J Invest Allerg Clin
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J Invest Allerg Clin · May 1997
High-resolution computed tomography in patients with bronchial asthma: correlation with clinical features, pulmonary functions and bronchial hyperresponsiveness.
The high-resolution computed tomography (HRCT) studies for bronchial asthma (BA) have revealed abnormal radiologic findings such as bronchial wall thickening, bronchiectasis, emphysema and mosaic pattern of lung attenuation. But the clinical significance of these findings are not yet clarified. In this study, we quantified the bronchial wall thickness and evaluated HRCT features in 57 BA subjects (338 bronchi) who had precipitating factors of irreversible airway remodeling, 19 COPD subjects (70 bronchi) and 10 healthy subjects (23 bronchi). ⋯ These results suggested the possibility that HRCT can be used for the differentiation of BA from COPD or healthy controls. Furthermore, patients having BA with abnormal HRCT changes demonstrate poor lung function and less hyperreactive bronchi than those without. We concluded that HRCT may be useful for the prognosis and treatment of bronchial asthma cases who have the precipitating factors of irreversible airway remodelling.
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J Invest Allerg Clin · Mar 1997
Interstitial pneumonitis induced in guinea pigs by the antigens of Rhizopus nigricans.
Rhizopus nigricans (Rn) is one of the most common members of the Mucorales that produces opportunistic infections and hypersensitivity states. Data concerning experimental induction in guinea pigs of hypersensitivity pneumonitis with a glycoprotein antigen are presented. This antigen was obtained from the mycelial and metabolic products of the cultures and was aerosolized during 12 weeks. ⋯ Single non-necrotizing granulomas were characteristic from the tenth week to the end of the experiment. The results from this animal model suggest that hypersensitivity pneumonitis is a typical delayed-type reaction due to chronic contact with the heterologous glycoprotein of Rn. The relation of Rn antigen and the development of occupational diseases of the lung such as malt-worker's lung and wood-trimmer's disease is proposed and discussed.
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J Invest Allerg Clin · May 1996
Positive allergological tests may turn negative with no further exposure to the specific allergen: a long-term, prospective, follow-up study in patients allergic to penicillin.
Preliminary literature reports suggest the possibility that, in an allergic patient, a previously positive allergological test may turn negative after a long period of time with no further exposure to the specific allergen. The aim of this study was to evaluate the rate by which a previously positive skin test or RAST may turn negative in a group of patients allergic to penicillin if no further exposure to the specific allergen occurs. Sixty-three patients allergic to penicillin (48 with type I allergy and 15 with type IV allergy) were enrolled in a long-term, prospective, follow-up study, undergoing a successive complete allergological testing within 6 years of the first positive examination. ⋯ Our results provide strong evidence that a positive allergological test performed in a drug-allergic patient may become negative with time, in the absence of further exposure to the specific antigen. A negative allergological test cannot, therefore, rule out the immunological basis of a drug sensitivity. This is why we always suggest advising patients with a personal history of drug hypersensitivity against any further administration of the responsible drug, even in the presence of a completely negative allergological examination.
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J Invest Allerg Clin · Sep 1994
Interpretation of spirometric tests in asthmatic patients with reduced forced vital capacity.
We have studied 175 consecutive asthmatic patients presenting with: 1) a reversible airflow obstruction, demonstrated by an increase in the forced expiratory volume in 1 second (FEV1) or in the forced vital capacity (FVC) by at least 12% along with an absolute increase of 200 ml versus prebronchodilator values after inhalation of salbutamol; 2) FVC below the lower normal limit before administration of the bronchodilator; and 3) normal FVC or slow vital capacity after bronchodilator. Two different criteria for the lower normal limit of the FEV1/FVC ratio were used to determine whether prebronchodilator spirometric patterns could be considered obstructive or not. The use of the predicted FEV1/FVC ratio as the lower normal limit allowed correct identification of obstruction in 94.9% of the patients, whereas taking the estimated fifth percentile as the lower normal limit of the FEV1/FVC correctly identified obstruction in only 78.9% of the asthmatics. Our results suggest that the predicted FEV1/FVC ratio is an adequate estimate of the lower normal limit in asthmatic patients with reduced FVC in order to distinguish obstructive from nonobstructive patterns.
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Hydatidosis can be a cause of anaphylaxis; it has been clearly established that the accidental rupture of a cyst during surgery can provoke severe anaphylactic reactions. Spontaneous anaphylaxis secondary to hydatid disease is much less frequent. ⋯ Two years after surgical resection of cysts, no new episodes of anaphylaxis have occurred. Hydatidosis is a cause of apparently spontaneous anaphylaxis and this is likely due to an IgE-mediated mechanism.