Asthmatic Airway Inflammation is More Closely Related to Airway Hyperresponsiveness to Hypertonic Saline than to Methacholine

BACKGROUND: Airway hyperresponsiveness (AHR) to direct stimuli, such as methacholine (MCh), is observed not only in asthma but other diseases. AHR to indirect stimuli is suggested to be more specific for asthma. The purpose of this study was to determine whether asthmatic airway inflammation is more closely related to AHR to hypertonic saline (HS), an indirect stimulus, than to MCh. METHODS: Sixty-four consecutive adult patients with suspected asthma (45 asthma and 19 non-asthma) performed a combined bronchial challenge and sputum induction with 4.5% saline, and MCh challenge on the next day. RESULTS: Both HS-PD15 and MCh-PC20 were significantly lower in asthma patients than in non-asthma patients. However, the sensitivity/ specificity for asthma was 48.9%/100%, respectively, in the HS test and 82.2%/ 84.2%, respectively, in the MCh test. There was a significant relationship between HS-PD15 and MCh-PC20 and only 52.9% of patients with MCh-PC20 4 mg/mL. There were significant correlations between both HS-PD15 and MCh-PC20 and FEV1, or sputum eosinophils, but FEV1 was more closely related to MCh-PC20 (r=0.478, p < 0.01) than to HS-PD15 (r=0.278, p < 0.05), and sputum eosinophils were more closely related to HS-PD15 (r=-0.324, p < 0.01) than to MCh-PC20 (r=-0.317, p < 0.05). Moreover, the IL-5 level (r=-0.285, p < 0.05) and IFN-gamma/IL-5 ratio (r=0.293, p < 0.05) in sputum were significantly related to HS-PD15, but not to MCh-PC20. CONCLUSION: HS-AHR may reflect allergic asthmatic airway inflammation more closely than MCh-AHR.

A Case of Cirsoid Aneurysm of the Scalp / 대한피부과학회지

Cirsoid aneurysm of the calp is a congenital arteriovenous malformation which is the result of abnormal connections betwe:.n the external carotid artery and scalp veins with a subsequent dilatation of vascular channels nd formation of aneurysm. We report a case of cirsoid aneurysm of the scalp on the left parieto-occipital area of 14-year-old female who had had 8 x 5 x 0.8 cm sized pulsating soft mass for 2 years. 4 vessel angiog raphy revealed a arteriovenous malformation that emerge mainly from a superficial temporal artery and occipital artery of the left external carotid artery and partially from the right superficial temporal artery and drined into the left scalp vein. The mass was removed by excision with ligation of the feeding arter es and followed up for 2 years without recurrence.