A Case of Occupational Rhinitis Caused by Porcine Pancreatic Extract Developing into Occupational Asthma

Porcine pancreatic extracts (PPE), which are widely used as a digestive drug in Korea, are composed of α-amylase and lipase. Such enzymes are commonly described as occupational allergens. This is the first report of occupational rhinitis caused by PPE developing into occupational asthma in a hospital nurse. She showed strong positive response in the skin prick test (SPT) (5+, wheal ratio of allergen to histamine) and had a high serum-specific IgE level to PPE, but showed a negative response in the methacholine bronchial challenge test (MBT). She had been exposed to PPE intermittently with intermittent medications for rhinitis. Two years later, she presented with rhinitis and additional asthmatic symptoms. In contrast to her first visit, she showed a positive response in the MBT, and developed bronchoconstriction in the PPE-bronchial provocation test (BPT). These findings suggest that inhalation of PPE powder can induce IgE-mediated occupational rhinitis in a hospital setting, which will develop into occupational asthma if avoidance is not complete

Changes of Alpha1-Antitrypsin Levels in Allergen-induced Nasal Inflammation

ObjectivesAlpha1-antitrypsin (AAT) is the main inhibitor of human neutrophil elastase, and plays a role in counteracting the tissue damage caused by elastase in local inflammatory conditions. The study evaluated the involvement of AAT in nasal allergic inflammation.MethodsForty subjects with mono-sensitization to Dermatophagoides pteronyssinus (Dpt) were enrolled. Twenty allergic rhinitis patients frequently complained of nasal symptoms such as rhinorrhea, stuffiness, sneezing, and showed positive responses to the nasal provocation test (NPT) with Dpt (Group I). The other 20 asymptomatic patients showed sensitization to Dpt but negative NPT (Group II). The levels of AAT, eosinophil cationic protein (ECP), and Dpt-specific IgA antibodies were measured in the nasal lavage fluids (NLFs), collected at baseline, 10 minutes, 30 minutes, 3 hours, and 6 hours after the NPT. Nasal mucosa AAT expression was evaluated with immunohistochemical staining from Group I and Group II.ResultsAt baseline, only the Dpt-specific IgA level was significantly increased in the NLFs of Group I compared with Group II, while ECP and AAT levels were not significantly different between two groups. After Dpt provocation, AAT, ECP, and Dpt-specific IgA levels were significantly increased in the NLFs of Group I during the early and late responses. The protein expression level of AAT was mostly found in the infiltrating inflammatory cells of the nasal mucosa, which was significantly increased in Group I compared to Group II.ConclusionThe increment of AAT showed a close relationship with the activation of eosinophils induced by allergen-specific IgA in the NLFs of patients with allergic rhinitis after allergen stimulation. These findings implicate AAT in allergen-induced nasal inflammation

Aflatoxin, deoxynivalenol, and zearalenone in swine diets: Predictions on growth performance

Dietary mycotoxins have been shown to cause detrimental effects in swine health and production. The objective of this study was to develop tools for predicting the effects of aflatoxin (AFL), deoxynivalenol (DON) and zearalenone (ZON) on feed intake (FI) and weight gain (WG) changes using a meta-analysis approach. A total of 80 and 63 observations were extracted from 18 experiments testing the effects of AFL on FI and WG, respectively, and the differences of AFL concentrations between the control and treatment groups ranged from 0.02 to 2.5 mg/kg. A total of 117 and 113 observations from 20 experiments were used for testing the effects of DON on FI and WG, respectively. The differences of DON concentrations between the control and treatment groups ranged from 0.5 to 10.5 mg/kg. A total of 16 and 17 observations from 18 experiments were used for testing the effects of ZON on FI and WG, respectively, and the differences of ZON concentrations between the control and treatment groups ranged from 0.2 to 9.0 mg/kg. Effects of experiment, initial body weight, and experimental period were not significant for developing prediction equations for the changes of FI and WG. The models developed for predicting FI and WG changes (ΔFI and ΔWG) as % by AFL concentrations as mg/kg were: ΔFI = -24.9 × AFL - 1.7 with r² = 0.70 and p<0.001; ΔFI = 0.4 - 51.6 × (1 - e-0.947×AFL) with r² = 0.79 and p<0.001; ΔWG = -22.7 × AFL - 4.0 with r² = 0.62 and p<0.001; and ΔWG = -1.4 - 50.3 × (1 - e-0.976×AFL) with r² = 0.69 and p<0.001. The equations for predicting ΔFI and ΔWG as % by DON concentrations as mg/kg were: ΔFI = -5.64 × DON - 0.13 with r² = 0.60 and p<0.001; and ΔWG = -6.49 × DON + 0.93 with r² = 0.61 and p<0.001. The feed consumption and growth rate of pigs decrease linearly and exponentially by the concentrations of AFL and linearly by the concentrations of DON. The equations provided herein may predict the effects of AFL and DON on swine production performance

Aflatoxin, deoxynivalenol, and zearalenone in swine diets: Predictions on growth performance

Dietary mycotoxins have been shown to cause detrimental effects in swine health and production. The objective of this study was to develop tools for predicting the effects of aflatoxin (AFL), deoxynivalenol (DON) and zearalenone (ZON) on feed intake (FI) and weight gain (WG) changes using a meta-analysis approach. A total of 80 and 63 observations were extracted from 18 experiments testing the effects of AFL on FI and WG, respectively, and the differences of AFL concentrations between the control and treatment groups ranged from 0.02 to 2.5 mg/kg. A total of 117 and 113 observations from 20 experiments were used for testing the effects of DON on FI and WG, respectively. The differences of DON concentrations between the control and treatment groups ranged from 0.5 to 10.5 mg/kg. A total of 16 and 17 observations from 18 experiments were used for testing the effects of ZON on FI and WG, respectively, and the differences of ZON concentrations between the control and treatment groups ranged from 0.2 to 9.0 mg/kg. Effects of experiment, initial body weight, and experimental period were not significant for developing prediction equations for the changes of FI and WG. The models developed for predicting FI and WG changes (ΔFI and ΔWG) as % by AFL concentrations as mg/kg were: ΔFI = -24.9 × AFL - 1.7 with r² = 0.70 and p<0.001; ΔFI = 0.4 - 51.6 × (1 - e-0.947×AFL) with r² = 0.79 and p<0.001; ΔWG = -22.7 × AFL - 4.0 with r² = 0.62 and p<0.001; and ΔWG = -1.4 - 50.3 × (1 - e-0.976×AFL) with r² = 0.69 and p<0.001. The equations for predicting ΔFI and ΔWG as % by DON concentrations as mg/kg were: ΔFI = -5.64 × DON - 0.13 with r² = 0.60 and p<0.001; and ΔWG = -6.49 × DON + 0.93 with r² = 0.61 and p<0.001. The feed consumption and growth rate of pigs decrease linearly and exponentially by the concentrations of AFL and linearly by the concentrations of DON. The equations provided herein may predict the effects of AFL and DON on swine production performance.As micotoxinas presentes nos alimentos tem efeitos prejudiciais na saúde e na produção porcina. O objetivo deste estudo foi desenvolver ferramentas para a predição dos efeitos da aflatoxina (AFL), deoxinivalenol (DON) e zearalenona (ZON) sobre o consumo de alimento (FI) e ganho de peso (WG) mediante uma metaanálise. Um total de 80 e 63 observações extraídas de 18 experimentos que avaliaram os efeitos da AFL sobre o FI e WG, respectivamente, encontraram que as diferenças de concentração de AFL entre os grupos controle e tratados variaram desde 0,02 até 2,5 mg/kg. Por outro lado, foram utilizados um total de 117 e 113 observações de 20 experimentos para provar os efeitos de DON em FI e WG, respectivamente. As diferenças de concentração de DON entre os grupos controle e tratados variaram desde 0.5 até 10,5 mg/kg. Por fim, um total de 16 e 17 observações de 18 experimentos foram utilizados para provar os efeitos de ZON em FI e GT, respectivamente, e as diferenças de concentração de ZON entre os grupos controle e tratados variaram desde 0,2 até 9,0 mg/kg. Os efeitos de Experimento, Peso corporal inicial e Período experimental não foram significativos para o desenvolvimento das equações de predição de mudanças em FI e WG. Os modelos desenvolvidos para predizer mudanças percentuais em FI e WG (ΔFI e ΔWG) segundo a concentração de AFL (mg/kg) foram: ΔFI = -24,9 × AFL - 1,7 com r² = 0,70 e p<0,001; ΔFI = 0,4-51,6 × (1 - e- 0.947 × AFL) com r² = 0,79 y p<0,001; ΔWG = -22,7 × AFL - 4,0 com r² = 0,62 e p<0,001, e ΔWG = -1,4 - 50,3 × (1 - e- 0.976 × AFL) con r² = 0,69 e p<0,001. As equações para predizer ΔFI e ΔWG (como %) pelas concentrações de DON (mg/kg) foram: ΔFI = -5,64 × DON - 0,13 com r² = 0,60 e p<0,001; e ΔWG = -6,49 + 0,93 × DON com r² = 0,61 e p<0,001. Conclusão: o consumo de alimento e a taxa de crescimento de porcos diminuem linearmente e exponencialmente segundo a concentração de AFL, e linearmente segundo a concentração de DON. As equações obtidas neste trabalho são de utilidade para predizer os efeitos de AFL e DON sobre o desempenho porcino.Las micotoxinas presentes en los alimentos tienen efectos perjudiciales en la salud y la producción porcina. El objetivo de este estudio fue desarrollar herramientas para predecir los efectos de aflatoxinas (AFL), deoxinivalenol (DON) y zearalenona (ZON) sobre el consumo de alimento (FI) y ganancia de peso (WG) mediante un meta-análisis. Un total de 80 y 63 observaciones provenientes de 18 experimentos que evaluaron los efectos de la AFL sobre el FI y WG, respectivamente, fueron tenidas en cuenta. Se encontró que las diferencias de concentración de AFL entre los grupos control y tratados variaron desde 0,02 hasta 2,5 mg/kg. De otro lado, se utilizaron un total de 117 y 113 observaciones de 20 experimentos para probar los efectos de DON en FI y WG, respectivamente. Las diferencias de concentración de DON entre los grupos control y tratados variaron desde 0,5 hasta 10,5 mg/kg. Por último, un total de 16 y 17 observaciones de 18 experimentos se utilizaron para probar los efectos de ZON en FI y GT, respectivamente; las diferencias de concentración de ZON entre los grupos control y tratados variaron desde 0,2 hasta 9,0 mg/kg. Los efectos de Experimento, Peso corporal inicial, y Período experimental no fueron significativos para el desarrollo de las ecuaciones de predicción de cambios en FI y WG. Los modelos desarrollados para predecir cambios porcentuales en FI y WG (ΔFI y ΔWG) según la concentración de AFL (mg/kg) fueron: ΔFI = -24,9 × AFL - 1,7 con r² = 0,70 y p<0,001; ΔFI = 0,4-51,6 × (1 - e- 0.947 × AFL) con r² = 0,79 y p<0,001; ΔWG = -22,7 × AFL - 4,0 con r² = 0,62 y p<0,001, y ΔWG = -1,4 - 50,3 × (1 - e- 0.976 × AFL) con r² = 0,69 y p<0,001. Las ecuaciones para predecir ΔFI y ΔWG (como %) por las concentraciones de DON (mg/kg) fueron: ΔFI = -5,64 × DON - 0,13 con r² = 0,60 y p<0,001; y ΔWG = -6,49 + 0,93 × DON con r² = 0,61 y p<0,001. El consumo de alimento y la tasa de crecimiento de cerdos disminuyen lineal y exponencialmente según la concentración de AFL; mientras que solamente se observa una disminución de tipo lineal en función de las concentraciones de DON. Las ecuaciones obtenidas en este trabajo podrían usarse para predecir los efectos de AFL y DON sobre el desempeño productivo del cerdo

Results of Tailor-Made Multilevel Surgery in Patients with Obstructive Sleep Apnea

Background and Objective The concept of tailor-made, multilevel surgery, including the nasal cavity, a multiple level of the pharynx, should be required to overcome the collapse at multiple levels of the upper airway because most patients show multilevel airway obstruction. The objective of this study was to evaluate the surgical results when the surgery was performed at the multilevel of the pharynx and in a tailor-made manner in obstructive sleep apnea (OSA) patients with multilevel obstruction in various evaluations of the obstruction site. Methods This is a retrospective analysis of data prospectively gathered on 86 OSA patients treated with multilevel surgery. Patients were evaluated with a questionnaire preoperatively and postoperatively at 1 month and more than 6 months, respectively. A polysomnography was used to evaluate the surgical results postoperatively at more than 6 months. Results Postoperative values for the questionnaire of both daytime and nighttime symptoms were significantly reduced after surgery. Daytime sleepiness checked by Epworth Sleepiness Scale (ESS) was significantly improved. The postoperative value of apnea-hypopnea index (AHI) was significantly improved after treatment. When the successful outcome was defined as a postoperative AHI < 5, 43.3% of patients met the criteria. The success rates of surgery among the groups according to severity were not statistically significant. Conclusions Multilevel surgery in a tailor-made manner shows relatively good results. This can be a solution for OSA patients when medical therapy, including nasal continuous positive airway pressure, is not tolerable. Precise and tenacious evaluation of the obstruction site is the key for increasing surgical success