 l/min/m2. A decrease in LV excentricity indices (end diastolic: 1.9 +/- 1 vs. 1.1 +/- 0.3, end systolic: 1.7 +/- 0.6 vs. 1.1 +/- 0.4, p < 0.05) proved a normalization of preoperatively altered septum motion. LV diastolic filling returned to normal limits: (E/A ratio: 0.62 +/- 0.34 vs. 1.3 +/- 0.8; p < 0.05); Peak E velocity: 0.51 +/- 0.34 vs. 0.88 +/- 0.28 m/sec, p < 0.05; Peak A velocity: 0.81 +/- 0.36 vs. 0.72 +/- 0.42 m/sec, ns; E deceleration velocity: 299 +/- 328 vs. 582 +/- 294 cm/sec2, p < 0.05; Isovolumic relaxation time: 134 +/- 40 vs. 83 +/- 38 m/sec, p < 0.05). We could show a marked decrease in RV afterload shortly after PTE with a profound recovery of right ventricular systolic function--even in case of severe pulmonary hypertension. A decrease in paradoxic motion of the interventricular septum and normalization of LV diastolic filling pattern resulted in a significant increase of cardiac index.

Aged↗
PubMed1997

Aromatic hydroxylation in nasal lavage fluid following ambient ozone exposure.

Ozone at ambient concentrations affects lung function and initiates an inflammatory response of the airways. However, the underlying mechanisms are poorly understood. In vitro studies have shown that ozone reacts with water to give reactive hydroxyl radicals capable of oxidizing a wide range of biomolecules. We conducted a study to determine if in vivo hydroxyl radical attack on human airways occurs under natural exposure to ozone. The relation of orthotyrosine to para-tyrosine as a measure of hydroxyl radical attack was analyzed in nasal lavage samples of 44 primary school children in an epidemiologic study. Repeated nasal lavages were performed between May and October 1991 both following "low" (daily half-hour maximum < 140 micrograms/m3, approximately 70 ppb) and "high" (daily half-hour maximum > 180 micrograms/m3, approximately 90 ppb) ozone exposure. Concomitantly, lung function tests were performed. On average, 11.6 (6-16) nasal lavages were performed for each of 24 study days (10 days following "low" ozone exposure and 14 days following "high" ozone exposure). Average ortho-tyrosine (median; 5-95% percentile) for each child was 0.037 mumol/L (0.016-0.064 mumol/L) and average para-tyrosine was 15.7 mumol/L (9.8-24.1 mumol/L). Ortho-tyrosine (as percentage of tyrosine) was significantly higher following days with "high" ozone exposure (0.18%) vs. days following "low" ozone exposure (0.02%; p = .0001). Ortho-tyrosine showed an inverse relationship with forced vital capacity (p = .01) but was not related to inflammation of the upper airways as assessed by cell counts of polymorphonuclear neutrophils. Hydroxyl radical attack subsequent to ambient ozone occurs in the upper airways of healthy children and is related to lung function decrements.

Air Pollutants↗
PubMed1997

Quantitative assessment of aortic stenosis by three-dimensional echocardiography.

The purpose of this study was to assess the feasibility of three-dimensional echocardiography in aortic stenosis. Planimetric determination of valve area and dynamic volume-rendered display were performed. Three-dimensional echocardiography permits display of any desired plane of the cardiac structure. Thus in the case of aortic stenosis, the plane used for planimetric evaluation can be positioned exactly through the valve orifice. Dynamic volume-rendered display may provide a spatial demonstration of the stenotic valve. In 48 patients aortic valve area was measured by planimetry. The three-dimensional data set was acquired by a workstation in the course of a multiplane transesophageal examination. Results were compared with those obtained by multiplane transesophageal two-dimensional planimetric technique and invasive measurement. A dynamic three-dimensional reconstruction was displayed. Planimetric determination of valve area was possible in 42 (88%) of 48 cases. Statistical analysis of the data acquired showed a good agreement between three-dimensional echocardiography and transesophageal echocardiography (mean difference +0.018 cm2; SD = 0.086) and between three-dimensional echocardiography and the invasive technique (mean difference +0.012 cm2; SD = 0.12). Dynamic volume-rendered display was possible in 42 of 48 cases. Three-dimensional echocardiography permits accurate and reliable determination of aortic valve area. Preoperative spatial recognition of the stenotic valve is possible by dynamic volume-rendered display.

Adult↗
PubMed1997

Childhood leukemia and electromagnetic fields: results of a population-based case-control study in Germany.

The investigation of an association between increased exposure to residential extremely-low frequency electromagnetic fields (ELF-EMF) and childhood leukemia was part of a population-based case-control study carried out between 1992 and 1995 in the northwestern part of Germany. A total of 129 children with leukemia and 328 controls participated in the EMF-study. Exposure assessment comprised measurements of the magnetic field over 24 hours in the child's bedroom at the residence where the child had been living for the longest period before the date of diagnosis, and spot measurements at all residences where the child had been living for more than one year. The median of the 24h-measurement in the child's bedroom was regarded as the most valid exposure variable. For children exposed to more than 0.2 microT, an elevated but not significant odds ratio (OR) was observed (OR = 3.2, 95 percent confidence interval = 0.7-14.9). These figures are based on only four leukemia cases and three controls since only 1.5 percent of the study population was classified as highly exposed. Exploratory analyses revealed ORs that were not statistically significantly increased for other characteristics of the magnetic field at varying cut-points. The results are comparable with those from other studies. Although not statistically significant, they may indicate a positive association between EMF and childhood leukemia.

Adolescent↗
PubMed1997

Increase in DNA single-strand break rejoining by continuous exposure of human mononuclear blood cells to radioiodine ((131)I) in vitro.

Radioiodine ((131)I) induced a dose- and time-dependent increase in DNA single-strand breaks (DNA-ssb) in human (G0) mononuclear blood cells (MNC) in vitro. Incubation of MNC with 22MBq (131)I/ml at 4 degrees C caused a linear, time-dependent induction of DNA-ssb (increase in elution rate: 24.7 x 10(-3) h(-1) per 100 min incubation with (131)I). However, if MNC were incubated at 37 degrees C a decrease in the slope of the time effect curve was observed after about 300 min incubation with 22 or 30 MBq (131)I/ml. The goodness of fit of different regression models was assessed by Akaike's Information Criterion (AIC). The best fit was obtained for a non-linear model (y=a+bx+cx(0.5); AIC=53.5; where x is incubation time and y is elution rate), whereas other models including the linear regression model y=a+bx; AIC=38.6) were worse. As the total induction of DNA-ssb at 4 degrees C was constant with time, the decrease in the slope of the time effect curve (DNA-ssb versus time) at 37 degrees C can be interpreted as an increase in rejoining of DNA-ssb. Inhibition of both RNA and protein synthesis clearly increased the extent of DNA-ssb observable after incubation with (131)I. Thus, during continuous exposure of MNC to (131)I, proteins were synthesized which rejoined DNA-ssb. However, incubation of MNC with (131)I (44 MBq/ml) at 37 degrees C under conditions expected to lead to inhibition of RNA and/or protein synthesis still resulted in a decrease of the slope of the time effect curve, indicating a stimulation of DNA-ssb rejoining. Thus, we favour the hypothesis that the increase in the activity of DNA-ssb rejoining, besides de novo synthesis of repair enzymes, is also caused by a post-translational stimulation of DNA-repair enzymes and that this stimulation possibly is mediated by DNA-fragments.

DNA Repair↗
PubMed1996

Prognostic significance of c-erB-2 mRNA in ovarian carcinoma.

The oncogene specific mRNA of c-erbB-2 was detected by the S1 nuclease protection assay in 95 ovarian cancer specimens. In 79 primary carcinomas, we found 16 (20%) with strong expression, 13 (17%) with weak expression, 4 (5%) with very weak expression, and 46 (58%) with no expression. In 3 of 16 recurrencies (19%) a strong expression of c-erbB-2 mRNA was detected, in 2 (12%) weak expression was detected, and in 11 (69%) no expression of c-erbB-2 mRNA was detected. Kaplan-Meier analysis revealed no significant association between strong expression of c-erbB-2 mRNA and survival of the 79 patients with primary cancer. However, in the subgroup of patients with FIGO (International Federation of Gynecology and Obstetrics) stages III and IV (n = 60) a shorter median survival time (12 months) was obtained for patients with strong c-erbB-2 mRNA expression compared to patients with no, very weak, and weak c-erbB-2 mRNA expression (25 months, P = 0.04). In addition, strong expression of c-erbB-2 mRNA did not depend on histologic grade, histologic type, and FIGO stage. Adverse prognostic factors include histologic type (serous carcinoma), high grade, high stage (FIGO stages III and IV), and residual of tumor after surgery. From our results we conclude that for all patients (FIGO stages I-IV) strong expression of c-erbB-2 mRNA is not a prognostic parameter, but in the subpopulation of patients with FIGO stage III and IV only, an association between strong c-erbB-2 mRNA expression and shorter median survival time was found, although statistical significance was weak (P = 0.04).

Female↗
PubMed1996

Meta-analyses of studies on the association between electromagnetic fields and childhood cancer.

During the last 15 years several studies have investigated a possible relationship between exposure to electromagnetic fields (EMF) and childhood cancer. There is considerable variation between these studies with respect to methods of exposure assessment and reported results. Methods of exposure assessment range from simple visual criteria to costly and time consuming measurements or estimations of electric flux density. Additional individual refinements further hinder the comparability of results. We carried out several meta-analyses of data published so far taking into account the heterogeneity between studies as far as possible. Our particular interest was to investigate a potential dose-response-like relationship by comparing analyses for different cut-off points of exposure. Our meta-analyses suggest a marginal association between all cancer diagnoses combined and EMF exposure assessed by the two-level wire code (odds ratio, OR = 1.37, 95% confidence interval, CI: 0.94-2.00). Based on this criterion a significant effect was found for bases of leukemia (OR = 1.66, CI: 1.11-2.49) but not for central nervous system (CNS) tumors (OR = 1.5, CI: 0.69-3.26) or lymphomas (OR = 1.32, CI: 0.52-3.37). A significant increase in overall cancer risk with increasing stages of the four-level wire code (P = 0.003) could not be confirmed when data of the initial study performed by Wertheimer and Leeper were excluded (P = 0.17). When the exposure criterion was based on distance to the transmission line, estimated ORs for all cancers combined and for leukemias increased with distances decreasing from 100 to 25 m. Those analyses incorporating data on measured or calculated EMFs demonstrated also an increase of overall cancer risk with higher cut-off points. However, regarding individual diagnoses, this finding was reflected only in the group of brain tumors. One possible explanation for the high degree of heterogeneity between studies--especially with respect to methods of exposure assessment and choice of the respective cutpoint relevant for an increase in cancer risk--could be that published cut-off points were not always chosen in advance, but were selected because in exploratory analyses the most striking results were obtained with these specific cut-off values. Should this speculation be true at least partially, any meta-analysis will yield a false-positive finding. Further results of comparable studies with strictly a priori planned analyses are necessary to properly investigate a possible link between EMF and childhood cancer.

Child↗
PubMed1996

Childhood leukaemia and exposure to pesticides: results of a case-control study in northern Germany.

The association between childhood leukaemia and exposure to pesticides was examined in a population-based case-control study conducted in Lower Saxony, Northern Germany. Between July 1988 and June 1992, 219 newly diagnosed cases were identified, of whom 173 participated in the study. Two sex- and age-matched control groups were recruited: local controls from the same communities as the newly diagnosed cases of leukaemia and state controls from other randomly selected communities in Lower Saxony. An additional study group consisted of 175 cases of solid tumours. When the leukaemia cases were compared with the local controls, positive associations with parental occupational exposure, particularly agriculture-related exposure, were observed, which were statistically non-significant. A significant association was found for pesticide use in gardens (odds ratio = 2.52, 95% confidence interval: 1.0-6.1). No positive associations were seen when the leukaemia cases were compared to the state controls, but this finding could be explained by a higher proportion of state controls living in rural areas. In communities with a significantly elevated standardised incidence ratio of childhood leukaemia over the last decade (1984-1993), the prevalence of pesticide use in the garden was 21%, compared with the 10% in other communities. None of the examined risk factors were more common among cases of solid tumours. Our findings add some evidence to the hypothesis that pesticides are a risk factor for childhood leukaemia, and there are good reasons to consider abundant pesticide use in rural areas as a possible cause for clustering of childhood leukaemia.

Adolescent↗
PubMed1996

[Prospective study of subjective stress caused by dobutamine stress echocardiography--effect on diagnostic accuracy].

UNLABELLED: We used a standardized questionnaire to assess physical and mental distress caused by dobutamine stress echocardiography (DSE). The examination was performed according to a standardized protocol (5-40 micrograms/kg/min including atropine). 91 patients (pts), 68 men (62 +/- 9 years), 23 women (65 +/- 7 years) were asked to quantify the severity of the following symptoms: palpitations, anxiety, headache, nausea, discomfort of left lateral position, angina pectoris and dyspnea. Numbers on a rating scale from 1-10 defined the degree of distress. Absence of a symptom equalled mark, 1, slight expression marks 2-4. Moderate expression was defined by marks 5-7 and very strong expression by marks 8-10. RESULTS: 86% of pts felt affected by one or more symptoms to a slight to moderate extent (mark 4 +/- 2.17). Palpitations were felt by 85% of the pts (mark 6 +/- 2.83), anxiety by 42% (mark 3 +/- 2.5), headache by 50% (3 +/- 2.54), nausea by 20% (2 +/- 1.72), angina pectoris by 42% (3 +/- 2.5), dyspnea by 30% (2 +/- 2.42) and discomfort of left lateral recumbent position by 43% (mark 3 +/- 2.59). 43 pts underwent coronary angiography. The negative predictive value of DSE to identify pts without a coronary artery stenosis extending a 50% diameter reduction was 85% for the 16 pts who reached their individual submaximal heart rate compared to 60% for those 27 pts who did not reach it. Unspecific symptoms led to test termination in these pts. The positive predictive values were comparable (89 and 94%). CONCLUSION: DSE causes physical and mental distress. If symptoms lead to test termination before age corrected submaximal heart rate is reached, normal wall motion does not exclude significant coronary artery disease.

Angina Pectoris↗
PubMed1995

Sensitization to mite allergens is a risk factor for early and late onset of asthma and for persistence of asthmatic signs in children.

BACKGROUND: To describe the natural history of asthma between the ages of 7 and 10 years and to analyze risk factors for prevalences, as well as new onset of asthma-like symptoms, a longitudinal study of 1812 children was conducted. METHODS: In four surveys, each 1 year apart, four asthma-like symptoms and several hypothetical risk factors were ascertained through standardized questionnaires. Sensitization to seven common inhalant allergens was measured by skin prick testing. Exposure to mite allergens (Der p I, Der f I) was assessed by measuring the antigen concentrations in the dust of each child's mattress. Occurrence of more than one asthma-like symptom closely related to the practioner's diagnoses of bronchial asthma and recurrent wheezy bronchitis was used as the outcome variable. RESULTS: After an initial prevalence of 14.5%, new onset of symptoms in children unaffected at the beginning was reported in 7.2% during the 3 years. Of the factors explaining prevalence and persistence of asthma-like symptoms (sensitization to mite allergens and animal danders, history of hay fever and eczema, low gestational age, male gender, parental atopy), only sensitization to mite allergens (odds ratio = 2.3, 95% confidence interval = 1.1-4.7) and parental atopy (odds ratio = 2.1, 95% confidence interval = 1.2-3.7) were also significantly associated with new onset. In a relatively small number of sensitized subjects with new onset of symptoms (n = 31), mite antigen concentration did not appear to be associated with incidence of symptoms. CONCLUSION: Sensitization to mite allergens antedated the onset of asthma-like symptoms, and no strong effect of allergen exposure on clinical development could be found. Thus the primary focus should be on preventing sensitization to mite allergens by implementing avoidance measures in infancy or at early school age in order to reduce the onset of asthma at a later stage.

Allergens↗
PubMed1995

Variability of peak expiratory flow rate in children: short and long term reproducibility.

BACKGROUND: Variability of peak expiratory flow (PEF) has been proposed as a surrogate for bronchial hyperresponsiveness. The normal range of variability of PEF for children has been reported and the test has been used to screen for asthma in population based studies. However, there is little information on the reproducibility of the method in epidemiological settings. METHODS: In a cohort study of primary school children the variability in PEF was recorded in two consecutive years for one week (first survey) and two weeks (second survey) using mini Wright peak flow meters. PEF was recorded twice daily (morning and evening) and average amplitude as a percentage of mean was calculated as a standard measure of PEF variability for each single week of PEF measurement. Children with PEF variability exceeding the 90% percentile of the distribution for the specific time period were regarded as having increased variability of PEF. RESULTS: Of 66 children with increased PEF variability in the first year, 13 (19.7%) had an abnormal test in the first week of the second year. Of 543 children with normal PEF variability in the first year, 44 (8.1%) had an abnormal test in the second study year (odds ratio 2.8, confidence interval (CI) 1.4 to 5.4). Of 646 children in the second survey 61 (9.4%) were abnormal during the first week and 68 (10.5%) had an increased PEF variability during the second week, but only 24 (3.7%) children had an increased PEF variability in both weeks. The sensitivity (specificity) for doctor-diagnosed asthma (12 month period prevalence) was 36.4% (91.0%) in the first week of the second survey. When measurements of both weeks of the second survey were used to calculate PEF variability there was little improvement in the sensitivity (38.1%) and specificity (91.5%), mainly because of decreased compliance in the second measurement week. CONCLUSIONS: In young children assessment of PEF variability in order to screen for asthma is of limited value because of the low reproducibility of the method.

Asthma↗
PubMed1995

Acidic particles and lung function in children. A summer camp study in the Austrian Alps.

Epidemiological studies have repeatedly demonstrated the effects of acidic particles on lung function. Three consecutive panels of children participating in a summer camp in the Austrian Alps were investigated. On-site pollution assessment consisted of 24-h measurements of particulate matter < 10 microns and the hydrogen, sulfate, and ammonium ion components. The 24-h maximums of ozone and daily pollen counts were also established. For 47, 45, and 41 subjects, daily FEV1, FVC, and peak expiratory flow were recorded. Fifteen percent, 11%, and 5% of participants, respectively, reported current asthma medication, indicating a markedly increased prevalence of respiratory disease. Mean levels of ambient pollutants were approximately 15% higher for the first panel than for the other two panels, but the hydrogen ion (H+) component was twice as high for Panel 1. The maximum H+ exposure during Panel 1 was 84 nmol/m3 (4 micrograms/m3 H2SO4 equivalent). For FEV1 in Panel 1, a significant decrease of -0.99 ml per nmol/m3 H+ (p = 0.01) was observed. For Panel 2, the FEV1/H+ coefficient was found to be similar (-0.74 ml per nmol/m3 H+; p = 0.28), while for Panel 3 it was in the opposite direction (0.10 ml per nmol/m3 H+; p = 0.83). The decrease in FEV1 observed in Panel 1 was more pronounced when the mean exposure during the previous 4 d was considered (-2.99 ml FEV1 per nmol/m3 H+; p = 0.004). We conclude that summer haze acidic particles may be associated with transient decreases in lung function in children.

Air Pollutants↗
PubMed1994

Relationship between atopy and frequent bronchial response to exercise in school children.

The natural history of a bronchial response to exercise (BRE) was studied in a cohort of primary-school children, who were followed over a 2-year period. In 1,094 children, three free-running tests were performed in 1-year intervals. Children who responded in one of the tests were designated as "infrequent" responders (20.5%), whereas those responding at two or all three occasions were designated as "frequent" responders (7.4%). A frequent positive BRE was closely associated with atopy (defined as skin test positivity to 1 of 7 common aeroallergens) and respiratory symptom status. Compared to atopics without respiratory symptoms, an increased risk for a frequent positive BRE was seen for atopic children who were symptomatic during the whole study period [odds ratio (OR) 25.4; confidence interval (CI) 6.9-94.0], who had gained symptoms (OR, 11.0; CI, 2.8-43.2) or who had symptoms at the beginning of the study but had lost them during follow-up (OR, 4.6; CI, 1.0-20.6). A sensitization to dust mites (OR, 8.0; CI, 4.3-15.0) but not to animal dander (OR, 2.3; CI, 1.0-5.2) or pollen (OR, 0.7; CI, 0.3-1.6) was significantly related to a frequent positive BRE. Our findings support the notion that while "children grow out of asthma," they might maintain their bronchial hyperresponsiveness. Regarding specific sensitization, mite allergy seems to play the predominant role.

Allergens↗
PubMed1994

Eosinophils and eosinophil cationic protein in children with and without sensitization to inhalant allergens.

Eosinophil inflammation is a common feature of allergic disorders and particularly in allergic asthma interest has been paid to related markers. In a community-based survey of 10-year-old children, the association of eosinophil count (EC) and serum eosinophil cationic protein (ECP) with allergic sensitization, clinical history and exposure to mite allergen was studied. Relying on the results of skin prick tests, the children were divided to three groups: (1) children showing no sensitization to one of the seven inhalant allergens (n = 16); (2) children with sensitization to at least one of five non-mite allergens (n = 16); and (3) children with sensitization to mite allergens (n = 75). Clinical history of asthma and hay fever was ascertained using standardized questionnaires. EC in peripheral blood and serum ECP were measured on one single occasion. Prior to blood sampling, mite allergen exposure at home had been assessed by taking dust samples and measuring the mite antigen concentration by means of an enzyme immunoassay. Compared to group 1, higher ECs were obvious in group 2 (P = 0.037) and in group 3 (P = 0.0013). Regarding serum ECP, higher levels occurred in group 2 (P = 0.0033) as well as in group 3 (P = 0.0001) when comparing them to the reference group. Sensitized children with neither asthma, nor asthma-like symptoms, nor hay fever (n = 28) did not have significantly lower ECs and serum ECP levels than those with hay fever (n = 15; P = 0.09, P = 0.17) and those with asthma (n = 22; P = 0.69, P = 0.64).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Mite allergen exposure is a risk for the incidence of specific sensitization.

BACKGROUND: Mite allergen exposure is essential for the process of specific allergic sensitization. However, it is not clear whether incidence of specific sensitization at school age depends on the level of mite antigen exposure. Therefore the relationship between mite allergen exposure and incidence of specific sensitization was investigated. METHODS: Eighteen hundred twelve primary school children were enrolled in a population-based 2-year follow-up study. In three consecutive skin prick tests (SPTs), each 12 months apart, sensitization to Dermatophagoides pteronyssinus (Dpt) and six non-Dpt allergens was ascertained. To assess exposure to Der p I between the first and second SPTs (period I) and the second and third SPTs (period II), the amount of antigen per gram of dust (taken from the children's mattresses was measured. By using the SPT reactions to Dpt as a basis, conversions after "no wheal" were classified as doubtful incidence (average yearly incidence = 6.7%) or definite incidence (average yearly incidence = 3.2%). Then, with the use of multiple logistic regression, the risk of exposure to Der p I (medians: 1.4 micrograms/gm in period I, 1.6 micrograms/gm in period II) was analyzed with adjustment being made for gender, low gestational age, parental atopy, and initial sensitization to non-Dpt allergens. RESULTS: Regarding doubtful incidence, the analysis failed to identify a reliable cutoff point of exposure. For definite incidence, the Der p I exposure represents a significant risk in the total population, starting from a concentration of 9 micrograms/gm. This effect is modified by an initial sensitization to non-Dpt allergens: for these children exposure to concentrations above 2 micrograms/gm poses a significant risk, whereas for the population without other initial sensitizations, only an extremely high cutoff limit (> 80 micrograms/gm) gains significance. CONCLUSION: Our data suggest that a concentration limit of 2 micrograms Der p I antigen per gram of dust should be regarded as minimal avoidance level for primary prevention in children with sensitization to other inhalant allergens.

Animals↗